Has the Prevalence of Disability Increased Over the Past Decade (2000–2007) in Elderly People? A Spanish Population-based Survey

doi:10.1016/j.jamda.2010.05.007

Journal of the American Medical Directors Association

Volume 13, Issue 2, February 2012, Pages 136-142

https://doi.org/10.1016/j.jamda.2010.05.007 Get rights and content

Abstract

Objectives

The main objectives of the current study were (1) to describe the prevalence of disability according to sociodemographic features, self-perceived health status, comorbidity, and lifestyle habits; (2) to determine factors associated with disability in men and women; and (3) to study the time trends prevalence of disability in the period 2000 to 2007.

Methods

We analyzed data taken from the Spanish National Health Surveys conducted in 2001 (n = 21,058), 2003 (n = 21,650), and 2006 (n = 29,478). For the current study, we included answers from adults aged 65 years and older. The main variable was disability including basic activities of daily living (ADLs), instrumental ADLs (IADLs), and mobility disability. We stratified the adjusted models by the main variables. We analyzed sociodemographic characteristics, self-perceived health status, lifestyle habits, and comorbid conditions using multivariate logistic regression models.

Results

The total number of individuals aged 65 years and older was 18,325 (11,346 women, 6,979 men). Women were significantly older than men in all the surveys (P < .001). Women showed higher prevalence of disability (ADL, IADL, and mobility) as compared with men in all surveys. Time trends in the total disability prevalence and whole age range showed a significant increase from 2000 to 2007 in both men and women (OR 1.13, 95% CI 1.1–1.7), particularly in individuals with older age. The variables significantly associated with a higher likelihood of reporting ADL and IADL disability were age older than 84, lower educational level, 2 or more comorbid chronic conditions, obesity (only in women), sleeping more than 8 hours per day, and not practicing physical exercise. Finally, variables that increased the probability of having mobility disability were age older than 84 years, lower educational level, 2 or more comorbid chronic conditions, and not practicing physical exercise. In addition, subjects with disability had a worse self-reported health status.

Conclusions

The current study revealed an increase in disability from 2000 to 2007 in the older Spanish population. We found that age older than 84 years, lower education levels, obesity, not practicing physical activity and sleeping more than 8 hours per day were associated with higher disability. Individuals with disability reported a worse self-perceived health status and a greater number of comorbid conditions.

Section snippets

Methods

We conducted a cross-sectional study using individualized data taken from the 2001, 2003, and 2006 Spanish National Health Survey (SNHS). The SNHS is performed by the Ministry of Health and Consumer Affairs and the National Statistics Institute (Instituto Nacional de Estadística [INE]) and covers a representative sample of the Spanish noninstitutionalized population. The data collection period ranged from February 2001 to November 2001 for the 2001 SNHS, from April 2003 to March 2004 for the

Statistical Analysis

In this study we analyzed disability separately for men and women and we excluded respondents with missing data for any disability outcome. We first analyzed descriptive measures for all variables of interest by age group and SNHS. Second, we compared reported prevalence for each aspect of disability and age group according to the SNHS. To perform bivariate comparisons, we used the 2-sided independent t tests for continuous variables and chi-square statistics for categorical variables. Third,

Results

The total number of subjects aged 65 years and older included in the study along the entire period was 18,325 (11,346 women and 6979 men). The mean age was 74.7 years for women and 74.2 years for men (P < .001): women were significantly older in all surveys. Tables 1 to 2 show the distribution by sociodemographic features and health-related variables among women and men included in the study population according to the SNHS conducted between 2000 and 2007.

Among women, the prevalence of those

Discussion

Our study revealed an increase in disability from 2000 to 2007 in the older Spanish population. We found that age older than 84 years, lower education level, obesity, not practicing physical activity, and sleeping longer than 8 hours per day were associated with higher disability. In addition, subjects presenting with disability had a worse self-perceived health status and a greater number of comorbid chronic conditions.

Our results are consistent with different recent studies conducted in

Conclusions

The current study revealed an increase in disability in the Spanish population over the past decade. Age older than 84 years, lower education level, obesity, not practicing physical activity, and sleeping longer than 8 hours per day were associated with higher disability. Subjects with disability reported a worse self-perceived health status and a greater number of comorbid conditions. Our results have clear implications for health and social services in Spain. Health and social services should

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: The authors have no conflicts on interest.

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Original StudyHas the Prevalence of Disability Increased Over the Past Decade (2000–2007) in Elderly People? A Spanish Population-based Survey

Abstract

Objectives

Methods

Results

Conclusions

Section snippets

Methods

Statistical Analysis

Results

Discussion

Conclusions

Ageing populations: the challenges ahead

Lancet

United Nations. Population Division. World Population Ageing 1950–2050

Basic ADL disability and functional limitation rates among older Americans From 2000–2005: The end of the decline?

J Gerontol A Biol Sci Med Sci

Assessing the building blocks of function: Utilizing measures of functional limitation

Am J Prev Med

Aging in America in the twenty-first century: Demographic forecasts from the MacArthur Foundation Research Network on an Aging Society

Milbank Q

National Center for Health Statistics. Health, United States, 2007: With Chartbook on Trends in the Health of Americans

Change in chronic disability from 1982 to 2004/2005 as measured by long-term changes in function and health in the US elderly population

PNAS

Disability trends among older Americans: National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2004

Am J Public Health

Phenotype of frailty: Characterization in the Women's Health and Aging Studies

J Gerontol A Biol Sci Med Sci

Quality of life at older ages: Evidence from the English longitudinal study of aging (Wave 1)

J Epidemiol Community Health

Predicting nursing home admission in the US: A meta-analysis

BMC Geriatr

A cohort study found good respiratory, sensory and motor functions decreased mortality risk in older people

J Clin Epidemiol

Deaths: Preliminary data for 2003. National Vital Statistics Reports, vol. 53, no. 15

Explaining the effect of gender on functional transitions in older persons

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Mobility limitations in the Medicare population: Prevalence and sociodemographic and clinical correlates

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Trends in disability and disability-free life expectancy among elderly people in Spain: 1986–1999

J Gerontol

Prevalence of disability and associated social and health-related factors among the elderly in Spain: A population-based study

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JAMA

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Annu Rev Public Health

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J Gerontol B Psychol Sci Soc Sci

Resolving inconsistencies in trends in old-age disability: Report from a technical working group

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Am J Public Health

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Health changes among Swedish oldest old: Prevalence rates from 1992 and 2002 show increasing health problems

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Functional ability in the elderly Swedish population from 1980 to 2005

Eur J Ageing

Change in disability-free life expectancy for Americans 70-years-old and older

Demography

Health and functioning among baby boomers approaching 60

J Gerontol B Psychol Sci Soc Sci

Original Study
Has the Prevalence of Disability Increased Over the Past Decade (2000–2007) in Elderly People? A Spanish Population-based Survey