Original Article

Incidence Rates of Disability and Its Associated Factors among Korean Community-Dwelling Older Adults


Background: We aimed to identify incidence rates of disability and its associated factors among Korean community-dwelling older adults.

Methods: The sample included 1,739 Koreans aged over 65 yr from the Korean Longitudinal Study of Aging (2006-2016) who reported no limitations in activities of daily living (ADL) or instrumental activities of daily living (IADL) at baseline (2006) and had complete data for other covariates. ADL, IADL, socio-demographic, lifestyle, and health-condition data were collected and analyzed using multiple logistic regression models.

Results: The 10-yr incidence rates of ADL and IADL disability in subjects with no disability at baseline were 11.6% and 21.6%, respectively. After adjusting for socio-demographic, lifestyle, and health-condition factors, the incidence of ADL disability was higher in women (odds ratio [OR] =1.418, 95% confidence interval [CI]=1.102-2.613) and increased with age (OR=1.170, 95% CI=1.133-1.208), multi-morbidity (OR=1.194, 95% CI=1.015-1.406), and obesity (OR=1.563, 95% CI=1.057-2.311). It decreased in subjects living alone (OR=0.531, 95% CI=0.328-0.856). The incidence of IADL disability increased with age (OR=1.131, 95% CI=1.102-1.161), multi-morbidity (OR=1.199, 95% CI=1.054-1.365), and cognitive disability (OR=1.422, 95% CI=1.083-1.866) and decreased for subjects living alone (OR=0.484, 95% CI=0.328-0.715) and with overweight (OR=0.725, 95% CI=0.532-0.988).

Conclusion: Incidence rates of disability differed considerably based on socio-demographic, lifestyle, and health-condition factors. These results suggest the importance of identifying factors that can decrease the risk of disability in this group and of prevention efforts in populations with a higher disability risk.

1. Christensen K, Doblhammer G, Rau R, et al (2009). Ageing populations: The challenges ahead. Lancet, 374(9696):1196-1208.
2. Statistics Korea (2018). 2018 statistics for elderly. Statistics Korea; Daejeon. Retrieved from http://kostat.go.kr/portal/eng/pressReleases/11/3/index.board
3. Martin LG, Schoeni RF, Andreski PM (2010). Trends in health of older adults in the United States: Past, present and future. Demography, 47(Suppl):S17-S40.
4. Koo B, Jae ES (2012). A study on the determinants of the incidence and the transition of older adult disability: findings from the Korea Longitudinal Study of Aging (KLOSA). Journal of the Korean Gerontological Society, 32(4):993-1011.
5. Friedland RB, Summner L (1999). Demographyis not destiny. National Academy on an Aging Society, The Gerontological Society of America, Washington, D.C.
6. Seeman TE, Merkin SS, Crimmins EM, et al (2010). Disability trends among older Americans: National Health and Nutrition Examination Surveys, 1988–1994 and 1999–2004. Am J Public Health, 100(1):100-7.
7. Sunwoo D (2015). Older persons' physical and cognitive functions, elderly caregiving, and policy considerarions. Health and Welfare Policy Forum, 223:40-57.
8. Hotta R, Makizako H, Doi T, et al (2018). Healthy behaviors and incidence of disability in community-dwelling elderly. Am J Health Behav, 42(1):51-58.
9. Lee Y, Kim J, Back JH, et al (2013). Changes in combined lifestyle risks and disability transition in older adults: Korean Longitudinal Study of Aging, 2006-2008. Prev Med, 56(2):124-129.
10. Van Oyen H, Berger N, Nusselder W, et al (2014). The effect of smoking on the duration of life with and without disability, Belgium 1997-2011. BMC Public Health, 14:723.
11. Lin JC, Guerrieri JG, Moore AA (2011). Drinking patterns and the development of functional limitations in older adults: longitudinal analyses of the health and retirement survey. J Aging Health, 23:806-821.
12. Sousa RM, Ferri CP, Acosta D, et al (2009). Contribution of chronic diseases to disability in elderly people in countries with low and middle incomes: A 10/66 Dementia Research Group population-based survey. Lancet, 374:1821-30.
13. Stenholm S, Westerlund H, Head J, et al (2015). Comorbidity and functional trajectories from midlife to old age: The Health and Retirement Study. J Gerontol A Biol Sci Med Sci, 70(3):332-8.
14. An R, Shi Y (2015). Body weight status and onset of functional limitations in U.S. middle-aged and older adults. Disabil Health J, 8(4):468.
15. Yoshimura N, Akune T, Fujiwara S, et al (2015). Incidence of disability and its associated factors in Japanese men and women: the Longitudinal Cohorts of Motor System Organ (LOCOMO) study. J Bone Miner Metab, 2015;33(2):186-191.
16. Auais M, Ahmed T, Alvarado B, et al (2019). Gender differences in four-year incidence of self-reported and performance-based functional ability: The International Mobility in Aging Study. Arch Gerontol Geriatr, 82:266-272.
17. Alexandre Tda S, Corona LP, Nunes DP, et al (2012). Gender differences in incidence and determinants of disability in activities of daily living among elderly individuals: SABE study. Arch Gerontol Geriatr, 55(2):431-7.
18. Rist PM, Liu SY, Glymour MM (2016). Families and disability onset: are spousal resources less important for individuals at high risk of dementia? Am J Geriatr Psychiatry, 24(7):585-594.
19. Michael YL, Berkman LF, Colditz GA, et al (2001). Living arrangements, social integration, and change in functional health status. Am J Epidemiol, 153(2):123-31.
20. Jeon EY (2006). Activity of daily living (ADL) and instrumental activity of daily living (IADL) of elderly in home. Journal of East-West Nursing Research, 12(1):56-61.
21. Yoon JL (2001). ADL and IADL of community dwelling Korean elderly. Journal of Korean Geriatrics Society, 5(2):139-150.
22. Kim JY, Lee SG, Lee SK (2010). The relationship between health behaviors, health status, activities of daily living and health-related quality of life in the elderly. J Korea Gerontol Soc, 30(2):471-484.
23. Shin ES, Cho YC (2012). Relationship between depressive symptoms and physical function (ADL, IADL) among the rural elderlies. Journal of Korea Academia-Industrial cooperation Society, 13(1):201-210.
24. Wang MJ (2010). The relations among ADL, self-efficacy, physical activity and cognitive function in Korean elders. J Korean Acad Community Health Nurs, 21(1):101-109.
25. Dong L, Freedman VA, Sanchez BN, et al (2019). Racial and ethnic differences in disability transitions among older adults in the United States. J Gerontol A Biol Sci Med Sci, 74(3):406-411.
26. Won CW, Yang KY, Rho YG, et al (2002). The development of Korean activities of daily living (K-ADL) and korean instrumental activities of daily living (K-ADL) Scale. Journal of the Korean Geriatrics Society, 6(2):107-120.
27. Korean Endocrine Society (2010). Management of Obesity. 2010 Recommendation. Endocrinology and Metabolism, 25(4):301-304.
28. Lee DY, Lee KU, Lee JH, et al (2002). A normative study of the mini-mental state examination in the Korean elderly. Journal of the Korean Neuropsychiatric Association, 41:508-525.
29. Radloff LS (1977). The CES-D scale: a self-report depression scale for research in the general population. Applied Psychological Measurement,1(3):385-401.
30. Rejeski WJ, Marsh AP, Chmelo E, et al (2009). The Lifestyle Interventions and Independence for Elders Pilot (LIFE-P): 2-year follow-up. J Gerontol A Biol Sci Med Sci, 64:462-7.
31. Stuck AE, Egger M, Hammer A, et al (2002). Home visits to prevent nursing home admission and functional decline in elderly people: systematic review and meta-regression analysis. JAMA, 287:1022-8.
32. Saito E, Ueki S, Yasuda N, et al (2014). Risk factors of functional disability among community-dwelling elderly people by household in Japan: a prospective cohort study. BMC Geriatr, 14:93.
33. Sarwari A, Fredman L, Langenberg P (1998). Prospective study on the relation between living arrangement and change in functional health status of elderly women. Am J Epidemiol, 147:370-378.
34. Wang D, Zheng J, Kurosawa M, et al (2009). Changes in activites of daily living (ADL) among elderly Chinese by marital status, living arrangement, and availability of healthcare over a 3-year period. Environ Health Prev Med, 14(2):128-41.
35. Drumond Andrade FC, Mohd Nazan AI, Lebrão ML, et al (2013). The impact of body mass index and weight changes on disability transitions and mortality in Brazilian older adults. J Aging Res, 2013:905094.
36. Zunzunegui MV, Alvarado BE, B´eland F, et al (2009). Explaining health differences between men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med, 68(2):235-42.
37. Raji MA, Al Snih S, Ray LA, et al (2004). Cognitive status and incidence disability in older Americans: findings from the Hispanic established population for the epidemiological study of the eldwely. Ethn Dis, 14:26-31.
38. Koo B (2013). The effects of cognitive functioning and depressive symptoms on ADL and IADL disability of the Korean old adults. Journal of the Korean Gerontological Society, 33(2):315-333.
39. Kumar A, Karmarkar AM, Tan A, et al (2015). The effect of obesity on incidence of disability and mortality in Mexicans aged 50 years and older. Salud Publica Mex, 57(1):s31–s38.
40. Walter S, Kunst A, MacKenbach J, et al (2009). Mortality and disability: the effect of overweight and obesity. Int J Obes (Lond), 33(12):1410-8.
41. Himes CL, Reynolds SL (2012). Effect of obesity on falls, injury, and disability. J Am Geriatr Soc, 60(1):124-129.
42. Dong H, Unosson M, Wressle E, et al (2012). Health consequences associated with being overweight or obese: a Swedish population-based study of 85-year-olds. J Am Geriatr Soc, 60(2):243-50.
IssueVol 49 No 9 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v49i9.4091
Disability Older adults; Korea

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How to Cite
KIM S, KIM M, HAN D. Incidence Rates of Disability and Its Associated Factors among Korean Community-Dwelling Older Adults. Iran J Public Health. 49(9):1718-1726.