JOURNAL OF AGING AND HEALTH / August 2001 Kabir et al. / ELDERLY PEOPLE IN BANGLADESH Influence of Sociocultural and Structural Factors on Functional Ability: The Case of Elderly People in Bangladesh

Objective: To describe and contextualize functional status of elderly people ( ≥ 60 years) in Bangladesh by relating it to gender, region, and socioeconomic status. Methods: In this community-based study (N = 696), functional status was described through assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL). Information was obtained on type of help used for ADLs and IADLs and reason for nonperformance of IADLs. Results: Findings indicate differ-ential performance in ADLs and IADLs by gender and region. Socioeconomic status is found to influence IADLs only. Empirical evidence regarding type of help used and reason for not performing a task enables understanding of sociocultural and structural influence on functional ability. Discussion: The underlying assumption of ADL and IADL instruments that an individual will perform an activity given physical or cogni-tive ability is questioned. It is suggested that sociocultural and structural factors are strong determinants of task performance. Viewing functional ability or functional dependence from a purely biomedical perspective may be illusory. Physical and mental abilities are not the only preconditions of functional independence. Severa