| Abstract |
Introduction: With aging come the first signs of physical health issues which often lead to functional deterioration though admittedly, such cases are neither ‘evenly distributed’ nor the same for all the elderly (Seeman, 2002; Mendes de Leon et al., 2001). It has become quite clear that beyond determining the physical symptoms, their origins and outcomes, a full assessment of functional ability is necessary if there is to be a proper evaluation of the health of the elderly person (Schultz, 1992).
The term ‘functional ability’ is defined as being the individual’s ability to prepare for and cope with the demands of daily activities (Verbrugge & Jette 1994,), which is vital to living independently.
Functional ability is considered a primary ingredient for ensuring the individual’s quality of life as it constitutes a powerful indicator for determining well-being during old age (Shcultz, 1992; Pope et al., 2001), an indirect way of assessing the overall effect of physical and environmental factors on the individual (Pope et al., 2001), and a risk factor for indicating increased institutionalization, mortality, as well as the increased use of health services (Seeman, 1996).
A number of studies show that functional status decline can be attributed to biological, psychological and social factors (Stuck, 1999). At the same time, social and mental parameters also come into play, these being one’s socio-economic status as well as social and family ties regarding social support, social networking and family support (Unger et al., 1999; Stuck et al., 1999; Lang et al., 2008; Pope, 2001; Rosso et al., 2013; Mendes de Leon et al., 2001). Social and family networks appear to be directly linked to an individual’s functional ability as they act chiefly as protective networks (Unger et al., 1999; Seeman et al., 1996). Therefore, functional disability does not simply come as a result of accumulating chronic pathological ailments but instead, embodies an adjustment process during which it is subject to a multitude of psycho-social an environmental factors. Thus, the disablement process is both complex and multifaceted. Although research has shown a growing interest in the benefits of social ties on functional ability, the results of their findings are not consistent (Avlund et al., 2004). As such, it remains unclear just how these factors affect the disablement process of functional disability.
Aim: The aim of the study is to assess functional disability in individuals aged 50 and over in the European study: “A Study on Health, Aging and Retirement in Europe” (SHARE study). The research question that arises is: Is functional disability always characterised by an accumulation of numerous physical and mental health issues, or is it due to the presence of independent psycho-social parameters?
Methods: Cross sectional data from the second wave (w2) of the Survey on Health, Ageing, and Retirement in Europe were used, analysing the responses of 13,974 adults aged 50+ (54,8% women and 45,2% men) from 13 European countries. Functional limitation was assessed using activities of daily living (ADL), instrumental activities of daily living (i-ADL) and mobility sensory index. Family ties were based on a customized model of family structural aspects. Multiple logistic regression analyses were used to examine the risk of functional limitations after adjusting for potential confounders.
Results: The mean value of family ties index is 5.98 (5.90-6.06). The majority of individuals that have functional status decline live alone, (54.9%), and have more than three children (44.7%). As regards family closeness and interaction, individuals with functional status decline live in close proximity to or even in the same house with other family members and have daily contact (35.5% and 49.6% respectively).
Those who appear to more frequently be at greater risk of acquiring decreased functional ability are women (OR 1.76 CI 1.43-2.17), individuals of advanced age (OR 1.72 CI 1.54-1.93), and those describing their general state of health as bad (OR 2.85 CI 2.45-3.32), those with chronic illnesses (OR 1.46 CI 1.30-1.65), physical health symptoms (OR 3.29 CI 2.92-3.71) and symptoms of depression (OR 1.93 CI 1.70-2.22). As regards family ties, decreased functional ability does not appear to affect low family relations.
Diminished family interaction appears to create the greatest risk for functional disability (OR 1.58 CI 1.13-2.22). Close proximity to the family home and family status appear to be protective factors against functional disability. Also, there does not seem to be a link between functional disability and having acquired a small number of children
As regards the results of the mean values of functional ability and family ties in European countries, it appears that the countries with a higher percentage of functional disability are those of southern Europe such as Greece, Italy and Spain, as well as a few countries in central Europe such as Poland. The remaining countries of central Europe as well as those of northern Europe had a lower percentage of functional disability. As for the family ties indicator, it appears to be higher in southern Europe (Italy, Spain, Greece) and much higher in Poland and in Holland, while in the remaining countries of central and northern Europe, it is not very high.
Conclusions: According to the results of the present study, functional disability does not seem to be affected by the presence of low family ties, On the contrary, it is affected by biological and demographic factors such as gender, age, chronic illnesses, depression, with the greatest degree of risk coming from self-reported health status and chronic health symptoms. However, in a further analysis of the family ties parameters and after checking for confounding factors, it appears that low family interaction greatly affects functional disability.
It therefore becomes clear that specific family ties, in terms of family interaction, may affect elderly people’s health and ability to function. Consequently, these findings offer great assistance to healthcare professionals as regards recognizing those factors, which are likely to lead to functional status decline of the elderly individual, especially when planning prevention strategies.
|
Search
