Functional Capacity And Physical Environmenal Demand. Exploration of Factors Influencing Everyday Activity and Health in the Elderly Population

The general aim of this thesis was to explore relationships between functional capacity, environmental factors, everyday activity, and health in the elderly population. Initially, the Enabler, an instrument for assessment of the physical home environment's accessibility, was translated to Swedish and revised, and tested for reliability and validity. Further, a systematic random sample of individuals aged 75-84, in ordinary housing in a Swedish rural district, was drawn. Multi-dimensional data were collected on home-visits (N=133). The main finding was that independence/ dependence in activities of daily living (ADL) correlated highly significantly with housing accessibility. The results also supported Lawton's docility hypothesis, i.e. that individuals with low functional capacity are more vulnerable to environmental demand. Finally, data from 25-years longitudinal investigations of a rural population were utilized for an analysis of the covariation between everyday activity and survival. Significant differences in survival between "more active" and "less active" females supported the occupational therapy (OT) core hypothesis: "Activity is health promoting." In this thesis, multi-dimensional methodology was developed and applied in empirical research. However, throughout the studies methodological problems were encountered and managed, for example concerning gender differences and differences between rural and urban areas. In conclusion, with the results presented a potential public health problem has been defined: housing accessibility problems covary with the prevalence of ADL disability in the elderly population. Health promotive and preventive efforts ought to be initiated, since reduced everyday activity is health-threatening. The results have practical implications for rehabilitation, especially for OT, and for public planning of housing for senior citizens, as well as theoretical implications for further understanding of the complex of disablement