effect of physical activity on independent living ability among community-dwelling elderly in urban areas of Liaoning Province in China: a population-based study

OBJECTIVE: Independent living ability is crucial for the elderly; however, its assessment performed in China employs various scales and lacks risk factors, especially behavioural and social-psychological factors, which could be improved through health education. This study aimed to assess the independent living ability of community-dwelling elderly in urban areas of China and to identify the association with behavioral and social-psychological factors. DESIGN: A population-based study using random cluster sampling method was performed in two core cities in Liaoning Province during March–November 2012. STUDY POPULATION: 3686 individuals who were >=65 years old, had no dementia and cognitive impairment, had lived in the sampled communities for >=5 years and could take part in the study were enrolled. MAIN OUTCOME MEASURES: Interviews were conducted to collect information of independent living ability, indicated by the instrumental activity of daily living (IADL), behavioural factors, social-psychological factors and confounders (demographic characteristics and health status). The Mini-Mental State Examination was used to screen for cognitive impairment. RESULTS: The independence rate was 46.3% in men and 41.1% in women. Structural equation modelling analysis showed that physical activity, drawn from taking a walk and doing exercise, had the strongest association with the IADL in both men (−0.34, SE 0.10) and women (−0.33, SE 0.11). Falling in the last year and worrying about falling were also significantly associated with IADL. The effects of regular drinking, feeling lonely and participating in entertainment were significant in men. CONCLUSION: The independent living ability of the elderly in urban areas in Liaoning Province in China was at a low level. Physical activity was one of the important roles in both men and women; whereas the role of social-psychological factors only existed in men. Gender-specific healthcare and education to avoid sedentary life should be advocated for the elderly to maintain/improve their independent living ability.