Patterns of Functional Disability in the Oldest Adults in China

Abstract

This study examined patterns of onset of activity of daily living (ADL) disability in a nationally representative sample of older adults in mainland China. Using longitudinal data from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2008 (N = 5,570), nonparametric methods were used to evaluate median age at onset of various ADL disabilities and differences in the incidence of disabilities according to sex. The sampled older Chinese adults developed ADL disabilities, on average, between the ages of 89 and 94. Women were likely to experience later onset than men. The results also show that the oldest adults generally lose bathing ability, followed by toileting, transferring, dressing, eating, and finally, continence. This order-derived from estimated median age at onset-was also found to be highly prevalent in subsequently disabled respondents in the sample. The disability experience of older adults in China is somewhat similar to that of older adults in Western developed countries; elderly adults tend to lose ability in activities that require lower extremity strength earlier than those that require upper extremity strength. The relative importance of the various ADL items in the hierarchical ordering has implications for early intervention to reduce the risk of functional disability in older adults and those at risk of transitions of care.

Disability Prior to Death Among the Oldest-Old in China

“…Interviewers asked participants if they needed personal assistance in performing five activities (bathing, transferring, dressing, eating, and toileting) or had problems with incontinence (12). ADL disability was defined as being incontinent or needing assistance in performing one or more of the five other activities (12,15,16). Severe ADL disability was defined as having disability in three or more of the six activities (7).…”

Disability incidence and functional decline among older adults with major chronic diseases

“…As one ages, health problems accumulate and people start to lose their ability to perform activities of daily living (ADLs), such as dressing, using the toilet, bathing, and eating. Past studies have shown that the pattern of ADL disability in geriatric populations follows a distinct progression [1–9]. These hierarchical patterns of functional decline or ADL scales – typically established using item response theory (IRT) methods and hazard models – have been reliably and validly assessed not only for the institutionalized population but also more generally for community-dwelling older adults [7].…”

Modelling multi-state health transitions in China: a generalised linear model with time trends

“…Mortality and morbidity data in the CLHLS have been found to be of good quality (Zeng, 2012) and have been used in many studies analysing health patterns of older Chinese (e.g. Peng et al ., 2010; Peng & Wu, 2015; Fong & Feng, 2016). With a sample size of over 128,000 exposure years we are able to estimate separate models for male and female residents in both urban and rural areas.…”