Table 2.

Summary of studies

Authors (Year)	Title	Objective	Problems and diseases	Sample	Methods	Results	Limitations	Comments
Velázquez Alva et al. (2013) [28]	“The link shared by sarcopenia, physical mobility, undernutrition, and basic activities of daily living in the context of older women from Mexico City”	assessing the association between sarcopenia and mobility, and basic activities of daily living (ADLs) of elderly women	Sarcopenia	90 women in Mexico City	“Baumgartner’s equation, The SENECA questionnaire, Katz index, linear regression models”	“Patients with sarcopenia had a higher prevalence of undernutrition and difficulty in climbing stairs -In terms of ADL, 64.9% of patients had intermediate independence.”	“cross-sectional design that doesn’t allow identifying causal links. Invalid Baumgartner’s equation”	“Sarcopenia is associated with difficulties in mobility and a higher prevalence of undernutrition, particularly difficulties in climbing stairs.”
Haewon Byeon et al. (2016) [29]	“The relationship between communication activities of daily living and quality of life among the elderly suffering from stroke”	investigate the relationship between (C-ADL1) and quality of life of elderly stroke patients to enhance the quality of life (QoL)	stroke	165 elderly, with stroke	“using multiple regression analysis between C-ADL and SSQOL3”	“C-ADL had a significant positive relationship with SSQOL. It is necessary to enhance stroke patients’ communication ability in daily living to raise their QoL.”	“exclusion of patients with severe aphasia, for whom test could not be conducted.”	“Some activity to enhance stroke patients’ communication ability in daily living to raise their QoL.”
Charernboon, T. et al. (2016) [30]	“Characteristic Profiles of Activities of Daily Living and Relationship with Cognitive Performance in Thai Elderly with Different Stages from Normal Cognitive Function, Mild Cognitive Impairment to Dementia”	“evaluating the functional difference among normal cognitive elderly, (MCI2), and dementia; also, the relationship between cognitive performance and functional abilities”	dementia	90 participants	“Spearman’s rank-order correlation, the Mann–Whitney U-test, Multiple regression model”	“IADL can be subtly impaired in people with MCI but markedly impaired in those with mild dementia. BADL1 begins to decline in moderate dementia and then reaches a level of severe impairment in severe dementia.”	demographic characteristics and cultures that are similar	“Designing specific ADL assessment tools for MCI would help in better differential diagnosis and prognosis for patients.”
Chen Shen, et al. (2018) [31]	“Unmet needs of activities of daily living among a community-based sample of disabled elderly people in Eastern China: a cross-sectional study”	“identify the prevalence and risk factors of unmet needs among the disabled elderly in China”	disabled elderly	303 older adults in China	“Using the Barthel Index (BI) and Functional Activities Questionnaire (FAQ), binary logistic regression analysis”	“93.1% of the disabled people had at least one unmet need. The unmet needs were using vehicles, stairs, working on a hobby social interaction and ambulating. The factors influencing unmet needs were related to the degree of disability in (IADL), the relationship with caregivers and the monthly income of caregivers.”	“collect more samples from different regions, find a better way to improve the precision and multiplicity of analyses”	“government and caregivers should take more action to prevent or reduce unmet needs among elderly individuals.”
Costa, FA, et al. (2018) [32]	“Contribution of chronic diseases to the prevalence of disability in basic and instrumental activities of daily living in elderly Brazilians: the National Health Survey”	“assess the contribution of selected chronic diseases to the prevalence of disability in elderly”	chronic diseases	10,537 elderly Brazilians	“A multinomial additive hazards model assesses the contribution”	“Contribution of chronic diseases to prevalence of disability was greater in younger elderly and highlighting the relevance of stroke and arthritis in men, and arthritis, hypertension, and diabetes in women.”	“a cross-sectional design, which does not allow for establishment of a temporal relationship”	“orient health services to target specific groups, considering age, sex, and current illnesses, aimed at preventing disability in elderly individuals.”
Farías-Antúsnez et al. (2018) [33]	“Disability related to basic and instrumental activities of daily living: a population-based study with elderly in Pelotas, Rio Grande do Sul”	“estimate the prevalence of disability related to basic and instrumental activities of daily living”	Disability	1.451 elderly in Brazil	“Poisson regression”	“Functional disability was associated with individuals older than 80 with less schooling years and affected by multiple morbidities.”	“possible reverse causality bias in some associations”	“social policies need to adjust to the new reality with the elaboration of policies and programmes focused on the health of elderly individuals.”
Furuta, M, et al. (2013) [34]	“Interrelationship of oral health status, swallowing function, nutritional status, and cognitive ability with activities of daily living in Japanese elderly people receiving home care services due to physical disabilities”	“examining direct and indirect relationships among oral health status, swallowing function, nutritional status, cognitive ability, and ADL in elderly”	physical disabilities	“286 elderly people living at home and receiving home care services”	“the BI, the Clinical Dementia Rating Scale, Path analysis to test pathways”	“Poor oral health status and cognitive impairment had a direct effect on denture wearing, and the consequent dysphagia, in addition to cognitive impairment, was positively associated with malnutrition.”	“a longitudinal study is needed to examine a temporal relationship.”	“maintaining or improving oral health status and swallowing function indirectly or directly contribute to preventing a decline in ADL in elderly people who require home care.”
Genkai, S.et al. (2015) [35]	“Loss of occlusal support affects the decline in activities of daily living in elderly people receiving home care”	“clarifying whether the absence of occlusal support would lead to a decline in ADL in elderly people receiving home care”	occlusal support	322 elderly in four prefectures	the Barthel Index	“““Factors related to declines in ADL in elderly people receiving home care were cognitive function and occlusal support.”	“small size of samples”	“the absence of occlusal support was a significant risk factor for a decline of the ADL in elderly people receiving home care.”
Ha, E; Kim, K (2013) [36]	“Factors that influence activities of daily living in the elderly with probable dementia”	“Identifying the factors that influence ADL in elderly individuals with probable dementia”	dementia	152 elderly in South Korea	Using independent t-tests, Pearson’s correlation and stepwise multiple regression	“Factors affecting ADL in elderly individuals with probable dementia were faecal incontinence, regularity of exercise, cognitive function, urinary incontinence, and CVA history.”	“further refinement of the underlying model is warranted.”	“Multidisciplinary interventions are essential to improve the ADL and prevent deterioration of cognitive function in elderly patients with probable dementia.”
Hesseberg, K.et al. (2013) [37]	“Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease”	“The aim is to examine disability in (IADL) in elderly persons”	Mild Cognitive Impairment and Alzheimer‘s Disease	729 patients	Multiple logistic regression	“Found an association between IADL and diagnosis, and a difference in the proportion of disability in IADL in patients with MCI and AD.”	“cross-sectional design that does not allow to conclusion on causality.”	“Problems with handling medication, shopping and preparing food are domains clinicians should be aware of regarding IADL disability.”
Hou, C, et al. (2018) [38]	“Trends of activities of daily living disability situation and association with chronic conditions among elderly aged 80 years and over In China”	“Investigating the cross-sectional trends of prevalence and severity of ADLs in old people and identifying the potential risk factors of disability”	Stroke and cognitive impairment	52,667 participants in China	GEE5 models with a logistic link and binominal distribution	“Prevalence of ADL disability declined among the old population without obeying a linear pattern. Temporal trends of ADL disability mainly attributed to the change of low disability level prevalence. Stroke/CVD and cognitive impairment were the most common risk factors of disability. Vision impairment-caused disability has become less common.”	“association of some important chronic diseases such as arthritis and depression symptom, and the effects of severity of diseases on functional disability were not examined”	“these findings from this study could provide information to develop preventive strategies and specific interventions for the reduction of disability in the oldest Chinese population.”
Masoudi Alavi N, et al. (2014) [39]	“Dependency in Activities of Daily Living Following Limb Trauma in Elderly Referred to Shahid Beheshti Hospital, Kashan, Iran in 2013″	“evaluating elderly independence in ADLs following limb trauma and its related factors in patients”	Limb Trauma	200 traumatic patients in Iran	Chi-square test, One-way and two-factor ANOVA, and Multiple regression analysis.	“More than three-quarters of elderly individuals were independent in ISADL before the trauma, but trauma in elderly patients had a substantial negative effect on patients’ ability and ADL function.”	“ISADL questionnaires were completed by phone call one to three months after trauma, which might affect the responses.”	“recommend continuing patients’ follow-up for longer periods and interventional studies to improve ISADL following trauma in elderly.”
Okabe, T, et al. (2017) [40]	“Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8–9-year follow-up”	“investigating risk factors for incident disability in ADL and determining whether there are differences in risk factors according to age groups”	incident disability	264 Japanese women	Student’s t-test used for continuous variables, the χ2-test, and regression analysis.	“A different set of risk factors was associated with incident ADL disability among women aged 40–64 years and women aged ≥65 years.”	“included only women, these results cannot be generalised to men.”	“Age-specific screening and intervention strategies are necessary for effective prevention of incident ADL disability.”
Orive, M; et al. (2015) [41]	“Changes in health-related quality of life and activities of daily living after hip fracture because of a fall in elderly patients: a prospective cohort study”	“evaluating changes in HRQoLe and the ability to conduct ADL among patients with hip fracture because of a fall”	hip fracture	150 Adults aged 65 or older	the BI and the Lawton Brody Index for ADL, the non-parametric Wilcoxon test	“Hip fractures have profound effects on HRQoL and ADL in both men and women, regardless of age.”	small sample	“The need for special follow-up care of elderly hip fracture patients in the immediate and late post fracture periods.”
Quail, JM, et al. (2011) [42]	“Unmet Need for Assistance to Perform Activities of Daily Living and Psychological Distress in Community-Dwelling Elderly Women”	“examining the possible association of physical assistance need with psychological distress”	psychological distress	530 women in Canada	multivariable linear regression	“Receiving assistance to meet IADL needs is associated with elevated psychological distress. Not receiving assistance, however, is associated with even greater distress.”	relied on self-reported disability, which may have caused some misclassification of disability.	“It is essential to provide elderly persons with the support they need and will accept to adapt both physically and mentally to declining health and function.”
Safa, A, et al. (2016) [39]	“Predictive Factors of Dependency in Activities of Daily Living Following Limb Trauma in the Elderly”	“evaluating the predictive factors of dependency in ADL following limb trauma in elderly”	Limb Trauma	200 patients, in Iran	the t-test and analysis of variance (ANOVA) and the multiple regression analysis	“Many factors, such as gender, age, education, type of trauma, and location of the injured organ, may predict ADL following limb trauma.”	small sample	“Knowing the predictive factors of dependence in ADL after trauma may help health systems to design effective and realistic strategies for rehabilitative programmes.”
Silva, AD, et al. (2014) [43]	“Association between the degree of physical impairment from leprosy and dependence in activities of daily living among the elderly in a health unit in the State of Minas Gerais”	“determining whether physical impairment from leprosy is associated with dependence among elderly individuals”	leprosy	186 elderly persons	the Statistical Package for the Social Sciences (SPSS)	“Leprosy physical impairment grade is associated with dependence for IADL, creating the need for greater social support and systematic monitoring by a multidisciplinary team.”	uses secondary data	“The importance of early diagnosis and treatment of leprosy to prevent physical impairment and dependence in later years.”
Takemasa S, et al. (2017) [44]	“Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopaedic outpatients”	““examining the health-related and subjective QoL of community-dwelling elderly females in orthopaedic outpatients, and how such QoL correlates with their ADL and IADL”	orthopaedic	27 elderly females	Using Spearman’s rank	“For community-dwelling elderly females to maintain good subjective and health-related QoL, controlling their pain is critical so that excruciating pain does not restrict their activities. They also need to maintain good health, feel happy and comfortable and have more opportunities for social interaction.”	small sample. Did not include men in the study	“supporting community-dwelling elderly females in orthopaedic outpatients to improve their sense of physical and mental well-being, and prevent and reduce their depression and physical pain, is required to improve their QoL.”
Liu, Y, et al. (2012) [45]	“The Unmet Activities of Daily Living (ADL) Needs of Dependent Elders and their Related Factors: An Approach from Both an Individual- and Area-Level Perspective”	“examining disabled elders’ unmet ADL needs and the factors associated with those unmet needs”	disabled elders	6820 elders from Taiwan	hierarchical linear modelling	“Highest percent of unmet ADL needs was for climbing stairs. The following factors as important: education level; living arrangements; number of illnesses; number of IADL limitations; caregiver’s age; the caregiver–patient relationship; care burden; household size.”	majority of respondents were female	“social welfare expenditure moderates unmet needs by provision of services, which means that the positive effect of social welfare services cannot be ignored; the government should play a supervisory role.”
Putthinoi, S. et al. (2016) [46]	“Performance in Daily Living Activities of the Elderly While Living at Home or Being Home-bound in a Thai Suburban Community”	“examining the ability of elderly in performing their daily activities while living at home or being home-bound in the community”	caducity	32 home-bound elderly people	cross-sectional survey	“Elderly individuals communicated independently. They acted independently in interpersonal interactions and relationships, but they needed assistance from people or equipment in some activities. Most of the home-bound elderly performed ADL independently, whereas elderly individuals living at home were dependent when using transportation and driving.”	small sample size	“Individuals living with chronic health conditions, most subjects could not independently perform these activities; transportation community and, social and civic life.”
Ohri, P. et al. (2014) [47]	“A Study of Daily Living Dependency Status among Elderly in an Urban Slum area of Dehradun”	“assessing the daily living dependency status among elderly individuals”	caducity	215 elderly	A cross-sectional study	“Out of the total, 93% individuals were independent in their ADLs. Maximum inability was found in bathing and dressing. In total, 70.7% of elderly were dependent on one or more IADLs, female elderly being more dependent than males.”	other parameters of geriatric age could be evaluated, such as nutritional status and morbidities in elderly	“Education and socioeconomic status had a positive effect on independence. Male elderly showed a maximum dependency for cooking and laundry, while females showed a greater dependency in using the telephone, managing money, and travelling.”

¹Communication Activities of Daily Living

²Stroke-Specific Quality of Life

³Mild cognitive impairment

⁴Basic activities of daily living

⁵Generalized estimating equation

⁶Health-related quality of life