title: Predictors of functional disability with focus on activities of daily living: A community based follow-up study in older adults in India.
abstract: BACKGROUND
  Disability in activities of daily living is a growing concern among older populations all over the world. India has one of the rapidly ageing populations and predicted burden of functional disability is higher for Indian older adults as compared to other ageing Asian countries.
  
  
  METHODS
  Total 1140 aged 60 years and over participated in a baseline study. 560 of them participated in the prospective cohort study conducted in the city of Pune, India. An interview and functional assessment using a questionnaire and Pune-FAAT tool was carried out in 2013-14. Binary logistic regression was used to obtain the factors that increased the odds of having ADL disability at follow-up.
  
  
  RESULTS
  The mean age of the study population was 69.73±5.48years. Squatting, walking and climbing functions were affected significantly. Total 376 participants (67.1%) reported difficulties and/or disability in performing activities of daily living (ADL) at follow-up. Hospitalization (OR=3.6; 95% CI: 1.9-6.7), being female (OR=2.3; 95% CI: 1.5-3.5), presence of two or more chronic diseases (OR=1.7; 95% CI: 1.1-2.7), experience of memory loss (OR=1.9; 95% CI: 1.2-3.0) and feeling of loneliness (OR=2.3; 95% CI: 1.0-5.3) increased the odds of being in the "With disability" group at follow-up. Apart from this, self-rated health and self-reported depression were associated with limitations in ADL.
  
  
  CONCLUSIONS
  Hospitalization and being female appeared to be the most significant risk factors for disability in urban older adults in India. Rehabilitation services after hospitalization, physical exercise, effective control on chronic illness, and social participation to reduce loneliness is recommended.
authors.affiliation: Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India. Electronic address: aarati@unipune.ac.in.
authors.forename: Aarti
authors.initials: A
authors.lastname: Nagarkar
authors.affiliation: Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Ganeshkhind, Pune, 411007 Maharashtra, India.
authors.forename: Yashoda
authors.initials: Y
authors.lastname: Kashikar
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002908:Chronic Disease; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D057566:Self Report; D016138:Walking / Q000502:physiology*
keywords: Disability; Functional decline; India; Longitudinal study; Older adults