Understanding Health Self-Management Challenges for Older Adults with and without Mobility and Sensory Disabilities
TimeWednesday, April 1412:30pm - 12:50pm EDT
DescriptionBackground: Managing health can be challenging for older adults due to declines in motor, perceptual and cognitive abilities, as well as multiple chronic conditions (Mitzner et al., 2013). Individuals with mobility and sensory disabilities more often encounter additional difficulties in managing health activities compared to people without disabilities (Dalton et al., 2003; Zhi Han et al., 2017). Although challenges of health self-management have been reported among older adults with single type of disability, little attention has been received for the population of older adults with different types of disabilities and no population-level analyses to understand the challenges of health activities have been conducted. The goals of this study were to (i) investigate the frequency of the challenges of six health activities (medication management, going to medical appointment, online health information seeking, handling medical plans, exercise, sleep) among older adults aged 65 and older, (ii) compare differences across five subgroups (non-disability, mobility, vision, hearing, multiple disability), and (iii) identify potential support solutions to provide guidance for interventions.
Method: We analyzed data from the eighth round (2018) of the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries age 65 and older in the US. We included only the participants who completed the surveys themselves (N=4,679) and categorized them into four disability sub-groups, including those who reported disabilities in mobility (n=1,675), hearing (n=563), vision (n=403) and multiple (n=105), as well as a non-disability group (N=2,562). We analyzed the specific questions in NHATS related to the six healthcare activities.
Results: Around one tenth of older adults reported difficulty with tracking medicines, more for individuals with hearing disabilities. More respondents with mobility and multiple disabilities received assistance with managing medicines. In addition, 16.1%-63.3% of respondents relied on others in reminding things and communication during doctor visits, with the highest percent in disability groups. Around one tenth of respondents changed their Medicare and medicine plan in the last year and 37.5-53.9% of them got assistance with it. Respondents with mobility and multiple disabilities were less likely to be physically active or go online for health-related information and were more likely to experience sleep problems (all p<.01). The number of chronic conditions was negatively associated with Internet use for health-related tasks (OR -.11, 95% CI -.16- -.06), walking (OR -.21, 95% CI -.25 - -.17) and vigorous activities (OR -.26, 95%CI -.31 - -.22).
Conclusions: Managing health is challenging for older adults with and without disabilities. This nationally representative sample provided valuable insights into the health challenges older adults experience, as well as the different patterns observed across those with and without disabilities. Individuals with mobility or multiple disabilities were more likely to experience challenges and to need assistance with health-related activities. These data provide guidance for the design of interventions that consider disability needs and health status and could be used to encourage health self-management for these populations.