Factors associated with ADL/IADL disability in community dwelling older adults in the Irish longitudinal study on ageing (TILDA)

Abstract

Awareness of sociodemographics and early interventions for pain and cognitive deficits could reduce ADL/IADL disability and promote successful ageing. Identification of variables that influence ADL/IADLs can be used to inform policy and practice. Implications for rehabilitation After age, pain and taking five or more medications were the strongest factors associated with difficulty in ADL/IADL combined and ADL alone. Practice therefore needs to be cognizant that it is not the disease label but the symptoms of a disease that affect ADL and IADL activities. Given the strong influence of pain on difficulties with ADL and IADL, there is a need for early interventions from a multidisciplinary perspective for pain reduction, control, and self-management. These interventions should include development of pain-coping strategies and exercises to maintain mobility. After age, being separated/divorced or living with non-spouse others are the strongest factors associated with IADL difficulties. Awareness of these social factors can be used to inform support mechanisms, such as development of community services and suitable housing for those with these changing sociodemographics. Unsurprisingly, cognitive impairments were strongly associated with IADL difficulties. Simple cognitive screening assessments could be used for early detection of cognitive changes. In order to maintain optimal cognitive functioning, rehabilitation professionals should facilitate older adults' engagement in activities that are cognitively demanding and socially interactive.

Gender differences in cognitive impairment among the old and the oldest‐old in China

“…Functional disabilities had a very small impact on gender differences. This is easily understandable, as disabilities naturally increase as people age, regardless of gender …”

Activities of daily living trajectories among institutionalised older adults: A prospective study

“…After controlling for residents’ sociodemographic characteristics in this study, we determined that the major risk factors for Group 1 were higher depressive symptoms, cognitive defects, and some chronic diseases; for groups 2 and 3, a few depressive symptoms and some chronic diseases were the primary risk factors, as well as younger age for Group 3. The early interventions for cognitive deficits could reduce ADL disability and promote successful ageing (Connolly et al., ). Treating residents’ depressive symptoms and enhancing their cognitive status are crucial for slowing ADL deterioration.…”

“…Stuck et al (1999) systematically reviewed 78 longitudinal studies published between 1985-1997 and found the risk factors of functional status decline in community-living older adults. The strongest evidence for an increased risk of functional status decline was found in cognitive impairment, depression, disease burden (comorbidity) (Stuck et al, 1999), and increased and reduced body mass index (BMI) (Connolly, Garvey, & McKee, 2017).…”

“…primary risk factors, as well as younger age for Group 3. The early interventions for cognitive deficits could reduce ADL disability and promote successful ageing(Connolly et al, 2017). Treating residents' depressive symptoms and enhancing their cognitive status are crucial for slowing ADL deterioration.After further analysing changes in each ADL measurement item, we found that dependence in ADL typically follows a certain…”

Determinants of difficulty in activities of daily living in ambulatory patients undergoing hemodialysis

“…Moreover, HD patients have been reported to show poor physical functioning (e.g., leg strength, standing balance, and walking ability), with high rates of depressive symptoms [9][10][11][12][13]. Recent studies have shown that poor standing balance, slow walking speed, presence of depression, and chronic kidney disease predict ADL difficulty in older community-living people [14][15][16][17]. Moreover, ADL difficulty has been shown to be an early predictor of loss of independence and mortality in older community-living people [18].…”