The Prevalence and Trends of Instrumental Activities of Daily Living Impairments in the United States from 2008–2018

Abstract

Background: Instrumental activities of daily living (IADL) are neuropsychological-driven tasks that are linked to cognitive dysfunction. Examining population-based IADL deficits may reveal insights for the presence of these impairments in the United States. Objective: This investigation sought to evaluate the prevalence and trends of IADL impairments in Americans. Methods: A secondary analysis of data from the 2006–2018 waves of the Health and Retirement Study was conducted. The overall unweighted analytic sample included 29,764 Americans aged≥50 years. Respondents indicated their ability to perform six IADLs: manage money, manage medications, use a telephone, prepare hot meals, shop for groceries, and use a map. Persons reporting difficulty or an inability to complete an individual IADL were considered as having a task-specific impairment. Similarly, those indicating difficulty or an inability to perform any IADL were classified as having an IADL impairment. Sample weights were utilized to generate nationally-representative estimates. Results: Having an impairment in using a map (2018 wave: 15.7% (95% confidence interval (CI): 15.0–16.4) had the highest prevalence in individual IADLs regardless of wave examined. The overall prevalence of IADL impairments declined during the study period (p < 0.001) to 25.4% (CI: 24.5–26.2) in the 2018 wave. Older Americans and women had a consistently higher prevalence of IADL impairments compared to middle-aged Americans and men, respectively. The prevalence of IADL impairments was also highest among Hispanics and non-Hispanic Blacks. Conclusion: IADL impairments have declined over time. Continued surveillance of IADLs may help inform cognitive screening, identify subpopulations at risk of impairment, and guide relevant policy.

Prevalence and Trends of Basic Activities of Daily Living Limitations in Middle-Aged and Older Adults in the United States

“…Moreover, ADLs are of a physical nature and include fundamental skills for basic self-care, while separate tasks such as instrumental activities of daily living (IADL) are necessary for independent living [6]. Accordingly, our findings for ADL limitation prevalence and trends differ from those examining IADLs [30]. Further investigating the extent of difficulty in performing ADLs and factors that can impact ADL ability may help inform interventions for prevention, treatment, and recovery.…”

Is 70 the new 60? A longitudinal analysis of cohort trends in intrinsic capacity in England and China

“…For example, a common IADL question relates to how easy it is to use a phone, yet phone type and use have changed with time. 23 .…”

The bidirectional relationship between activities of daily living and frailty during short-and long-term follow-up period among the middle-aged and older population: findings from the Chinese nationwide cohort study

“…The prevalence rate of BADL disability among middle-aged and older community-dwelling adults in China was found to be 16.7%, IADL disability was 21.5% ( 23 ), and ADL disability was 19.4% ( 24 ). 2006–2018 study in United States including middle-aged and older participants showed that 25.4% presented IADL impairments, and the prevalence of impairments in IADL was highest among females and older individuals ( 25 ). A cross-sectional study of older adults residing in Brazilian communities in 2015–2016 found that the prevalence of IADL and BADL disabilities was 45.1 and 13.5%, respectively ( 26 ).…”