Short-term Trends in Functional Limitation and Disability Among Older Asians: A Comparison of Five Asian Settings

Abstract

The objective of this paper is to examine short-term trends in the prevalence of limitation in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Nagi physical functioning tasks among persons age 60 years or older in five Asian settings: Indonesia, the Philippines, Singapore, Taiwan and the Beijing Municipality. The data come from recent panel surveys of older adults that span a period of 3-4 years during the mid to late 1990s. Results suggest a general trend toward an increase in functional limitation in four of the five settings, with the most pronounced increases occurring for the Nagi functioning tasks. Compositional differences in the population accounted for little of the increase. The paper discusses the potential implications of these results and places them in the context of past and current trends in functional limitation observed in the United States.

Studying Disability Trends in Aging Populations

“…Nagi's tasks for physical functioning typically include standing for 15 min, crouching, squatting, kneeling, stooping, raising one's hands overhead, grasping with fingers, lifting a heavy object, climbing stairs, walking 200-300 m, walking five kilometers, and standing up from a chair Martin et al 2011;Nagi 1965;Ofstedal, et al 2007). …”

“…We assumed a linear change and both sexes shared the same trend. (h) The trends in ADL disability for China in the 1990s was from Gu and Zeng (2006) and Gu et al (2009 Indonesia and the Philippines in the 1990s (Ofstedal et al 2007) and even reversed in Thailand after 2005 (Karcharnubarn 2010). Although we are unable to identify IADL trends for many countries, existing data suggest that trends in IADL disability were more or less similar to trends in ADL disability in most countries/areas.…”

“…There is a growing body of research examining trends in physical disability (thereafter referred to as disability, unless noted otherwise) at older ages in both developed (e.g., Freedman et al 2002;Lafortune et al 2007;Schoeni et al 2006) and in developing countries (e.g., Gu et al 2009;Lima-Costa et al 2012;Martin et al 2011;Ofstedal et al 2007). More recently, some studies have begun to investigate the possible causes attributable to disability trends and the consequences of these trends (e.g., Cutler et al 2009b;Freedman et al 2007Freedman et al , 2008aFreedman et al , 2008bJagger et al 2009;Schoeni et al 2008Schoeni et al , 2009.…”

Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs

“…5 Against this backdrop, the discourse on challenges of ageing and health in SSA centres not, as it does in industrialized countries, on queries about expected trends in old age morbidity, mortality and disability and the sustainability of existing health and care systems. [6][7][8] The focus, rather, are concerns about a heightened vulnerability of older persons to detrimental health outcomes -in two respects. On one level, older populations in SSA are deemed to be at particularly high risk of ill-health and disability from age-related chronic non-communicable disease (CNCD), due to a lifetime of exposure to conditions of deprivation and a growing prevalence of modifiable CNCD risk factors.…”

Old age mortality in Eastern and South-Eastern Asia

“…Global effort in collecting time series data on risk behaviors at the country or sub-national levels is necessary. Fifth, studies have shown that health conditions among several elderly populations in the region is getting worse, in spite of prolonged longevity (Cheung and Yip 2010;Ofstedal et al 2007). Yet we are unable to examine possible trajectories of health expectancies (Robine and Michel 2004) primarily because of space limitations and lack of nationwide data.…”