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Background The Global Activity Limitation Indicator (GALI) is part of the Minimum European Health Module and has been shown to be a valid indicator of functional limitations. The present study aims to identify determinants of GALI prevalence among adults in Europe. Methods We used data from the European Health Interview Survey (EHIS) Wave 2 which included adults aged 15 years and older and was conducted between 2013 and 2015 in all European Union member states. We examined patterns regarding age, sex, education and chronic diseases. After excluding some inconsistencies in the data the sample size was 284,732 respondents from 26 countries. When making comparisons across countries one has to bear in mind that the data was collected through different modes, the indicators were obtained through various instruments and in some countries interviews were conducted not always with the target person, but with a proxy person. Results Our findings revealed that age and education are very strong determinants of functional limitation in all countries. Sex showed to be mostly non-significantly associated, however in some Eastern and Southern countries it plays a significant role. The additional factors examined showed less consistent picture. While chronic diseases with stronger disease burden were associated with higher limitation, diseases that are well treatable (like high blood pressure) showed in some countries strong associations with functional limitation while in others there was no clear relationship. Conclusions Having in mind the aging of the population, the problem with the functional limitation in higher ages will increase furthermore. This is an issue which should be taken into account in health promotion policies. The role of chronic diseases and their association with disability cannot be neglected. Prevention policies should put more effort in identifying earlier the vulnerable population (e.g. less educated) and promote health care initiatives. Key messages Age and education are strong determinants of functional limitation across all European countries. Sex showed inconsistent patterns. Functional limitation is in general strongly associated with chronic disease. However, differences in Europe were found with regard to some specific conditions.

Factors associated with activity limitation: are the risk patterns the same across Europe?