Has the prevalence of disability increased over the past decade (2000-2007) in elderly people? A Spanish population-based survey

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.