ABSTRACT

Objective: The aim of this study was to investigate and examine the associations between the motor function of upper and lower extremities and independent instrumental activities of daily living (IADLs) in community-dwelling older adults who are non-beneficiaries of the long-term care insurance program. Based on the results, we suggest the way to provide the community health care services effectively for the non-beneficiaries of the long-term care insurance program. Methods: For this cross-sectional study, we used the 2015 Elderly Cohort database which was collected and administrated by National Health Insurance of South Korea. Information on the motor disability of four extremities, dependency in ten IADLs items, age, sex, living status, socioeconomic status, and cognitive function were used for analysis. Descriptive analysis and binary logistic regression analysis were conducted using SAS Enterprise 7.1. Results: Data from 3,706 older adults without missing valus were used for analysis. Mean age was 81.48 years (SD 5.27) and female was 75.63%. The rates of people without motor disability in four extremities for each were 77.8% - 95.7%. Excepting for bodycare (50.0%) and medication (70.4%) which showed relatively high rate of independence, the levels of independence in eight items were 13.5% - 45.7%. Although there were differences according to the extremities, motor disability was positively associated with dependency in IALDs when adjusting for confounders. Conclusion: Compared to the rate of extremities without motor disability, the rate of dependence in IADLs was relatively high. There were statistically significant positive associations between motor function of extremities and dependent IADLs. It is recommended that developing diverse community health care services in addition to utilizing the present health care services to prevent non-beneficiary older adults of the long-term care insurance program from entering long-term care service users group.