PSYCHOSOCIAL PATHWAYS EFFECT ON THE RELATIONSHIP OF FUNCTIONAL LIMITATIONS AND SELF-IDENTIFIED DISABILITY. (11th November 2018)

• Record Type: Journal Article
• Authors: Duan, Y; Shippee, T; Olsen Baker, M; Angert, J
• Is Part Of: Innovation in aging. Volume 2(2018)Supplement 1
• Page Start: 743
• Page End: 743
• Publication Date: 2018-11-11
• Subjects: Aging -- Periodicals; Gerontology -- Periodicals; 612.67
• DOI: 10.1093/geroni/igy023.2739
• Languages: English
• ISSNs: 2399-5300

Abstract

Abstract: Disability is often defined as difficulty doing everyday activities due to a health or physical problem. However, disabled older adults might have different psychosocial experiences or perceptions toward functional limitations that determine if they identify themselves as disabled individuals. This study aimed to examine the mediating effects of community inclusion and negative mood on the relationship between functional limitation and self-identified disability (SID) among older adults receiving public-funded long-term services and supports (LTSS), and used cross-sectional data obtained from 2015 Minnesota National Core Indicators-Aging and Disabilities project in which 1, 976 older adults were interviewed about the services they receive. A structural equation modeling approach was applied using a diagonally weighted least squares estimation procedure. Functional limitation measured by three indicators of difficulties performing everyday activities was found to be significantly related to both a higher likelihood of SID (b=0.983, p<0.001), and two psychosocial factors: community inclusion (b=-0.159, p<0.001) and negative mood (b=0.179, p<0.001). Both community inclusion and negative mood had a significant direct effect on SID (b=-0.166, 0.075, p<0.001), with community inclusion having an indirect effect through the mediation of negative mood (b=-0.170, p<0.001). In conclusion, functional limitation was a strong determinant of SID. Limited community inclusion and negative mood partially explained why older adults with functional limitation identified themselves as disabled individuals. Study findings challenge existing socio-medical models of disability that define disability as equivalent to functional limitations, and suggest the focus of LTSS development should be expanded to include support for older adults' psychosocial needs.