WHODAS 2.0-BO: normative data for the assessment of disability in older adults

Ferrer, Michele Lacerda Pereira; Perracini, Monica Rodrigues; Rebustini, Flávio; Buchalla, Cassia Maria

doi:10.11606/S1518-8787.2019053000586

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Original Article • Rev. Saúde Pública 53 • 2019 • https://doi.org/10.11606/S1518-8787.2019053000586 copy

WHODAS 2.0-BO: normative data for the assessment of disability in older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE:

To examine the normative data of WHODAS 2.0-BO for older Brazilians (World Health Disability Assessment Schedule – Brazilian version for older people) and its distribution according to sex, age, health, subjective health perception, performance in a mobility test and presence of chronic diseases and depression.

METHODS:

Cross-sectional study, with 350 participants with 60 years of age or older, men and women, patients of a geriatric specialized center for medical consultations or rehabilitation. The older adults were evaluated using a semi-structured questionnaire containing demographic and clinical data (WHODAS 2.0-BO) and the geriatric depression scale (GDS), having been subsequently subjected to a mobility test (Timed Up and Go). The data were analyzed via their distribution in percentiles of the population and via analysis of variance.

RESULTS:

Two-hundred and sixty-six (76%) participants were women, and the average age was 71.8 (DP = 6.7) years old. The average score in WHODAS 2.0-BO was 4.3 (DP = 5.2) points, the highest value found having corresponded to 33 points. The average time for the Timed Up and Go test was 10.0 (SD = 3.2) seconds. About 30% of the older adults did not report any difficulties in the tasks evaluated by WHODAS 2.0-BO and half of the sample scored up to two points.

CONCLUSIONS:

A score corresponding to 12 points in the 90 percentile on a scale from zero to 40 was observed, which suggests severe disability. The score in WHODAS 2.0-BO increased with the advance in age, as well as in the presence of comorbidities, negative health perception, depression, high blood pressure, visual and hearing impairment and mobility impairment.

DESCRIPTORS:
Aged; Disability Evaluation; International Classification of Functioning, Disability and Health; Comorbidity; Socioeconomic Factors; Surveys and Questionnaires, standards

Variable		n	%	Score in WHODAS 2.0-BO		p
Variable		n	%	Mean (SD)	Median	p
Age group (years)						0.025^a a p ≤ 0.05 by the Kruskal-Wallis test.
	60 \|-\| 69	136	38.9	3.7 (5.2)	2.0
	70 \|-\| 79	170	48.6	4.4 (5.1)	3.0
	80 or more	44	12.6	5.5 (5.2)	4.0
Gender						0,982^b b p ≤ 0.05 by the Mann-Whitney test.
	Male	84	24.0	3.7 (4.0)	3.0
	Female	266	76.0	4.4 (5.5)	2.0
Marital status						0.078^a a p ≤ 0.05 by the Kruskal-Wallis test.
	Married	148	42.3	4.0 (5.1)	2.0
	Single	29	8.3	2.3 (3.5)	1.0
	Widow/widower	142	40.6	4.7 (5.3)	3.0
	Divorced	31	8.9	5.1 (6.0)	3.0
Education level						0.003^a a p ≤ 0.05 by the Kruskal-Wallis test.
	Illiterate	13	3.7	10.1 (7.2)	10.0
	Elementary school	267	76.3	4.2 (4.9)	3.0
	High school	51	14.6	4.0 (5.4)	2.0
	Higher education	19	5.4	3.5 (4.8)	2.0
Lives alone						0.531^b b p ≤ 0.05 by the Mann-Whitney test.
	Yes	101	28.9	3.9 (4.6)	2.0
	No	248	71.1	4.4 (5.4)	3.0
Diseases reported
	CVA	26	7.4	5.1 (4.8)	4.0	0.061^b b p ≤ 0.05 by the Mann-Whitney test.
	Parkinson's disease	11	3.1	5.1 (4.2)	5.0	0.244^b b p ≤ 0.05 by the Mann-Whitney test.
	Depression	83	23.7	6.3 (6.6)	3.0	< 0.001^b b p ≤ 0.05 by the Mann-Whitney test.
	Arterial hypertension	243	69.4	4.7 (5.1)	3.0	0.001^b b p ≤ 0.05 by the Mann-Whitney test.
	Diabetes	144	41.1	4.4 (4.9)	3.0	0.190^b b p ≤ 0.05 by the Mann-Whitney test.
	Urinary incontinence	76	21.7	5.2 (5.8)	4.0	0.061^b b p ≤ 0.05 by the Mann-Whitney test.
Uses mobility aid devices
	Yes	40	11.4	9.0 (5.5)	8.5	< 0.001^b b p ≤ 0.05 by the Mann-Whitney test.
	No	310	88.6	3.7 (4.8)	2.0
Visual impairment						< 0.001^b b p ≤ 0.05 by the Mann-Whitney test.
	Yes	182	52.0	5.0 (5.3)	3.0
	No	168	48.0	3.5 (5.0)	2.0
hearing impairment						0.040^b b p ≤ 0.05 by the Mann-Whitney test.
	Yes	112	32.0	5.0 (5.3)	3.0
	No	238	68.0	3.9 (5.1)	2.0
Subjective health perception						< 0.001^a a p ≤ 0.05 by the Kruskal-Wallis test.
	Very good	51	14.6	1.0 (2.0)	0.0
	Good	142	40.6	2.6 (3.0)	2.0
	Average	131	37.4	6.1 (5.8)	5.0
	Poor	19	5.4	9.2 (6.5)	7.0
	Very poor	7	2.0	12.3 (10.1)	9.0
GDS						< 0.001^b b p ≤ 0.05 by the Mann-Whitney test.
	Up to 5 points	292	83.4	3.4 (4.2)	2.0
	Above 5 points	58	16.6	8.4 (7.3)	7.0
TUGT
	0–10 seconds	212	60,6	2.6 (3.9)	2.0
	11 seconds or more	138	39.4	6.9 (5.8)	5.5	< 0.001^b b p ≤ 0.05 by the Mann-Whitney test.

Score	n	%	Accumulated %
0.0	102	29.1	29.1
1.0	29	8.3	37.4
2.0	45	12.9	50.3
3.0	32	9.1	59.4
4.0	24	6.9	66.3
5.0	19	5.4	71.7
6.0	14	4.0	75.7
7.0	20	5.7	81.4
8.0	9	2.6	84.0
9.0	5	1.4	85.4
10.0	8	2.3	87.7
11.0	4	1.1	88.9
12.0	10	2.9	91.7
13.0	5	1.4	93.1
14.0	5	1.4	94.6
15.0	2	0.6	95.1
16.0	4	1.1	96.3
17.0	2	0.6	96.9
18.0	1	0.3	97.1
19.0	1	0.3	97.4
20.0	4	1.1	98.6
21.0	1	0.3	98.9
22.0	1	0.3	99.1
23.0	1	0.3	99.4
24.0	1	0.3	99.7
33.0	1	0.3	100.0
Total	350	100.0

Difficulties in the last 30 days to	None	Mild	Medium	Severe	Extreme/I am unable to
1 – Stand for periods as long as or longer than 30 minutes	217 (62.0)	57 (16.3)	59 (16.9)	14 (4.0)	3 (0.9)
2 – Do your daily chores	244 (69.7)	53 (15.1)	39 (11.1)	13 (3.7)	1 (0.3)
3 – Learn a new task, for example, how to get to a new place	243 (69.4)	52 (14.9)	42 (12.0)	7 (2.0)	6 (1.7)
4 –Difficult to engaging (participating) in the community's activities (for example, festivities, religious activities and others) in the same way as everyone else	298 (85.1)	33 (9.4)	15 (4.3)	4 (1.1)	0 (0.0)
5 – been emotionally affected by your health problems	261 (74.6)	47 (13.4)	29 (8.3)	11 (3.1)	2 (0.6)
6 – Walk a great distance, as for example, one kilometer (about 10 blocks)	170 (48.6)	51 (14.6)	72 (20.6)	43 (12.3)	14 (4.0)
7 – Wash your whole body	310 (88.6)	21 (6.0)	18 (5.1)	0 (0.0)	1 (0.3)
8 – Dress yourself	287 (82.0)	36 (10.3)	24 (6.9)	3 (0.9)	0 (0.0)
9 – Maintain a friendship	303 (82.6)	31 (8.9)	15 (4.3)	1 (0.3)	0 (0.0)
10 – Work on a daily basis	289 (82.6)	37 (10.6)	19 (5.4)	4 (1.1)	1 (0.3)

Variable		Percentiles
Variable		25	50	75	90
Total sample – Sex		0.0	2.0	6.0	12.0
	Men	0.2	3.0	5.0	9.0
	Women	0.0	2.0	7.0	12.0
Age group (years)
	60–69	0.0	2.0	5.0	10.3
	70–79	0.0	3.0	7.0	12.0
	80 or more	2.0	4.0	7.0	14.5
Number of diseases
	0	0.0	0.0	2.0	7.0
	1–2	0.0	2.0	5.0	10.0
	3 or more	2.0	4.0	8.0	14.0
How much the difficulties interfere with your life
	Nothing	2.0	3.0	4.0	7.0
	Mildly	0.0	1.0	3.0	5.0
	Some	2.0	4.0	7.5	13.6
	Very much	6.0	10.0	14.0	18.3
	Totally	7.5	11.0	17.0	–

In the past 30 days, how muchdifficulty did you have in:
1 – Standing for long periods such as 30 minutes?	None	Mild	Moderate	Severe	Extreme/Can not do
2 – Taking care of your household responsabilities?	None	Mild	Moderate	Severe	Can not do
3 – Learning a new task, for example, how to get to a new place?	None	Mild	Moderate	Severe	Can not do
4 – Joining in community acitivities(for example, festivities, religious activities and others) in the same way as everyone else?	None	Mild	Moderate	Severe	Can not do
5 – Have you been emotionally affected by your health problems?	None	Mild	Moderate	Severe	Can not do
6 – Waling a long distance such asa kilometer (about 10 blocks)?	None	Mild	Moderate	Severe	Can not do
7 – Washing your whole body?	None	Mild	Moderate	Severe	Can not do
8 –getting dressed?	None	Mild	Moderate	Severe	Can not do
9 – Maintaiing n a friendship?	None	Mild	Moderate	Severe	Can not do
10 – your day-to-day work?	None	Mild	Moderate	Severe	Can not do

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E-mail: revsp@usp.br

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[1] Correspondence: Michele L P Ferrer, Rua Afonso de Freitas, 523/73 Paraíso 04006-052 São Paulo, SP, Brasil, E-mail: michele.ferrer@hotmail.com