Abstract
Background Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences. Methods We use data from the Asset and Health Dynamics of the Oldest Old (n = 1607) and Chinese Longitudinal Healthy Longevity Survey (n = 5570) for years 1998–2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods. Results Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach's alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time. Conclusions The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China.
| Original language | English |
|---|---|
| Pages (from-to) | 123-127 |
| Number of pages | 5 |
| Journal | Archives of Gerontology and Geriatrics |
| Volume | 74 |
| DOIs | |
| Publication status | Published - 1 Jan 2018 |
Keywords
- ADL scales
- Disability
- Functional loss
- Oldest-old
- Population aging
Cite this
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Comparing the loss of functional independence of older adults in the U.S. and China. / Fong, Joelle H.; Feng, Jun.
In: Archives of Gerontology and Geriatrics, Vol. 74, 01.01.2018, p. 123-127.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Comparing the loss of functional independence of older adults in the U.S. and China
AU - Fong, Joelle H.
AU - Feng, Jun
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences. Methods We use data from the Asset and Health Dynamics of the Oldest Old (n = 1607) and Chinese Longitudinal Healthy Longevity Survey (n = 5570) for years 1998–2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods. Results Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach's alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time. Conclusions The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China.
AB - Background Functional loss among older adults is known to follow a hierarchical sequence, but little is known about whether such sequences differ across socio-cultural contexts. The aim of this study is to construct activities of daily livings (ADL) scales for oldest-old adults in the United States and China so as to compare their functional loss sequences. Methods We use data from the Asset and Health Dynamics of the Oldest Old (n = 1607) and Chinese Longitudinal Healthy Longevity Survey (n = 5570) for years 1998–2008. ADL items are calibrated within a scale using the Rasch measurement model. Rasch scores are averaged across survey waves to identify the ADL loss sequence for each study population. We also assess scale stability over measurement periods. Results Factor analyses confirm that the ADL items in each study population can be combined meaningfully to form a hierarchical sequence. Internal consistency assessed by Cronbach's alpha is high (0.81 to 0.95). We find that bathing is the first activity that both older Americans and Chinese have difficulty with, while eating is the last activity. There are, however, differences in the rank order for toileting (ranked more challenging in the Chinese sample) and dressing (ranked more challenging in the U.S. sample). Item orderings are stable over time. Conclusions The results highlight the relative importance of bathing in the functional loss sequence for older adults, regardless of socio-cultural context. Health interventions are needed to address deficits in the bathroom environment, especially in developing countries like China.
KW - ADL scales
KW - Disability
KW - Functional loss
KW - Oldest-old
KW - Population aging
UR - http://www.scopus.com/inward/record.url?scp=85032507884&partnerID=8YFLogxK
U2 - 10.1016/j.archger.2017.10.020
DO - 10.1016/j.archger.2017.10.020
M3 - Article
VL - 74
SP - 123
EP - 127
JO - Archives of Gerontology and Geriatrics
JF - Archives of Gerontology and Geriatrics
SN - 0167-4943
ER -