Long-Term Changes in Older Adults’ Independence Levels for Performing Activities of Daily Living in Care Settings: A Nine-Year Follow-Up Study

This study aimed to clarify the variability in the independence profiles of specific activities of daily living (ADL) among older men and women. The research subjects were 5872 older adults (1143 men and 4729 women) certified as requiring nursing care or support (based on data obtained from the nursing care insurance certification survey database) who could be surveyed in both 2009 and 2018. Using item response theory, this study compared longitudinal data of difficulties faced by older adults during ADL. The results indicated that among the long-term care insurance-certified persons, in 2009, men had higher ADL difficulty than women in all ADL items, and in 2018, there was no significant difference in items other than dressing and excretion. Furthermore, the difference in the rate of ADL difficulty level over 9 years was significantly higher in women than in men. It was shown that the progression of ADL disability due to aging is faster in men on a yearly basis, but it increases in women with aging. Therefore, it was suggested that the rate of ADL difficulty varies depending on age and sex.