Background: Increases in dependence among older adults cause increases in care needs and social care burden. Instrumental activities of daily living (IADL) are often used to assess the independence of older adults residing in communities. Various factors affect IADL limitations, but few studies confirm gender differences in IADL limitations in older adults. This study explored the changes in incidence of IADL limitations across 14 years and identified the factors associated with IADL limitations according to gender among older adults in Korea.Method: This study uses secondary data analysis with 2006–2020 data from the Korean Longitudinal Study of Aging (KLoSA), a longitudinal cohort study. Among the total 10,254 participants, 1,230 adults aged 65 years and over who met the criteria were included in the final analysis. For each IADL item, a limitation was defined when the response was partial or complete dependence. Multivariate logistic regression was performed to identify the factors (in 2006) associated with IADL limitations in 2020.Results: The mean age of the participants at baseline was 69.64 years (SD 3.93), and 61.0% of participants were female. Total scores for IADL limitations increased gradually across 14 years in all participants, and observed changes were statistically significant. The top three ranked items of IADL limitations differed according to gender in 2020: the top limitations in men were preparing meals, laundry, and using public transportation, and the top limitations in women were using public transportation, going out, and handling money. Factors associated with total IADL limitations were grip strength in men and age, dementia, fear of fall, and grip strength in women. Factors associated with the top three ranked items of IADL limitations differed according to gender.Conclusion: The incidence of IADL limitations gradually increased in all participants over a 14-year period. In older adults in Korea, gender differences were confirmed in the factors associated with IADL limitations, as well as in the main limited activities. To minimize IADL limitations in community-residing older adults, it is necessary to plan tailored interventions.

Background: Loss of the ability to perform activities of daily living (ADLs) leads to negative health outcomes such as reduced quality of life, institutionalization, and mortality. In Korea, the proportion of older adults with disabilities is increasing along with rapid population aging. Therefore, providing a comprehensive approach to the prevention and management of ADL limitations in people with disabilities is necessary. This can be accomplished by understanding the trends and factors affecting these limitations over time. Purpose: This study was developed to examine the longitudinal trend and factors affecting ADL limitations over time among people with disabilities in Korea. Methods: Data from 346 people with disabilities in the 2008–2020 Korean Welfare Panel Study were used. Bivariate analysis and a Kendall trend test were performed to determine the longitudinal trends for ADL limitations, and multiple logistic regression was used to evaluate whether relevant variables could predict these limitations. Results: The prevalence of ADL limitations among people with disabilities increased by 16.5% over the 12 years of the study. The highest rate of increase in these limitations over time was found in people with mental disorders (27.8%), those over 65 years of age (27.3%), and those with depression (25.6%). In multiple logistic regression, the odds ratios of the variables were slightly different at each survey wave. However, severe disability and low educational level were consistently found to be associated with ADL limitations over time. Conclusions: The findings provide evidence of a significant relationship between level of disability and/or educational status and ADL limitations in people with disabilities in Korea. To prevent the development of ADL limitations in people with disabilities, comprehensive identification of longitudinal trends and factors affecting ADL limitations is necessary. Early intervention, including integrated services such as home rehabilitation services to prevent ADL limitations, especially for disabled people with severe disabilities and low educational levels, has the potential to delay ADL limitations.

문설화, et al. J Korean Acad Community Health Nurs. 2021 Jun;32(2):162-174. https://doi.org/10.12799/jkachn.2021.32.2.162

There is insufficient information on whether the use of assistive devices is associated with a lower burden on caregivers of individuals with disabilities. This study was conducted (1) to examine how care recipient-level factors, caregiver-level factors, and the use of assistive devices were associated with caregiver burden, and (2) to investigate the assistive device needs of caregivers. This cross-sectional descriptive study used surveys. The participants were caregivers of people with disabilities living in Korea (n = 499). The independent variables were care recipient-level factors, caregiver-level factors, and utilization of assistive devices. The outcome variable, caregiver burden, was measured using the Korean Caregiver Burden Scale. For the data analysis, multivariate logistic regression models were built on the caregiver burden using variables that showed statistical significance in the univariate analysis. Model 1 included care recipient-level factors. Model 2 included caregiver-level factors in addition to care-recipient factors to examine caregiver factors associated with burden. Model 3 included the utilization of care devices, in addition to the variables used in Model 2, to investigate whether the use of care devices was associated with a lower burden. Caregivers who were married, were informal caregivers, or experienced greater psychological stress had an increased probability of experiencing caregiver burden. Moreover, not using assistive devices increases the odds of experiencing caregiver burden. The most desirable properties of devices are transfer, mobility, and bathing. As the use of assistive devices is associated with caregiver burden, such care devices should be developed and provided to caregivers based on their individual needs.