Does a Reduction in Receiving Assistance With Daily Activities Among Older Adults in Mexico Indicate An Increase in Unmet Needs or a Decrease in Needs for Care?

Abstract

Objectives: The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care.

Methods: We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if anyone helped them with the task. Logistic regression was used to estimate adjusted odds ratios (aOR) for cohort differences in ≥1 ADL limitations and help with ≥1 ADL. We used a decomposition analysis to identify participant characteristics that mediated cohort differences in receiving help with ≥1 ADL.

Results: The 2018 cohort had higher odds for ≥1 ADL limitations (aOR = 1.85, 95% CI = 1.60-2.14) but lower odds for help with ≥1 ADL (aOR = 0.66, 95% CI = 0.49-0.89). Among participants with ADL disability, the 2018 cohort had fewer living children and a lower prevalence of probable dementia. The lower number of living children and lower prevalence of probable dementia explained 9.34% and 43.7% of the cohort effect on receiving help with ≥1 ADL, respectively.

Discussion: The declining percentage of older adults in Mexico with ADL disability receiving assistance may not reflect increasing unmet needs. However, the increased prevalence of ADL disability will increase the number of older adults needing informal care.

Keywords: Activities of daily living; Caregiving; Cohort analysis.