Research Paper
Trajectories of limitations in activities of daily living among older adults in Mexico, 2001–2012

https://doi.org/10.1016/j.dhjo.2016.01.011Get rights and content

Abstract

Background

Trajectories of disability are an essential component to understand the burden of disability at the societal level. Longitudinal studies, compared to cross-national studies, enable a better analysis of the progression of physical limitations among the elderly. However, information on disability dynamics in developing countries is limited.

Objectives

This paper examines the changes in activities of daily living (ADLs) in an 11-yr. period in the Mexican elderly population aged 60 or older and identifies how sociodemographic variables alter these trajectories.

Methods

The data come from the Mexican Health and Aging Study (MHAS), a national sample of adults born in 1951 or earlier, including a baseline survey in 2001 and follow-ups in 2003 and 2012.

Results

The ADL score increased on average by 0.03 for every year respondents aged after 60. In contrast, the ADL score was reduced by 0.06 for every additional year of education.

Conclusions

Age, gender, and years of education were confirmed to influence the trajectories of ADL limitations. Understanding the patterns of deterioration of functional limitations will help public health policies to better serve the population.

Section snippets

Sample

Data come from the Mexican Health and Aging Study (MHAS), a nationally representative study of health and aging in Mexicans born in 1951 or earlier. Participants were first interviewed in 2001 in a stratified sample representative of the national population (response rate of 92%) with follow-ups in 2003 (response rate of 93%) and 2012 (response rate of 88%). The database provides detailed health characteristics such as limitations with ADLs and IADLs, cognition, depression, and mobility.27, 28,

Results

At baseline, 7.1% of respondents aged 60 or older had limitations in one ADL, 2.4% had limitations in two ADLs, and 3.2% had limitations in three or more ADLs (results not shown). Dressing represents the most prevalent activity that respondents cannot do by themselves. At baseline, 9.2% of our sample reported needing help getting dressed and by 2012 this number increased to 16.2%. Transferring in and out of bed is the second most prevalent ADL. In 2001, 8.0% reported having difficulties and

Discussion

ADLs are commonly used as a tool to evaluate the health status of older adults and, difficulties with ADLs can also be a predictor of quality of life. Traditionally, studies measuring ADL disability tended to focus on a specific limitation or the effect of these limitations on several diseases or on the risk of mortality. Respondents are usually classified as disabled or not.44 In addition, most of these studies were done in the context of a developed country where socioeconomic inequalities

Conclusions

Aging and physical disability have a magnified impact in a developing country like Mexico. First, the population is aging rapidly in a very short period of time.52 Second, income inequalities combined with infectious and parasitic diseases as well as chronic and degenerative diseases53 cause social exclusion of some segments of the population, particularly those living in rural areas which can lead to limited access to health care services.54 Third, economic and institutional infrastructure and

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    Funding: This work was supported in part by the National Institute on Aging at the National Institutes of Health (grant R01 AG018016) and by the Advanced Rehabilitation Research Training Program at the National Institute on Disability and Rehabilitation Research (postdoctoral training grant H133P110012)

    Conflicts of interest: None.

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