A more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, China

Abstract

Background: No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. We conducted a more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, a city in the central Guangdong Province of Southern China. Methods: A total of 819 individuals aged ≥60 years were recruited from Dongguan home-based care system of via a two-stage selection process. We interviewed participants and assessed their ability level using the Ability Assessment for Older Adults, which defined by a combination of activity of daily living, sensory perception, mental status and social involvement. Conditional probability and Logistic regression approaches were used to assess the strength of association between each pair of conditions. Factors significantly associated with disability were identified via χ 2 tests and multinomial ordinal logistic regression. Results: Of the 819 included participants (mean age 87 ±4.7 years), 75.5% were female, 76.7% had any disability, and 62.3% had a mild disability. The occurrence of any deficits significantly increased the likelihood of the co-occurrence of other deficits (odds ratio [OR] > 1, P < 0.05), with the lowest prevalence odds ratio observed among individuals with sensory and communication deficiency (OR: 2.99; 95% confidence interval [CI]: 2.21-4.05). Multivariable ordinal logistic regression analysis indicated that physical activity (OR: 0.96; 95% CI: 0.93-0.99), sedentary behavior (OR: 1.25; 95% CI: 1.13-1.38), not watching television (OR: 1.7; 95% CI: 1.07-2.72) and age (OR: 1.09; 95% CI: 1.02-1.17) were significantly associated with disability. Conclusions: Impairment of ADL, sensory perception, mental status or social involvement increased the likelihood of risk of the co-occurrence of other deficits. Comprehensive disability among older adults receiving home-based care is associated with age, sedentariness, physical activity and TV viewing.