Activities of daily living trajectories among institutionalised older adults: A prospective study

Huai‐Ting Kuo, Kuan‐Chia Lin, Chung‐Fu Lan and I‐Chuan Li

Journal of Clinical Nursing, 2017, vol. 26, issue 23-24, 4756-4767

Abstract: Aims and objectives To examine activities of daily living trajectory groups among older residents in Taiwan, and to determine the relative risks of demographic characteristics and health status in explaining the trajectory group of activities of daily living. Background Activity of daily living is a crucial indicator of health status for institutionalised older adults. activities of daily living is a dynamic process and has differences in trajectory groups. Design This study was a 3‐year longitudinal analysis of long‐term care facility residents in Taiwan. Methods A total of 364 older residents completed the entire research process. We used group‐based trajectory modelling and multinomial logistic models for statistical analysis. Results The result of this study revealed that three activities of daily living trajectory groups among older residents exhibited high dependency with gradually declining function (Group 1, 22.53%), low dependency with gradually declining function (Group 2, 43.13%) and persistent independent function (Group 3, 34.34%). Compared with Group 3, Group 1 was related to the following potential risk factors: older age, female, nonmainland China born and a married status. After considering resident health status in the analysis, three significant factors emerged for Group 1: the number of chronic diseases (odds ratio = 2.45), depressive symptoms (odds ratio = 1.71) and cognitive status (odds ratio = 83.11). Compared with Group 3, Group 2 was related to older age. After adding resident health status to the analysis, two significant factors of Group 2 emerged: the number of chronic diseases (odds ratio = 1.68) and depressive symptoms (odds ratio = 1.74). Conclusion The findings of this study indicated that health factors, including the number of chronic diseases, cognitive status and depressive symptoms, were more likely to contribute to the development of a decline pattern of activities of daily living. Relevance to clinical practice Appropriate exercise programmes and physical activities, according to residents’ personal characteristics and activities of daily living status, is crucial for improving physical functioning, alleviating depression and cognitive defects in institutionalised older adults.

Date: 2017
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