Dahalan, Latifah and Ismail, Ab. Aziz Al-Safi and Ag. Mat, Hamzah
(2004)
The epidemiology of physical disability among elderly in Kota Bharu, Kelantan.
The epidemiology of physical disability among elderly in Kota Bharu, Kelantan.
(Submitted)
Abstract
Globally, the decline in fertility and mortality as well as improvement in life
expectancy ·were said to be responsible for the aging population by the year 2020. In
Malaysia, the elderly population was 1.2 million or 5. 9% of the 20 million total population
in the country in 1995. This number was projected to increase to 11.3% by the year 2020.
Elderly population are prone to get physical disability as well as chronic medical illnesses.
This is a cross-sectional study to determine the prevalence of physical disability and its
associated risk factors among elderly, aged 60 years and above. A total of 270 participants
were taken randomly under 3 health clinics under Kota Bharu oper~tional !areas by using
multistage sampling. Guided- questionnaire were administered and the subjects were asked
to go to clinics or community centre on the appointed date for physical e~amination and
blood taking for fasting blood sugar and total cholesterol. Physical disability was measured
by activities of daily,living ( ADLs) and instrumental's activities of ~aily living ( IADLs).
ADLs is comprise of bathing, dressing, going to toilet, transferring from bed or chair,
continence, and feeding. Whereas IADLs encotnpass the following domestic function :
using the telephone, using transportation, shopping, cooking, house-keeping, taking
medication and budgeting. The IADLs methods offer indicators of" applied " problem that
extend the disability theme of ADLs scales to include some elements of handicap concept.Physical disability was defined as the inability to accomplish one or more ADLs or IADLs.Separate multiple logistic regression was used to determine the risk factors for both
physical disabilities. The prevalence of physical disabilities in ADLs and IADLs were
10.7% ( 95% CI: 7, 14) and 34.8% ( 95% CI: 29, 41) respectively. Significant risk
factors of ADLs were age (OR=2.669, 95%CI: 1.1 07, 6.643), hearing impairment (OR=
. 2.539, 95%CI: 1.034,6.233), diastolic blood pressure (OR= 3.803, 95%CI:1.249, 11.578),
and total cholesterol (OR= 1.535, 95%CI: 1.071, 2.200).Wherea~ for IADL were age
(OR=2.391, 95%CI: 1.185,4.827), income (OR= 0.219, 95%CI:0.078, 0.615),diastolic
blood pressure (OR=2.023, 95°/oCI: 1.038,3.941 ), marital status (OR=2.378,
95%CI:1.227,4.609 ) and obesity (OR=4.679,95%CI:l.544, 14.182). There was a strong
significant association between ADLs and IADLs (OR=9.012, 95%CI:3.400, 23.887). The
prevalence of physical disability for ADLs and IADLs were 10.7% and 34.8% respectively
and it was similar with others studies. These findings also suggested that certain sociodemographic
characteristics ( i.e age, income & marital status ), life-style behavior
( obesity) and medical illnesses (hearing impainnent, total blood cholesterol and high
diastolic blood pressure) were significant risk factors of physical' disability in elderly.
Physical disability in ADLs was a strong predictor for physical disability· in IADL. The
majority of predictors of physical disability that were identified by this study are
potentially subject to modification either by treatment, life-style change or special device.
Public health efforts to reduce prevalence of all these factors in both sexes should continue.
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