title: Limitations in Activities of Daily Living in Community-Dwelling People Aged 75 and Over: A Systematic Literature Review of Risk and Protective Factors.
abstract: BACKGROUND
  Most older people wish to age in place, for which functional status or being able to perform activities of daily living (ADLs) is an important precondition. However, along with the substantial growth of the (oldest) old, the number of people who develop limitations in ADLs or have functional decline dramatically increases in this part of the population. Therefore, it is important to gain insight into factors that can contribute to developing intervention strategies at older ages. As a first step, this systematic review was conducted to identify risk and protective factors as predictors for developing limitations in ADLs in community-dwelling people aged 75 and over.
  
  
  METHODS
  Four electronic databases (CINAHL (EBSCO), EMBASE, PsycINFO and PubMed) were searched systematically for potentially relevant studies published between January 1998 and March 2016.
  
  
  RESULTS
  After a careful selection process, 6,910 studies were identified and 25 were included. By far most factors were examined in one study only, and most were considered risk factors. Several factors do not seem to be able to predict the development of limitations in ADLs in people aged 75 years and over, and for some factors ambiguous associations were found. The following risk factors were found in at least two studies: higher age, female gender, diabetes, hypertension, and stroke. A high level of physical activity and being married were protective in multiple studies. Notwithstanding the fact that research in people aged 65 years and over is more extensive, risk and protective factors seem to differ between the 'younger' and 'older' olds.
  
  
  CONCLUSIONS
  Only a few risk and protective factors in community-dwelling people aged 75 years and over have been analysed in multiple studies. However, the identified factors could serve both detection and prevention purposes, and implications for future research are given as well.
authors.affiliation: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Anne
authors.identifier: http://orcid.org/0000-0002-8235-6662
authors.initials: A
authors.lastname: van der Vorst
authors.affiliation: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: G A Rixt
authors.initials: GA
authors.lastname: Zijlstra
authors.affiliation: Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.|Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium.
authors.forename: Nico De
authors.initials: N
authors.lastname: Witte
authors.affiliation: Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Daan
authors.initials: D
authors.lastname: Duppen
authors.affiliation: Department of Geriatrics, University Hospital, University of Bern, Bern, Switzerland.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Stuck
authors.affiliation: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
authors.affiliation: Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.|Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
authors.forename: Jos M G A
authors.initials: JM
authors.lastname: Schols
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D065840:Protective Factors; D012307:Risk Factors; D012959:Socioeconomic Factors