The Prevalence and Correlates of Activity Limitations Among the Elderly in Informal Caregiving Settings in Colombo District, Sri Lanka: A Community Based Cross-Sectional Study.

Background: Limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) reduce the independence of the elderly and compromise the quality of life. Objective: This study examined the prevalence and factors affecting the ADL and IADL limitations of elderly. Methods: In this community based cross-sectional study, a representative sample (n=723) of elderly aged >65 years was obtained by multi-stage cluster sampling. ADL and IADL were assessed using validated Sinhala versions of 10-item Barthel Index and Lawton IADL scales respectively. Simple and multiple logistic regression analyses were conducted to find the factors associated with ADL/IADL limitations. Results: Mean±SD age was 72.23±6.3 years. Mean±SD ADL and IADL scores were 94.42±17.08 (out of 100) and 6.58±2.3 (out of 8) respectively. Of the elderly, 16.9% and 39.4% had more than one ADL and IADL limitations respectively. Out of the ADL limited elderly, 91.8% had IADL limitations. Most of the ADL (80.3%) and IADL (76.5%) limited elderly had more than one chronic disease. Age (75-84 years odds ratio [OR]=3.03, p<0.001; >85 years OR=3.80, p<0.001), male gender (OR=1.79, p<0.05), history of a stroke (OR=6.12, p<0.001) and arthritis (OR=1.96, p>0.05) showed significant positive associations with ADL limitations in adjusted model. IADL limitations positively associated with age (75-84 years OR=2.91, p<0.001; >85 years OR=3.93, p<0.001), having more than one disease condition (OR=1.67, p<0.05) and history of a stroke (OR=5.53, p<0.001) in the adjusted model. Conclusion: The mean scores for ADL and IADL are high in this sample indicating a low disability level. Almost all elderly with ADL limitations also had IADL limitations. The odds of having ADL and IADL were greatest for the elderly who are over 75 years and has had a stroke. It is recommended that comorbidities are managed optimally in order to minimize activity limitations among elderly in informal caregiving settings. [ABSTRACT FROM AUTHOR]