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      Instrumental Activities of Daily Living (iADL) Limitations in Europe: An Assessment of SHARE Data

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          Abstract

          This study aims to evaluate the instrumental activities of daily living (iADLs) limitations in Europe and its association with socio-demographic characteristics, economic parameters and physical and mental health status. We used data from the wave 6 of SHARE database. Individuals were classified as having either none or one or more limitations on iADLs. Participants aged 65 or more years who answered all questions for the variables included in this work were selected. A total of 54.8% of participants were female and had a mean age of 74.37 (SD = 7.08) years. A global prevalence of 1 or more iADLs in Europe was shown to be 23.8% and more prevalent in women than in men (27.1% vs. 17.6%) and in people aged 85 years or more (51.5%). Older age, female gender, lower education, physical inactivity, frailty, having two or more chronic diseases, presence of depression, polypharmacy, poor self-perception of health and lower network satisfaction were found to be factors associated with the presence of 1 or more iADLs limitation. This study highlights the burden of iADLs limitations at the European level. These are based on a multidimensional biopsychosocial model and are associated with both health conditions and environmental factors. This intersection between the physical and social world underscores its potential as a health indicator and can, to some extent, explain some of the pronounced differences seen among European countries. Different inter-tasks can also stress different dimensions of health indicators in distinct and specific groups of individuals. Minimizing the impact of iADL limitations can improve the quality and sustainability of public health systems.

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          Frailty in Older Adults: Evidence for a Phenotype

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            Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living

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              Frailty in elderly people

              Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                10 October 2020
                October 2020
                : 17
                : 20
                : 7387
                Affiliations
                [1 ]Agrupamento de Centros de Saúde (ACES) Entre Douro e Vouga I—Feira Arouca, Faculdade de Medicina da Universidade do Porto, 4200-450 Porto, Portugal; di.portelasilva@ 123456gmail.com
                [2 ]Applied Molecular Biosciences Unit (UCIBIO) Requimte (Rede de Química e Tecnologia), Porto4Ageing, Faculdade de Farmácia da Universidade do Porto, 4050-047 Porto, Portugal; martassalmada@ 123456gmail.com (M.A.); luismidao@ 123456gmail.com (L.M.)
                [3 ]Laboratory of Biochemistry, Department of Biological Sciences, University of Porto, 4050-313 Porto, Portugal
                Author notes
                [* ]Correspondence: emcosta@ 123456ff.up.pt ; Tel.: +35-12-2042-8500
                Author information
                https://orcid.org/0000-0001-7913-7461
                Article
                ijerph-17-07387
                10.3390/ijerph17207387
                7599802
                33050460
                cdde0c4b-bc7b-4ad5-b668-51623da8436b
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 01 August 2020
                : 07 October 2020
                Categories
                Article

                Public health
                iadls,share,ageing,public health
                Public health
                iadls, share, ageing, public health

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