Time trends in and the determinants of disability among elderly Taiwanese, 1994-2004
This longitudinal study was conducted between 1994 and 2004 in a cohort of southern Taiwan community-living elderly residents. This study aims to investigate the longitudinal change in disability, by using a ten-year longitudinal data set with six set cross-sectional data to exam-ine the trends of disability and the determinants. Disability was assessed using the Physical Activities of Daily Living (7PADLs) and Instrumental Activities of Daily Living (7IADLs) scales. Socio-demographic factors; socioeconomic factors; living arrangements; lifestyle behaviours and health status were chosen as the predictors of each specific disability. eneralized estimating equation (GEE) regression models were used to analyse longitudinal data on variation in disability change over time and its determinants across the same cohort. The study showed great increase in the development of disability. Especially, the PADL disabilities increased even more than IADL disabilities. The study highlighted that respondents who were older female from low SES, being single, divorced or widowed, did not exercise regularly and poor health status, especially due to hypertension, diabetes, gastrointestinal problems and depression, were at a higher risk of being disabled. It was interesting to note the moderate/severe disability (PADL) increased even more persistent than mild disability (IADL). It seems likely that chronic diseases are of cen-tral significance of most disabilities, while depression is observed as the most significant risk factor for IADL disability only. Effort to lower the trends of disability in the elderly should target the risk factors that identified in this study, and have better management of the persistent disability.