Academic journal article Gender & Behaviour

Social and Health Determinants of Gender Differences in Functional Disability among Older Adults in Indonesia

Academic journal article Gender & Behaviour

Social and Health Determinants of Gender Differences in Functional Disability among Older Adults in Indonesia

Article excerpt


Information on functional disability (long-term activity limitation) and health among the older men and women population in Indonesia is important for understanding living conditions among older adults (World Health Organization, 2011). Compared to older men, older women report more often higher rates of functional disability than men despite them having lower rates of mortality (Hosseinpoor et al. 2012; Zeki Al Hazzouri, Mehio Sibai, Chaaya, Mahfoud & Yount, 2011). In Indonesia nationally representative data from the 1993 and 1997 Indonesia Family Life Survey (IFLS) show an increasing prevalence of Daily Activity Limitations (ADL) (4.2 to 6.5%) (Ofstedal et al., 2007). Arifin, Braun and Hogervorst (2012) found that in 2005 among older adults in Indonesia the prevalence ADLs was low (2.9% and 3.1% having difficulty using the toilet and getting dressed, respectively, etc.) and the prevalence of Instrumental Daily Activity Limitations (IADLs) was high (12.1% among men and 18.7% among women). In a review of the Chinese ageing population, the prevalence of ADLs ranged from 3.0% to 11.6%, and the prevalence of IAdLs ranged from 7.9% to 50.2% (Dong & Su, 2016).

Sociodemographic factors, health status factors such as having chronic conditions, health risk behaviours and lack of social capital have been found associated with functional disability. Sociodemographic risk factors for functional disability include increasing age (e.g., Debpuur, Welaga, Wak & Hodgson, 2010; Dong & Su, 2016; Gómez-Olivé, Thorogood, Clark, Kahn & Tollman, 2010; Razzaque, Nahar, Khanam & Streatfield, 2010), being female (Dong & Su, 2016; Debpuur et al. 2010; Gómez-Olivé et al., 2010; Razzaque et al. 2010), lower education (Dong & Su, 2016; Gómez-Olivé et al., 2010; Kaneda, Zimmer, Dong & Su, 2007; Serrano-Alarcón & Perelman, 2017), lower economic status (Ahmed, Vafaei, Auais, Guralnik & Zunzunegui, 2016; Debpuur et al., 2010; Dong & Su, 2016; Serrano-Alarcón & Perelman, 2017), and rural residences (Dong & Su, 2016).

Health status and chronic condition risk factors include the number of chronic conditions (Dong & Su, 2016; Sujarwoto S, Tampubolon, 2015), specific chronic conditions such as heart attack, arthritis, asthma (Astuti & Budijanto, 2008; Rodrigues et al., 2009). In a study in Brazil, among men stroke, back pain, and arthritis, and among women diabetes, heart diseases, and arthritis most significantly contributed to disability (Yokota et al., 2016). Further, mental health problems have been found to be associated with functional disability, such as depression (Dong & Su, 2016; Rodrigues et al. 2009; Sujarwoto & Tampubolon, 2015) and sleep problems (Rodrigues et al., 2009). Moreover, obesity increased the odds for disability among obese older adults in high-income countries (Koyanagi et al., 2015) and in Indonesia significant effects of obesity on ADLs was found (Sujarwoto & Tampubolon, 2015).

Behavioural risk factors include tobacco use (Sujarwoto S, Tampubolon, 2015; Sun, Park, Klemmack, Roff & Li, 2009), infrequent fruit and vegetable consumption and physical inactivity (Ribeiro et al., 2016), and other factors include cognitive impairment (Dong & Su, 2016) and low grip strength (Cano-Gutiérrez, Borda, Reyes-Ortiz, Arciniegas & Samper-Ternent, 2017). Lack of social capital and social support networks have also been found to be associated with functional disability (Cao & Rammohan, 2016; MendozaNúñez et al., 2017).

Little is known about the recent prevalence and predictors of functional status and disability of gender differences among older adults in Indonesia. Additional data are needed to close this gap in knowledge. This study aims to investigate social and health determinants of functional disability among individuals 50 years and older in a national probability sample who participated in Indonesia Family Life Survey (IFLS-5) in 20142015. …

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