Self-Reported Disability and Its Association with Performance-Based Limitation in Elderly Men: A Comparison of Three European Countries

• Published in: Journal of the American Geriatrics Society (JAGS) 2003-06, Vol.51 (6), p.782-788
• Main Authors: Van Den Brink, Carolien L., Tijhuis, Marja, Kalmijn, Sandra, Klazinga, Niek S., Nissinen, Aulikki, Giampaoli, Simona, Kivinen, Paula, Kromhout, Daan, Van Den Bos, Geertrudis A.M.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Analysis. Health state; Biological and medical sciences; Cohort Studies; Comparative analysis; countries; Cross-Cultural Comparison; Cross-Sectional Studies; Crosscultural studies; Disability; Disabled Persons - psychology; Disabled Persons - statistics & numerical data; elderly; Elderly men; Epidemiology; Finland; Finland - epidemiology; Functional performance; functional status; General aspects; Geriatric Assessment - statistics & numerical data; Handicapped people; Humans; Italy; Italy - epidemiology; Male; Medical sciences; Netherlands; Netherlands - epidemiology; Older people; physical function; Public health. Hygiene; Public health. Hygiene-occupational medicine; rated health; Self-Assessment; self-report; Selfreport; Task Performance and Analysis
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1046/j.1365-2389.2003.51258.x

OBJECTIVES: To compare self‐reported disability and performance‐based limitation and their association in elderly men from three European countries. DESIGN: Cross‐sectional data from a cohort study collected around 1990. SETTING: Three cohorts from Finland, the Netherlands, and Italy. PARTICIPANTS: One thousand one hundred sixty‐one men aged 70 and older. MEASUREMENTS: Disability and functional limitation were measured in a standardized way in three countries. Self‐reported disability was estimated by questionnaire, assessing three domains of activities of daily living: instrumental activities of daily living, mobility, and activities of daily living (score 0–3). Functional limitation was measured by performance tests (score 0–16), with 0 indicated the healthiest score. RESULTS: Self‐reported disability and performance‐based limitation scores differed between countries. Mean self‐reported disability score was worse in Italy (0.72) and the Netherlands (0.70) than in Finland (0.54). Italian men scored worst on the performance‐based tests (mean 4.80 vs 4.04 for Finland and 3.74 for the Netherlands). Differences in self‐reported disability remained after adjusting for performance scores: Dutch men reported more disabilities (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.23–2.25) than men in Finland (reference group) and Italy (OR = 1.08, 95% CI = 0.77–1.53). Self‐reported disability was positively associated with performance‐based score (OR = 1.28, 95% CI = 1.21–1.35) and did not differ between countries. CONCLUSION: Cross‐cultural variation was noted in self‐reported disability adjusted for performance score. These differences may be due to sociocultural and physical environmental factors. Self‐reported disability was consistently associated with performance‐based limitation in Finland, the Netherlands, and Italy.