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Table 1 Midlife disability prevalence and disability definitions

From: The importance of disability as a health issue for mid-life women

Reference Study, year, geographic location Midlife sample Disability definition Disability prevalence (95 % CI)
United States studies, national samples
 Altman & Gulley 2009 [45] Joint Canada/United States Survey of Health, 2002–2003, United States and Canada national samples 40–64 years Disability in 4 question domains: Restriction of Activities Screener (reduction of activities at home, school, work); Health Utilities Index (functional abilities including vision, hearing, speech, mobility, dexterity, emotional well being, cognition, pain); Activity and Participation Screener (restriction caused by physical, mental or emotional problem); and Physical Functioning Limitation  
Men & women • 40–49 years, Canada 19.82 % (14.16, 25.48)
• 50–64 years, Canada 25.32 % (19.17, 31.47)
• 40–49 years, United States 16.80 % (12.47, 21.13)
• 50–64 years, United States 28.59 % (23.67, 33.51)
 Mitra et al. 2009 [46] Medical Expenditure Panel Survey, 2004, United States national sample 40–61 years At least one of the following: limitations in work, housework, or school; walking limitations; cognitive limitation; limitations in seeing or hearing  
Men and women • 40–49 years 29.7 %
• 50–61 years 45.4 %
 Hottman et al. 2005 [5] Survey of Income and Program Participation, 2005, United States national sample 45–64 years At least one of the following: (women only) 25.9 %
Men & women • Use of an assistive aid 4.6 % (4.2, 5.0)
• Difficulty performing ADLs 4.1 % (3.7, 4.5)
• Difficulty performing IADLs 6.0 % (5.5, 6.5)
• Difficulty performing specified functional activities 19.4 % (18.6, 20.2)
• Reported of selected impairments 6.9 % (6.4, 7.4)
• Limitation in ability to work around house 10.7 % (10.1, 11.3)
• Limitation in ability to work at Job/business 11.3 % (10.7, 11.9)
 Martin et al. 2010 [33] National Health Interview Survey, 2005–2007, United States national sample 50–64 years Difficulty with physical functions due to a health problem 42.0 %
Men & women • Needing help with IADLs 6.7 %
• Needing help with ADLs 6.0 %
 Zhao et al. 2009 [47] Behavioral Risk Factor Surveillance System, 2005, United States national sample 50–65 years Self-reported limitations in participation in activities because of physical, mental, or emotional problems or whether health problems required use of special equipment  
Men & women • 50–54 years 22.9 % (21.3, 24.5)
• 55–59 years 28.8 % (27.8, 29.8)
• 60–65 years 28.8 % (27.8, 29.8)
United States studies, local samples
 Khoury et al. 2013 [69] Female Medicaid beneficiaries, 2001–2005, Florida 36–64 years Presence of at least one physically disabling conditions but no use of a mobility assistive device  
Women • 36–45 years 35.79 %
• 46–55 years 47.22 %
• 56–64 years 53.30 %
Presence of at least one physically disabling conditions and use of a mobility assistive device  
• 36–45 years 2.92 %
• 46–55 years 5.59 %
• 56–64 years 9.17 %
 Brown et al. 2014 [41] Patients admitted to San Francisco General Hospital, 2010–2011, San Francisco, California 55–59 years Needing help with at least one ADL 2 weeks before hospital admission 28.9 %
Men & women • Needing help with bathing 21.1 %
• Needing help with dressing 20.5 %
• Needing help with transferring 14.5 %
• Needing help with eating 9.0 %
• Needing help with toileting 9.6 %
Needing help with at least 2 IADLs 2 weeks before hospital admission 36.1 %
• Needing help with shopping 32.5 %
• Needing help with light housework 30.6 %
• Needing help with meal preparation 30.1 %
• Needing help with transportation 21.1 %
• Needing help with medication management 20.7 %
• Needing help with money management 16.9 %
• Needing help with using the telephone 7.2 %
 Mann et al. 2015 [48] Behavioral Risk Factor Surveillance System (BRFSS), 2011, South Carolina 45–64 years Affirmative response to standard BRFSS disability questions:  
Men & women Self-reported limitation in “activities because of physical, mental, or emotional problems”
Or
Self-reported health problem that requires use of special equipment such as a cane, wheelchair, special bed, or special telephone.
• 45–54 years 22.1 % (20.0, 24.3)
• 55–64 years 23.3 % (21.4, 25.2)
 Karvonen-Gutierrez & Ylitalo 2013 [32] Michigan Study of Women’s Health Across the Nation, 2011, Michigan 55.9–67.7 years 36-item World Health Organization Disability Assessment Schedule, severe-extreme disability:  
Women only • Global score 5.05 % (2.84, 7.26)
• Understanding and communicating 5.05 % (2.84, 7.23)
• Getting around 19.31 % (15.41, 23.41)
• Self-care 4.26 % (2.22, 6.30)
• Getting along with people 6.12 % (3.70, 8.54)
• Engaging in life activities, non-work 43.16 % (35.07, 51.25)
• Engaging in life activities, work 8.62 % (5.00, 12.23)
• Participation in society 8.78 % (3.92, 11.64)
 Arterburn et al. 2012 [52] Group Health Plan enrollees, Washington 40–65 years Modified World Health Organization Disability Assessment Schedule, any disability:  
Women only • Global score Not reported
• Understanding and communicating 26 %
• Getting around 27 %
• Self-care 7 %
• Getting along with people 17 %
• Engaging in life activities, non-work 46 %
• Engaging in life activities, work 45 %
• Participation in society 24 %
International studies
 Hosseinpoor et al. 2012 [16] World Health Survey, 2002–2004, 57 countries 50–59 years World Health Organization Report on Disability definition, based upon Item Response Theory model using data from questions in multiple domains.  
Men & women • 50–54 year old women 27.3 % (25.1, 29.5)
• 55–59 year old women 30.5 % (28.0, 33.0)
Europe
 Kattainen et al. 2004 [39] Finland Health 2000 Survey, 2000–2001, Finland 45–64 years Blindness or being unable to perform without help or having marked difficulty at least one of 7.8 %
Women the following: moving about in the house, getting in/out of bed, dressing, carrying a 5-kg shopping bag, walking 500 m without rest, climbing a flight of stairs without rest, managing grocery shopping
 Krishnan et al. 2004 [40] Cross-sectional study in Central Finland District, 2000, Finland 36–65 Health Assessment Questionnaire (HAQ) disability index score >0. HAQ assesses difficulty with performing activities in 8 functional categories: dressing/grooming, arising, eating, walking, hygiene, reach, grip, and common daily activities.  
Women • 36–40 years 14.7 % (7.9, 21.4)
• 41–45 years 17.4 % (10.4, 24.4)
• 46–50 years 25.0 % (17.4, 32.6)
• 51–55 years 25.6 % (17.7, 33.5)
• 56–60 years 36.7 % (27.0, 46.4)
• 61–65 years 33.1 % (24.4, 41.7)
 Klijs et al. 2011 [81] Dutch PLOS-survey (Permanent Onderzoek Leefsituatie), 2001–2007, the Netherlands 55–59 years Major difficulty doing or only able to do with help at least one of the following: walk up and down the stairs, walk outside, enter/leave the house, sit down/get up from a chair, move around on the same floor, get in/out of bed, eat/drink, get dressed/undressed, wash face/hands, wash completely 6 %
Women
 Almazan-Isla et al. 2014 [60] Residents from Cinco Villas, Spain, 2008–2009, Spain 50–59 years 36-item World Health Organization Disability Assessment Schedule, severe-extreme disability, women only  
Men & women • Global score 1.27 %
• Understanding and communicating 1.27 %
• Getting around 8.28 %
• Self-care 2.55 %
• Getting along with people 1.27 %
• Engaging in life activities, non-work 12.74 %
• Engaging in life activities, work 4.46 %
• Participation in society 6.00 %
Africa
 Miszkurka et al. 2012 [54] World Health Organization World Health Study, 2002–2003, Burkina Faso, Mali, and Senegal 35–64 years Mobility disability, defined as self-reported mild, moderate, severe or extreme difficulty or unable to move around.  
Men and women • 35–44 years, Burkina Faso, women 21 % (16, 28)
• 35–44 years, Mali, women 22 % (19, 26)
• 35–44 years, Senegal, women 36 % (28, 44)
• 45–54 years, Burkina Faso, women 25 % (19, 32)
• 45–54 years, Mali, women 31 % (24, 39)
• 45–54 years, Senegal, women 41 % (23, 63)
• 55–64 years, Burkina Faso, women 52 % (40, 64)
• 55–64 years, Mali, women 48 % (38, 58)
• 55–64 years, Senegal, women 56 % (38, 72)
 Payne et al. 2013 [55] Malawi Longitudinal Study of Families and Health, 2010, Malawi 45–64 years Having any health problem that limits ability to carry out culturally-relevant moderate activities or strenuous activities.  
Men & women • Moderately disabled (‘somewhat limited’ in either moderate or strenuous activities) 22.4 %
• Severely disabled (‘limited a lot’ in either moderate or strenuous activities) 5.3 %
 Wandera et al. 2014 [56] Uganda National Household Survey, 2010, Uganda 50–59 years Having a lot of difficulty or being unable to perform at least one of the following OR having some difficulty with at least two of the following: difficulty seeing, even if wearing glasses; difficulty hearing, even if wearing a hearing aid; difficulty walking or climbing steps; difficulty remembering or concentrating; difficulty washing all over or dressing, feeding and toileting; difficulty communicating because of a physical, mental or emotional health condition. 24.8 %
Women
Asia
 Zheng et al. 2011 [57] China National Survey, 2006, China 45–64 years Doctor-diagnosed disability following positive screen for self-reported visual, hearing, speech, physical, intellectual or mental disability  
Men and women • 45–54 years 11.0 %
• 55–64 years 13.2 %
 Peng et al. 2010 [58] China National Sample Survey on Disability, 2006 35–64 years Visual, intellectual, mental or physical disability assessed from an impairment-based examination  
Women • 35–39 years 3.48 % (3.41, 3.55)
• 40–44 years 4.18 % (4.10, 4.26)
• 45–49 years 5.32 % (5.21, 5.34)
• 50–54 years 6.38 % (6.27, 6.49)
• 55–59 years 8.77 % (8.62, 8.92)
• 60–64 years 12.35 % (12.15, 12.55)
 Hairi et al. 2010 [59] Alor Gajah Older People Health Survey, 2007–2008, Malaysia 60–64 years Level of independence in ADLs. 5-item scale included feeding, dressing, bathing, toileting and transferring. 6-item scale additionally included walking. 10-item scale additionally included grooming, bladder control, bowel control, and stair climbing.  
Women • 10 item ADL dependence 5.3 % (2.6, 10.1)
• 6 item ADL dependence 4.7 % (2.2, 9.4)
• 5 item ADL dependence 2.9 % (1.1, 7.9)