Trends in ADL and IADL disability in community-dwelling older adults in Shanghai, China, 1998-2008

We investigated trends in activities of daily living (ADL) and instrumental activities of daily living (IADL) disability from 1998 to 2008 among elder adults in Shanghai, China. Our data came from 4 waves of the Shanghai Longitudinal Survey of Elderly Life and Opinion (1998, 2003, 2005, and 2008). ADL and IADL disabilities were recorded dichotomously (difficulty vs. no difficulty). The major independent variable was survey year. Covariates included demographics, socioeconomic conditions, family and social support, and other health conditions. Nested random-effect models were applied to estimate trends over time, referenced to 1998. In comparison with the baseline year (1998), older adults in 2008 had lower odds of being ADL disabled, though the effect was no longer statistically significant when other health conditions were taken into account. Elders in 2003, 2005, and 2008 were 20%-26%, 17%-38%, and 53%-64% less likely to be IADL disabled than those in 1998, respectively, depending on the set of covariates included in the model. Shanghai elders experienced substantial improvements in both ADL and IADL disability prevalence over the past decade. The trend toward improvement in IADL function is more consistent and substantial than that of ADL function.