title: Prevalence, characteristics, and acute care utilization of disabled older adults with an absence of help for activities of daily living: Findings from a nationally representative survey.
abstract: The aim of this study was to investigate the prevalence, characteristics, and acute care utilization of community dwelling disabled older adults with an absence of help for activities of daily living (ADL).
  
  
  
  We analyzed cross-sectional data from a nationally representative sample of people aged 65 years and over (n=2904) participating in the 2009 National Health Interview Survey in Taiwan. Disability was defined as self-reporting a lot of difficulty or complete inability to carry out one or more ADL tasks. Participants with disability were asked whether they received help in the form of personal assistance or assistive devices to complete ADL tasks, with a yes response indicating the presence of help and a no response indicating the absence of help. Hospitalization and emergency department visits was assessed as a dichotomous variable (any or none), respectively.
  
  
  
  An absence of available help for ADL disability was reported in 16.6% of disabled older adults. Disabled older adults reporting an absence of help were more likely to be female. After adjustment for other factors, compared to older adults without disability, older adults with disability not receiving help for ADL tasks were highly related to hospitalization (OR=4.57; 95%CI=[1.51-13.82]) and emergency department visits (OR=3.52; 95%CI=[1.15-10.76]) during the past year, respectively.
  
  
  
  We found that there is high prevalence of absence of help to perform ADL tasks in older adults with disability, and that this absence of help for ADL disability is associated with a greater burden of acute care utilization than those without disability.
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan City, Taiwan.
authors.forename: Hui-Hsuan
authors.initials: HH
authors.lastname: Wang
authors.affiliation: Healthy Aging Research Center, Chang Gung University, Tao-Yuan City, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan City, Taiwan; Traumatological Division, Department of Orthopedics, Chang Gung Memorial Hospital, Tao-Yuan City, Taiwan.
authors.forename: Yea-Ing Lotus
authors.initials: YI
authors.lastname: Shyu
authors.affiliation: Division of Preventive Medicine and Health Service Research, Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan.
authors.forename: Hsing-Yi
authors.initials: HY
authors.lastname: Chang
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan City, Taiwan.
authors.forename: Yuh-Bin
authors.initials: YB
authors.lastname: Bai
authors.affiliation: Sydney School of Public Health, University of Sydney, NSW, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Stanaway
authors.affiliation: Division of Endocrinology and Metabolism, Departments of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Tao-Yuan City, Taiwan.
authors.forename: Jen-Der
authors.initials: JD
authors.lastname: Lin
authors.affiliation: Department of Health Care Management, College of Management, Chang Gung University, Tao-Yuan City, Taiwan; Healthy Aging Research Center, Chang Gung University, Tao-Yuan City, Taiwan; Division of Endocrinology and Metabolism, Departments of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Tao-Yuan City, Taiwan. Electronic address: clli@mail.cgu.edu.tw.
authors.forename: Chia-Lin
authors.initials: CL
authors.lastname: Li
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology
keywords: Absence help; Acute care utilization; Disability; Taiwan