Changes in person-environmental fit and ADL dependence among older Swedish adults. A 10-year follow-up

In order to investigate the relation between personal functional capacity and the physical housing environment during the aging process, the aim of this study was to give a long-term description of person-environmental fit (P-E fit) problems in terms of housing accessibility and ADL dependence among older adults, and to study their relationships at three points in time.

A 10- year longitudinal design was used: baseline (1994), follow- up 1 (2000) and follow-up 2 (2004). Using the Swedish national population register, a baseline sample of persons aged 75-84 years was identified. Of the 133 participants at baseline, the 31 participants still available at follow-up 2 were included in this study. Data on housing accessibility, functional limitations and dependence in ADL were collected by means of interviews and observations at home visits.

P-E fit problems increased significantly between baseline and follow-up 1 and between follow-ups 1 and 2. No significant changes in overall ADL dependence were recorded. The total number of functional limitations, dependence on walking aids and P-E fit were significantly correlated to ADL dependence, at both follow-up 1 and follow-up 2, but not at baseline.

Results confirm that functional decline is a major driver toward increased ADL dependence during the aging process, whereas environmental barriers per se are not related to such disability. Instead, P-E fit is significantly related to ADL dependence, and the relationship grows stronger with advancing age.