|
Sign In to gain access to subscriptions and/or personal tools.
|
Gender Differences in Lower Extremity Function in Latin American EldersSeeking Explanations From a Life-Course Perspective
Beatriz Eugenia Alvarado, MD, PhD
Université de Montréal, Canada, be.alvarado.llano{at}umontreal.ca
Ricardo O. Guerra, PhD
Federal University of Rio Grande do Norte, Brazil
Maria Victoria Zunzunegui, PhD
Université de Montréal, Canada
Objective: The authors examined the contribution of life-course exposures to gender differences in mobility in later life. Method: Data originate from a survey of persons aged 60 and older living in six Latin American and Caribbean cities (n = 10,661). Lower extremity limitations (LEL) were defined as the presence of three or more reported difficulties with five activities: lifting and carrying 10 lb, walking several blocks, climbing a flight of stairs, kneeling/ stooping/crouching, and getting up from a chair. Data were pooled after testing homogeneity of effects across cities. A multivariate model was fitted using logistic regression analysis. Complete data analyses were performed on 8,166 (72%) participants. Results: Prevalence of LEL varies across cities (9.3—23.7% in men, 23.3—42.9% in women). Intervening life-course and health factors explained a small proportion of the gender difference in LEL (odds ratio = 2.39; 95% confidence interval = 2.04—2.79). Childhood hunger was predictive of LEL in women, and a stronger association between depression and LEL was found in men than in women. Little education and insufficient income were associated with LEL for both men and women. Discussion: Life-course exposures predict mobility, but further research is needed to identify intervening factors relating gender to mobility in old age.
Key Words: lower extremities mobility gender life course aging
References
- Ahacic, K., Parker, M.G., & Thorslund, M. (2003). Mobility limitations 1974-1991: Period changes explaining improvement in the population. Social Science and Medicine, 57, 2411-2422.[CrossRef][Medline]
[Order article via Infotrieve]
- Albala, C., Lebrao, M.L., Leon Diaz, E.M., Ham-Chande, R., Hennis, A.J., Palloni, A., et al. (2005). Encuesta Salud, Bienestar y Envejecimiento (SABE): Metodología de la encuesta y perfil de la poblacioón estudiada [The health, well-being, and aging ("SABE") survey: Methodology applied and profile of the study population]. Revista Panamericana de Salud Publica, 17, 307-322.[Medline]
[Order article via Infotrieve]
- Al Snih, S., Fisher, M.N., Raji, M.A., Markides, K.S., Ostir, G.V., & Goodwin, J.S. (2005). Diabetes mellitus and incidence of lower body disability among older Mexican Americans. Journal of Gerontology Series A: Biological Science Medical Sciences, 60, 1152-1156.
- Al Snih, S., Ray, L., & Markides, K.S. (2006). Prevalence of self-reported arthritis among elders from Latin America and the Caribbean and among Mexican Americans from the southwestern United States. Journal of Aging Health, 18, 207-223.[Abstract/Free Full Text]
- Alvarado, B.E., Zunzunegui, M.V., Del, S.T., & Beland, F. (2002). Cognitive decline is related to education and occupation in a Spanish elderly cohort. Aging Clinical Experimental Research, 14, 132-142.
- Arber, S. (1997). Comparing inequalities in women's and men's health: Britain in the 1990s. Social Science and Medicine, 44, 773-787.[CrossRef][Web of Science]
- Arndt, V., Rothenbacher, D., Daniel, U., Zschenderlein, B., Schuberth, S., & Brenner, H. (2005). Construction work and risk of occupational disability: A ten-year follow up of 14,474 male workers. Occupational Environmental Medicine, 62, 559-566.[CrossRef]
- Barbosa, A.R., Souza, J.M., Lebrao, M.L., Laurenti, R., & Marucci Mde, F. (2005). Functional limitations of Brazilian elderly by age and gender differences: Data from SABE survey. Cadernos de Saude Publica, 21, 1177-1185.[Medline]
[Order article via Infotrieve]
- Barcelo, A., Pelaez, M., Rodriguez-Wong, L., & Pastor-Valero, M. (2006). The prevalence of diagnosed diabetes among the elderly of seven cities in Latin America and the Caribbean: The health wellbeing and aging (SABE) project. Journal of Aging and Health, 18, 224-239.[Abstract/Free Full Text]
- Beekman, A.T., Kriegsman, D.M., Deeg, D.J., & van Tilburg, W. (1995). The association of physical health and depressive symptoms in the older population: Age and sex differences. Social Psychiatry and Psychiatric Epidemiology, 30, 32-38.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Beland, F., & Zunzunegui, M.V. (1999). Predictors of functional status in older people living at home. Age and Ageing, 28, 153-159.[CrossRef]
- Beland, F., Zunzunegui, M.V., Alvarado, B., Otero, A., & Del Ser, T. (2005). Trajectories of cognitive decline and social relations. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 60, P320-P330.
- Ben-Shlomo, Y., & Kuh, D. (2002). A life course approach to chronic disease epidemiology: Conceptual models, empirical challenges and interdisciplinary perspectives. International Journal of Epidemiology, 31, 285-293.[Free Full Text]
- Beydoun, M.A., & Popkin, B.M. (2005). The impact of socio-economic factors on functional status decline among community-dwelling older adults in China. Social Science and Medicine, 60, 2045-2057.[CrossRef][Medline]
[Order article via Infotrieve]
- Broese van Groenou, M.I., Deeg, D.J., & Penninx, B.W. (2003). Income differentials in functional disability in old age: Relative risks of onset, recovery, decline, attrition and mortality. Aging Clinical Experimental Research, 15, 174-183.
- Carter, A.O., Hambleton, I.R., Broome, H.L., Fraser, H.S., & Hennis, A.J. (2006). Prevalence and risk factors associated with obesity in the elderly in Barbados. Journal of Aging and Health, 18, 240-258.[Abstract/Free Full Text]
- Cheng, Y.H., Chi, I., Boey, K.W., Ko, L.S., & Chou, K.L. (2002). Self-rated economic condition and the health of elderly persons in Hong Kong. Social Science and Medicine, 55, 1415-1424.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Coppin, A.K., Ferrucci, L., Lauretani, F., Phillips, C., Chang, M., Bandinelli, S., et al. (2006). Low socioeconomic status and disability in old age: Evidence from the inchianti study for the mediating role of physiological impairments. Journal of Gerontology Series A: Biological Science Medical Sciences, 61, 86-91.
- Dyer, A.R. (1986). A method for combining results from several prospective epidemiologic studies. Statistics Medicine, 5, 303-317.[CrossRef]
- Femia, E.E., Zarit, S.H., & Johansson, B. (2001). The disablement process in very late life: A study of the oldest-old in Sweden. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 56, P12-P23.
- Fried, L.P., Bandeen-Roche, K., Kasper, J.D., & Guralnik, J.M. (1999). Association of comorbidity with disability in older women: The women's health and aging study. Journal of Clinical Epidemiology, 52, 27-37.[CrossRef]
- Guralnik, J.M., Ferrucci, L., Simonsick, E.M., Salive, M.E., & Wallace, R.B. (1995). Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556-561.[Abstract/Free Full Text]
- Hardy, R., & Kuh, D. (2005). Social and environmental conditions across the life course and age at menopause in a British birth cohort study. BJOG, 112, 346-354.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Hatch, S.L. (2005). Conceptualizing and identifying cumulative adversity and protective resources: Implications for understanding health inequalities. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 60(Spec. No. 2), 130-134.
- Janssen, I., Heymsfield, S.B., & Ross, R. (2002). Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. Journal of the American Geriatric Society, 50, 889-896.[CrossRef]
- Kauhanen, L., Lakka, H.M., Lynch, J.W., & Kauhanen, J. (2006). Social disadvantages in childhood and risk of all-cause death and cardiovascular disease in later life: A comparison of historical and retrospective childhood information. International Journal of Epidemiology, 35, 962-968.[Abstract/Free Full Text]
- Keddie, A.M., Peek, M.K., & Markides, K.S. (2005). Variation in the associations of education, occupation, income, and assets with functional limitations in older Mexican Americans. Annals of Epidemiology, 15, 579-589.[CrossRef]
- Kuh, D., Bassey, E.J., Butterworth, S., Hardy, R., & Wadsworth, M.E. (2005). Grip strength, postural control, and functional leg power in a representative cohort of British men and women: Associations with physical activity, health status, and socioeconomic conditions. Journal of Gerontology Series A: Biological Sciences Medical Sciences, 60, 224-231.
- Kuh, D., Ben-Shlomo, Y., Lynch, J., Hallqvist, J., & Power, C. (2003). Life course epidemiology. Journal of Epidemiology and Community Health, 57, 778-783.[Abstract/Free Full Text]
- LaCroix, A.Z., Guralnik, J.M., Berkman, L.F., Wallace, R.B., & Satterfield, S. (1993). Maintaining mobility in late-life. 2. Smoking, alcohol-consumption, physical-activity, and body-mass index. American Journal of Epidemiology, 137, 858-869.[Abstract/Free Full Text]
- Lamb, V.L. (1997). Gender differences in correlates of disablement among the elderly in Egypt. Social Science and Medicine, 45, 127-136.[CrossRef][Medline]
[Order article via Infotrieve]
- Launer, L.J., Harris, T., Rumpel, C., & Madans, J. (1994). Body mass index, weight change, and risk of mobility disability in middle-aged and older women: The epidemiologic follow-up study of NHANES I. Journal of the American Medical Association, 271, 1093-1098.[CrossRef]
- Lawlor, D.A., Batty, G.D., Morton, S.M., Clark, H., Macintyre, S., & Leon, D.A. (2005). Childhood socioeconomic position, educational attainment, and adult cardiovascular risk factors: The Aberdeen children of the 1950s cohort study. American Journal of Public Health, 95, 1245-1251.[Abstract/Free Full Text]
- Lawrence, R.H., & Jette, A.M. (1996). Disentangling the disablement process. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 51, S173-S182.
- Leveille, S.G., Penninx, B.W., Melzer, D., Izmirlian, G., & Guralnik, J.M. (2000). Sex differences in the prevalence of mobility disability in old age: The dynamics of incidence, recovery, and mortality. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 55, S41-S50.
- Li, C.-Y., Wu, S.C., & Wen, S.W. (2000). Longest held occupation in a lifetime and risk of disability in activities of daily living. Occupational Environmental Medicine, 57, 550-554.[CrossRef]
- Mansson, N.O., Rastam, L., Eriksson, K.F., & Israelsson, B. (1998). Socioeconomic inequalities and disability pension in middle-aged men. International Journal of Epidemiology, 27, 1019-1025.[Abstract/Free Full Text]
- Melzer, D., & Parahyba, M.I. (2004). Socio-demographic correlates of mobility disability in older Brazilians: Results of the first national survey. Age and Ageing, 33, 253-259.[CrossRef]
- Morley, J.E., Perry, H.M., Iii, & Miller, D.K. (2002). Editorial: Something about frailty. Journal of Gerontology Series A: Biological Sciences Medical Sciences, 57, M698-M704.
- Murtagh, K.N., & Hubert, H.B. (2004). Gender differences in physical disability among an elderly cohort. American Journal of Public Health, 94, 1406-1411.[Abstract/Free Full Text]
- Oman, D., Reed, D., & Ferrara, A. (1999). Do elderly women have more physical disability than men do? American Journal of Epidemiology, 150, 834-842.[Abstract/Free Full Text]
- Omran, A.R. (1983). The epidemiologic transition theory. A preliminary update. Journal of Tropical Pediatrics, 29, 305-316.
- Ostir, G.V., Markides, K.S., Black, S.A., & Goodwin, J.S. (1998). Lower body functioning as a predictor of subsequent disability among older Mexican Americans. Journal of Gerontology Series A: Biological Sciences Medical Sciences, 53, M491-M495.
- Peek, M.K., Ottenbacher, K.J., Markides, K.S., & Ostir, G.V. (2003). Examining the disablement process among older Mexican American adults. Social Science and Medicine, 57, 413-425.[CrossRef]
- Pelaez, M., Palloni, A., Albala, C., Alfonso, J.C., Ham-Chande, R., Hennis, A.J., et al. (2004). SABE survey on health, well-being, and aging in the Latin America and the Caribbean, 2000. Ann Arbor, MI: Inter-university Consortium for Political and Social Research.
- Pinzon, S.A., & Solas, O. (2002). Politicas y marco juridico [Policy and legislation]. In T. Engler & M. Pelaez (Eds.), Mas vale por viejo. Washington, DC: Banco Interamericano de Desarrollo.
- Raji, M.A., Kuo, Y.F., Al Snih, S., Markides, K.S., Peek, M.K., & Ottenbacher, K.J. (2005). Cognitive status, muscle strength, and subsequent disability in older Mexican Americans. Journal of the American Geriatrics Society, 53, 1462-1468.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Reyes-Ortiz, C.A., Al Snih, S., & Markides, K.S. (2005). Falls among elderly persons in Latin America and the Caribbean and among elderly Mexican Americans. Revista Panamericana de Salud Publica, 17, 362-369.[Medline]
[Order article via Infotrieve]
- Reyes-Ortiz, C.A., Ostir, G.V., Pelaez, M., & Ottenbacher, K.J. (2006). Cross-national comparison of disability in Latin American and Caribbean persons aged 75 and older. Archives of Gerontology and Geriatrics, 42, 21-33.[CrossRef]
- Rosa, T.E., Benicio, M.H., Latorre Mdo, R., & Ramos, L.R. (2003). Fatores determinantes da capacidade funcional entre idosos [Determinant factors of functional status among the elderly]. Revista de Saude Publica, 37(1), 40-48.[Web of Science][Medline]
[Order article via Infotrieve]
- Sarwari, A.R., Fredman, L., Langenberg, P., & Magaziner, J. (1998). Prospective study on the relation between living arrangement and change in functional health status of elderly women. American Journal of Epidemiology, 147, 370-378.[Abstract/Free Full Text]
- Tabbarah, M., Crimmins, E.M., & Seeman, T.E. (2002). The relationship between cognitive and physical performance: Macarthur studies of successful aging. Journal of Gerontology Series A: Biological Sciences Medical Sciences, 57, M228-M235.[CrossRef]
- van Gool, C.H., Kempen, G.I., Penninx, B.W., Deeg, D.J., Beekman, A.T., & van Eijk, J.T. (2005). Impact of depression on disablement in late middle aged and older persons: Results from the longitudinal aging study Amsterdam. Social Science and Medicine, 60, 25-36.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Veijola, J., Puukka, P., Lehtinen, V., Moring, J., Lindholm, T., & Vaisanen, E. (1998). Sex differences in the association between childhood experiences and adult depression. Psychological Medicine, 28, 21-27.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Verbrugge, L.M. (1985). Gender and health: An update on hypotheses and evidence. Journal of Health and Social Behavior, 26, 156-182.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- von dem Knesebeck, O., Luschen, G., Cockerham, W.C., & Siegrist, J. (2003). Socioeconomic status and health among the aged in the United States and Germany: A comparative cross-sectional study. Social Science and Medicine, 57, 1643-1652.[CrossRef]
- Wallace, S.P., & Gutierrez, V.F. (2005). Equity of access to health care for older adults in four major Latin American cities. Rev Panam Salud Publica, 17, 394-409.[Web of Science][Medline]
[Order article via Infotrieve]
- Wray, L.A., Alwin, D.F., & McCammon, R.J. (2005). Social status and risky health behaviors: Results from the health and retirement study. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 60(Spec. No. 2), 85-92.
- Wray, L.A., & Blaum, C.S. (2001). Explaining the role of sex on disability: A population-based study. The Gerontologist, 41, 499-510.
- Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., et al. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
- Zunzunegui, M.V., Alvarado, B. E., Del Ser, T., & Otero, A. (2003). Social networks, social integration, and social engagement determine cognitive decline in community-dwelling Spanish older adults. Journal of Gerontology Series B: Psychological Sciences Social Sciences, 58, S93-S100.
- Zunzunegui, M.V., Pinzon, S.A., Beland, F., Pantelides, E.A., Albala, C., & Pratts, O. (2002). Estado de salud, capacidad funcional y necesidades [Health status, functional capacity and needs]. In T. Engler & M. Pelaez (Eds.), Mas vale por viejo. Washington, DC: Banco Interamericano de Desarrollo.
- Zunzunegui, M.V., Pinzon, S.A., Engler, T., & Pantelides, E.A. (2002). Condiciones y estilos de vida [Life conditions and life styles]. In T. Engler & M. Pelaez (Eds.), Mas vale por viejo. Washington, DC: Banco Interamericano de Desarrollo.
- Zyzanski, S.J., Medalie, J.H., Ford, A.B., & Grava-Gubins, I. (1989). Living arrangements and well-being of the elderly. Family Medicine Journal, 21, 199-205.
Journal of Aging and Health, Vol. 19, No. 6,
1004-1024 (2007)
DOI: 10.1177/0898264307308618

CiteULike Complore Connotea Del.icio.us Digg Reddit Technorati Twitter What's this?
This article has been cited by other articles:

|
 |

|
 |
 
B. E. Alvarado, M.-V. Zunzunegui, F. Beland, and J.-M. Bamvita
Life Course Social and Health Conditions Linked to Frailty in Latin American Older Men and Women
J. Gerontol. A Biol. Sci. Med. Sci.,
December 1, 2008;
63(12):
1399 - 1406.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|