Gender differences in functioning for older adults in ruralBangladesh. The impact of differential reporting?

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Abstract
BACKGROUND: The purpose of this study is to examine gender differencesin functional ability among older adults in rural Bangladesh in terms ofboth self-reported activities of daily living and observed physicalperformance and to evaluate the extent to which differential reporting bygender contributes to disparities between the two measures. METHODS: In1996, the Matlab Health and Socio-Economic Survey collected data onself-reported activities of daily living (ADLs) and observed physicalperformance for 1,893 men and women aged 50 and older in the MatlabSurveillance area in rural Bangladesh. Gender differences were examined inboth self-reported ADLs and physical-performance measures. Withphysical-performance measures as the gold standard, logistic regression wasused to determine how much of the gender difference in the self- reportedfunction was explained by physical-performance ability controlling for age.RESULTS: Older women in this study population consistently had morelimitations than men in both self-reported ADLs and observed physicalperformance. For the same level of observed physical performance, however,older women were more likely than men were to report a higher level of ADLlimitation. This reported female health disadvantage varied considerablydepending on the nature of the ADLs being examined and the type of scoringsystem used for the ADLs. CONCLUSIONS: One has to be somewhat cautious ininterpreting gender differences in self-reported ADL limitations, as theyare affected by the gender-specific nature of the reported activity and bygender differences in the perception of response categories.

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