Hostname: page-component-76fb5796d-5g6vh Total loading time: 0 Render date: 2024-04-30T03:43:35.578Z Has data issue: false hasContentIssue false
  • English
  • Français

Correlates of limitations in activities of daily living and mobility among community-dwelling older Singaporeans

Published online by Cambridge University Press:  21 December 2010

ANGELIQUE CHAN ,
CHETNA MALHOTRA  and
TRULS ØSTBYE
ANGELIQUE CHAN
Affiliation:
Department of Sociology, National University of Singapore, Singapore. Program in Health Services and Systems Research, Duke-National University of Singapore, Singapore.
CHETNA MALHOTRA*
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore, Singapore.
TRULS ØSTBYE
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore, Singapore. Department of Community and Family Medicine, Duke University, North Carolina, USA.
*
Address for correspondence: Chetna Malhotra, Program in Health Services and Systems Research, Duke-National University of Singapore, 8 College Road, Singapore169857. E-mail: chetna.malhotra@duke-nus.edu.sg
Get access Rights & Permissions [Opens in a new window]

Abstract

Most research on activity limitations has focused on the association between chronic health conditions and activity limitations and given little attention to their social and financial implications. In this paper, we study the correlates of limitations in the activities of daily living (ADL) and mobility among older Singaporeans (aged 55 or more years), based on the ‘disability frameworks’ or pathways proposed by Nagi, Verbrugge and the International Classification of Functioning, Disability and Health. Data from the 2005 National Survey of Senior Citizens in Singapore was used. The weighted prevalence of ADL and mobility limitations was calculated, overall and in subgroups. Logistic regression models were used to assess predictors of ADL and mobility limitations and variation in involvement with family, society, work, use of services and perceived financial adequacy, by ADL and mobility status was studied. We found the overall weighted prevalence of ADL and mobility limitation to be 5 and 8 per cent, respectively. Significant risk factors for ADL and mobility limitation were being older (aged 75 or more years), widowed, having diabetes, joint/bone problems, stroke, cancer and low income. Individuals with ADL and mobility limitations had lower involvement with family, society and work, and perceived financial adequacy, while use of services was higher. The findings underline the importance of improving elderly services for sustained integration of disabled elderly within the community.

Keywords

disabilitysocial functioningincome adequacyelderly
Type
Articles
Information
Ageing & Society , Volume 31 , Issue 4 , May 2011 , pp. 663 - 682
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Blazer, D. G. 1982. Social support and mortality in an elderly community population. American Journal of Epidemiology, 115, 5, 684–94.CrossRefGoogle Scholar
Branch, L. G., Wetle, T. T., Scherr, P. A., Cook, N. R., Evans, D. A., Hebert, L. E., Masland, E. N., Keough, M. E. and Taylor, J. O. 1988. A prospective study of incident comprehensive medical home care use among the elderly. American Journal of Public Health, 78, 3, 255–59.Google Scholar
Brorsson, B. and Asberg, K. H. 1984. Katz index of independence in ADL: reliability and validity in short-term care. Scandinavian Journal of Rehabilitation Medicine, 16, 3, 125–32.Google Scholar
Chalise, H. N., Saito, T. and Kai, I. 2008. Functional disability in activities of daily living and instrumental activities of daily living among Nepalese Newar elderly. Public Health, 122, 4, 394–96.Google Scholar
Chan, A. and Jatrana, S. 2007. Gender differences in health among older Singaporeans. International Sociology, 22, 4, 463–91.CrossRefGoogle Scholar
Chan, A., Ofstedal, M. and Hermalin, A. 2002. Changes in subjective and objective measures of economic well-being and their interrelationship among the elderly in Singapore and Taiwan. Social Indicators Research, 57, 3, 263–300.Google Scholar
Chappell, N. L. and Blandford, A. A. 1987. Health service utilization by elderly persons. Canadian Journal of Sociology/Cahiers canadiens de sociologie, 12, 3, 195–215.Google Scholar
Chen, P., Yu, E. S., Zhang, M., Liu, W. T., Hill, R. and Katzman, R. 1995. ADL dependence and medical conditions in Chinese older persons: a population-based survey in Shanghai, China. Journal of the American Geriatrics Society, 43, 4, 378–83.CrossRefGoogle Scholar
Chiu, H., Hsieh, Y., Mau, L. and Lee, M. 2005. Associations between socio-economic status measures and functional change among older people in Taiwan. Ageing & Society, 25, 3, 377–95.CrossRefGoogle Scholar
Dunlop, D. D., Manheim, L. M., Sohn, M. W., Liu, X. and Chang, R. W. 2002. Incidence of functional limitation in older adults: the impact of gender, race, and chronic conditions. Archives of Physical Medicine and Rehabilitation, 83, 7, 964–71.Google Scholar
Foley, D. J., Ostfeld, A. M., Branch, L. G., Wallace, R. B., McGloin, J. and Cornoni-Huntley, J. C. 1992. The risk of nursing home admission in three communities. Journal of Aging Health, 4, 2, 155–73.Google Scholar
Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D. and Anderson, G. 2004. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. Journal of Gerontology: Medical Sciences, 59, 3, M255–63.Google Scholar
Fried, T. R., Bradley, E. H., Williams, C. S. and Tinetti, M. E. 2001. Functional disability and health care expenditures for older persons. Archives of Internal Medicine, 161, 21, 2602–07.Google Scholar
Goldman, N., Korenman, S. and Weinstein, R. 1995. Marital status and health among the elderly. Social Science and Medicine, 40, 12, 1717–30.Google Scholar
Gregg, E., Beckles, G., Williamson, D., Leveille, S., Langlois, J., Engelgau, M. and Narayan, K. 2000. Diabetes and physical disability among older US adults. Diabetes Care, 23, 9, 1272–77.CrossRefGoogle Scholar
Guralnik, J. M., LaCroix, A. Z., Abbott, R. D., Berkman, L. F., Satterfield, S., Evans, D. A. and Wallace, R. B. 1993. Maintaining mobility in late life. I. Demographic characteristics and chronic conditions. American Journal of Epidemiology, 137, 8, 845–57.Google Scholar
Han Kwee Ho, K. M., Taizo, Wada, Miyuki, Kimura, Toru, Kita and Kiyofumi, Saijoh 2002. Factors associated with ADL dependence: a comparative study of residential care home and community-dwelling elderly in Japan. Geriatrics and Gerontology International, 2, 2, 80–86.Google Scholar
Jette, A. M. 2006. Toward a common language for function, disability, and health. Physical Therapy, 86, 5, 726–34.Google Scholar
Lauretani, F., Russo, C. R., Bandinelli, S., Bartali, B., Cavazzini, C., Di Iorio, A., Corsi, A. M., Rantanen, T., Guralnik, J. M. and Ferrucci, L. 2003. Age-associated changes in skeletal muscles and their effect on mobility: an operational diagnosis of sarcopenia. Journal of Applied Physiology, 95, 5, 1851–60.Google Scholar
Meng-Kin, L. 1998. Health care systems in transition II. Singapore. Part I: An overview of health care systems in Singapore. Journal of Public Health, 20, 1, 16–22.Google Scholar
Ministry of Community Development, Youth and Sports (CDYS) 2006. Report on the Ageing Population. Committee on Ageing Issues, CDYS, Singapore.Google Scholar
Nagi, S. 1965. Some conceptual issues in disability and rehabilitation. In Sociology and Rehabilitation. American Sociological Association, Washington DC, 100–13.Google Scholar
National Trades Union Congress Income Insurance Co-operative Limited (NTUCIIC) 2010. Health Insurance. NTUCIIC, Singapore. Available online at http://www.income.com.sg/insurance/eldershield/ [Accessed 8 October 2010].Google Scholar
Ng, T. P., Niti, M., Chiam, P. C. and Kua, E. H. 2006. Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54, 1, 21–9.Google Scholar
Ofstedal, M., Zimmer, Z., Hermalin, A., Chan, A., Chuang, Y.-L., Natividad, J. and Tang, Z. 2007. Short-term trends in functional limitation and disability among older Asians: a comparison of five Asian settings. Journal of Cross-cultural Gerontology, 22, 3, 243–61.CrossRefGoogle ScholarPubMed
Sauvaget, C., Yamada, M., Fujiwara, S., Sasaki, H. and Mimori, Y. 2002. Dementia as a predictor of functional disability: a four-year follow-up study. Gerontology, 48, 4, 226–33.Google Scholar
Schoeni, R. F., Liang, J., Bennett, J., Sugisawa, H., Fukaya, T. and Kobayashi, E. 2006. Trends in old-age functioning and disability in Japan, 1993–2002. Population Studies, 60, 1, 39–53.Google Scholar
Seeman, T. E., Kaplan, G. A., Knudsen, L., Cohen, R. and Guralnik, J. 1987. Social network ties and mortality among the elderly in the Alameda County Study. American Journal of Epidemiology, 126, 4, 714–23.CrossRefGoogle ScholarPubMed
Singapore Department of Statistics 2001. Census of Population 2000 Statistical Release 1: Demographic Characteristics. Department of Statistics, Singapore. Available online at http://www.singstat.gov.sg/pubn/popn/c2000sr1/t1-7.pdf [Accessed 8 October 2010].Google Scholar
Singapore Department of Statistics 2008. Complete Life Tables 2003–2006 for Singapore Resident Population. Department of Statistics, Singapore.Google Scholar
SingHealth 2007. Ageing in Place: A Service Guide for Healthy Ageing. Singhealth Quality Management Department, Singapore. Available online at http://www.aic.sg/wp-content/uploads/2010/03/Community-Service-Guide1.pdf [Accessed 8 October 2010].Google Scholar
Spiers, N. A., Matthews, R. J., Jagger, C., Matthews, F. E., Boult, C., Robinson, T. G. and Brayne, C. 2005. Diseases and impairments as risk factors for onset of disability in the older population in England and Wales: findings from the Medical Research Council Cognitive Function and Ageing Study. Journals of Gerontology: Biological Sciences and Medical Sciences, 60, 2, 248–54.Google Scholar
Strawbridge, W. J., Cohen, R. D., Shema, S. J. and Kaplan, G. A. 1996. Successful aging: predictors and associated activities. American Journal of Epidemiology, 144, 2, 135–41.Google Scholar
Stoller, M. A. and Stoller, E. P. 2003. Perceived income adequacy among elderly retirees. Journal of Applied Gerontology, 22, 2, 230–51.CrossRefGoogle Scholar
Teo, P., Chan, A. and Straughan, P. 2003. Providing health care for older persons in Singapore. Health Policy, 64, 3, 399–413.Google Scholar
Valderrama-Gama, E., Damian, J., Ruigomez, A. and Martin-Moreno, J. M. 2002. Chronic disease, functional status, and self-ascribed causes of disabilities among non-institutionalized older people in Spain. Journal of Gerontology: Medical Sciences, 57, 11, M716–21.Google Scholar
Verbrugge, L. M. and Jette, A. M. 1994. The disablement process. Social Science and Medicine, 38, 1, 1–14.CrossRefGoogle ScholarPubMed
Wallace, M. and Shelkey, M. 2008. Try this: best practices in nursing care to older adults. Katz Index of Independence in Activities of Daily Living (ADL). American Journal of Nursing, 108, 4, 67–8.Google Scholar
World Health Organization. 2002. Towards a Common Language for Functioning, Disability and Health: The International Classification of Functioning, Disability and Health. World Health Organization, Geneva. Available online at http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf [Accessed 8 October 2010].Google Scholar
Wu, S. C., Leu, S. Y. and Li, C. Y. 1999. Incidence of and predictors for chronic disability in activities of daily living among older people in Taiwan. Journal of the American Geriatrics Society, 47, 9, 1082–6.CrossRefGoogle ScholarPubMed
Yadav, S. 2001. Disability and handicap among elderly Singaporeans. Singapore Medical Journal, 42, 8, 360–7.Google ScholarPubMed
Yam, H. K., Mercer, S. W., Wong, L. Y., Chan, W. K. and Yeoh, E. K. 2009. Public and private healthcare services utilization by non-institutional elderly in Hong Kong: is the inverse care law operating? Health Policy, 91, 3, 229–38.Google Scholar