Classified Comparison and Cause Analysis of the Characteristics of Co-Disabilities Among Older Adults With Physical Disability in China

Abstract

Background

The aim of the study is to investigate the characteristics of co-disabilities among older adults with physical disabilities (PDs) in China in 1987 and 2006, and the correlation between other co-occurring disabilities and the presence and severity of PD among the older adults.

Methods

The study is a cross-sectional comparative study. The data were derived from the first and second China National Sample Survey on Disability. Case counts and prevalence rates were used to compare the characteristics of PD and “co-disabilities comprising PD and other disabilities” (CdPDD) in these two surveys. The binary logistic regression was used to analyze the correlation.

Results

(1) From 1987 to 2006, the age-standardized prevalence rates of PD, sole PD, and CdPDD among older adults in China all increased, and these increases were more pronounced in rural older adults. (2) In both years, co-disabilities involving PD and hearing-speech disability had the highest percentage distribution and age-standardized prevalence rate, accounting for more than 60%, and this pattern was consistent in both urban and rural older adults. (3) Speech and intellectual disabilities were consistently associated with higher odds of PD and moderate-to-severe PD in both the overall sample and the urban–rural subgroup analyses. (4) Co-disabilities involving PD and mental disability showed a marked increase over time in both urban and rural older adults, particularly for multiple-CdPDD.

Conclusions

PD and CdPDD among older adults in China increased markedly from 1987 to 2006, especially in rural areas. Hearing-speech-related co-disabilities remained the dominant pattern, while mental-related co-disabilities increased most rapidly. The associations of different co-occurring disability types with PD and moderate-to-severe PD varied. In the short term, priority should be given to identifying high-risk co-disability combinations and strengthening screening, referral, rehabilitation follow-up, and continuity of care, particularly in rural areas. In the longer term, a more integrated co-disability management framework is needed to better connect rehabilitation, mental health, primary healthcare, and long-term care services. Greater use of the co-disability rate indicator may also help guide priority setting and service planning.