title: Self-reported disability and its association with performance-based limitation in elderly men: a comparison of three European countries.
abstract: 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.
authors.affiliation: National Institute of Public Health and the Environment, Bilthoven, The Netherlands. carolien.van.den.brink@rivm.nl
authors.forename: Carolien L
authors.initials: CL
authors.lastname: van den Brink
authors.forename: Marja
authors.initials: M
authors.lastname: Tijhuis
authors.forename: Sandra
authors.initials: S
authors.lastname: Kalmijn
authors.forename: Niek S
authors.initials: NS
authors.lastname: Klazinga
authors.forename: Aulikki
authors.initials: A
authors.lastname: Nissinen
authors.forename: Simona
authors.initials: S
authors.lastname: Giampaoli
authors.forename: Paula
authors.initials: P
authors.lastname: Kivinen
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.forename: Geertrudis A M
authors.initials: GA
authors.lastname: van den Bos
mesh_terms: 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