Cardio-metabolic and socio-demographic risk factors associated with dependency in basic and instrumental activities of daily living among older Iranian adults: Bushehr elderly health program.

ABSTRACT

BACKGROUND: Iran's population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. METHODS: The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. RESULTS: Mean (Standard Deviation) of the participants' age was 69.3 (6.4) years (range 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI) 2.3 (1.9-2.9)), having a lower education level, a history of diabetes mellitus (OR 1.4 (1.2-1.7)) and past smoking (OR 1.3 (1.0-1.6)), and no physical activity (OR 1.5 (1.2-1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR 2.4 (1.9-3.0)), having a lower education level, no physical activity (OR 2.2 (1.6-2.9)) and daily intake of calories (OR 0.99 (0.99-0.99)) were associated with dependency in BADL. CONCLUSION: Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.