Trends in Disability in Activities of Daily Living Among Chinese Older Adults, 1997–2006: The China Health and Nutrition Survey

Liang, Yajun; Song, Aiqin; Du, Shufa; Guralnik, Jack M.; Qiu, Chengxuan

doi:10.1093/gerona/glu204

Cited by 60 publications

(64 citation statements)

References 27 publications

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“…This study supports the idea that the decreasing prevalence of ADL disability in Chinese older adults, as previously reported, might be partly attributed to the declining incidence of disability. Furthermore, previous research has revealed a pattern of functional decline and recovery in ADL in older adults, and the transition from ADL‐disabled condition to active status is nontrivial .…”

Section: Discussionsupporting

confidence: 92%

“…Previous studies have reported a different prevalence of ADL disability between urban and rural areas in China, although the rural–urban difference tends to diminish over time . Similarly, the current study found that the incidence of ADL disability was generally comparable in rural and urban residents in the three cohorts, although the decline in incident disability was more evident in rural residents.…”

Section: Discussionsupporting

confidence: 69%

“…A decline in the prevalence and incidence of disability in activities of daily living (ADLs) in the past 2 to 3 decades has been reported in older adults in high‐income countries . In China, several studies have also shown a downward trend in prevalence of ADL disability in older adults . It is likely that the favorable trend in prevalence of ADL disability is due partly to a declining incidence of disability, but no population‐based studies have investigated the secular trends in incidence of ADL disability in China.…”

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confidence: 99%

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Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

Liang

Welmer

Wang

et al. 2016

J American Geriatrics Society

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BACKGROUND A decline in prevalence of disability in activities of daily living (ADL) among Chinese elderly people has been reported, but data on secular trends of incidence of ADL disability are sparse. OBJECTIVES We seek to investigate the time trends in incidence of ADL disability among Chinese older adults, and further, to explore factors potentially contributing to the trends. DESIGN A population-based prospective study. SETTING Participants were selected from nine provinces of China through a multistage, randomized, cluster sampling process. PARTICIPANTS We identified three consecutive cohorts of people aged ≥60 years within China Health and Nutrition Survey: cohort 1993-2000 (n=831), cohort 1997-2004 (n=1,091), and cohort 2000-2006 (n=1,152). MEASUREMENTS Disability in ADL was defined as inability to perform at least one of the five self-care activities, i.e., transferring, dressing, toileting, bathing, and feeding. Data were analyzed with Cox and generalized estimating equation models. RESULS The incidence (per 1,000 person-years) of ADL disability significantly decreased from 35.3 in 1993-2000 and 28.9 in 1997-2004 to 24.3 in 2000-2006 in Chinese older adults (Ptrend<.001). The incidence of ADL disability significantly decreased in both men and women, in young-old adults (aged 60-74 years), and in those living in rural area (Ptrend<.02) after controlling for multiple potential influential factors. Of the five ADL items, the decline in incidence of disability was significant in transferring (Ptrend<.001) and bathing (Ptrend=.002) and marginally significant in toileting (Ptrend=.061), but the incidence was stable in dressing (Ptrend=.384) and feeding (Ptrend=.258). CONCLUSION The incidence of ADL disability decreased from 1993 to 2006 among older adults in China, especially in transferring and bathing, independent of socio-demographics, lifestyles, and chronic health conditions.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 69%

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confidence: 99%

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Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

Liang

Welmer

Wang

et al. 2016

J American Geriatrics Society

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“…The first is the mixed effects of the two opposing processes of the “compression of morbidity (benefits of success)” and “expansion of morbidity (costs of success)”. On one hand, the later cohorts might benefit from progress resulted from more effective disease treatment, healthier lifestyles, declining disability effects of some major chronic diseases such as stroke and cardio-metabolic disease, 15 and improved standards of living, due to rapid socioeconomic development in China. This “benefits of success” implied that the later oldest-old cohort experienced reduced mortality rates by postponement of senescence, and reached older ages with improved health and functional capacity in daily living.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 However, Wu et al concluded that dementia prevalence among elderly aged 70+ was in general increasing, based on an evaluation of seventy prevalence studies of dementia in Mainland China, Hong Kong and Taiwan from 1980 to 2012. 17 Similarly, Chan et al found that the prevalence of all forms of dementia at ages 65–69 and 95–99 in China in 2010 increased 44.4% and 43.7%, respectively, compared to 1990.…”

Section: Introductionmentioning

confidence: 99%

Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study

et al. 2017

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Background The oldest-old (≥80 years) are the most rapidly growing age group globally, and they are most in need of health care and assistance. The aim of this study was to explore whether increased longevity is leading to populations of healthier oldest-old (compression of disability; benefits of success), or to less healthy and disabled oldest-old (expansion of disability, costs of success). Methods Data are from Chinese Longitudinal Healthy Longevity Study (CLHLS). Three pairs of cohorts aged 80–89, 90–99 and 100–105 (in total 19,528 oldest-old participants) were examined; the two cohorts in each pair were born ten years apart, with the same age at the time of the assessment in the CLHLS 1998 and 2008 surveys. Findings Controlling for various confounding factors, compared to cohorts born 10-years earlier, death rates at oldest-old ages among later cohorts were substantially reduced annually by 0.2%–1.3%, and their disabilities of Activities of Daily Living had significantly reduced annually by 0.8%–2.6%; however, the later cohorts’ cognitive impairment rates increased annually by 0.7%–2.2% and objective physical performance capacity (stand-up from a chair, pick-up a book from floor, turning around 360°) decreased annually by 0.4%–3.8%. We also found that mortality of female oldest-old was substantially lower, but their functional capacities in ADL, cognition and physical performance were worse, compared to their male counterparts (mostly P<0.001). Interpretation These empirical findings can be explained by the theoretical framework of mixed effects of two opposing processes: advances in medications, lifestyle and socioeconomics may compress ADL disability, that is, “benefits of success”, but lifespan extension may expand disability of physical and cognitive functioning as more frail elderly survive with health problems, that is “costs of success”. Recent improvements in living standards and availability of facilities for daily living among Chinese elderly may also contribute to the contrasting trends of ADL disability and physical performance.

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China Health and Nutrition Survey, 1989–2019

Zhang

Wang

2021

Encyclopedia of Gerontology and Population Aging

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Trends in Disability in Activities of Daily Living Among Chinese Older Adults, 1997–2006: The China Health and Nutrition Survey

Abstract: The prevalence of disability in basic ADLs among Chinese older adults decreased from 1997 to 2006. Stroke and multiple cardiometabolic diseases appear to become less disabling over time, which may partly contribute to the favorable trend in ADL disability.

Cited by 60 publications

References 27 publications

Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: a cohort study

China Health and Nutrition Survey, 1989–2019

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