Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

Abstract

BackgroundThe prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.MethodsA population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting).ResultsTen, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation.ConclusionsThe prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing countries. Associations with socio-demographic and other health related variables were consistent with other studies.

Nutritional and functional assessment of hospitalized elderly: Impact of sociodemographic variables

“…Hairi et al showed that advancing age was significantly associated with functional limitation [35]. We did not find significant correlation between disability and income, however, a study done ona random sample of persons, 55-85 years of age, drawn from the population registers of 11 municipalities found that low socioeconomic status had been associated with physical disability [36].…”

“…Bergamini et al found that older Italian men and women showed similar prevalence of functional limitation, 31% and 28%, respectively [37]. However, Hairi et al found that female gender was significantly associated with functional limitation; they suggested that disadvantages resulting from limited education may contribute to the greater physical disability and functional limitation burden experienced by older women in their study [35].…”

Profile of the elderly in physical therapy and its relation to functional disability

“…Female gender and older age appear on a recurring basis as risk factors for functional disability in the majority of studies 16,19,20 and the present study is no exception. Women have a higher life expectancy than men and pass a greater proportion of their life with functional disability; moreover, when affected by this condition, they live for a longer period with dependency 21 .…”

Living Arrangements and Conditions of Older Persons in Namibia

“…Even among HIV infected populations in South Africa, older women were still at a higher risk of disabilities compared to older men [13]. Studies in middle income countries have also reported increased disability among older women [14] [15]. In developed countries like USA, older women were also disadvantaged in terms of the prevalence of disability [16].…”