Urban-rural disparity in disability and its influencing factors among the elderly in Tai′an city

  Objective  To examine current situation and influencing factors of disability among urban and rural elderly residents in Tai'an municipality, and to provide evidence for promoting healthy aging in the population.

  Methods   Face-to-face interviews were conducted among 3 896 elderly residents ( ≥ 60 years) recruited with multistage random cluster sampling in 6 prefectures/counties/districts of Tai′an municipality, Shandong province during July – August 2020. The Physical Self-Maintenance Scale (PSMS) for activities of daily living (ADL) assessment, Pittsburgh Sleep Quality Index (PSQI) for sleep status evaluation, and a self-designed general questionnaire were adopted in the survey for analyzing ADL and its associates of the elderly.

  Results   Of the 3 864 elderly averagely aged 68.89 ± 5.98 years, 4.8% were assessed as having disabilities (with a PSMS score of higher than 6), with a significantly higher disability ratio among the rural elderly than that among the urban elderly (5.5% vs. 3.5%, χ² = 8.040; P < 0.05). The results of multivariate logistic regression analysis revealed following significant influencing factors of disability: (1) risk factors for urban elderly: aged ≥ 80 years (odds ratio OR = 7.058), poor self-rated health (OR = 3.237), and poor sleep quality (OR = 6.288); (2) protective factors for urban elderly: participating in the basic medical insurance for urban employees (OR = 0.146) or the basic medical insurance for urban and rural residents (OR = 0.180); (3) risk factors for rural elderly: aged 70 – 79 years (OR = 2.116) or ≥ 80 years (OR = 7.270), fair self-rated health (OR = 2.256) or poor self-rated health (OR = 4.368), suffering from chronic diseases (OR = 3.290), falling history in the previous year (OR = 2.151); and (4) protective factors for rural elderly: participating in physical exercise (OR = 0.568).

  Conclusion  The prevalence of disability was higher among rural elderly residents than that among urban elderly residents and the prevalence was influenced by age and self-rated health for both rural and urban elderly in Tai′an municipality.