Epidemiology and Factors Associated With Self-Care Difficulty in a National Saudi Sample: A Retrospective Study

Independent living depends on basic self-care tasks, yet their impairment has not been quantified at the national level in Saudi Arabia. This study aimed to estimate the national prevalence of self-care difficulty among Saudi citizens and identify associated factors across demographic (sex, age, education, marital status), geographic (administrative region), clinical (severity, cause, duration, chronic disease), and family/household indicators (relationship to household head, consanguinity) using the 2017 Saudi National Disability Survey. A retrospective cross-sectional analysis was conducted using the 2017 Saudi National Disability Survey (N = 20 408 362 Saudis). Thirteen Washington Group indicators were extracted; design-based χ² tests and survey-weighted logistic regression assessed associations. Overall, 238 984 individuals (1.2%) reported difficulty with bathing, dressing, or toileting-1.1% of males (112 319) and 1.3% of females (126 665). Most cases co-occurred with additional disabilities (227 609; 1.1%); isolated self-care difficulty was uncommon (11 375; 0.1%). Adjusted odds were higher in Asīr (AOR = 1.42, 95% CI 1.30-1.55) and Ḥā'il (AOR = 1.36, 95% CI 1.22-1.53) relative to Al-Riyadh, rose sharply with severe/extreme limitation (AOR = 6.11, 95% CI 5.71-6.54), and were elevated among individuals from first-cousin marriages (AOR = 1.58, 95% CI 1.48-1.68). Disease-related aetiology, disability duration ≥ 25 years, and receipt of Ministry of Labour benefits were independent correlates, whereas tertiary education unexpectedly predicted higher risk. Self-care difficulty affects a modest proportion of Saudis, yet the absolute burden approaches a quarter-million people, clustering in peripheral provinces and among long-standing, severe cases. Targeted rehabilitation, premarital genetic counselling, and regionally equitable service expansion will be essential to fulfil Vision 2030 equity goals. Routine national monitoring of activity-of-daily-living limitations is needed to guide person-centred resource allocation.