Predictors of Dependency in Instrumental Activities of Daily Living Among Community Dwelling Elderly in A Rural Field Practice Area of a Tertiary Care Hospital in Chengalpattu District, Tamilnadu, India- A Cross Sectional Study

Lavanya M; Pradeep  MVM; Aamina  Hussain; Anantharaman VV; Logaraj M

doi:10.55489/njcm.160120254791

Authors

Lavanya M Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRMIST, Tamil Nadu, India
Pradeep MVM Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRMIST, Tamil Nadu, India
Aamina Hussain Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRMIST, Tamil Nadu, India
Anantharaman VV Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRMIST, Tamil Nadu, India
Logaraj M Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRMIST, Tamil Nadu, India

DOI:

https://doi.org/10.55489/njcm.160120254791

Keywords:

Elderly, Lawton, IADL, Tamilnadu, India

Abstract

Background: Longer lifespans of elderly are associated with chronic illnesses that impair functioning, making it harder to carry out daily activities and making assistance necessary. The aim was to estimate the prevalence of dependence in Instrumental Activities of Daily Living (IADL) among elderly and to determine its sociodemographic and health related predictors.

Methodology: This cross-sectional study was conducted among elderly in Chengalpattu district from December 2023 to May 2024. Sample size was determined by multistage random sampling. A semi-structured questionnaire consisting of sociodemographic details and Lawton scale to assess dependence were used to collect data. Data was entered in Ms Excel and analysed using SPSS version 26.

Results: Mean age of participants was 67.4 ± 7.4 years. 131 (43.7%) of them were at risk of malnutrition and 83 (27.7%) were malnourished. Majority (n=178,59.3%) experienced increased IADL dependency. Binary logistic regression analysis showed increasing age, lower socioeconomic status, Divorced/Widowed/Unmarried, smoking and tobacco use, hospitalizations within previous year were significant predictors of IADL dependency.

Conclusions: The study concluded that a considerable proportion of our study population was suffering from IADL dependency (59.3%), with majority demonstrating mild to moderate degree of dependency. To prevent disease in its early stages, arrangements can be made for community-based extensive geriatric health assessments.

References

World Health Organization. Ageing [Internet]. World Health Organization. 2021. Available from: https://www.who.int/health-topics/ageing#tab=tab_1

Robine JM, Cubaynes S. Worldwide demography of centenarians. Mechanisms of Ageing and Development. 2017 Jul;165:59-67. DOI: https://doi.org/10.1016/j.mad.2017.03.004 PMid:28315698

Mishra V. India's Projected Aged Population (65+), Projected Life Expectancy at Birth and Insecurities Faced by Aged Population. Ageing Int. 2020 Mar;45(1):72-84. DOI: https://doi.org/10.1007/s12126-019-09350-0

Chauhan S, Arokiasamy P. India's demographic dividend: state-wise perspective. Journal of Social and Economic Development. 2018 Apr;20(1):1-23. DOI: https://doi.org/10.1007/s40847-018-0061-7

Agarwal A, Lubet A, Mitgang E, Mohanty S, Bloom DE. Population Aging in India: Facts, Issues, and Options. SSRN Electronic Journal. 2016; DOI: https://doi.org/10.2139/ssrn.2834212

Phelan EA, Williams B, Penninx BWJH, LoGerfo JP, Leveille SG. Activities of Daily Living Function and Disability in Older Adults in a Randomized Trial of the Health Enhancement Program. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2004 Aug 1;59(8):M838-M843. DOI: https://doi.org/10.1093/gerona/59.8.M838 PMid:15345735

Arokiasamy P, Uttamacharya U, Jain K, Biritwum RB, Yawson AE, Wu F, et al. The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC Medicine. 2015 Aug 3;13(1). DOI: https://doi.org/10.1186/s12916-015-0402-8 PMid:26239481 PMCid:PMC4524360

Baltes MM, Mayr U, Borchelt M, Maas I, Wilms HU. Everyday Competence in Old and Very Old Age: An Inter-disciplinary Perspective. Ageing and Society. 1993 Dec;13(4):657-80. DOI: https://doi.org/10.1017/S0144686X00001392

Luiz Roberto Ramos, Monica Rodrigues Perracini, Etsuko, Kalache A. Significance and management of disability among urban elderly residents in Brazil. 1993 Oct 1;8(4):313-23. DOI: https://doi.org/10.1007/BF00972560 PMid:24389964

Environment UN. Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030 [Internet]. UNEP - UN Environment Programme. 2016. Available from: https://www.unep.org/resources/report/global-nutrition-report-2016-promise-impact-ending-malnutrition-2030

Kaiser MJ, Bauer JM, Rämsch C, Uter W, Guigoz Y, Cederholm T, et al. Frequency of Malnutrition in Older Adults: A Multinational Perspective Using the Mini Nutritional Assessment. Journal of the American Geriatrics Society. 2010 Sep;58(9):1734-8. DOI: https://doi.org/10.1111/j.1532-5415.2010.03016.x PMid:20863332

Gokhale D, Garg R, George RM. Assessing the link between nutritional status, functional capacity, and morbidity profile in the community-dwelling elderly of Maharashtra, India. International Journal of Africa Nursing Sciences. 2023 Dec 30;20:100654-4. DOI: https://doi.org/10.1016/j.ijans.2023.100654

Ng TP, Niti M, Chiam PC, Kua EH. Prevalence and Correlates of Functional Disability in Multiethnic Elderly Singaporeans. Journal of the American Geriatrics Society. 2006 Jan;54(1):21-9. DOI: https://doi.org/10.1111/j.1532-5415.2005.00533.x PMid:16420194

Taş Ü, Verhagen AP, Bierma-Zeinstra SMA, Hofman A, Odding E, Pols HAP, et al. Incidence and risk factors of disability in the elderly: The Rotterdam Study. Preventive Medicine. 2007 Mar;44(3):272-8. DOI: https://doi.org/10.1016/j.ypmed.2006.11.007 PMid:17184831

Yoshida D, Ninomiya T, Doi Y, Hata J, Fukuhara M, Ikeda F, et al. Prevalence and Causes of Functional Disability in an Elderly General Population of Japanese: The Hisayama Study. Journal of Epidemiology. 2012;22(3):222-9. DOI: https://doi.org/10.2188/jea.JE20110083 PMid:22343328 PMCid:PMC3798623

Gupta S, Gupta P, Mani K, Rai S, Nongkynrih B. Functional disability among elderly persons in a rural area of Haryana. Indian Journal of Public Health. 2014;58(1):11. DOI: https://doi.org/10.4103/0019-557X.128155 PMid:24748351

Veerapu N, A. P, P. S, G. A. Functional dependence among elderly people in a rural community of Andhra Pradesh, South India. International Journal of Community Medicine and Public Health. 2016;1835-40. DOI: https://doi.org/10.18203/2394-6040.ijcmph20162051

Nutrition Screening as easy as MNA. A guide to completing the Mini Nutritional Assessment (MNA®) Screen and intervene. Nutrition can make a difference. 2 Mini Nutritional Assessment (MNA®) [Internet]. Available from: https://www.mna-elderly.com/sites/default/files/2021-10/mna-guide-english.pdf

Graf C. The lawton instrumental activities of daily living (IADL) scale [Internet]. 2007. Available from: https://www.alz.org/careplanning/downloads/lawton-iadl.pdf

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country. BMC Public Health. 2010 Aug 18;10(1). DOI: https://doi.org/10.1186/1471-2458-10-492 PMid:20716377 PMCid:PMC2933720

Gudjonsson MC, Michelet M, Strand BH. CHARACTERISTICS OF NORWEGIAN OLDER ADULTS LIVING ALONE OVER THREE DECADES (1995-2019). Innovation in Aging. 2022 Nov 1;6(Supplement_1):720-0. DOI: https://doi.org/10.1093/geroni/igac059.2627

León-Muñoz LM, Guallar-Castillón P, García-Esquinas E, Galán I, Rodríguez-Artalejo F. Alcohol drinking patterns and risk of functional limitations in two cohorts of older adults. Clinical Nutrition. 2017 Jun;36(3):831-8. DOI: https://doi.org/10.1016/j.clnu.2016.05.005 PMid:27256558

Nykänen I, Lönnroos E, Kautiainen H, Sulkava R, Hartikainen S. Nutritional screening in a population-based cohort of community-dwelling older people. European Journal of Public Health. 2012 Apr 25;23(3):405-9. DOI: https://doi.org/10.1093/eurpub/cks026 PMid:22539629

Park JH, Hwang HY, Chun YE. Factors Associaated with Nutritional Risk in the Elderly: Focusing on ADL/IADL. Asia-pacific Journal of Convergent Research Interchange. 2023 Nov 29;9(11):549-62. DOI: https://doi.org/10.47116/apjcri.2023.11.42

Zuccolo PF, Ávila R, Nakano EY, Litvoc J, Lopes MA, Bottino CMC. P2‐159: Instrumental activities of daily living in a sample of healthy nondemented Brazilian elderly and its relation to social‐demographic variables. Alzheimer's & Dementia. 2010 Jul;6(4S_Part_12). DOI: https://doi.org/10.1016/j.jalz.2010.05.1207

Murat MF, Ibrahim Z, Adznam SN 'Asyura, Chan YM. Prevalence and determinants of Instrumental Activities of Daily Living (IADL) disability among communitydwelling elderly in a semi-urban setting in Peninsular Malaysia. Malaysian Journal of Nutrition. 2019 Mar 29;25(1):13-25. DOI: https://doi.org/10.31246/mjn-2018-0142

Hayakawa T, Okamura T, Okayama A, Kanda H, Watanabe M, Kita Y, et al. Relationship between 5-year decline in instrumental activity of daily living and accumulation of cardiovascular risk factors: NIPPON DATA90. Journal of Atherosclerosis and Thrombosis [Internet]. 2010 Feb 1 [cited 2021 May 1];17(1):64-72. DOI: https://doi.org/10.5551/jat.1727 PMid:20081323

Zisberg A, Sinoff G, Agmon M, Tonkikh O, Gur-Yaish N, Shadmi E. Even a small change can make a big difference: the case of in-hospital cognitive decline and new IADL dependency. Age and Ageing. 2016 Apr 15;45(4):500-4. DOI: https://doi.org/10.1093/ageing/afw063 PMid:27085179