Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006 - American Geriatric Society

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 ADLs 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.

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