Risk factors for activity of daily living-disability in the elderly living in 5 cities of China
Received:September 04, 2017  Revised:October 12, 2017
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DOI:10.11915/j.issn.1671-5403.2017.12.206
Key words:aged  case-control study  disability  mini-nutritional assessment short form
Author NameAffiliationE-mail
JING Xiao-Fan Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu 610041, China  
SUN Jian-Qin Department of Clinical Nutrition, Huadong Hospital, Fudan University, Shanghai 200040, China  
LIU Yuan Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu 610041, China  
CHEN Wei Department of Enteral and Parenteral Nutrition, Peking Union Medical College Hospital, Beijing 100730, China  
LI Ming Department of Nutrition and Food Hygiene, West China Public Health School, Sichuan University, Chengdu 610041, China  
MO Bao-Qing Department of Nutrition and Food Hygiene, School of Public Health, Nanjing Medical University, Nanjing 211166, China  
WAN Xue-Mei Jinyang Health Service Center, Chengdu 610045, China  
HUANG Cheng-Yu Department of Nutrition and Food Hygiene, West China Public Health School, Sichuan University, Chengdu 610041, China hcynuph@163.com 
YANG Min Research Center for WesternRural Health Development, Chengdu 610041, China  
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Abstract:
      Objective To investigate the influencing factors for activity of daily living (ADL)-disability in the elderly. MethodsA case-control study was performed on the elderly subjects (over 65 years old) who came from nursing homes, community health centers and general hospitals in Beijing, Shanghai, Guangzhou, Chengdu, and Chongqing. Face-to-face questionnaires and physical examinations were conducted on the participants to survey their DLA, health and nutritional statuses. ADL-Barthel index and mini-nutritional assessment short form (MNA-SF) were used for assessment of disability and nutritional status. SPSS statistics 16.0 was used to perform the statistical analysis. Chi-square test was employed for intragroup comparison, and multivariate logistic regression analysis was adopted for the influencing factors for ADL-disability. Results A total of 4929 subjects were finally enrolled in this study, and according to disability condition, they were assigned into case group (<20 points, n=379) and control group (≥60 points,n=4450). Significant discrepancies were found in age, city, institution, and comorbidities (cardiovascular and cerebrovascular diseases, digestive diseases, respiratory diseases, urinary diseases, and skeletal diseases) between the 2 groups (P<0.05). There were obvious differences in consciousness, breath, temperature, edema, mocous membrane, skin elasticity, chewing ability and tooth (P<0.05). Among the all participants, 50.90% (2509/4929) were at adequate nutritional status, 33.66% (1659/4929) at risk of malnutrition, and 15.44% (761/4929) in malnutrition. Notable differences were also seen in the nutritional status between the 2 groups (P<0.001). Multivariate logistic regression analysis showed that mental and nervous diseases (OR=3.41), poor masticatory function (OR=2.03), cardiovascular diseases (OR=1.87), over 90 years old (OR=1.84) and urinary diseases (OR=1.55) were risk factors for ADL-disability, while adequate nutritional status (OR=0.73) and digestive diseases (OR=0.51) were the protective factors. Conclusion The elderly over 90 years old, with poor masticatory function, and suffering from mental and nervous diseases, cardiovascular diseases and urinary diseases are prone to ADL-disability.
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