Quality of Life Research

, Volume 15, Issue 9, pp 1471–1479 | Cite as

The prevalence of person-perceived participation restriction in community-dwelling older adults

  • Ross Wilkie
  • George Peat
  • Elaine Thomas
  • Peter Croft



To estimate the prevalence, nature and distribution of person-perceived participation restriction, in community-dwelling older adults.


Population based cross-sectional postal survey of 11,055 adults aged 50 years and over in North Staffordshire, United Kingdom. Person-perceived participation restriction was measured using the Keele Assessment of Participation which covers 11 different aspects of life mapped to the World Health Organization’s International Classification of Functioning. Four-week period prevalence was calculated for restriction in any, multiple and for each aspect separately. Prevalence estimates were calculated for the total sample, and for each age and gender stratum.


A total of 7,878 subjects responded (adjusted response – 71.3%). The 4-week period prevalence of any participation restriction was 51.8%; 3.3% had substantial restriction. Participation restriction increased with age (p<0.001) and, for moderate and substantial restriction, was more frequent in women. The prevalence of restricted participation in individual aspects of life ranged from 3.8% (work) to 25.9% (mobility outside the home).


Some restriction of participation ‚as and when we want it’ is common in the general population and increases with age, although severe restriction only affects a minority. The distribution of person-perceived participation restriction is similar to that of impairments and activity limitation in community-dwelling older adults.

Key words

General population Elderly Participation restriction Person-perceived ICF 


  1. 1.
    Robine JM, Jagger C, Mathers CD, Crimmins EM, Suzman RM, Peron Y. Introduction. In: Robine JM,␣Jagger C, Mathers CD, Crimmins EM, Suzman RM (eds), Determining Health Expectancies. Chichester: John Wiley and sons, 2003Google Scholar
  2. 2.
    World Health Organization. (2001). International Classification of Functioning, Disability and Health. World Health Organization, GenevaGoogle Scholar
  3. 3.
    Harwood RH, Jitapunkul S, Dickinson E, Ebrahim S. (1994). Measuring handicap: Motives, methods, and a model. Qual Health Care 3:53–57PubMedGoogle Scholar
  4. 4.
    Harwood RH, Prince M, Mann A, Ebrahim S. (1998). Associations between diagnoses, impairments, disability and handicap in a population of elderly people. Int J Epidemiol 27:261–268PubMedCrossRefGoogle Scholar
  5. 5.
    Moore EG, Rosenberg MW, Fitzgibbon SH. (1999). Activity limitation and chronic conditions in Canada’s elderly, 1986–2011. Disabil Rehabil 21:196–210PubMedCrossRefGoogle Scholar
  6. 6.
    Martin J, Meltzer H, Elliot D. (1987). OPCS Surveys of Disability in Great Britain: The Prevalence of Disability Among Adults. OPCS, HMSO, LondonGoogle Scholar
  7. 7.
    Beckett LA, Brock DB, Lemke JH, Mendes de Leon CF, Guralnik JM, Fillenbaum GG, Branch LG, Wetle TT, Evans DA. (1996). Analysis of change in self-reported physical function among older persons in four population studies. Am J Epidemiol 143:766–778PubMedGoogle Scholar
  8. 8.
    Ferrucci L, Penninx BW, Leveille SG, Corti MC, Pahor M, Wallace R, Harris TB, Havlik RJ, Guralnik JM. (2000). Characteristics of non-disabled older persons who perform poorly in objective tests of lower extremity function. J Am Geriatr Soc 48:1102–1110PubMedGoogle Scholar
  9. 9.
    Badley EM, Tennant A. (1993). Impact of disablement due to rheumatic disorders in a British population: Estimates of severity and prevalence from the Calderdale Rheumatic Disablement Survey. Ann Rheum Dis 52:6–13PubMedGoogle Scholar
  10. 10.
    Bebbington AC, Darton RA. (1996). Healthy life expectancy in England and Wales: Recent evidence. PSSRU, LondonGoogle Scholar
  11. 11.
    Cousins C, Jenkins J, Laux R. Disability data from the Labour Force Survey: Comparing 1997–1998 with the past. In: Office for National Statistics. Labour Market Trends (June edition). HMSO: London, 1998Google Scholar
  12. 12.
    Fried LP, Bandeen-Roche K, Kasper JD, Guralnik JM. (1999). Association of comorbidity with disability in older women: The Women’s Health and Aging Study. J Clin Epidemiol 52:27–37PubMedCrossRefGoogle Scholar
  13. 13.
    Harwood RH, Prince MJ, Mann AH, Ebrahim S. (1998). The prevalence of diagnoses, impairments, disabilities and handicaps in a population of elderly people living in a defined geographical area: the Gospel Oak project. Age Ageing 2:707–714Google Scholar
  14. 14.
    Schwartz CE, Rapkin BD. (2004). Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal. Health Qual Life Outcomes 2:14PubMedCrossRefGoogle Scholar
  15. 15.
    Carr AJ, Gibson B, Robinson PG. (2001). Measuring quality of life: Is quality of life determined by expectations or experience? Br Med J 322:1240–1243CrossRefGoogle Scholar
  16. 16.
    Doherty M. (2001). Risk factors for progression of knee osteoarthritis. Lancet 358:775–776PubMedCrossRefGoogle Scholar
  17. 17.
    Freedman VA, Martin LG. (1998). Understanding trends in functional limitations among older Americans. Am J Public Health 88:1457–1462PubMedGoogle Scholar
  18. 18.
    Thomas E, Wilkie R, Peat G, Hill S, Dziedzic KS, Croft PR. (2004). The epidemiology and management of clinical osteoarthritis in the older population: Prospective 3-year study of natural history and health care utilisation in the general population. BMC Musculoskel Disorders 5(1):2CrossRefGoogle Scholar
  19. 19.
    Trinder P. South Stoke Primary Care Trust. Demography and Deprivation Profile. Directorate of Health Policy and Public Health, North Staffordshire Health, 2002 http://www.nsha.co.uk/home/library/hp/hpGoogle Scholar
  20. 20.
    Trinder P. Newcastle-under-Lyme Primary Care Trust. Demography and Deprivation Profile. Directorate of Health Policy and Public Health, North Staffordshire Health, 2002 http://www.nsha.co.uk/home/library/hp/hpGoogle Scholar
  21. 21.
    Ware J Jr, Kosinski M, Keller SD. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233PubMedCrossRefGoogle Scholar
  22. 22.
    Wilkie R, Peat GM, Thomas E, Hooper H, Croft PR. (2005). The Keele assessment of participation: A new instrument to measure participation restriction in population studies. Combined qualitative and quantitative examination of its psychometric properties. Qual Life Res 14(8):1889–1899PubMedCrossRefGoogle Scholar
  23. 23.
    Bland M. (1995). An Introduction to Medical Statistics 2nd edn. Oxford Medical Publications, OxfordGoogle Scholar
  24. 24.
    Office for National Statistics. (2002). Health Quarterly 20. Office for National Statistics, LondonGoogle Scholar
  25. 25.
    Pettit T, Livingston G, Manela M, Kitchen G, Katona C, Bowling A. (2001). Validation and normative data of health status measures in older people: The Islington study. Int J Geriatr Psychiatry 16:1061–1070CrossRefGoogle Scholar
  26. 26.
    Thomas E, Peat G, Harris L, Wilkie R, Croft PR. (2004). The prevalence of pain and pain interference in a general population of older adults: Cross-sectional findings from the North Staffordshire Osteoarthritis Project (NorStOP). Pain 110:361–368PubMedCrossRefGoogle Scholar
  27. 27.
    Ueda S, Okawa Y. (2003). The subjective dimension of functioning and disability: What is it and what is it for? Disabil Rehabil 25:596–601PubMedCrossRefGoogle Scholar
  28. 28.
    Leveille SG, Penninx BW, Melzer D, Izmirlian G, Guralinik JM. (2000). Sex differences in the prevalence of mobility disability in old age: The dynamics of incidence, recovery, and mortality. J Gerontol B Psychol Sci Soc Sci 55:S41–50PubMedGoogle Scholar
  29. 29.
    Odding E, Valkenburg HA, Stam HJ, Hofman A. (2002). Determinants of locomotor disability in people aged 55 years and over: The Rotterdam study. Eur J Epidemiol 17:1033–1041CrossRefGoogle Scholar
  30. 30.
    Papageourgiou AC, Croft PR, Ferry S, Jayson MI, Silman AJ. (1995). Estimating the prevalence of low back pain in the general population. Evidence from the South Manchester Back Pain Survey. Spine 20:1889–1894CrossRefGoogle Scholar
  31. 31.
    Harwood RH, Rogers A, Dickinson E, Ebrahim S. (1994b). Measuring handicap: The London Handicap Scale, a new outcome measure for chronic disease. Qual Health Care 3:11–16CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Ross Wilkie
    • 1
  • George Peat
    • 1
  • Elaine Thomas
    • 1
  • Peter Croft
    • 1
  1. 1.Primary Care Sciences Research CentreKeele UniverstityKeele, StaffordshireUnited Kingdom

Personalised recommendations