4.4 Article

Functional Capacity and Difficulties in Activities of Daily Living From a Cross-National Perspective

Journal

JOURNAL OF AGING AND HEALTH
Volume 35, Issue 5-6, Pages 356-369

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/08982643221128929

Keywords

aging; disability; health; cognitive function; physical function

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This study investigated the predictive role of physical and cognitive functioning on developing difficulties in daily activities, and whether country-level factors moderated these associations. The results showed that higher grip strength was associated with a lower risk of developing limitations in both basic and instrumental activities. Similar associations were found for peak flow, word recall, and temporal orientation. These associations were generally strong and significant across most countries, with some variations in countries with lower GDP and service coverage.
Objectives: This study investigated whether physical and cognitive functioning predicts developing difficulties in basic or instrumental activities of daily living (ADL/IADL), and whether country-level factors moderated the associations. Methods: 69,227 adults aged 50+ from 19 countries were followed for up to 14 years. Cox regression and meta-regression analyses were used. Results: Higher grip strength was associated with a 45% lower risk of developing ADL limitations and a 47% lower risk of IADL limitations. The corresponding values were 22% and 23% for peak flow, 20% and 23% for word recall, and 20% and 24% for temporal orientation. The associations were similar and statistically significant in most countries, but some associations were weaker in countries with lower GDP and lower service coverage. Discussion: Good physical and cognitive functional capacity protects from ADL and IADL limitations consistently across Western countries. The associations may be stronger in countries with more resources.

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