Gender differences in associations between ADL and other health indicators in 1992 and 2002

Research has shown increased prevalence rates over time in several health indicators in the older population. These increases have not been accompanied by corresponding increases in ADL and IADL disability. As disability and other health indicators follow different trends, the associations between them may change. And, as both health and disability also appear to follow different trends for men and women, we can expect gender differences in the associations. We examined gender differences in how objective tests of function, as well as self-reported health and function indicators, were associated with ADL/IADL in 1992 and 2002.

Data came from the Swedish Panel Study of Living Conditions among the Oldest Old (SWEOLD), a nationally representative interview survey of persons aged 77+.

Compared with men, women had significantly higher prevalence rates for most health indicators in both survey years, but there were no significant gender differences in ADL/IADL limitations. Prevalence rates increased significantly between 1992 and 2002 for all health indicators, but not for ADL/IADL. Most of the associations between ADL/IADL and other health indicators were stronger for men than for women. The overall pattern found was that associations have become weaker for women over time; for men, the picture was mixed.

The changing associations between ADL/IADL and other health indicators may reflect complex interplay between changes in several social and environmental factors, some of which may be modifiable. ADL/IADL appear to reflect different dimensions of health and different kinds of needs for men and women.