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Functioning and disability analysis by using WHO Disability Assessment Schedule 2.0 in older adults Taiwanese patients with dementia
Authors:Shih-Wei Huang  Kwang-Hwa Chang  Reuben Escorpizo  Wen-Chou Chi  Chia-Feng Yen  Hua-Fang Liao
Affiliation:1. Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan;2. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;3. Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan;4. Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;5. Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA;6. Swiss Paraplegic Research, Nottwil, Switzerland;7. Department of Public Health, Tzu Chi University, Hualien, Taiwan;8. Chinese Association of Early Intervention Profession for Children with Developmental Delays, Hualien City, Taiwan;9. School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
Abstract:Background: To analyse the disability status of elderly Taiwanese dementia patients by using the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). Methods: We enrolled 12 126 disabled elderly (>65 years) patients with dementia during July 2012–January 2014 from the Taiwan Data Bank of Persons with Disability. Trained interviewers evaluated the standardised scores in the six WHODAS 2.0 domains. Student’s t test was used for comparing WHODAS 2.0 scores of male and female dementia patients with different age groups. Results: The study population comprised 12 126 patients; 7612 were women and 4514 were men. The WHODAS 2.0 scores showed that the dementia patients had global activity limitation and participation restriction in all domains. Dementia-induced disability was prominent in male patients in all of the domains of the WHODAS 2.0. The domains of life activities, getting along with people and cognition were more strongly affected than the other domains. However, women experienced more rapid functional decline than men did as they aged. Conclusion: The data analysed in this large-scale, population-based study revealed crucial information on dementia-induced disability in elderly patients on the basis of the WHODAS 2.0 framework.
  • Implications for rehabilitation
  • Dementia patients have global functional disability in all domains of WHODAS 2.0 and multidisciplinary team is needed for rehabilitation programme intervention for these patients.

  • When considering the rehabilitation resource and strategy, the domains of cognition, activities of daily living and life activities should be focussed.

  • When dementia patients aged 65–75 years old, male patients got more restriction of function than female and more medical resource allocation for disabled male patients is recommended.

  • With ageing, female dementia patients exhibited more rapid functional decline than male patients did and more budget about rehabilitation for maintain functional and dementia progression is crucial for female patients.

Keywords:Dementia, gender difference  ICF  Taiwan  World Health Organisation Disability Assessment Schedule 2.0
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