Longitudinal Predictors of Functional Impairment in Older Adults in Europe – Evidence from the Survey of Health, Ageing and Retirement in Europe

Objective: To examine time-dependent predictors of functional impairment in older
adults in Europe longitudinally.
Methods: Data were derived from the Survey of Health Ageing, and Retirement in
Europe (2004-2013). Functional impairment was assessed by using activities of daily
living (ADL) and instrumental activities of daily living (IADL) indices. Fixed effects
regressions were used to estimate the effects of sociodemographic factors (age,
marital status, living situation, and income deciles (median split)), lifestyle factors
(smoking status and alcohol consumption per week), depression, cognitive function
and chronic diseases on the outcome variables.
Results: Longitudinal regressions revealed that functional impairment increased
significantly with age, the occurrence of depression, cognitive impairment, the number
of chronic conditions, and less than daily alcohol consumption in the total sample and
in both sexes. Moreover, the onset of smoking and living without a spouse/partner in
household increased functional impairment in the total sample. The effect of
depression on functional impairment was significantly more pronounced in men.
Conclusion: Our findings highlight the relevance of changes in age, depression,
cognitive function, smoking and chronic diseases for functional impairment. Since
particularly depression and smoking may be avoidable, developing strategies to
prevent depression or stop smoking might be useful approaches to postpone functional
impairment in older adults.