Article

PURPOSE: To identify the factors associated with disability across many domains
using a large powered sample in the activities of daily living (ADL) and
instrumental activities of daily living (IADL). METHODS:
Those aged >/=65 years
from the Irish longitudinal study on ageing (TILDA) were included in this cross
sectional analysis. Three logistic regression models were used to examine the
relationships between 25 health, psychological and sociodemographic variables and
difficulties in ADL, IADL and ADL/IADL combined.
RESULTS: The proportion of those
reporting combined ADL/IADL difficulties was 18%. More individuals reported
difficulty with ADLs (13%) than IADLS (11%). The main model showed that after
age, the top three factors associated with difficulty in ADL/IADL combined were
pain, taking five or more medications and depression. After age, the factors with
the highest impact on ADL disability were pain, taking five or more medications
and body mass index (BMI); the factors with the highest impact on IADL were being
separated or divorced, living with others (non-spouse) and self-rated memory.
CONCLUSIONS: Awareness of sociodemographics and early interventions for pain and
cognitive deficits could reduce ADL/IADL disability and promote successful
ageing. Identification of variables that influence ADL/IADLs can be used to
inform policy and practice. Implications for rehabilitation After age, pain and
taking five or more medications were the strongest factors associated with
difficulty in ADL/IADL combined and ADL alone. Practice therefore needs to be
cognizant that it is not the disease label but the symptoms of a disease that
affect ADL and IADL activities. Given the strong influence of pain on
difficulties with ADL and IADL, there is a need for early interventions from a
multidisciplinary perspective for pain reduction, control, and self-management.
These interventions should include development of pain-coping strategies and
exercises to maintain mobility. After age, being separated/divorced or living
with non-spouse others are the strongest factors associated with IADL
difficulties. Awareness of these social factors can be used to inform support
mechanisms, such as development of community services and suitable housing for
those with these changing sociodemographics. Unsurprisingly, cognitive
impairments were strongly associated with IADL difficulties. Simple cognitive
screening assessments could be used for early detection of cognitive changes. In
order to maintain optimal cognitive functioning, rehabilitation professionals
should facilitate older adults' engagement in activities that are cognitively demanding and socially interactive.

Langue : ANGLAIS