4.5 Article

Functional Limitations, Social Integration, and Daily Activities in Late Life

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/geronb/gbab014

Keywords

Disability; Disablement process model; Ecological momentary assessments; Functional impairments

Funding

  1. National Institute on Aging (NIA) [R01AG046460, P30AG066614]
  2. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [P2CHD042849]

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The study suggests that functional limitations in community-dwelling older adults are associated with patterns of activity that may lead to further limitations, disability, or loss of autonomy. Longitudinal follow-up is needed to establish subsequent patterns of decline or stability.
Objectives: Disability in late life has been associated with increases in receiving care and loss of autonomy. The Disablement Process Model suggests that physical impairments lead to functional limitations that contribute to disabilities in managing household, job, or other demands. Yet, we know surprisingly little about how functional limitations are related to activities throughout the day among community-dwelling adults or the possible moderating role of social integration on these associations. Methods: Community-dwelling adults (N = 313) aged 65 and older completed a baseline interview assessing their functional limitations, social ties, and background characteristics. Over 5-6 days, they answered questions about daily activities and encounters with social partners every 3 h on handheld Android devices. Results: Multilevel logistic models revealed that functional limitations are associated with an increased likelihood of activities associated with poor health (e.g., TV watching, medical appointments) and reduced likelihood of social activities, or physical activities, chores, or leaving the home. Most moderation analyses were not significant; family and friends did not mitigate associations between functional limitations and daily activities, with the exception of medical appointments. Individuals with functional limitations were more likely to attend medical appointments when with their social partners than when alone. Discussion: This study provided a modest indication that functional limitations in community-dwelling older adults are associated with patterns of activity that may lead to further limitations, disability, or loss of autonomy. Findings warrant longitudinal follow-up to establish subsequent patterns of decline or stability.

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