Explaining higher functional disability in women compared to men among older adults - the Singapore Chinese Health...

Studies suggest that the higher prevalence of functional disability in women could be explained by differences in social and health-related factors. We examined these factors in association with disability among Chinese older adults in Singapore.

We used data from 13,788 participants who attended the third follow-up interviews in the Singapore Chinese Health Study, when the mean age was 72.86 ± 6.23 years. Participants who had overall scores > 8 on the Lawton Instrumental Activities of Daily Living (IADL) Scale were considered to have functional disability. Multivariable logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association with functional disability.

The age-adjusted OR (95% CI) for the association with functional disability in women compared to men was 1.29 (1.20-1.39). However, after additional adjustment for other determinants of functional disability, this OR (95% CI) was attenuated to 0.96 (0.88-1.05). This association was largely mediated by lack of formal education (45.8%), weak handgrip strength (20.3%), arthritis (15.0%) and abdominal obesity (8.4%). Furthermore, age, lack of education, hypertension, diabetes, coronary artery disease, arthritis and abdominal obesity were associated with significantly higher odds of disability in women than in men (P-values of interactions with gender ≤ 0.042).

Lower educational attainment, musculoskeletal conditions, and abdominal obesity may contribute to a higher likelihood of disability in women. Additionally, abdominal obesity, arthritis and cardiometabolic diseases showed stronger associations with functional disability in women than in men.