Sir,
We read the article entitled “Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India” by Keshari and Shankar with great interest.[1] The study intended to describe the prevalence and spectrum of functional disability in the urban elderly. The authors observed that nearly 53.6% of the study participants had some functional disability. However, they failed to provide vital information that would have explained the results better.
A general description of the study population in terms of proportion of young-old, old-old, and oldest-old, educational status, socioeconomic status, living arrangements, and the presence of comorbidities in the elderly was not given. Functional disability in the elderly is often related to these factors.[2,3]
Although the study population was selected using a multistage probability sampling technique, there was still the possibility that a relatively larger proportion of the study participants were from the age group of 60–69 years. If this was the case, then it might explain why nearly 85% of the study population required no assistance for self-care activities of daily living (ADL). A description of the comorbidities could have explained the need for assisted mobility for more than 53% of the study population.
We also felt that a Z-test showing significant difference in the proportion of participants who required assistance between the two domains does not add any further value to the study and was, therefore, redundant. Instead a test of association between functional disability and factors such as age group, presence of comorbidities, socioeconomic status, and access to healthcare would have helped identify the vulnerable groups among the elderly, so that interventions may be targeted toward these groups as described in similar studies.[2,4]
Furthermore, a mention of Instrumental ADL[5] would have added more value to the description of functional status of the elderly.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Keshari P, Shankar H. Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from central India. J Family Community Med. 2017;24:86–90. doi: 10.4103/jfcm.JFCM_80_16. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Medhi GK, Hazarika NC, Borah PK, Mahanta J. Health problems and disability of elderly individuals in two population groups from same geographical location. J Assoc Physicians India. 2006;54:539–44. [PubMed] [Google Scholar]
- 3.Joshi K, Kumar R, Avasthi A. Morbidity profile and its relationship with disability and psychological distress among elderly people in Northern India. Int J Epidemiol. 2003;32:978–87. doi: 10.1093/ije/dyg204. [DOI] [PubMed] [Google Scholar]
- 4.Beydoun MA, Popkin BM. The impact of socio-economic factors on functional status decline among community-dwelling older adults in China. Soc Sci Med. 2005;60:2045–57. doi: 10.1016/j.socscimed.2004.08.063. [DOI] [PubMed] [Google Scholar]
- 5.Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:179–86. [PubMed] [Google Scholar]