Elsevier

Annals of Epidemiology

Volume 8, Issue 6, August 1998, Pages 402-409
Annals of Epidemiology

Original Reports
Chronic Conditions and Disabilities Among Seniors: An Analysis of Population-Based Health and Activity Limitation Surveys

https://doi.org/10.1016/S1047-2797(98)00006-4Get rights and content

Abstract

PURPOSE: To describe the prevalence of disabilities and the medical conditions and risk factors associated with mobility and agility disabilities among seniors.

METHODS: In the 1986 and 1991 Canadian Census, every fifth person answered a screening question about activity limitation and disabilities. A probability sample of both those reporting and not reporting disability was selected to complete the Health and Activity Limitations Surveys (HALS) in 1986 and 1991. These two cross-sectional surveys conducted five years apart collected detailed activity limitation information about persons over 15 years of age. The current analysis was based on only respondents aged 65 years and older. The sample size for 65 years and older was 38518 in 1986 and 5106 in 1991. A computer link with the Census data provided household income and additional socio-demographic data for all respondents.

RESULTS: Over 40% of Canadian seniors reported at least one disability, and approximately a quarter of disabled seniors were classified as severely disabled. Mobility and agility disabilities accounted for over 80% of all disabilities reported by seniors, and senior women were more likely than men to report having a mobility or agility disability. Arthritis/rheumatism was reported as the cause of over 30% of all mobility and agility disabilities.

CONCLUSIONS: The continued monitoring of disabilities through surveys such as HALS will help determine the prevalence as well as aid in the identification of the causes of disabilities. Such information may be used to guide the implementation of appropriate public health interventions that will meet the changing health care needs of seniors.

Introduction

The population of most industrialized countries is aging and Canada is no exception. In 1994, 3.4 million Canadians, representing approximately 12% of the population, were seniors 65 years of age and older. By the year 2021, the population of seniors is expected to increase by 50% to over five million (1). It has been well established that increasing age is associated with worsening health and decreasing functional ability among seniors 2, 3, 4, 5, and that this decline is generally associated with increased demands on the health care system 5, 6, 7.

To determine the prevalence of disabilities among Canadians and the impact these have on the lives of the disabled, Statistics Canada conducted cross-sectional nationwide Health and Activity Limitation Surveys (HALS) in 1986 and again 1991. Findings from the 1986 HALS demonstrated that disabilities among Canadian seniors were greater in older age groups and were more prevalent among women than men (8). The current paper extends these findings by using both the 1986 and 1991 HALS to examine the prevalence of disabilities among seniors in both survey years. Medical conditions reported as being the primary cause for the two most common types of disabilities among seniors, mobility and agility (9), were also examined along with risk factors associated with having a mobility or agility disability.

Section snippets

Survey Design

Both the 1986 and 1991 HALS were cross-sectional surveys designed to gather information about disabilities experienced by Canadians and the impact these disabilities had on their daily living. HALS defined a disability as “any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.” An individual was classified as disabled if the restriction lasted or was expected to last at least six months and

Population Characteristics

Table 2 presents an overview of the characteristics of Canadians 65 years of age and older in 1986 and 1991. Overall, there was little change in their characteristics of two cross-sectional populations over the five year period with the exception of an increase in level of household income. In 1986, the majority of seniors reported a total household income under Cdn $10,000 (54.9%), whereas in 1991, the majority reported a household income of Cdn $10,000–$24,999 (50.4%). However, much of this

Discussion

The lack of availability of finer age groupings from HALS data for the senior population necessitated the extraction of age distributions from 1986 and 1991 Canadian Censuses (1). Population distribution from census data revealed a slight change in population structure of people over the age of 65 years. Specifically the 65–74 years old group decreased from 62% of the senior population to 60%, while the 75-years and older group increased from 38% to 40% of the senior population from 1986 to

Acknowledgements

During this project, Dr. Raina was funded as a Career Scientist by The R. Samuel McLaughlin Centre for Gerontological Health Research, McMaster University, Hamilton, Ontario and his research was supported by Seniors’ Independence Research Program. Funding for this project was provided by Division of Aging and Seniors, Health Canada, Ottawa, Ontario. We would like to thank Dr. Andria Scanlan and two reviewers of this manuscript for their helpful comments.

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