Self-reported disability and its association with performance-based limitation in elderly men: a comparison of three European countries.
OBJECTIVE
To compare self-reported disability and performance-based limitation and their association in elderly men from three European countries.


METHODS
Cross-sectional data from a cohort study collected around 1990.


METHODS
Three cohorts from Finland, the Netherlands, and Italy.


METHODS
One thousand one hundred sixty-one men aged 70 and older.


METHODS
Disability and functional limitation were measured in a standardized way in three countries. Self-reported disability was estimated by questionnaire, assessing three domains of activities of daily living: instrumental activities of daily living, mobility, and activities of daily living (score 0-3). Functional limitation was measured by performance tests (score 0-16), with 0 indicated the healthiest score.


RESULTS
Self-reported disability and performance-based limitation scores differed between countries. Mean self-reported disability score was worse in Italy (0.72) and the Netherlands (0.70) than in Finland (0.54). Italian men scored worst on the performance-based tests (mean 4.80 vs 4.04 for Finland and 3.74 for the Netherlands). Differences in self-reported disability remained after adjusting for performance scores: Dutch men reported more disabilities (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.23-2.25) than men in Finland (reference group) and Italy (OR = 1.08, 95% CI = 0.77-1.53). Self-reported disability was positively associated with performance-based score (OR = 1.28, 95% CI = 1.21-1.35) and did not differ between countries.


CONCLUSIONS
Cross-cultural variation was noted in self-reported disability adjusted for performance score. These differences may be due to sociocultural and physical environmental factors. Self-reported disability was consistently associated with performance-based limitation in Finland, the Netherlands, and Italy.
van den Brink
Carolien L
CL
National Institute of Public Health and the Environment, Bilthoven, The Netherlands. carolien.van.den.brink@rivm.nl
Tijhuis
Marja
M
Kalmijn
Sandra
S
Klazinga
Niek S
NS
Nissinen
Aulikki
A
Giampaoli
Simona
S
Kivinen
Paula
P
Kromhout
Daan
D
van den Bos
Geertrudis A M
GA
D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005387:Finland / Q000453:epidemiology; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012647:Self-Assessment; D013647:Task Performance and Analysis