Activities of daily living trajectories among institutionalised older adults: A prospective study.
OBJECTIVE
To examine activities of daily living trajectory groups among older residents in Taiwan, and to determine the relative risks of demographic characteristics and health status in explaining the trajectory group of activities of daily living.


BACKGROUND
Activity of daily living is a crucial indicator of health status for institutionalised older adults. activities of daily living is a dynamic process and has differences in trajectory groups.


METHODS
This study was a 3-year longitudinal analysis of long-term care facility residents in Taiwan.


METHODS
A total of 364 older residents completed the entire research process. We used group-based trajectory modelling and multinomial logistic models for statistical analysis.


RESULTS
The result of this study revealed that three activities of daily living trajectory groups among older residents exhibited high dependency with gradually declining function (Group 1, 22.53%), low dependency with gradually declining function (Group 2, 43.13%) and persistent independent function (Group 3, 34.34%). Compared with Group 3, Group 1 was related to the following potential risk factors: older age, female, nonmainland China born and a married status. After considering resident health status in the analysis, three significant factors emerged for Group 1: the number of chronic diseases (odds ratio = 2.45), depressive symptoms (odds ratio = 1.71) and cognitive status (odds ratio = 83.11). Compared with Group 3, Group 2 was related to older age. After adding resident health status to the analysis, two significant factors of Group 2 emerged: the number of chronic diseases (odds ratio = 1.68) and depressive symptoms (odds ratio = 1.74).


CONCLUSIONS
The findings of this study indicated that health factors, including the number of chronic diseases, cognitive status and depressive symptoms, were more likely to contribute to the development of a decline pattern of activities of daily living.


CONCLUSIONS
Appropriate exercise programmes and physical activities, according to residents' personal characteristics and activities of daily living status, is crucial for improving physical functioning, alleviating depression and cognitive defects in institutionalised older adults.
Cardinal Tien Junior College of Healthcare and Management, Yilan County, Taiwan.
Huai-Ting
HT
Kuo
Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
Kuan-Chia
KC
Lin
Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan.
Chung-Fu
CF
Lan
Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan.
I-Chuan
http://orcid.org/0000-0003-3349-7263
IC
Li
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002908:Chronic Disease; D060825:Cognitive Dysfunction / Q000523:psychology; D003863:Depression / Q000523:psychology; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D007326:Institutionalization; D016015:Logistic Models; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013624:Taiwan
activity of daily living; long-term care; trajectory