Limitations in instrumental activities of daily living among community dwelling older adults in Kerala, India

Abstract Introduction Instrumental Activities of Daily Living (IADL) are complex functional tasks essential for independent community living. Assessing IADL limitations is especially important in Kerala state of India, which has a rapidly aging population, high morbidity, and high life expectancy, as it enables early detection of functional decline and better understanding of functional needs among older adults. We assessed IADL functioning and indentified associated factors among older adults in Kerala. Methods A cross-sectional community-based study was conducted among 452 older adults aged 60–80 years in Thiruvananthapuram district, Kerala, using multistage cluster sampling. The Lawton IADL Scale was employed to assess functional competence across eight domains. Data on socio-demographics, lifestyle behaviors, morbidity, and fall history were collected. Stress was measured using Perceived Stress scale. Multiple logistic regression analysis was performed to identify factors associated with IADL dependence. Results Prevalence of IADL dependence was 38.9% (95% confidence interval (CI), 34.4–43.6). Dependence was most common in tasks such as shopping, household work, and transportation. In multivariate analysis, IADL dependence was significantly associated with advanced age [odds ratio (OR) 6.46, 95% CI, 3.89–10.74], female gender (OR:4.27, 95% CI, 2.47–7.37), presence of chronic morbidities (OR:2.85, 95% CI, 1.23–6.56), history of falls (OR:2.09, 95% CI, 1.24–3.54), and moderate-to-high stress (OR:2.00, 95% CI, 1.19–3.38) compared to their counterparts. Conclusions IADL dependence poses a significant challenge for Kerala’s aging population. Strengthening early screening and implementing preventive, supportive interventions are essential to maintain functional independence and enhance quality of life for older adults.