Title: Sex disparities in the prevalence of disabilities: A population-based study in a low-income community

Abstract

\n Background: Functional disability continues to be a significant public health problem that increases older adults’ vulnerability to experience a diminished quality of life, loss of independence, higher healthcare costs and health services utilization, and increased risks of mortality. Thus, we aimed to study the prevalence of disabilities by sex according to the types of daily living activities, controlling for specific sociodemographic variables among older Hispanics from low-income communities.Methods: We used a cross-sectional epidemiological research design, considering a complex sampling design of households to interview adults ≥65 years living in low-income communities in Puerto Rico. Functional disability was measured by the PROMIS ® Physical Function Short Form-20 T-score. The prevalences of disability were estimated using the logistic regression model, weighting by the effect of the sampling. Our estimated prevalences were compared between sexes using the prevalence ratio (PR), which was estimated with logistic regression models, controlling for age, income, number of chronic conditions, high and low impact of chronic conditions in functional disabilities, marital status, and sampling design.Results: We recruited 211 older Hispanics from randomly selected sample. Their mean age was 74.4 ± 7.1 years, with female predominance (57.3%). The estimated prevalence of physical function disability using T-score among females was 2.70 (95% CI: 1.4, 5.1) times the estimated prevalence of physical function disability among males. Women were more likely to report functional disabilities in instrumental activities of daily living, self-care activities, and functional mobility compared to males. These sex differences were largely explained by differences in disability-related chronic conditions.Conclusions: The females in our study bear the greater burden of physical function disability in their adult age. Health policies as well as future studies should be targeted at reducing the burden of physical function disabilities in different types of daily activities through gender sensitive disability self-management programs.