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Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006
Author(s) -
Liang Yajun,
Welmer AnnaKarin,
Wang Rui,
Song Aiqin,
Fratiglioni Laura,
Qiu Chengxuan
Publication year - 2017
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14468
Subject(s) - toileting , medicine , bathing , activities of daily living , incidence (geometry) , gerontology , cohort , cohort study , prospective cohort study , population , demography , physical therapy , environmental health , surgery , physics , pathology , sociology , optics
Objectives To investigate time trends in incidence of activity of daily living ( ADL ) disability of Chinese older adults and to explore factors potentially contributing to trends. Design Population‐based prospective study using a multistage, randomized, cluster sampling process. Setting Nine provinces of China. Participants Three consecutive cohorts of people aged 60 and older from the China Health and Nutrition Survey: cohort 1993–2000 (n = 831), cohort 1997–2004 (n = 1,091), cohort 2000–2006 (n = 1,152). Measurements Disability in ADL s was defined as inability to perform at least one of five self‐care activities (transferring, dressing, toileting, bathing, feeding). Data were analyzed using Cox and generalized estimating equation models. Results The incidence (per 1,000 person‐years) of ADL disability decreased significantly from 35.3 in 1993–2000 and 28.9 in 1997–2004 to 24.3 in 2000–2006 in Chinese older adults ( P trend < .001). The incidence of ADL disability decreased significantly in men and women, in young‐old adults (aged 60–74), and in those living in rural areas (all P trend ≤ .02) after controlling for multiple potential influential factors. Of the five ADL items, decline in incidence of disability was significant in transferring (P trend < .001) and bathing ( P trend = .002) and marginally significant in toileting ( P trend = .06) but stable in dressing ( P trend = .38) and feeding ( P trend = .26). Conclusion The incidence of ADL disability decreased from 1993 to 2006 in older adults in China, especially in transferring and bathing, independent of sociodemographic, lifestyle, and chronic health conditions.