An assessment of factors related to disability in ADL and IADL in elderly inhabitants of rural areas of south-eastern Poland
More details
Hide details
Department of Medicine, Institute of Physiotherapy, University of Rzeszow, Poland
Center for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Poland
Corresponding author
Agnieszka Beata Ćwirlej-Sozańska   

Department of Medicine, Institute of Physiotherapy, University of Rzeszow, Rzeszow, Poland, Warszawska 26 A, 35-205 Rzeszów, Poland
Ann Agric Environ Med. 2018;25(3):504-511
Introduction and objective:
Demographic changes in Europe have resulted in anincreased demand for healthcare and social care for the elderly. The aim of this study was to analyze the factors related to disability in ADL and IADL among elderly inhabitants of rural areas of southeastern Poland.

Material and methods:
The study involved 426 subjects aged 71–80 years. To assess their activities of daily living, the Katz ADL Scale was used, and the Lawton IADL Scale was used to assess their instrumental activities in daily living.

The subjects reported at least one problem with IADL (43.19%) more often than with ADL (36.85%). The strongest factors related to difficulties with ADL were assessment of satisfaction with life, using assistive devices, and having one’s home suitably adapted. The strongest factors related to IADL were the assessment of satisfaction with life, education, using assistive devices and performing moderate physical exercise at a minimum of 150 minutes per week.

Age, education, pain, falls, household not fully adapted for one’s needs, using assistive devices, lack of satisfaction with life, and low assessment of quality of life had a significant impact on the prevalence of ADL and/or IADL disabilities in the elderly inhabitants of rural areas. Most of these factors can be subject to modification. They are also a complex of predictors that allow for identifying and supporting those elderly patients from rural areas who are the most vulnerable.

Population structure and ageing. Eurostat. (access: 2017.10.14).
Organistion World Health Organistion. Global health and aging. Geneva:World Health i 2011.
Stuck AE, Beck JC, Egger M. Preventing disability in elderly people. Lancet. 2004; 364(9446): 1641–1642.
Tas U, Verhagen AP, Bierma-Zeinstra SMA, Odding E, Koes BW. Prognostic factors of disability in older people: a systematic review. Br J Gen Pract. 2007; 57(537): 319–323.
Kempen GM, Myers AM, Powell LE. Hierarchical structure in ADL and IADL: Analytical assumptions and applications for clinicians and researchers. J Clin Epidemiol. 1995; 48(11): 1299-1305.
Hung WW, Ross JS, Boockvar KS, Siu AL. Recent trends in chronic disease, impairment and disability among older adults in the United States. BMC Geriatr. 2011; 18(11): 47.
Verropoulou G , Tsimbos C . Disability trends among older adults in ten European countries over 2004–2013, using various indicators and Survey of Health, Ageing and Retirement in Europe (SHARE) data. Ageing & Society. 2016; 31: 1.
Feng Q, Zhen Z, Gu D, Wu B, Duncan PW, Purser JL. Trends in ADL and IADL disability in community-dwelling older adults in Shanghai, China, 1998-2008. J Gerontol B Psychol Sci Soc Sci. 2013; 68(3): 476-85.
Stuck AE, Walthert JM, Nikolaus T, Büla CJ, Hohmann C, Beck JC. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Soc Sci Med. 1999; 48: 445–469.
Taş U, Verhagen AP, Bierma-Zeinstra SM, Hofman A, Odding E, Pols HA, Koes BW. Incidence and risk factors of disability in the elderly: the Rotterdam study. Prev Med. 2007; 44: 272–278.
Tyszka S, Solon-Lipiński M. Stan zdrowia ludności wiejskiej w Polsce. Forum Inicjatyw Rozwojowych Fundacji Europejski Fundusz Rozwoju Wsi Polskiej, Warszawa, 2015.
Błędowski P, Szatur-Jaworska B, Szweda-Lewandowska Z, Kubic P. Raport na temat sytuacji osób starszych w Polsce. Instytut Pracy i Spraw Socjalnych Warszawa, Warszawa, 2012.
Kinsella K, He W. An Aging World: 2008. Washington, DC: National Institute on Aging and U.S. Census Bureau, 2009.
Katz S, Downs TD, Cash HR, Grotz RC. Progress in development of the index of ADL. Gerontologist. 1970; 1: 20-30.
Lawton MP, Brody EM. Assessment of older people: self--maintaining and instrumental of daily living. Gerontologist. 1969; 9: 179-186.
Fries JF. Reducing disability in older age. JAMA. 2002; 288: 3164–3166 .
Coelho T Paul C, Gobbens RJ, Fernandes L. Determinants of frailty: the added value of assessing medication. Front Aging Neurosci. 2015; 7(56): 25954195.
Thompson WW, Zack MM, Krahn GL, Andresen EM, Barile JP. Health-relatedquality of life among older adults with and without functional limitations. Am J Public Health. 2012; 102: 496–502.
Fried LP Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty,and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004; 59(3): 255-263.
Hung WW, Ross JS, Boockvar KS, Siu AL. Recent trends in chronic disease, impairment and disability among older adults in the United States. BMC Geriatrics. 2011; 11: 47.
Banks J, Nazroo J, Steptoe A. The dynamics of ageing: evidence from the English Longitudinal Study of Ageing 2002–12 (Wave 6) 2014. (access: 2017.11.14).
Arokiasamy P, Uttamacharya U, Jain K, Biritwum RB, Yawson AE, Wu F. The impact of multimorbidity on adult physical and mental health in low- and middle-income countries: what does the study on global ageing and adult health (SAGE) reveal? BMC Med. 2015; 13: 178.
Boulos C, Salameh P, Barberger-Gateau P. Malnutrition and frailty in community dwelling older adults living in a rural setting. Clinical Nutrition (Edinburgh, Scotland). 2016; 35(1): 138-143.
Connolly D, Garvey J, McKee G. Factors associated with ADL/IADL disability in community dwelling older adults in the Irish longitudinal study on ageing (TILDA). Disabil Rehab. 2017; 39(8): 809-816.
Covinsky KE, Lindquist K, Dunlop DD, Yelin E. Pain, functional limitations, and aging. J Am Geriatr Soc. 2009; 57: 1556–1561.
Scudds RJ, Robertson JM. Pain factors associated with physical disability in a sample of community-dwelling senior citizens. J Gerontol A Biol Sci Med Sci. 2000; 55: M393–M399.
Andrews JS, Cenzer IS, Yelin E, Covinsky KE. Pain as a risk factor for disability or death. J Am Geriatr Soc. 2013; 61: 583–589.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; 9: Cd007146.
Gagnon N, Flint AJ, Naglie G, Devins GM. Affective correlates of fear of falling in elderly persons. Am J Geriatr Psychiatry. 2005; 13: 7–14.
Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing 2008; 37: 19–24.
Greenberg SA. Analysis of measurement tools of fear of falling for high-risk, community-dwelling older adults. Clin Nurs Res. 2012; 21(1): 113–30.
Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012; 9: Cd00714.
Çinarli T, Koç Z. Fear and Risk of Falling, Activities of Daily Living, and Quality of Life: Assessment When Older Adults Receive Emergency Department Care. Nurs Res. 2017; 66(4): 330-335.
Peron EP, Gray SL, Hanlon JT. Medication use and functional status decline in older adults: a narrative review. Am J Geriatr Pharmacother. 2011; 9(6): 378-391.
Corsonello A, Onder G, Abbatecola AM, Guffanti, Gareri EE, Lattanzio PF. Explicit criteria for potentially inappropriate medications to reduce the risk of adverse drug reactions in elderly people: from Beers to STOPP/START criteria.Drug Safety. 2012; 35 Suppl: 121-128.
Shah KN, Joshi HM, Christian RP, Patel KP, Malhotra SD. Prevalence of potentially inappropriate medications and prescription cost analysis among older cardiac patients in an outpatient department of a tertiary care hospital in India. J Basic Clin Pharm. 2016; 7(4): 110-115.
Marengoni A, von Strauss E, Rizzuto D, Winblad B, Fratiglioni L. The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons. A community-based, longitudinal study. J Intern Med. 2009; 265(2): 288–295.
Marengoni A, Angleman S, Fratiglioni L. Prevalence of disability according to multimorbidity and disease clustering: a population-based study. J Comorbidity. 2011; 1: 11–18.
Toole LO, Connolly D, Smith S. Impact of an occupationbased self-management programme on chronic disease management. Aust Occup Ther J. 2013; 60(1): 30-8.
Smith C, Hale L. The effects of non-pharmacological interventions on fatigue in four chronic illness conditions: a critical review. Phys Ther Rev. 2007; 12: 324–34.
Stark S. Removing Environmental Barriers in the Homes of Older Adults with Disabolitaties Improves Occupational Performance. OTJR: Occupation, Participation and Health. 2004; 24(1): 32-40.
Ahrentzen S, Tural E. The role of building design and interiors in ageing actively at home. Building Research & Information. 2015; 43(5): 582-601.
Castro-Costa E, Dewey M, Stewart R, Banerjee S, Huppert F, Mendonca-Lima C, et al. Prevalence of depressive symptoms and syndromes in later life in ten European countries: the SHARE study. Br J Psychiatry. 2007; 191: 393-401.
Kaur B, Kaur Mal H. Association between Malnutrition and Depression among Elderly of Selected Rural Area of district Faridkot, Punjab. Int J Community Health Med Res. 2017; 3(1): 41-45.
World Federation for Mental Health Depression: A Global Crisis. World Mental Health Day October 10, 2012. Occoquan World Federation for Mental Health: 2012.
Andersson LB, Marcusson J, Wressle E. Health-related quality of life and activities of daily living in 85-year-olds in Sweden. Health Soc Care Comm. 2013; 22: 368–374.
Buliński L, Błachnio A. Health in old age, and patients’ approaches to telemedicine in Poland. Ann Agric Environ Med. 2017; 24(2): 322–328.
Chou KL, Chi I. Successful aging among the young-old, old-old, and oldest-old Chinese. Int J Aging Hum Dev. 2002; 54(1): 1–14.
Ferring FD, Balducci C, Burholt V, Wenger C, Thissen F, Weber G, et al. Life satisfaction of older people in six European countries: findings from the European study on adult well-being. Eur J Ageing. 2004; 1: 15–25.
Parker PD, Martin AJ, Marsh HW. Factors predicting life satisfaction: A process model of personality, multidimensional self-concept, and life satisfaction. Aust J Guid Couns. 2008; 18: 15 –22.
Suh S, Choi H, Lee C, Cha M, Jo I. Association between knowledge and attitude about aging and life satisfaction among older Koreans. Asian Nurs Res. 2012; 6(3): 96–101.
Franse CB, van Grieken A, Qin L, Melis RF, Rietjens JC, Raat H. Socioeconomic inequalities in frailty and frailty components among community-dwelling older citizens. Plos ONE. 2017; 12(11): 1-15.
Tsai Y. Education and disability trends of older Americans, 2000-2014. J Publ Health (Oxford, England).2017; 39(3): 447-454.
Yeh SC, Shih CT, Chuang CH, Tsay SF. The Relationship between Social Supports and Life Satisfaction for Elderly in Kaohsiung. Manag Rev. 2004; 12(2): 399-427.
Krause N. Common facets of religion, unique facets of religion, and life satisfaction among older African Americans. J Gerontol B Psychol Sci Soc Sci. 2004;59:109–117.
Journals System - logo
Scroll to top