Disability among older people in a southern European city in 2006: trends in gender and socioeconomic inequalities

Abstract

Background and aims: We wished to describe disability prevalence in people aged >or=65 years in Barcelona in 2006, its trends since 1992, and disability inequalities by gender and socioeconomic position (SEP).

Methods: This was a cross-sectional design, including data from the 1992, 2000, and 2006 Barcelona Health Interview Surveys (noninstitutionalized population >or=65 years old). Disability was defined as having difficulty carrying out at least one of seven activities of daily living (ADL). The number of ADLs carried out with difficulty was considered a measure of disability severity. Independent variables were age and educational level as a measure of SEP. Prevalence and prevalence ratio (PR) of disability stratified by sex were obtained through log-binomial regression models or using zero-inflated Poisson regression models.

Results: The prevalence of disability increased between 1992 and 2006 among women but not men because of the higher increase in older age among women. Disability prevalence was 30% in men and 53% in women in 2006. Disability inequalities by SEP were present in all the ADL analyzed and in all 3 years, remaining stable throughout the period. Overall, the PR of disability in lower SEP compared with higher SEP was 1.61 (95% CI 1.32-1.98) in men and 1.53 (95% CI 1.33-1.76) in women.

Conclusions: Disability prevalence is increasing among older women at the turn of the century in this southern European city, and socioeconomic inequalities in disability persist. Although women have longer life expectancy, their disability prevalence in older age is much higher than that of men.