• Yajun Liang, Anna-Karin Welmer, Rui Wang, Aiqin Song, Laura Fratiglioni, and Chengxuan Qiu.
• Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.
• J Am Geriatr Soc. 2017 Feb 1; 65 (2): 306-312.

ObjectivesTo investigate time trends in incidence of activity of daily living (ADL) disability of Chinese older adults and to explore factors potentially contributing to trends.DesignPopulation-based prospective study using a multistage, randomized, cluster sampling process.SettingNine provinces of China.ParticipantsThree consecutive cohorts of people aged 60 and older from the China Health and Nutrition Survey: cohort 1993-2000 (n = 831), cohort 1997-2004 (n = 1,091), cohort 2000-2006 (n = 1,152).MeasurementsDisability in ADLs was defined as inability to perform at least one of five self-care activities (transferring, dressing, toileting, bathing, feeding). Data were analyzed using Cox and generalized estimating equation models.ResultsThe incidence (per 1,000 person-years) of ADL disability decreased significantly from 35.3 in 1993-2000 and 28.9 in 1997-2004 to 24.3 in 2000-2006 in Chinese older adults (Ptrend < .001). The incidence of ADL disability decreased significantly in men and women, in young-old adults (aged 60-74), and in those living in rural areas (all Ptrend ≤ .02) after controlling for multiple potential influential factors. Of the five ADL items, decline in incidence of disability was significant in transferring (Ptrend < .001) and bathing (Ptrend = .002) and marginally significant in toileting (Ptrend = .06) but stable in dressing (Ptrend = .38) and feeding (Ptrend = .26).ConclusionThe incidence of ADL disability decreased from 1993 to 2006 in older adults in China, especially in transferring and bathing, independent of sociodemographic, lifestyle, and chronic health conditions.© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

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