Questions that apply to all articles

What gender or race differences are there in the ability to complete ADLs?

What risk factors influence the ability to complete ADLs?

Yi, Z., Yuzhi, L., & George, L. K. (2003). Gender Differentials of the Oldest Old in China. Research on Aging, 25(1): 65–80.

Based on unique data from a sample of nearly 9,000 people ages 80 to 105 interviewed in 22 provinces in 1998, we found that gender differentials in educational attainment among the Chinese oldest old are enormous: Many more women are illiterate. Oldest old women are more likely to be widowed and economically dependent, much less likely to have pensions, and thus more likely to live with their children and rely on children for financial support and care. The female oldest old in China are also seriously disadvantaged in activities of daily living, physical performance, cognitive function, and self-reported health, as compared with their male counterparts; these gender differences are more marked with advancing age. The large gender differentials among the Chinese oldest old need serious attention from society and government, and any old-age insurance and service programs to be developed or reformed must benefit older women and men equally.

• How may gender impact activities of daily living of Chinese in very late adulthood?

Li, L. W. (2005). Predictors of ADL Disability Trajectories Among Low-Income Frail Elders in the Community. Research on Aging. 27(6): 615–642.

In this study, the author examined the effects of psychosocial and health factors on the ADL disability trajectory of low-income frail elders living in the community. She analyzed three-year longitudinal data with a maximum of 15 repeated observations from a cohort of elderly participants in Michigan’s Medicaid Waiver Program (N=3,161), using the hierarchical linear modeling approach. Baseline data of this cohort were taken in 1999; a reassessment was conducted about every three months. The analysis shows that major risk factors for a poor activity of daily living (ADL) disability trajectory include being Black, older, living with nonspouse others, and no confidence in functional improvement. Presence of arthritis, cancer, and cognitive limitation had significant and modest effects on ADL disability trajectories. The findings have implications to community-based intervention programs for frail elderly persons in the community.

• In what ways do race, age, living arrangements and beliefs influence the activity of daily living skills (trajectory)?

Li, L. W. (2005). Trajectories of ADL Disability Among Community-Dwelling Frail Older Persons. Research on Aging, 27(1): 56–79.

This study examines how activity of daily living (ADL) disability of community-living frail elders changes in a two-year period and how the pattern of change varies between those who subsequently died or were institutionalized and those who continued to live in the community. Multiple waves of data from a cohort of older participants (N = 3,161) in Michigan’s Medicaid Waiver Program were analyzed using the hierarchical linear modeling (HLM) approach. The results suggest that changes in ADL disability were nonlinear and the pattern of change varied by their subsequent status. Participants who subsequently died or were institutionalized exhibited a steep increase in ADL disability during the last few months before the events, whereas continued community residents were relatively stable in ADL disability during the two-year study period. Within each group, substantial individual variation in ADL disability trajectories exists. Implications of the findings to research and practice are discussed.

• How is monitoring changes in ADL functioning useful?