Comparing the loss of functional independence of older adults in the U.S. and China

Joelle H. Fong, Jun Feng

Research output: Contribution to journalArticleResearchpeer-review

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.

LanguageEnglish
Pages123-127
Number of pages5
JournalArchives of Gerontology and Geriatrics
Volume74
DOIs
StatePublished - 1 Jan 2018

Keywords

  • ADL scales
  • Disability
  • Functional loss
  • Oldest-old
  • Population aging

Cite this

@article{2b35dc60612b426792feee7d681aefb2,
title = "Comparing the loss of functional independence of older adults in the U.S. and China",
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.",
keywords = "ADL scales, Disability, Functional loss, Oldest-old, Population aging",
author = "Fong, {Joelle H.} and Jun Feng",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.archger.2017.10.020",
language = "English",
volume = "74",
pages = "123--127",
journal = "Archives of Gerontology and Geriatrics",
issn = "0167-4943",
publisher = "Elsevier",

}

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 journalArticleResearchpeer-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

T2 - Archives of Gerontology and Geriatrics

JF - Archives of Gerontology and Geriatrics

SN - 0167-4943

ER -