Incidence of ADL Disability in Older Persons, Physical Activities as a Protective Factor and the Need for Informal and Formal Care--Results from the SNAC-N Project

PLoS One. 2015 Sep 25;10(9):e0138901. doi: 10.1371/journal.pone.0138901. eCollection 2015.


Background: The aim of the study was to examine 1) the incidence of disability in Activities of Daily Living (ADL), in persons 78 years and older 2) explore whether being physical active earlier is a significant predictor of being disability free at follow-up and 3) describe the amount of informal and formal care in relation to ADL-disability.

Methods: Data were used from a longitudinal community-based study in Nordanstig (SNAC-N), a part of the Swedish National Study on Aging and Care (SNAC). To study objectives 1) and 2) all ADL-independent participants at baseline (N = 307) were included; for objective 3) all participants 78 years and older were included (N = 316). Data were collected at baseline and at 3- and 6-year follow-ups. ADL-disability was defined as a need for assistance in one or more activities. Informal and formal care were measured using the Resource utilization in Dementia (RUD)-instrument.

Results: The incidence rates for men were similar in the age groups 78-81 and 84 years and older, 42.3 vs. 42.5/1000 person-years. For women the incidence rate for ADL-disability increased significantly from the age group 78-81 to the age group 84 years and older, 20.8 vs.118.3/1000 person-years. In the age group 78-81 years, being physically active earlier (aOR 6.2) and during the past 12 month (aOR 2.9) were both significant preventive factors for ADL-disability. Both informal and formal care increased with ADL-disability and the amount of informal care was greater than formal care. The incidence rate for ADL-disability increases with age for women and being physically active is a protective factor for ADL-disability.

Conclusion: The incidence rate for ADL-disability increases with age for women, and being physical active is a protective factor for ADL-disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Dementia / epidemiology
  • Dementia / prevention & control*
  • Disabled Persons / statistics & numerical data*
  • Female
  • Health Care Surveys
  • Health Services for the Aged*
  • Humans
  • Male
  • Motor Activity*
  • Sweden

Grant support

This study was supported by grants from the Swedish Brain Power, Center for Gender Medicine at Karolinska Institutet, the Alzheimer Foundation Sweden, and Karolinska Institutet Foundations. The sponsors had no role in the design, methods, participant recruitment, data collection, analysis, or preparation of the manuscript.