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Published on: April 23, 2014
Prevalence of functional limitations in older remote-living Aboriginal Australians
Kate Smith1,2, Zoë Hyde1,2, Leon Flicker1
1Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia.
Introduction:
To better tailor prevention and care strategies, there is a need to identify modifiable factors associated with functional impairment in older Aboriginal people, and related service needs.
Objective:
To investigate the prevalence and associated factors for functional impairment in older Aboriginal people, and related service needs.
Design:
Cross-sectional survey of 289 Aboriginal people aged ≥45 years living in the remote Kimberley region of Western Australia. Factors associated with functional impairment were explored with logistic regression.
Findings:
41.2% (95% CI 35.6%-47.0%) of participants required assistance with at least one I/ADL, and 26.0% (95% CI 21.2%-31.3%) required assistance with two or more I/ADLs. A core activity limitation (required assistance with showering, dressing or cooking) was reported by 15.9% (95% CI 12.1%-20.6%). In multivariable logistic regression analyses, older age, diabetes, difficulty walking, head injury, higher depression score and worse cognition were associated with needing help with two or more I/ADLs, while older age, history of stroke, higher depression score and worse cognition were associated with the presence of a core activity limitation. The proportion of participants receiving support with I/ADLs ranged from 71.2% to 97.6%. Support was generally provided by family and friends rather than service providers.
Discussion:
The key modifiable factors associated with functional impairment in older Aboriginal people living in remote regions are diabetes, depression and cognitive impairment. Services required are transport and socio-cultural activities, and ensuring support for family providing the majority of care.
Conclusions:
This study highlights the need for holistic prevention strategies and care for older Aboriginal people with functional limitations and their families.
