title: Trends in disability in activities of daily living among Chinese older adults, 1997-2006: the China Health and Nutrition Survey.
abstract: BACKGROUND
  A decline in prevalence of late-life disability in activities of daily living (ADLs) has been reported in Western countries. We investigate the time trend of disability in basic ADLs among Chinese older people in 1997-2006, and explore the potential contribution of cardiometabolic diseases to the trend.
  
  
  METHODS
  The study included 7,845 participants (age ≥ 60 years) in the China Health and Nutrition Survey who were examined in 1997, 2000, 2004, and 2006. Data on ADLs were collected through interviews. Disability in basic ADLs was defined as need of assistance or inability to perform at least one of the five self-care activities of bathing, dressing, toileting, feeding, and transferring. Generalized estimating equation models were used to test the time trend in ADL disability and its association with cardiometabolic diseases.
  
  
  RESULTS
  Prevalence of ADL disability decreased from 13.2% in 1997 to 9.9% in 2006; the trend was statistically evident among people aged 60-69 years, women, and rural residents (p trend < .05). From 1997 to 2006, the prevalence of ADL disability decreased at a relative annual rate of 3.1% in total sample; the decline was statistically more evident in young-olds than older-olds, in men than women, and in rural than urban residents. The disabling effect decreased over time for stroke (p trend = .032) and multiple cardiometabolic diseases (p trend = .014).
  
  
  CONCLUSIONS
  The prevalence of disability in basic ADLs among Chinese older adults decreased from 1997 to 2006. Stroke and multiple cardiometabolic diseases appear to become less disabling over time, which may partly contribute to the favorable trend in ADL disability.
authors.affiliation: School of Public Health, Jining Medical University, Shandong, China. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden. yajun.liang@ki.se.
authors.forename: Yajun
authors.initials: Y
authors.lastname: Liang
authors.affiliation: School of Public Health, Jining Medical University, Shandong, China.
authors.forename: Aiqin
authors.initials: A
authors.lastname: Song
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Shufa
authors.initials: S
authors.lastname: Du
authors.affiliation: University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Jack M
authors.initials: JM
authors.lastname: Guralnik
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
authors.forename: Chengxuan
authors.initials: C
authors.lastname: Qiu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D057566:Self Report; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology
keywords: Activities of daily living; Aging; China.; Disability; Secular trends