How urban versus rural residency relates to basic activities of daily living among older people in Central China

Although basic activities of daily living (BADL) have been associated with quality of life in older adults, the differences in BADL between urban and rural residency in Central China are not fully clear. This study aimed to assess and compare the prevalence and influencing factors of BADL among older adults in urban versus rural areas. A cross-sectional on-site study among urban and rural older adults (≥ 60 years old) was conducted in Central China in 2022. Participants were included using multistage cluster random sampling. Sociodemographic characteristics, lifestyles, health conditions, and BADL were assessed using questionnaires. Univariate and multivariate analyses were used to identify the factors associated with BADL. Propensity score matching (PSM) was performed to explore the association between urban versus rural older residency and BADL limitations. In total, 31,534 participants (81.76% from rural areas) were included, and the prevalence of BADL limitations was 12.30% (95% CI 11.94-12.67%). The urban participants (14.59%, 95% CI 13.68-15.50%) showed a significantly (P < 0.001) higher prevalence of BADL limitations than their rural counterparts (11.79%, 95% CI 11.39-12.18%). Living alone (aOR 1.420, 95% CI 1.288-1.567) and type 2 diabetes (aOR 1.146, 95% CI 1.025-1.281) were factors associated with BADL only among the rural participants. PSM analysis revealed a 6.06% difference in BADL limitations between the urban and rural participants. Older females showed a significantly (P < 0.05) higher prevalence of BADL limitations than older males in both rural and urban areas. In Central China, urban older adults had a higher prevalence of BADL limitations than their rural counterparts. There were differences in factors associated with BADL between urban versus rural older adults. BADL limitations affected more older females than males in both rural and urban areas.