Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-26T08:43:27.075Z Has data issue: false hasContentIssue false
  • English
  • Français

Design for independent living: activity demands and capabilities of older people

Published online by Cambridge University Press:  12 May 2010

DAVID SEIDEL ,
KATHRYN RICHARDSON ,
NATHAN CRILLY ,
FIONA E. MATTHEWS ,
P. JOHN CLARKSON  and
CAROL BRAYNE
DAVID SEIDEL*
Affiliation:
Engineering Design Centre, University of Cambridge, Cambridge, UK.
KATHRYN RICHARDSON
Affiliation:
Institute of Public Health, University of Cambridge, Cambridge, UK.
NATHAN CRILLY
Affiliation:
Engineering Design Centre, University of Cambridge, Cambridge, UK.
FIONA E. MATTHEWS
Affiliation:
Medical Research Council Biostatistics Unit, Cambridge, UK.
P. JOHN CLARKSON
Affiliation:
Engineering Design Centre, University of Cambridge, Cambridge, UK.
CAROL BRAYNE
Affiliation:
Institute of Public Health, University of Cambridge, Cambridge, UK.
*
Address for correspondence: David Seidel, Engineering Design Centre, University of Cambridge, Trumpington Street, CambridgeCB2 1PZ, UK E-mail: djs216@eng.cam.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The ability to perform the instrumental activities of daily living (IADLs) is an important focus for the promotion of independent living in old age. If strategies to enable older people to remain in their own homes are to be developed, advances must be made in understanding the demands associated with IADLs. This paper reports on a study of how activity demands – the body postures, actions and hand functions involved in cooking, housework, laundering and shopping – relate to the capabilities of a sample of older people in Great Britain. Task data were analysed for 4,886 community-dwelling 55–93-year-olds who were enrolled in a follow-up survey to the 1996/97 Family Resources Survey. Logistic regression models were used to calculate adjusted odds ratios for associations between functional limitations and IADL difficulty. Attributable fraction estimates were also used to assess the population impact of the functional limitations. Comparable effect sizes were observed across activities for limitations in body postures (standing, reaching and bending/stooping), actions (lifting/lowering and holding/carrying) and hand functions. Most of the difficulties were attributable to limitations in body postures, primarily bending/stooping, whereas actions and hand functions accounted for much less difficulty. We present a matrix of the potential impact that design changes to alleviate each limitation would have on the ability to perform the activities studied. This can help to prioritise interventions aimed at supporting continued independent living.

Keywords

designindependent livingIADLsactivity demandcapabilityolder people
Type
Research Article
Information
Ageing & Society , Volume 30 , Issue 7 , October 2010 , pp. 1239 - 1255
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, S. M., Mor, V., Raveis, V. and Houts, P. 1993. Measurement of need for assistance with daily activities: quantifying the influence of gender roles. Journal of Gerontology, 48, 4, S204–11.Google Scholar
Avlund, K. and Schultz-Larsen, K. 1991. What do 70-year-old men and women actually do? And what are they able to do? From the Glostrup survey in 1984. Aging (Milan), 3, 1, 39–49.Google Scholar
Berkman, C. S. and Gurland, B. J. 1998. The relationship among income, other socioeconomic indicators, and functional level in older persons. Journal of Aging and Health, 10, 1, 81–98.CrossRefGoogle ScholarPubMed
Brady, A. R. 1998. Adjusted population attributable fractions from logistic regression. Stata Technical Bulletin, 42, 8–12.Google Scholar
Clark, M. C., Czaja, S. J. and Weber, R. A. 1990. Older adults and daily living task profiles. Human Factors, 32, 5, 537–49.Google Scholar
Clarke, P. and George, L. K. 2005. The role of the built environment in the disablement process. American Journal of Public Health, 95, 11, 1933–9.Google Scholar
Devore, D. 1998. 1996 Disability Survey: Follow-up to the Family Resources Survey. Her Majesty's Stationery Office, London.Google Scholar
Fors, S., Thorslund, M. and Parker, M. G. 2006. Do actions speak louder than words? Self-assessed and performance-based measures of physical and visual function among old people. European Journal of Ageing, 3, 1, 15–21.CrossRefGoogle ScholarPubMed
Furner, S. E., Rudberg, M. A. and Cassel, C. K. 1995. Medical conditions differentially affect the development of IADL disability: implications for medical care and research. The Gerontologist, 35, 4, 444–50.CrossRefGoogle ScholarPubMed
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E. and Wallace, R. B. 1995. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 9, 556–61.Google Scholar
Haley, S. M., Jette, A. M., Coster, W. J., Kooyoomjian, J. T., Levenson, S., Heeren, T. and Ashba, J. 2002. Late life function and disability instrument. II. Development and evaluation of the function component. Journal of Gerontology A: Medical Sciences, 57, 4, M217–22.Google ScholarPubMed
Jagger, C., Arthur, A. J., Spiers, N. A. and Clarke, M. 2001. Patterns of onset of disability in activities of daily living with age. Journal of the American Geriatrics Society, 49, 4, 404–9.Google Scholar
Keates, S. and Clarkson, P. J. 2003. Countering Design Exclusion: An Introduction to Inclusive Design. Springer-Verlag, London.Google Scholar
Kirwan, B. and Ainsworth, L. K. 1992. A Guide to Task Analysis: The Task Analysis Working Group. Taylor and Francis, London.CrossRefGoogle Scholar
Kivinen, P., Sulkava, R., Halonen, P. and Nissinen, A. 1998. Self-reported and performance-based functional status and associated factors among elderly men: the Finnish cohorts of the seven countries study. Journal of Clinical Epidemiology, 51, 12, 1243–52.CrossRefGoogle ScholarPubMed
Kovar, M. G. and Lawton, M. P. 1994. Functional disability: activities and instrumental activities of daily living. Annual Review of Gerontology and Geriatrics, 14, 57–75.Google Scholar
Lawton, M. P. 1980. Housing the elderly: residential quality and residential satisfaction among the elderly. Research on Aging, 2, 3, 309–28.Google Scholar
Lawton, M. P. and Brody, E. M. 1969. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 3, 179–86.CrossRefGoogle ScholarPubMed
Magaziner, J., Bassett, S. S., Hebel, J. R. and Gruber-Baldini, A. 1996. Use of proxies to measure health and functional status in epidemiologic studies of community-dwelling women aged 65 years and older. American Journal of Epidemiology, 143, 3, 283–92.Google Scholar
Ng, T. P., Niti, M., Chiam, P. C. and Kua, E. H. 2006. Physical and cognitive domains of the instrumental activities of daily living: validation in a multiethnic population of Asian older adults. Journal of Gerontology A: Biological Sciences and Medical Sciences, 61, 7, 726–35.Google Scholar
Nikula, S., Jylhä, M., Bardage, C., Deeg, D. J., Gindin, J., Minicuci, N., Pluijm, S. M. and Rodriguez-Laso, A. 2003. Are IADLs comparable across countries? Sociodemographic associates of harmonized IADL measures. Aging Clinical and Experimental Research, 15, 6, 451–9.Google Scholar
Ostir, G. V., Markides, K. S., Black, S. A. and Goodwin, J. S. 1998. Lower body functioning as a predictor of subsequent disability among older Mexican Americans. Journal of Gerontology A: Biological Sciences and Medical Sciences, 53, 6, 491–95.Google ScholarPubMed
Parker, C. J., Morgan, K. and Dewey, M. E. 1997. Physical illness and disability among elderly people in England and Wales: the Medical Research Council Cognitive Function and Ageing Study. Journal of Epidemiology and Community Health, 51, 5, 494–501.Google Scholar
Reuben, D. B., Siu, A. L. and Kimpau, S. 1992. The predictive validity of self-report and performance-based measures of function and health. Journal of Gerontology: Medical Sciences, 47, 4, M106–10.Google Scholar
Rogers, W. A., Meyer, B., Walker, N. and Fisk, A. D. 1998. Functional limitations to daily living tasks in the aged: a focus group analysis. Human Factors, 40, 1, 111–25.Google Scholar
Satariano, W. A. 2006. Epidemiology of Aging: An Ecological Approach. Jones and Bartlett, Sudbury, Massachusetts.Google Scholar
Seidel, D., Crilly, N., Matthews, F. E., Jagger, C., Brayne, C., Clarkson, P. J. and the Medical Research Council Cognitive Function and Ageing Study 2009. Patterns of functional loss among older people: a prospective analysis. Human Factors, 51, 5, 669–80.Google Scholar
Sidenvall, B., Nydahl, M. and Fjellström, C. 2001. Managing food shopping and cooking: the experiences of older Swedish women. Ageing & Society, 21, 2, 151–68.Google Scholar
Smith, L. A., Branch, L. G., Scherr, P. A., Wetle, T., Evans, D. A., Hebert, L. and Taylor, J. O. 1990. Short-term variability of measures of physical function in older people. Journal of the American Geriatrics Society, 38, 9, 993–8.CrossRefGoogle ScholarPubMed
Spector, W. D., Katz, S., Murphy, J. B. and Fulton, J. P. 1987. The hierarchical relationship between activities of daily living and instrumental activities of daily living. Journal of Chronic Diseases, 40, 6, 481–9.CrossRefGoogle ScholarPubMed
Stuck, A. E., Walthert, J. M., Nikolaus, T., Büla, C. J., Hohmann, C. and Beck, J. C. 1999. Risk factors for functional status decline in community-living elderly people: a systematic literature review. Social Science and Medicine, 48, 4, 445–69.CrossRefGoogle ScholarPubMed
Stump, T. E., Clark, D. O., Johnson, R. J. and Wolinsky, F. D. 1997. The structure of health status among Hispanic, African American, and White older adults. Journal of Gerontology B: Social Sciences, 52, 1, S49–60.Google Scholar
Verbrugge, L. M. 1990. The iceberg of disability. In Stahl, S. M. (ed.), Longevity: Health and Health Care in Later Life. Sage, Newbury Park, California, 55–75.Google Scholar
Verbrugge, L. M. and Jette, A. M. 1994. The disablement process. Social Science and Medicine, 38, 1, 1–14.CrossRefGoogle ScholarPubMed
Ward, G., Jagger, C. and Harper, W. 1998. A review of instrumental ADL assessments for use with elderly people. Reviews in Clinical Gerontology, 8, 1, 65–71.CrossRefGoogle Scholar
Weber, R. A., Czaja, S. J. and Redmond, G. 1988. Computer-assisted coding and analysis of videotapes: task analysis of older persons performing activities of daily living. Paper presented at the 41st annual scientific meeting of the Gerontological Society of America, 18–22 November, San Francisco, California.Google Scholar
Whittle, H. and Goldenberg, D. 1996. Functional health status and instrumental activities of daily living performance in non-institutionalised elderly people. Journal of Advanced Nursing, 23, 2, 220–7.Google Scholar
Wiener, J. M., Hanley, R. J., Clark, R. and Van Nostrand, J. F. 1990. Measuring the activities of daily living: comparisons across national surveys. Journal of Gerontology, 45, 6, S229–37.CrossRefGoogle ScholarPubMed