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IJE Advance Access published online on August 24, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl183
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted April 27, 2006

Original paper

Trends and educational disparities in functional capacity among people aged 65-84 years

Tommi Sulander 1 *, Tuija Martelin 2, Päivi Sainio 3, Ossi Rahkonen 4, Aulikki Nissinen 1, and Antti Uutela 1

1 Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
2 Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
3 Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland; Orton Rehabilitation Unit, Invalid Foundation, Helsinki, Finland
4 Department of Public Health, University of Helsinki, Finland

* To whom correspondence should be addressed.
Tommi Sulander, E-mail: tommi.sulander{at}ktl.fi


  Abstract

Background This study examined 10 year trends in functional capacity by gender, age, and education among elderly Finns aged 65-84 years, focusing on difficulties in basic activities of daily living (BADL). Educational disparities and their trends in the prevalence of these difficulties were also assessed.

Methods Data were derived from nationally representative monitoring surveys conducted biennially from 1993 to 2003 by the National Public Health Institute (KTL). A total of 5740 men and 5746 women were included in the study (response rate 80%). Activities of daily living (ADL) measures were used to assess levels of functional capacity. Education was divided into two groups: low (0-8 years) and high (9+ years). Age-adjusted trends and logistic regression analyses were computed.

Results A clear downward trend in BADL difficulties was observed in all age groups in both genders. 80-84 year olds had clearly poorer functional ability than 65-69 year olds, even when adjusted for chronic diseases. Despite the overall improvement in functional capacity in both educational groups, low educational status persistently predicted poorer functional capacity. When chronic diseases and survey period were controlled for, the educational disparities attenuated slightly but remained significant.

Conclusions The number of Finnish elderly with BADL difficulties has declined markedly over the past 10 years. However, persistent educational disparities continue to present a challenge to public health initiatives for reducing inequalities in health.

Keywords: functional capacity; education; elderly people; trends.
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