The vulnerability of rural elderly Indonesian people to disability: an analysis of the national socioeconomic survey

Background: There is a high prevalence of elderly people aged 65 and older with disabilities in low-and middle-income countries (LMICs), including Indonesia. Due to differences in urban–rural characteristics, this study examined the disability of Indonesian elderly people considering urban–rural disparity by adopting the International Classification of Functioning, Disability and Health (ICF) scheme.
Methods: The cross-sectional design used a sample of 16,054 older people aged 65 and over from the 2018 National Socio-Culture and Education Module of the National Socio-Economic Survey (Susenas-MSBP). Disability was measured using functional status questionnaires of Susenas that had adopted the UN Washington Group’s short set of disability questions. The threshold was at least one domain coded “a lot of difficulty” or “cannot do it all”, or two of the six domains coded “some difficulty” Logistic regression analysis was performed to examine disability-associated factors.
Results: The prevalence of disability in this study were 35.1%. Disability among the elderly tended to be more highly rated in ages 85+ (OR 4.57; 95% CI: 4.54–4.59) than in ages 65–74. Unemployed elderly had higher risk of disability compared with those who were employed (OR 2.48; 95% CI: 2.47–2.49). Elderly who did not participate in leisure activities were 1.8 times more likely to have disability than those who participated. Female, unmarried status, low protein intake, and health complaints were more vulnerable to disabilities. However, physical exercises were protecting factor of disability among elderly. Compared to urban elderly people, rural elderly people had lower percentages of high educational attainment, balanced high protein intake, and leisure activities.
Conclusions: Rural elderly people in Indonesia were more vulnerable to disabilities, which could be attributed to lower educational attainment, a lower balanced protein intake, and fewer leisure activities. As a result, the importance of socialization with family/friends, a high protein intake, and leisure activities in assisting the elderly in rural areas with disability issues must be emphasized.