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Losing the Ability in Activities of Daily Living in the Oldest Old: A Hierarchic Disability Scale from the Newcastle 85+ Study

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  • Andrew Kingston
  • Joanna Collerton
  • Karen Davies
  • John Bond
  • Louise Robinson
  • Carol Jagger

Abstract

Objectives: To investigate the order in which 85 year olds develop difficulty in performing a wide range of daily activities covering basic personal care, household care and mobility. Design: Cross-sectional analysis of baseline data from a cohort study. Setting: Newcastle upon Tyne and North Tyneside, UK. Participants: Individuals born in 1921, registered with participating general practices. Measurements: Detailed health assessment including 17 activities of daily living related to basic personal care, household care and mobility. Questions were of the form ‘Can you …’ rather than ‘Do you…’ Principal Component Analysis (PCA) was used to confirm a single underlying dimension for the items and Mokken Scaling was used to determine a subsequent hierarchy. Validity of the hierarchical scale was assessed by its associations with known predictors of disability. Results: 839 people within the Newcastle 85+ study for whom complete information was available on self-reported Activities of Daily Living (ADL). PCA confirmed a single underlying dimension; Mokken scaling confirmed a hierarchic scale where ‘Cutting toenails’ was the first item with which participants had difficulty and ‘feeding’ the last. The ordering of loss differed between men and women. Difficulty with ‘shopping’ and ‘heavy housework’ were reported earlier by women whilst men reported ‘walking 400 yards’ earlier. Items formed clusters corresponding to strength, balance, lower and upper body involvement and domains specifically required for balance and upper/lower limb functional integrity. Conclusion: This comprehensive investigation of ordering of ability in activities in 85 year olds will inform researchers and practitioners assessing older people for onset of disability and subsequent care needs.

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  • Andrew Kingston & Joanna Collerton & Karen Davies & John Bond & Louise Robinson & Carol Jagger, 2012. "Losing the Ability in Activities of Daily Living in the Oldest Old: A Hierarchic Disability Scale from the Newcastle 85+ Study," PLOS ONE, Public Library of Science, vol. 7(2), pages 1-7, February.
    • Handle: RePEc:plo:pone00:0031665
    DOI: 10.1371/journal.pone.0031665
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    1. Takuhiro Okabe & Makoto Suzuki & Naoki Iso & Koji Tanaka & Akira Sagari & Hironori Miyata & Gwanghee Han & Michio Maruta & Takayuki Tabira & Masahiro Kawagoe, 2021. "Long-Term Changes in Older Adults’ Independence Levels for Performing Activities of Daily Living in Care Settings: A Nine-Year Follow-Up Study," IJERPH, MDPI, vol. 18(18), pages 1-13, September.
    2. Natalia Wołoszyn & Joanna Grzegorczyk & Agnieszka Wiśniowska-Szurlej & Justyna Kilian & Andrzej Kwolek, 2020. "Psychophysical Health Factors and Its Correlations in Elderly Wheelchair Users Who Live in Nursing Homes," IJERPH, MDPI, vol. 17(5), pages 1-16, March.
    3. Elizabeth G Wloch & Diana Kuh & Rachel Cooper, 2016. "Is the Hierarchy of Loss in Functional Ability Evident in Midlife? Findings from a British Birth Cohort," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-13, May.
    4. Kofi Awuviry-Newton & Kylie Wales & Meredith Tavener & Julie Byles, 2020. "Do factors across the World Health Organisation's International Classification of Functioning, Disability and Health framework relate to caregiver availability for community-dwelling older adults in G," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-15, May.
    5. Bo Hu & Javiera Cartagena-Farias & Nicola Brimblecombe, 2022. "Functional disability and utilisation of long-term care in the older population in England: a dual trajectory analysis," European Journal of Ageing, Springer, vol. 19(4), pages 1363-1373, December.

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