Dataset Information

Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood.

ABSTRACT:

Objectives

The ability of older adults to live independently is often assessed with a battery of questions known as Instrumental Activities of Daily Living (IADLs). Many of these questions query the difficulty conducting household activities that have been predominantly conducted by women (e.g., the ability to prepare a meal), especially for cohorts now in old age. Although previous research has documented gender differences in IADL limitations, it has not been documented whether IADLs equivalently measure the same latent construct for men and women.

Methods

We apply psychometric tests of measurement invariance to data from the 1998 Health and Retirement Study. We then estimate corrected models that account for violations of measurement invariance across genders.

Results

We find that IADLs do not equivalently measure same latent construct for men and women. We find that men are more likely not to do the IADL activities for reasons unrelated to health limitations, which may reflect gendered expectations regarding household activities. Accounting for this we still find that women report greater health-related IADL limitations than men.

Discussion

Researchers should be cautious making gender comparisons for IADLs without attending to the gender-specific measurement properties of many of the items of which the IADL is comprised.

SUBMITTER: Sheehan CM

PROVIDER: S-EPMC6460339 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Publications

Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood.

Sheehan Connor M CM Tucker-Drob Elliot M EM

The journals of gerontology. Series B, Psychological sciences and social sciences 20190401 4

<h4>Objectives</h4>The ability of older adults to live independently is often assessed with a battery of questions known as Instrumental Activities of Daily Living (IADLs). Many of these questions query the difficulty conducting household activities that have been predominantly conducted by women (e.g., the ability to prepare a meal), especially for cohorts now in old age. Although previous research has documented gender differences in IADL limitations, it has not been documented whether IADLs e ...[more]

PMID: 28158847

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Project description:Poor functional status is common after critical illness, and can adversely impact the abilities of intensive care unit (ICU) survivors to live independently. Instrumental activities of daily living (IADL), which encompass complex tasks necessary for independent living, are a particularly important component of post-ICU functional outcome.To conduct a systematic review of studies evaluating IADLs in survivors of critical illness.We searched PubMed, CINAHL, Cochrane Library, SCOPUS, and Web of Science for all relevant English-language studies published through December 31, 2016. Additional articles were identified from personal files and reference lists of eligible studies. Two trained researchers independently reviewed titles and abstracts, and potentially eligible full text studies. Eligible studies included those enrolling adult ICU survivors with IADL assessments, using a validated instrument. We excluded studies involving specific ICU patient populations, specialty ICUs, those enrolling fewer than 10 patients, and those that were not peer-reviewed. Variables related to IADLs were reported using the Patient Reported Outcomes Measurement Information System (PROMIS).Thirty of 991 articles from our literature search met inclusion criteria, and 23 additional articles were identified from review of reference lists and personal files. Sixteen studies (30%) published between 1999 and 2016 met eligibility criteria and were included in the review. Study definitions of impairment in IADLs were highly variable, as were reported rates of pre-ICU IADL dependencies (7-85% of patients). Eleven studies (69%) found that survivors of critical illness had new or worsening IADL dependencies. In three of four longitudinal studies, survivors with IADL dependencies decreased over the follow-up period. Across multiple studies, no risk factors were consistently associated with IADL dependency.Survivors of critical illness commonly experience new or worsening IADL dependency that may improve over time. As part of ongoing efforts to understand and improve functional status in ICU survivors, future research must focus on risk factors for IADL dependencies and interventions to improve these cognitive and physical dependencies after critical illness.

Project description:Individuals with sickle cell disease (SCD) experience neurocognitive decline, low medication adherence, increased unemployment, and difficulty with instrumental activities of daily living (IADL). The relationship between self-perceived cognitive difficulties and IADLs, including employment, school enrollment, independence, engagement in leisure activities, and medication adherence is unknown. We hypothesized that self-reported difficulties across neurocognitive areas would predict lower IADL skills. Adolescent and adult participants of the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) (n = 2436) completed patient-reported outcome (PRO) measures of attention, executive functioning, processing speed, learning, and comprehension. Cognitive symptoms were analyzed as predictors in multivariable modeling. Outcome variables included 1) an IADL composite that consisted of employment, participation in school, reliance on others, and leisure pursuits, and 2) hydroxyurea adherence. Participants reported cognitive difficulty across areas of attention (55%), executive functioning (51%), processing speed (57%), and reading comprehension (65%). Executive dysfunction (p < 0.001) and sometimes or often experiencing learning difficulties (p < 0.001 and p = 0.04) and poor comprehension (p = 0.000 and p = 0.001), controlled for age (p < 0.001), pain (p < 0.001), and hydroxyurea use (p = 0.001), were associated with poor IADL skills. Executive functioning difficulties (p = 0.021), controlled for age (p = 0.013 for ages 25-34), genotype (p = 0.001), and hemoglobin (p = 0.004), predicted hydroxyurea non-adherence. Analysis of PRO measures indicated that cognitive dysfunction is prevalent in adolescents and adults with SCD. Cognitive dysfunction translated into clinically meaningful outcomes. PRO of cognitive symptoms can be used as an important adjunct clinical tool to monitor symptoms that impact functional skills, including engagement in societal activities and medication adherence.

Dataset Information

Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood.

Objectives

Methods

Results

Discussion

Publications

Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood.

Similar Datasets

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