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Published in: BMC Geriatrics 1/2020

Open Access 01-12-2020 | Research article

Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study

Authors: Wen-Ling Liao, Yu-Hung Chang

Published in: BMC Geriatrics | Issue 1/2020

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Abstract

Background

This study aims to identify the age trajectories of disability in instrumental activities of daily life (IADLs) over 11 years and their correlates, and to estimate disability-free life expectancy for identified trajectory groups in middle-aged and older adults.

Methods

We included 3118 participants aged 50 and over without IADL limitations at baseline from the Taiwan Longitudinal Study in Aging, followed across 1996–2007. We used group-based trajectory models to identify age trajectories of IADL disability, and multiple logistic regressions to examine their correlates. Sullivan method was used to compute IADL disability-free life expectancy for trajectory groups at different ages.

Results

We identified two trajectories groups: 67.7% of participants classified as the late-onset group and 32.3% as the early-onset group. Female (adjusted odds ratio [aOR]: 1.93, 95% confidence interval [95% CI]: 1.54, 2.41), not being employed (aOR: 1.30, 95% CI: 1,08, 1,56), poor/fair self-rated health (aOR: 1.31, 95% CI:1.09, 1.58), hypertension (aOR: 1.32, 95% CI: 1.07, 1.63), diabetes mellitus (aOR: 2.29, 95% CI: 1.72, 3.07), arthritis (aOR: 1.42, 95% CI: 1.11, 1.81), stroke (aOR: 2.21, 95% CI: 1.04, 4.70), and one-point increase in a 10-item depression scale (aOR: 1.04, 95% CI: 1.02, 1.06) were associated with early-onset of disability, whereas higher education (aOR: 0.59, 95% CI: 0.42, 0.81), regular exercise (aOR: 0.76, 95% CI: 0.62, 0.93), and participating voluntary or club activities (aOR: 0.78, 95% CI: 0.65, 0.93) related to the late-onset. IADL disability-free life expectancies at 65 years old in the late-onset group were 15.6 years for women and 14.4 for men, respectively, comprising 56.6 and 64.2% of their remaining life, whereas those of the early-onset group were 4.8 and 4.6 years for women and men respectively, comprising 22.5 and 27.2% of remaining life.

Conclusions

Early-onset of IADLs disability may correlate to chronic conditions, and engagement in employment, exercise, and social participation were associated with a reduced risk of early disability in IADLs.
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Literature
3.
go back to reference Millán-Calenti JC, Tubío J, Pita-Fernández S, González-Abraldes I, Lorenzo T, Fernández-Arruty T, Maseda A. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010;50(3):306–10. https://doi.org/10.1016/j.archger.2009.04.017.CrossRefPubMed Millán-Calenti JC, Tubío J, Pita-Fernández S, González-Abraldes I, Lorenzo T, Fernández-Arruty T, Maseda A. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010;50(3):306–10. https://​doi.​org/​10.​1016/​j.​archger.​2009.​04.​017.CrossRefPubMed
6.
go back to reference World Health Organization (WHO). ICF: International classification of functioning, disability and health: short version. Geneva: WHO; 2001. World Health Organization (WHO). ICF: International classification of functioning, disability and health: short version. Geneva: WHO; 2001.
15.
go back to reference Chang M, Hermalin A. 1989 survey of health and living status of the elderly in Taiwan: questionnaire and survey design. Comparative Study of the Elderly in Four Asian Countries Research Report: No. 89-1. Ann Arbor: Population studies center, University of Michigan; 1989. Chang M, Hermalin A. 1989 survey of health and living status of the elderly in Taiwan: questionnaire and survey design. Comparative Study of the Elderly in Four Asian Countries Research Report: No. 89-1. Ann Arbor: Population studies center, University of Michigan; 1989.
16.
go back to reference Chen YJ, Dai YT, Yang CT, Wang TJ, Teng YH. A review and proposal on patient classification in long-term care system. Taipei: Department of Health, Taiwan; 1995. Chen YJ, Dai YT, Yang CT, Wang TJ, Teng YH. A review and proposal on patient classification in long-term care system. Taipei: Department of Health, Taiwan; 1995.
20.
go back to reference Nagin DS. Group-based modeling of development. Cambridge: Harvard University Press; 2005.CrossRef Nagin DS. Group-based modeling of development. Cambridge: Harvard University Press; 2005.CrossRef
29.
go back to reference Jonkman NH, Del Panta V, Hoekstra T, Colpo M, van Schoor NM, Bandinelli S, Cattelani L, Helbostad JL, Vereijken B, Pijnappels M. Predicting trajectories of functional decline in 60-to 70-year-old people. Gerontology. 2018;64(3):212–21.CrossRefPubMed Jonkman NH, Del Panta V, Hoekstra T, Colpo M, van Schoor NM, Bandinelli S, Cattelani L, Helbostad JL, Vereijken B, Pijnappels M. Predicting trajectories of functional decline in 60-to 70-year-old people. Gerontology. 2018;64(3):212–21.CrossRefPubMed
31.
go back to reference United Nations. Report of the Second World Assembly on Ageing. Madrid, 8-12 April 2002. New York: United Nations; 2002. United Nations. Report of the Second World Assembly on Ageing. Madrid, 8-12 April 2002. New York: United Nations; 2002.
43.
46.
Metadata
Title
Age trajectories of disability in instrumental activities of daily living and disability-free life expectancy among middle-aged and older adults in Taiwan: an 11-year longitudinal study
Authors
Wen-Ling Liao
Yu-Hung Chang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2020
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01939-4

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