ADL dependence in the elderly population living in the community: the influence of functional limitations and physical environmental demand

Empirical research elucidating the relationships between aspects of functional competence and environmental factors is lacking. This study aimed to analyse how functional limitations in the individual and housing accessibility problems influence ADL dependence in the elderly population, and to test Lawton's docility hypothesis. Data were collected from 133 Swedish subjects aged 75–84, who were living in the community. The main finding was that dependence in ADL correlated highly significantly with housing accessibility problems. The results also revealed significantly more ADL disability in the group of respondents in whom the heaviest environmental demands were identified, supporting the docility hypothesis. Although the study had limitations because the data required the use of non-parametric statistics, so restricting possible interpretations of the effects of geriatric comorbidity, the results indicated that interventions such as housing adaptations ought to be most effective with frail individuals. To promote independence in the general population, society has to work towards more accessible housing. More research is needed considering more environmental dimensions and elderly people's subjective apprehension of their housing environment. (Less)

[1]  A M Jette,et al.  Musculoskeletal impairments and physical disablement among the aged. , 1990, Journal of gerontology.

[2]  S. Iwarsson,et al.  Housing standards, environmental barriers in the home, and subjective general apprehension of housing situation among the rural elderly. , 1996 .

[3]  J. Guralnik,et al.  Predictors of healthy aging: prospective evidence from the Alameda County study. , 1989, American journal of public health.

[4]  P. L. Fox.  Environmental modifications in the homes of elderly Canadians with disabilities. , 1995, Disability and rehabilitation.

[5]  S. Iwarsson,et al.  Basic accessibility in modern housing--a key to the problems of care in the domestic setting. , 1993, Scandinavian journal of caring sciences.

[6]  U. Sonn,et al.  Assessment of activities of daily living in the elderly. A study of a population of 76-year-olds in Gothenburg, Sweden. , 2020, Scandinavian journal of rehabilitation medicine.

[7]  A M Jette,et al.  Functional limitations and disability among elders in the Framingham Study. , 1992, American journal of public health.

[8]  J. Kiernat.  ENVIRONMENT:: THE HIDDEN MODALITY , 1982 .

[9]  E. Badley.  The genesis of handicap: definition, models of disablement, and role of external factors. , 1995, Disability and rehabilitation.

[10]  M. Powell Lawton,et al.  Environment and aging , 1980 .

[11]  T. Stengel.  INFANT BEHAVIOR, MATERNAL PSYCHOLOGICAL REACTION, AND MOTHER-INFANT INTERACTIONAL ISSUES ASSOCIATED WITH THE CRISIS OR PREMATURITY: , 1982 .

[12]  Susanne Iwarsson,et al.  Development of a Novel Instrument for Occupational Therapy of Assessment of the Physical Environment in the Home—A Methodologic Study on “The Enabler” , 1996 .

[13]  P. Fougeyrollas,et al.  Documenting environmental factors for preventing the handicap creation process: Quebec contributions relating to ICIDH and social participation of people with functional differences. , 1995, Disability and rehabilitation.

[14]  U. Sonn,et al.  Instrumental activities of daily living related to impairments and functional limitations in 70-year-olds and changes between 70 and 76 years of age. , 1995, Scandinavian journal of rehabilitation medicine.

[15]  J. Potter,et al.  Predictors of mortality in outpatient geriatric evaluation and management clinic patients. , 1994, Journal of gerontology.

[16]  R. L. Kane,et al.  Developing a New Metric for ADLs , 1995, Journal of the American Geriatrics Society.

[17]  Housing conditions of elderly people in a city. The Albertina Project. , 1994, Scandinavian journal of primary health care.

[18]  S. Katz,et al.  STUDIES OF ILLNESS IN THE AGED. THE INDEX OF ADL: A STANDARDIZED MEASURE OF BIOLOGICAL AND PSYCHOSOCIAL FUNCTION. , 1963, JAMA.

[19]  R. Hagedorn.  Occupational Therapy: Foundations for Practice : Models, Frames of Reference and Core Skills , 1991 .

[20]  M. Law,et al.  Person-environment assessments in occupational therapy. , 1994, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[21]  A. Wister,et al.  Environmental Adaptation by Persons in their Later Life , 1989, Research on aging.

[22]  On Scaling Methodology and Environmental Influences in Disability Assessments: The Cumulative Structure of Personal and Instrumental ADL among Older Adults in a Swedish Rural District , 1997 .

[23]  Environmental influences on the cumulative structure of instrumental ADL: an example in osteoporosis patients in a Swedish rural district , 1998, Clinical rehabilitation.

[24]  R. Zimmerman,et al.  Environmental Adjustments to Declining Functional Ability , 1991 .

[25]  A. Campbell,et al.  Disease, impairment, disability and social handicap: a community based study of people aged 70 years and over. , 1994, Disability and rehabilitation.

[26]  F. Clark,et al.  Occupational Science: The Evolving Discipline , 1996 .

[27]  M. Fine,et al.  Disability Beyond Stigma: Social Interaction, Discrimination, and Activism , 1988 .

[28]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[29]  L. Nordenfelt.  On the notions of disability and handicap , 1993 .