ArticleBMC geriatrics2026
Unmet needs of activities of daily living among older adults living in their own homes: a community-based cross-sectional study.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionUnmet needs for activities of daily living (ADLs) are likely to increase with advancing age. This study explored the prevalence of unmet needs, its associated factors, and the perspectives regarding the care received by older adults living in their own homes in the Colombo District, Sri Lanka.
methodsA representative cross-sectional sample of community-based older adults (n = 723), aged ≥ 65 years, was obtained by multi-stage cluster sampling. Limitations in ADLs were measured using a validated Sinhala version of the 10-item Barthel Index, and the unmet needs were assessed using six specific questions. Simple and multiple logistic regression were used in data analysis.
resultsMean(± SD) age of the older adults with unmet needs (n = 71) was 76.07 ± 8.44 years, with 84.5% males. Out of 723 older adults, 122 (16.8%) had limitations in activities of daily living (ADLs), among whom 71 (58.2%) reported unmet needs. The mean (± SD) ADL scores of the total sample, older adults with ADL limitations, and those with unmet needs were 94.42 ± 17.1, 67.17 ± 28.94 and 55.00 ± 30.16 (out of 100), respectively. The majority (63.4%) reported unmet needs for > 3 ADLs, while the prevalence of unmet needs for different ADLs ranged from 15.4% to 91.5%. The commonest unmet need was for walking and climbing steps (91.5%), followed by bathing (76%) and transferring (73.2%). Factors that showed significant (p < 0.001) positive associations with unmet needs in the adjusted model were male gender (odds ratio [OR] = 3.73, confidence interval [CI] = 1.80-7.7), age (75-84 years OR = 2.91, CI = 1.65-5.12; >85 years OR = 5.23, CI = 2.28-11.98) and disabling stroke (OR = 6.13, CI = 2.46-15.3). The majority were dissatisfied with the care they received (56.7%, n = 34) and with the caregivers' knowledge of caregiving (83.3%, n = 50).
conclusionOlder adults living in their own homes reported unmet needs, particularly in walking, climbing, bathing, and transferring. Factors that enhance the occurrence of unmet needs include advancing age, male gender and disabling stroke. The provision of assistive devices in mobilization and, capacity building of caregivers would help bridge this gap. Engaging nursing trainers in implementing structured home-based caregiver training programs and a multidisciplinary approach focused on mobility support is recommended.
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