Impacts of chronic diseases on limited basic activities of daily living in middle-aged and elderly people in China

  Objective  To explore the influence of chronic diseases on the limitation of basic activities of daily living (BADL) among middle-aged and elderly people in China and to provide references for enhancing the quality of life in the population.

  Methods  We extracted data of 5 296 middle-aged and elderly persons on status of chronic diseases and the limitation of BADL from the two datasets of China Health and Retirement Longitudinal Survey (CHARLS) conducted in 2011 and 2013. We adopted Cox proportional hazard regression model to evaluate impacts of chronic diseases on the limitation of BADL among the participants.

  Results  Of the participants, 1 584 (29.91%), 1 222 (23.07%), and 1 210(22.85%) were identified being suffering from one, two, and at least three types of chronic disease and 1 280 (24.17%) were free from any chronic disease. At the second wave of CHARLS, 1 172 (22.13%) participants reported the transition from having no limitation in their BADL to having the limitation within the two years from the first wave of CHARLS. Among the participants reporting the limitation, 921 (78.58%), 192 (16.38%), and 59 (5.04%) reported mild, moderate, and severe limitation and the reported proportion of limitation in BADL rose up significantly with the increment of age (χ²_trend = 51.949, P < 0.001), with the limitation proportions of 15.86%, 21.53%, 23.98%, and 29.34% for the participants with no, one, two, and at least three of chronic diseases, respectively. The results of Cox proportional hazard regression analysis revealed that after adjusting for confounding factors such as gender, age, marital status, education and economic situation, chronic diseases associated with BADL limitation were hypertension, stroke, kidney disease, stomach or other digestive disease, and arthritis/ rheumatism (all P < 0.05); while, after adjusting for gender, age, marital status, education, economic situation, and other chronic diseases, only hypertension, kidney disease, and arthritis/ rheumatism were associated with BADL limitation (all P < 0.05).

  Conclusion  Both the number and type of chronic diseases are associated with basic activities of daily living limitation and promoting the management on specific chronic diseases such as hypertension, kidney disease, and arthritis/ rheumatism will help reduce the risk of basic activities of daily living limitation among middle-aged and elderly population in China.