Functioning and disability analysis by using WHO Disability Assessment Schedule 2.0 in older adults Taiwanese patients with dementia

Abstract

Background: To analyse the disability status of elderly Taiwanese dementia patients by using the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0). Methods: We enrolled 12 126 disabled elderly (>65 years) patients with dementia during July 2012–January 2014 from the Taiwan Data Bank of Persons with Disability. Trained interviewers evaluated the standardised scores in the six WHODAS 2.0 domains. Student’s t test was used for comparing WHODAS 2.0 scores of male and female dementia patients with different age groups. Results: The study population comprised 12 126 patients; 7612 were women and 4514 were men. The WHODAS 2.0 scores showed that the dementia patients had global activity limitation and participation restriction in all domains. Dementia-induced disability was prominent in male patients in all of the domains of the WHODAS 2.0. The domains of life activities, getting along with people and cognition were more strongly affected than the other domains. However, women experienced more rapid functional decline than men did as they aged. Conclusion: The data analysed in this large-scale, population-based study revealed crucial information on dementia-induced disability in elderly patients on the basis of the WHODAS 2.0 framework.

Implications for rehabilitation

• Dementia patients have global functional disability in all domains of WHODAS 2.0 and multidisciplinary team is needed for rehabilitation programme intervention for these patients.

• When considering the rehabilitation resource and strategy, the domains of cognition, activities of daily living and life activities should be focussed.

• When dementia patients aged 65–75 years old, male patients got more restriction of function than female and more medical resource allocation for disabled male patients is recommended.

• With ageing, female dementia patients exhibited more rapid functional decline than male patients did and more budget about rehabilitation for maintain functional and dementia progression is crucial for female patients.

Keywords:

• Dementia, gender difference
• ICF
• Taiwan
• World Health Organisation Disability Assessment Schedule 2.0

Acknowledgements

We thank Guan-Yu Chen, Pei-Hsin Chen and Kai-Hsiang Chuang for helping us prepare this manuscript.

Declaration of interest

This study was supported by Ministry of Health and Welfare, Taiwan (No. 98M8178, No. 99M4080, No. 99M4073, No. 100M4145, No. 101M4100, No. 102M4018 and No. 103M03F4037).