AAR  Vol.3 No.5 , November 2014
Real and Perceived Physical Functioning in Italian Elderly Population: Associations with BADL and IADL
ABSTRACT
This study aimed to identify the key physical abilities (aerobic endurance, gait speed, balance, strength) and psychological variables associated with the level of basic (BADL) and instrumental (IADL) activities of daily living in an autonomous community-dwelling elderly population in Italy. 135 elderly people (63% women; mean age = 73.3, SD = 5.5) were included in the study. Stepwise regression was performed to verify the association between these variables and the level of BADL and IADL in the elderly participants. Results showed that balance (β = -0.21, p < 0.01) and perception of physical functioning (β = 0.32, p < 0.0001) were the key individual variables related to BADL scores, and IADL score was associated with perception of physical functioning (β = 0.30, p < 0.0001) and upper limb strength (β = 0.21, p < 0.05). The results demonstrate a relationship between physical functioning and ADL, both real physical functioning and perceived physical functioning.

Cite this paper
Candela, F. , Zucchetti, G. , Magistro, D. , Ortega, E. and Rabaglietti, E. (2014) Real and Perceived Physical Functioning in Italian Elderly Population: Associations with BADL and IADL. Advances in Aging Research, 3, 349-359. doi: 10.4236/aar.2014.35045.
References
[1]   Menec, V.H. (2003) The Relation between Everyday Activities and Successful Ageing: A 6-Year Longitudinal Study. Journal of Gerontology Series B. Psychological Sciences and Social Sciences, 58B, 74-82.
http://dx.doi.org/10.1093/geronb/58.2.S74

[2]   Barucha, A.J., Pandav, R., Shen, C., Dodge, H.H. and Ganguly, M. (2004) Predictors of Nursing Facility Admission: A 12-Year Epidemiological Study in the United States. Journal of the American Geriatric Society, 52, 434-439.
http://dx.doi.org/10.1111/j.1532-5415.2004.52118.x

[3]   Gaugler, J.E., Duval, S., Anderson, K.A. and Kane, R.L. (2007) Predicting Nursing Home Admission in the U.S.: A Meta-Analysis. Bio Med Cental Geriatrics, 7, 13.

[4]   Hjaltadottir, I., Hallberg, I.R., Ekwall, A.K. and Nyberg, P. (2001) Predicting Mortality of Residents at Admission to Nursing Home: A Longitudinal Cohort Study. BMC Health Medic Research, 11, 86.
http://dx.doi.org/10.1186/1472-6963-11-86

[5]   Millan-Calenti, J.C., Tubio, J., Pita-Fernandez, S., Gonzales-Abraldes, I., Lorenzo, T., Fernandez-Arruty, T. and Maseda, A. (2010) Prevalence of Functional Disability in Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and Associated Factors, as Predictors of Morbidity and Mortality. Archives of Gerontology and Geriatrics, 50, 306-310.
http://dx.doi.org/10.1016/j.archger.2009.04.017

[6]   Vermeulen, J., Neyens J.CL., van Rossum, E., Spreeuwenberg, M.D. and De Witte, L.P. (2011) Predicting ADL Disability in Community-Dwelling Elderly People Using Physical Frailty Indicators: A Systematic Review. Bio Med Central Geriatrics, 11, 33.

[7]   Stuck, A.E., Walthert, J.M., Nikolaus T., Bula C.J., Hohmann, C. and Beck, J.C. (1999) Risk Factors for Functional Status Decline in Community-Living Elderly People: A Systematic Literature Review. Social Science & Medicine, 48, 445-469.
http://dx.doi.org/10.1016/S0277-9536(98)00370-0

[8]   Huang, W., Perera, S., Van Swearingen, J. and Studenski, S. (2010) Performance Measures Predict Onset of Activity of Daily Living Difficulty in Community-Dwelling Older Adults. Journal of the American Geriatric Society, 58, 844-852.
http://dx.doi.org/10.1111/j.1532-5415.2010.02820.x

[9]   Van Kan, G.A., Rolland Y., Andrieu, S., Bauer, J., Beauchet, O., Bonnefoy, M. and Vellas, B. (2009) Gait Speed at Usual Pace as a Predictor of Adverse Outcomes in Community-Dwelling Older People. An International Academy of Nutrition and Ageing (IANA) Task Force. The Journal of Nutrition, Health and Aging, 13, 881-889.
http://dx.doi.org/10.1007/s12603-009-0246-z

[10]   Perrig-Chiello, P., Perrig, W., Uebelbacher, A. and Stahelin, H. (2006) Impact of Physical and Psychological Resources on Functional Autonomy in Old Age. Psychology, Health & Medicine, 11, 470-482.
http://dx.doi.org/10.1080/13548500600726633

[11]   Onder, G., Penninx, B.W.J.H., Ferrucci, L., Fried, L.P., Guralnik, J.M. and Pahor, M. (2003) Measures of Physical Performance and Risk for Progressive and Catastrophic Disability: Results from the Women’s Health and Aging Study. Journals of Gerontology Series A. Biological Sciences and Medical Sciences, 60, 74-79.
http://dx.doi.org/10.1093/gerona/60.1.74

[12]   Chou, C., Hwang, C.L. and Wu, Y.T. (2012) Effect of Exercise on Physical Function, Daily Living Activities, and Quality of Life in the Frail Older Adults: A Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 93, 237-244.
http://dx.doi.org/10.1016/j.apmr.2011.08.042

[13]   Gu, M.O. and Conn, V.S. (2008) Meta-Analysis of the Effects of Exercise Interventions on Functional Status in Older Adults. Research in Nursing & Health, 31, 594-603. http://dx.doi.org/10.1002/nur.20290

[14]   Daniels, R., van Rossum, E., de Witte, L., Kempen, G.I.J.M. and van den Heuvel, W. (2008) Interventions to Prevent Disability in Frail Community-Dwelling Elderly: A Systematic Review. BMC Health Services Research, 8, 278.
http://dx.doi.org/10.1186/1472-6963-8-278

[15]   Jylha, M. (2009) What Is Self-Rated Health and Why Does It Predict Mortality? Towards a Unified Conceptual Model. Social Science & Medicine, 69, 307-316.
http://dx.doi.org/10.1016/j.socscimed.2009.05.013

[16]   Cesare, M., Onder, G., Zamboni, V., Manini, T., Shorr, R.I., Russo, A., Bernabei, R., Pahor, M. and Landi, F. (2008) Physical Function and Self-Rated Health Status as Predictors of Mortality: Results from Longitudinal Analysis in the ilSIRENTE Study. BMC Geriatrics, 8, 34.

[17]   Schnittker, J. (2005) When Mental Health Becomes Health: Age and the Shifting Meaning of Self-Evaluations of General Health. Milbank Quarterly, 83, 397-423.
http://dx.doi.org/10.1111/j.1468-0009.2005.00407.x

[18]   Johnson, R.J. and Wolinsky, F.D. (1993) The Structure of Health Status among Older Adults: Disease, Disability, Functional Limitation, and Perceived Health. Journal of Health and Social Behavior, 34, 105-121.
http://dx.doi.org/10.2307/2137238

[19]   Hall-Lord, M.L., Larsson, G. and Steen, B. (1999) Chronic Pain and Distress in Older People: A Cluster Analysis. International Journal of Nursing Practice, 5, 78-85.
http://dx.doi.org/10.1046/j.1440-172x.1999.00157.x

[20]   Covinsky, K.E., Lindquist, K., Dunlop, D.D. and Yelin, E. (2009) Pain, Functional Limitations and Ageing. Journal of the American Geriatrics Society, 57, 1556-1561.
http://dx.doi.org/10.1111/j.1532-5415.2009.02388.x

[21]   Candela, F., Zucchetti, G. and Magistro, D. (2013) Individual Correlates of Autonomy in Activities of Daily Living of Institutionalized Elderly Individuals: An Exploratory Study in a Holistic Perspective. Holistic Nursing Practice, 27, 284-291.
http://dx.doi.org/10.1097/HNP.0b013e31829b9483

[22]   Ormel, J., Rijsdijk, F.V., Sullivan, M., van Sonderen, E. and Kempen, G.I.J.M. (2002) Temporal and Reciprocal Relationship between IADL/ADL Disability and Depressive Symptoms in Late Life. Journal of Gerontology Series B. Psychological Sciences and Social Sciences, 57, 338-347.
http://dx.doi.org/10.1093/geronb/57.4.P338

[23]   Penninx, B.W.J.H., Leveille, S., Ferrucci, L., van Eijk, J.T. and Guralnick, J.M. (1999) Exploring the Effect of Depression on Physical Disability: Longitudinal Evidence from the Established Populations for Epidemiologic Studies of Elderly. American Journal of Public Health, 89, 1346-1352.
http://dx.doi.org/10.2105/AJPH.89.9.1346

[24]   Schneider, G., Driesch, G., Kruse, A., Wachter, M., Nehen, H. and Heuft, G. (2004) What Influences Self-Perception of Health in the Elderly? The Role of Objective Health Condition, Subjective Well-Being and Sense of Coherence. Archives of Gerontology and Geriatrics, 39, 227-237. http://dx.doi.org/10.1016/j.archger.2004.03.005

[25]   Cutler, D.M. (2001) Declining Disabilities among the Elderly. Health Affairs, 20, 11-27.
http://dx.doi.org/10.1377/hlthaff.20.6.11

[26]   Jones, C.J. and Rikli, R.E. (2002) Measuring Functional Fitness in Older Adults. The Journal of Active Ageing, 25-30.

[27]   Katz, S., Ford, A.B., Moskowitz, R.W., Jackson, B.A. and Jaffe, M.W. (1963) Studies of Illness in the Aged: The Index of ADL: A Standardized Measure of Biological and Psychosocial Function. Journal of the American Medical Association, 185, 914-919.
http://dx.doi.org/10.1001/jama.1963.03060120024016

[28]   Lawton, M.P. and Brody, E.M. (1969) Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living. The Gerontologist, 9, 179-186. http://dx.doi.org/10.1093/geront/9.3_Part_1.179

[29]   LaPlante, M.P. (2010) The Classic Measure of Disability in Activities of Daily Living Is Biased by Age But an Expanded IADL/ADL Measure Is Not. The Journals of Gerontology Series B. Psychological Sciences and Social Sciences, 65, 720-732.
http://dx.doi.org/10.1093/geronb/gbp129

[30]   Sturnieks, D.L., St George, R. and Lord, S.R. (2008) Balance Disorders in the Elderly. Clinical Neurophysiology, 38, 467-478.
http://dx.doi.org/10.1016/j.neucli.2008.09.001

[31]   Hobeika, C.P. (1999) Equilibrium and Balance in the Elderly. Ear, Nose & Throat Journal, 78, 558-562.

[32]   Folstein, M., Folstein, S. and McHugh, P.R. (1975) Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12, 189-198.
http://dx.doi.org/10.1016/0022-3956(75)90026-6

[33]   National Institute of Statistics (2010) Annuario Statistico Italiano 2011 [Statistical Italian Yearbook-2011] [Data File]. ISTAT, Roma.
http://www.istat.it

[34]   Kempen, G.I., Miedema, I., Ormel, J. and Molenaar, W. (1996) The Assessment of Disability with the Groningen Activity Restriction Scale. Conceptual Framework and Psychometric Properties. Social Science & Medicine, 43, 1601-1610.
http://dx.doi.org/10.1016/S0277-9536(96)00057-3

[35]   Gill, T.M., Robinson, J.T. and Tinetti, M.E. (1998) Difficulty and Dependence: Two Components of the Disability Continuum among Community-Living Older Persons. Annals of Internal Medicine, 128, 96-101.
http://dx.doi.org/10.7326/0003-4819-128-2-199801150-00004

[36]   Rikli, R.E. and Jones, C.J. (1999) The Development and Validation of a Functional Fitness Test for Community-Residing Older Adults. Journal of Aging and Physical Activity, 7, 129-161.

[37]   Podsiadlo, D. and Richardson, S. (1991) The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons. Journal of the American Geriatrics Society, 39, 142-148.

[38]   Jones, C.J., Rikli, R.E., Max, J. and Noffal, G. (1998) The Reliability and Validity of a Chair Sit-and-Reach Test as a Measure of Hamstring Flexibility in Older Adults. Research Quarterly for Exercise and Sport, 69, 338-343.
http://dx.doi.org/10.1080/02701367.1998.10607708

[39]   Apolone, G. and Mosconi, P. (1999) The Italian SF-36 Health Survey: Translation, Validation and Norming. Journal of Clinical Epidemiology, 51, 1025-1036. http://dx.doi.org/10.1016/S0895-4356(98)00094-8

[40]   Fava, G.A. (1983) Assessing Depressive Symptoms across Cultures: Italian Validation of the CES-D Self-Rating Scale. Journal of Clinical Psychology, 39, 249-251.
http://dx.doi.org/10.1002/1097-4679(198303)39:2<249::AID-JCLP2270390218>3.0.CO;2-Y

[41]   Hocking, R.R. (1976) The Analysis and Selection of Variables in Linear Regression. Biometrics, 32, 1-50.

[42]   Baron, R.M. and Kenny, D.A. (1986) The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations. Journal of Personality and Social Psychology, 51, 1173-1182.
http://dx.doi.org/10.1037/0022-3514.51.6.1173

[43]   Naik, A.D., Concato, J. and Gill, T.M. (2004) Bathing Disability in Community-Living Older Persons: Common, Consequential, and Complex. Journal of the American Geriatrics Society, 52, 1805-1810.
http://dx.doi.org/10.1111/j.1532-5415.2004.52513.x

[44]   Okumiya, K.K., Matsubayashi, K.K., Nakamura, T.T., Fujisawa, M.M., Osaki, Y.Y., Doi, Y.Y. and Ozawa, T.T. (1999) The Timed “Up & Go” Test and Manual Button Score Are Useful Predictors of Functional Decline in Basic and Instrumental ADL in Community-Dwelling Older People. The Journal of the American Geriatrics Society, 47, 497-498.

[45]   Shumway-Cook, A., Brauer, S. and Woollacott, M. (2000) Predicting the Probability for Falls in Community-Dwelling Older Adults Using the Timed Up & Go Test. Physical Therapy, 80, 896-903.

[46]   Ho, K.H., Matsubayashi, K., Wada, T., Kimura, M., Kita, T. and Saijoh, K. (2002) Factors Associated with ADL Dependence: A Comparative Study of Residential Care Home and Community-Dwelling Elderly in Japan. Geriatrics & Gerontology International, 2, 80-86.
http://dx.doi.org/10.1046/j.1444-1586.2002.00026.x

[47]   Magistro, D., Liubicich, M.E., Candela, F. and Ciairano, S. (2014) Effect of Ecological Walking Training in Sedentary Elderly People: Act on Aging Study. The Gerontologist, 54, 611-623.
http://dx.doi.org/10.1093/geront/gnt039

[48]   Liubicich, M.E., Magistro, D., Candela, F., Rabaglietti, E. and Ciairano, S. (2012) Physical Activity and Mobility Function in Elderly People Living in Residential Care Facilities. “Act on Aging”: A Pilot Study. Advances in Physical Education, 2, 54-60.
http://dx.doi.org/10.4236/ape.2012.22010

[49]   Liubicich, M.E., Candela, F., Magistro, D., Rabaglietti, E. and Ortega, E. (2012) Physical Functioning: The Mediating Effect on ADLs and Vitality in Elderly Living in Residential Care Facilities. “Act on Ageing”: A Pilot Study. Health (1949-4998), 4, 407-414.

 
 
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