Multi-morbidity, disability and adaptation strategies among community-dwelling adults aged 75 years and older

Hon K. Yuen, Ph.D., O.T.R./L., Laura K. Vogtle, Ph.D., O.T.R./L.
Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL 35294, USA

Disability and Health Journal, Volume 9, Issue 4|
Published online: March 24, 2016


The impact of multi-morbidity and disability on the use of adaptation strategies in older adults has not been well researched.


This study investigated categories of adaptation strategies that community-dwelling older adults use to complete their daily activities, identified factors that are associated with the use of behavioral adaptations, and examined the relationship among multi-morbidity, disability and adaptation strategies in this population.


A mixed methods research design was used. 105 community-dwelling older adults with ages ranging from 75 to 94 years completed a questionnaire and semi-structured interview on types of chronic illnesses (multi-morbidity), amount of difficulty in completing daily activities (degree of disability), and types of behavioral efforts made to complete daily activities that are challenging (adaptation strategies). The model of selective optimization with compensation (SOC) was used to categorize these strategies.


The findings revealed that older adults use a wide range of adaptations with compensation and selection the most (40.4%) and least (16.5%) frequently reported respectively. Degree of disability was uniquely associated with the frequency of using SOC strategies while controlling for other factors. Furthermore, degree of disability was a mediator for multi-morbidity in predicting frequency of using SOC strategies.


The findings support that older adults using behavioral adaptations to cope with functional decline is prevalent. Knowing the types of adaptation that older adults employed and the indirect relationship between multi-morbidity and frequency of using SOC strategies, with degree of disability as the mediator will be helpful in planning interventions and prevention programs for educating older adults.