Diversity in the Factors Associated with ADL-Related Disability among Older People in Six Middle-Income Countries: A Cross-Country Comparison

Abstract

The low- and middle-income countries (LMICs) are experiencing rapid population ageing, yet knowledge about disability among older populations in these countries is scarce. This study aims to identify the prevalence and factors associated with disability among people aged 50 years and over in six LMICs. Cross-sectional data from the World Health Organization (WHO) Study on global AGEing and adult health Wave 1 (2007–2010) in China, Ghana, India, Mexico, the Russian Federation, and South Africa was used. Multivariable logistic regression analyses were undertaken to examine the association between sociodemographic factors, health behaviours, chronic conditions, and activities of daily living (ADL) disability. The prevalence of disability among older adults ranged from 16.2% in China to 55.7% in India. Older age, multimorbidity, and depression were the most common factors related to disability in all six countries. Gender was significant in China (OR = 1.14, 95% CI: 1.01–1.29), Ghana (OR = 1.22, 95% CI: 1.01–1.48) and India (OR = 1.65, 95% CI: 1.37–1.99). Having no access to social capital was significantly associated with ADL disability in China (OR = 2.57, 95% CI: 1.54–4.31) and South Africa (OR = 4.11, 95% CI: 1.79–9.43). Prevalence data is valuable in these six ageing countries, with important evidence on mitigating factors for each. Identifying determinants associated with ADL disability among older people in LMICs can inform how to best implement health prevention programmes considering different country-specific factors.

Association of Cardio-Metabolic Risk Factors and Basic and Instrumental Activities of Daily Living Among Elderly People;Bushehr Elderly Health Program

“…In a study in Netherlands, age was reported as one of the most important predictors of disability (6). In another study conducted in 6 middle and low-income countries, older age, were also identi ed as the important factor affecting disability (7). Our study results were in agreement with these results.…”

“…In another study conducted in 6 middle and low-income countries (India, Ghana, South Africa, Mexico, Russia, and China), age, chronic diseases (such as hypertension, angina, stroke, diabetes, chronic lung disease, asthma, and arthritis) and depression were identi ed as the most important factors affecting disability. Other factors (such as gender, marital status, education, social capital, physical activity, BMI) either had no role or played a different role in societies (7).…”

Associations between complex multimorbidity, activities of daily living and mortality among older Norwegians. A prospective cohort study: the HUNT Study, Norway

“…A systematic review from 2015 concluded that multimorbidity predicts future functional decline in adults, but comparisons between studies are hampered by the heterogeneity in definitions and operationalizations of multimorbidity and functional decline and the included cohort studies had short follow-up time (1-3 years) [9]. Later studies including four cross-sectional and two cohort studies with 1 and 2 years follow-up time have also found associations between multimorbidity and ADL/IADL disability [34][35][36][37][38]. It may seem that disease combinations including depression and cognitive impairment increase the risk for ADL/IADL disability substantially compared to combinations of only somatic disease [37,39].…”

Relationship between Individual Social Capital and Functional Ability among Older People in Anhui Province, China

“…Our findings may be of salient relevance for devising more targeted and effective interventions to prevent the onset of functional limitations among community-dwelling older adults. ) found that the prevalence of functional disability among older people ranged from 16.2% in China to 55.7% in India [8].Greater attention has been paid to exploring the correlates concerning the health and well-being of older adults [9]. Previous studies from China and abroad have both found that advanced age [10,11], frailty [12,13], depression [14] underweight or obesity, physical inactivity, a poor self-rated health, less engagement in level social activities, and pain [15] were most commonly associated with the incidence of ADL or IADL disability.…”

“…Our findings may be of salient relevance for devising more targeted and effective interventions to prevent the onset of functional limitations among community-dwelling older adults. ) found that the prevalence of functional disability among older people ranged from 16.2% in China to 55.7% in India [8].…”