Table 1_Gender differences in advanced activities of daily living: evidence from the longitudinal study of health and aging in Mexico 2012–2018.xlsx

BackgroundPerforming advanced activities of daily living (AADLs) is a component of healthy aging (HA) because it involves functional capacity. The ability to perform them can be hampered by several factors, which appear different for men and women.
ObjectiveTo evaluate the performance data of AADLs in older Mexican adults from Mexican Health and Aging Study (MHAS) from 2012 to 2018 and to determine the risk factors for not performing AADLs.
MethodsA secondary longitudinal analysis of the 2012 and 2018 waves of the MHAS was conducted. Adults ≥60 years, from both sexes, who answered at least eight of the nine questions analyzed, without or only mild cognition impairment in 2012, and who were interviewed in both waves were included. An AADL construct with nine questions from the MHAS including physical/leisure, social and productive domains was used. The Cox proportional regression model was used as a longitudinal analysis to determine the risk factors to not perform ≥3 AADLs.
Results4,738 adults were ≥60 years old and met the inclusion criteria, 2,617 were women (54%). Total AADLs were diminished in 2018 (2.68 ± 1.39 vs. 2.61 ± 1.34, p < 0.01); however, women performed more AADLs in 2018 than in 2012, contrary to men. Risk factor to not perform ≥3 AADLs in women were age ≥70 years and sedentary lifestyle. Men have the same risk factors in addition to low scholarship and live in urban locations. After control by confounder factors, the risk of not performing ≥3 AADLs was in the overall model HR = 1.25 (95% confidence intervals (CI): 1.17–1.37), women HR = 1.20 (95%CI: 1.08–1.32), and men HR = 1.26 (95%CI: 1.17–1.35).
ConclusionOur findings show that the execution of ≥3 AADLs is age-dependent over 80 years. Although this capacity could be gender-dependent, the environment and public policies can be determining factors.

背景：开展工具性日常生活活动（Advanced Activities of Daily Living, AADLs）是健康衰老（Healthy Aging, HA）的核心组成部分，因其与个体功能容量密切相关。此类活动的执行能力会受多种因素制约，且这些因素在男性与女性群体中存在差异。

研究目的：评估2012至2018年墨西哥健康与老龄化研究（Mexican Health and Aging Study, MHAS）中墨西哥老年成年人的工具性日常生活活动执行数据，并明确无法完成工具性日常生活活动的危险因素。

研究方法：本研究针对墨西哥健康与老龄化研究2012年与2018年两轮调研数据开展次级纵向分析。纳入标准为：年龄≥60岁的男女成年受试者，2012年时完成全部9项分析问题中的至少8项，无认知损害或仅存在轻度认知损害，且在两轮调研中均接受了访谈。本研究采用源自墨西哥健康与老龄化研究的包含9个问题的工具性日常生活活动维度框架，该框架涵盖身体/休闲、社交与生产活动三大领域。采用Cox比例风险回归模型开展纵向分析，以明确无法完成≥3项工具性日常生活活动的危险因素。

研究结果：共有4738名年龄≥60岁的成年受试者符合纳入标准，其中女性2617名，占比54%。2018年时受试者的工具性日常生活活动总得分较2012年有所下降（2.68±1.39 vs. 2.61±1.34，p<0.01）；但与男性群体相反，女性在2018年的工具性日常生活活动完成量较2012年有所提升。女性无法完成≥3项工具性日常生活活动的危险因素为年龄≥70岁与久坐生活方式；男性除上述两项危险因素外，还包括受教育程度低下与居住于城镇地区。在控制混杂因素后，整体模型中无法完成≥3项工具性日常生活活动的风险比（Hazard Ratio, HR）为1.25（95%置信区间（Confidence Interval, CI）：1.17~1.37），女性群体HR为1.20（95%CI：1.08~1.32），男性群体HR为1.26（95%CI：1.17~1.35）。

研究结论：本研究结果显示，无法完成≥3项工具性日常生活活动的风险在80岁以上群体中呈年龄依赖性。尽管此类活动的执行能力存在性别差异，但环境与公共政策或为决定性影响因素。