Trends and educational disparities in functional capacity among people aged 65-84 years

Abstract

Background: This study examined 10 year trends in functional capacity by gender, age, and education among elderly Finns aged 65-84 years, focusing on difficulties in basic activities of daily living (BADL). Educational disparities and their trends in the prevalence of these difficulties were also assessed.

Methods: Data were derived from nationally representative monitoring surveys conducted biennially from 1993 to 2003 by the National Public Health Institute (KTL). A total of 5740 men and 5746 women were included in the study (response rate 80%). Activities of daily living (ADL) measures were used to assess levels of functional capacity. Education was divided into two groups: low (0-8 years) and high (9+ years). Age-adjusted trends and logistic regression analyses were computed.

Results: A clear downward trend in BADL difficulties was observed in all age groups in both genders. 80-84 year olds had clearly poorer functional ability than 65-69 year olds, even when adjusted for chronic diseases. Despite the overall improvement in functional capacity in both educational groups, low educational status persistently predicted poorer functional capacity. When chronic diseases and survey period were controlled for, the educational disparities attenuated slightly but remained significant.

Conclusions: The number of Finnish elderly with BADL difficulties has declined markedly over the past 10 years. However, persistent educational disparities continue to present a challenge to public health initiatives for reducing inequalities in health.