Limitations in Activities of Daily Living in Community-Dwelling People Aged 75 and Over: A Systematic Literature Review of Risk and Protective Factors

Anne van der Vorst, G. A. Rixt Zijlstra, Nico De Witte, Daan Duppen, Andreas E. Stuck, Gertrudis I. J. M. Kempen, Jos M. G. A. Schols

Research output: Contribution to journalArticlepeer-review

59 Citations (Scopus)


BackgroundMost older people wish to age in place, for which functional status or being able to performactivities of daily living (ADLs) is an important precondition. However, along with the substantialgrowth of the (oldest) old, the number of people who develop limitations in ADLs orhave functional decline dramatically increases in this part of the population. Therefore, it isimportant to gain insight into factors that can contribute to developing intervention strategiesat older ages. As a first step, this systematic review was conducted to identify risk andprotective factors as predictors for developing limitations in ADLs in community-dwellingpeople aged 75 and over.MethodsFour electronic databases (CINAHL (EBSCO), EMBASE, PsycINFO and PubMed) weresearched systematically for potentially relevant studies published between January 1998and March 2016.ResultsAfter a careful selection process, 6,910 studies were identified and 25 were included. By farmost factors were examined in one study only, and most were considered risk factors. Severalfactors do not seem to be able to predict the development of limitations in ADLs in peopleaged 75 years and over, and for some factors ambiguous associations were found. Thefollowing risk factors were found in at least two studies: higher age, female gender, diabetes, hypertension, and stroke. A high level of physical activity and being married wereprotective in multiple studies. Notwithstanding the fact that research in people aged 65years and over is more extensive, risk and protective factors seem to differ between the‘younger’ and ‘older’ olds.ConclusionOnly a few risk and protective factors in community-dwelling people aged 75 years andover have been analysed in multiple studies. However, the identified factors could serveboth detection and prevention purposes, and implications for future research are given aswell.
Original languageEnglish
Article numbere0165127
Number of pages18
JournalPLoS ONE
Issue number10
Publication statusPublished - 19 Oct 2016

Cite this