Determinants of Disability among Elderly Population in Rural Minia, Egypt

Eman M. Mahfouz1 and Hala AwadAllah2

1 Faculty of Medicine, El MinAbstracia University
2 Public Health Environment Institiute, Ein Shams University, Cairo, Egypt

Corresponding author: Hala AwadAllah
    Lectrurer of Public Health Environment Institiute, Ein Shams University

CEJOEM 2007, Vol.13. No.1.: 55–69


Key words:
ADL, disability, elderly, medical conditions, diabetes, osteo-arthritis, self-rating of health


Abstract:
Background: A key measure of functional independence in elderly age is the ability to do activities of daily living (ADL) without the assistance of another person.
    Methods: 506 rural population in El Minia, aged over 60 yrs were subjected to an interview questionnaire, where activities of daily living (ADLs) and self-rated health were assessed. Five items from Katz's ADLs (bathing, dressing, transfer, toileting, and eating) were used to construct a three-level five-item ADL scale: not disabled (no disabilities), moderately disabled (1–2 disabilities), and severely disabled (3–5 disabilities).
    Design: household based cross sectional study using an interview questionnaire.
    Objective: To describe the functional capacity and self-rated health.
    Results: Nearly 10% of the participants could be categorized as being disabled with variable levels of severity. Both moderate and severe disability were found to be more prevalent among females where nearly 67% and 54% of female elders were classified as moderately or severely disabled, respectively. Female elders were more liable to report poor health status than males. The results of this study revealed that the most common causes of disability were diabetes mellitus (22%), osteoarthritis and fracture (20%), followed by chronic obstructive pulmonary diseases (16%), eye problems (8%) and cardiovascular diseases (6%). Osteoarthritis and diabetes mellitus significantly contributed to the occurrence of disability. About 68% of the participants had a positive history of health problems, 30% were bed-ridden and about 24% were hospitalized for various reasons at some time during the last year. Almost 7% and 48% self-rated their health as poor and fair, respectively. Mean number of days staying in bed or admitted to hospital as inpatients during the last year were significantly more among elders with disability than their counterparts without disability (142 and 14.5 days vs. 22.2 days and 14.3 days, respectively). Rural elderly population experiencing disability in El Minia was found to belong to low socioeconomic class. Single status was significantly related to the occurrence of both disability and poor health status, where up to 54% of the elderly with either moderate or severe disability were unmarried and about 66% rated their health as poor.
    Conclusion: Disability in ADL and poor health were prevalent among nearly 10% and 7% of the elderly population in rural Minia, respectively. Diabetes and osteoarthritis were more prevalent among the disabled and significantly contributed to the disability in themselves. Disability was also associated with age, low income, female gender, and single status.
    Recommendations: Adequate multiple responses should be developed to the problems ssociated with disability.


Received: 11 April 2007
Accepted: 24 September 2007

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