Prevalence and correlates of functional disability in multiethnic elderly Singaporeans

OBJECTIVES: To make comparative estimates of prevalence of late-life functional disability, examine sociodemographic and health correlates, investigate sex and ethnic differences, and estimate population attributable risk of modifiable risk factors. DESIGN: Population-based survey. SETTING: Multiethnic population of Singapore (3 million residents). PARTICIPANTS: Noninstitutionalized Chinese, Malay, and Indian people aged 60 and older (N=1,079) MEASUREMENTS: Functional disability was defined as needing help in at least one basic activity of daily living (ADL) task in the 10 items of the Barthel Index. Five basic ADLs (eating, bathing, dressing, transferring, toileting) were used to compare prevalence with those reported from other national surveys and with reported past prevalence within the country. RESULTS: The prevalence of disability in at least one of five ADL items (6.6% in those aged > or = 65) appeared lower than elsewhere, including China, but higher than reported past prevalence within the country. Functional disability on at least one of the 10 ADL items was independently associated with female sex, Indian ethnicity, older age, poor self-rated health, specific chronic diseases, cognitive impairment, sensory impairment, and living with others. The population attributable risks for leading modifiable factors were arthritis (12%) and cognitive impairment (14%). CONCLUSION: Lower prevalence of functional disability accompanies rapid aging and health transition in Singapore than in other countries but higher prevalence than reported past prevalence within the country. Associations with sociodemographic and health-related factors were consistent with Western studies, including unexplained sex and ethnic differences.