The twenty-first century is often called the age of ageing.¹ In the words of Seneca; “old age is an incurable disease”, but more recently, Sir James Sterling Ross Commented: “You do not heal old age. You protect it, you promote it, and you extend it”. ² Ageing is a physiological process which is associated with progressive degeneration of all organs and tissues of the body. The rate at which degeneration occurs does not strictly follow the chronological age. There are ethnic, racial and genetic differences amongst individual. The biological age and chronological age do not show any correlation, although they are closely related to each other. ³ Geriatrics is the study of medical aspects and care of elderly.⁴ In 1980, United Nations recommended 60 years as the age of transition to the elderly segment of the population.⁵ Geriatric people have special health problems that are different from those of young. Usually, the disease process in the elderly is multiple and the duration and severity of both acute and chronic conditions are longer for the aged than the young.⁶ Urbanization, nuclearization of family, migration and dual career families are making care of the elderly more and more of personal and social problems in India.⁷

         Activities of daily living (ADLs) is the term used to refer to the daily activities of self-care within the place of residence of an individual, the outdoor environments, or both. Health professionals refer to the ability or the inability to perform the ADLs as an important measurement of functional status of an individual, particularly with regard to the people with disabilities and the elderly.  It has been only in the last few years that health care planners and the governments have started taking measures to address age related issues. Despite the felt need of the aged data regarding the health of the elderly are still inadequate. This is more so in most developing countries like India. This cross-sectional descriptive study was carried out to make an assessment of activities of daily living amongst elderly in rural area.

The present cross sectional study was undertaken in field practice area medical college to study on basic activities of daily living among geriatrics population. All the elderly (60 years of age and above) were included in present study. Total number of study participants were 393. All the elderly of 60 years and above were first enlisted from house to house survey with the help of Voters ID and other available record. Initially the pilot study was carried out in the field practice area for pretesting the proforma and necessary modifications were made in proforma and same was finalized. Family members were explained about the purpose of the study and efforts were taken for their maximum co-operation in the study. The investigator paid house to house visit and interviewed all the 393 study subjects. Pre-tested structured questionnaire was used to obtain information about name, age, sex, marital status, education, occupation, living arrangement and activities of daily living etc. from the study subjects. Statistical Analysis: Analysis was done by using percentages, Chi-square test and test of significance of difference between two proportions.

The age of elderly in the present study ranged from 60-100 years. Majority of elderly were in the age group 60-64 years i.e. 32.32% followed by 27.23% in the age group 65- 69 years, 19.08% in the age group 70-74 years, 14.25% in the age group 75-79 years and least in the age group 80 years and above i.e.7.12%. The percentage of elderly females was more in the present study i.e. 54.20% as compared to elderly males i.e. 45.80%. The ratio of male to female elderly was 1:1.18.

Table No.1: Distribution of Elderly According to Basic Activities of Daily Living

 Table No.1 shows distribution of elderly according to basic activities of daily living. Among 393 elderly studied, it was observed that 384 (97.71%) were able to bath, 387 (98.47%) were able to transfer the object, 387 (98.47%) were having ability for self-feeding, 384 (97.71%) were having ability for self-dressing, 386 (98.22%) elderly were ambulatory and 387 (98.47%) were able to go for toilet.

Table No.2: Distribution of Elderly According to Instrumental Activities of Daily Living

Table no.2 shows distribution of elderly according Instrumental activities of daily living. It was observed that 190 (89.20%) females and 61 (33.89%) males were able to prepare meal and this difference was statistically significant (Z=13.42, p<0.01). 151 (83.89%) males and 117 (54.93%) females were able to do shopping and this difference was statistically significant (Z=6.62, p<0.01).

121 (67.22%) males and 142 (66.67%) females were able to do light

homework. 59 (32.78%) males and 69 (32.39%) females were having practice

of exercise. 127 (70.55%) males and 70 (32.86%) females were having ability of financial management and this difference was statistically significant (Z=8.05, p<0.01). 130 (72.22%) males and 110 (51.64%) females were having ability of medication management and this differences was statistically significant (Z=4.30, p<0.01).

Table No.3: Distribution of Elderly According to Instrumental Activities of Daily Living and their Age

   χ2 =56.07, df =20, p < 0.001

Table no.3 shows that in the age group 60-64 years, 95 (37.85%) elderly were able to prepare meal whereas elderly above 80 years only 16 (6.37%) were able to prepare meal.

In the age group 60-64 years, 98(36.57%) elderly were able to do shopping whereas elderly above 80 years only 17 (6.34%). were able to do shopping. Similarly elderly in the age group 60-64 year 117 (44.59%) were able to do light homework, 46 (35.94%) were having practice of exercise, 77 (39.08%) were having ability of financial management and 111 (46.25%) were having ability of medication management whereas elderly above 80 years 8 (3.04%) were able to do light homework, 12(9.37%) were having practice of exercise, 10 (5.08%) were having ability of financial management and 6 (2.50%) were having ability of medication management. Significant association was found between the age of elderly and instrumental activities of daily livings (χ2 =56.07, p<0.001). It is observed that as the age progresses activities declines.

Das RA et al in their community-based cross-sectional study conducted in Kerala, India, found that functional limitation was significantly more prevalent among the elderly aged above 70 years.⁸ Sekhon H et al in their cross-sectional descriptive in 2014 study observed that there was no difference between males and females in ADL.⁹ The study also revealed that dependency increased with age in both genders. These findings are similar to those of our current study. Gupta et al in their study conducted in Haryana, observed that prevalence of ADL limitations was less among males as compared to females.¹⁰ Another study observed found that activity limitation was significantly more pervasive among the elderly population aged 70 years and above.¹¹

Abilities of elderly in managing daily activities inside home are very good. However, majority cannot manage outdoor activities like shopping, banking. It is observed that as the age progresses activities declines.

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