New research points to global differences in activity limitations and assistive device use

A new survey of more than 175,000 people in 25 countries shows that individuals in low- and middle-income countries face greater challenges in daily activities and are less likely to use assistive devices compared to people in high-income countries. These findings raise concerns about the global burden of disability, especially in low-income countries.

Despite declines in deaths and cardiovascular disease and increases in life expectancy worldwide, people in low- and middle-income countries still experience significantly worse health outcomes than those in high-income countries. However, less is known about the global prevalence of disabilities and how they vary from country to country.

In the first prospective study of its kind, participants were asked about limitations in mobility, vision and hearing. The study found that activity limitations are common worldwide, with difficulties walking, bending and seeing being the most common. A third of participants reported at least one disability, with these problems particularly prevalent among older adults and women.

Activity limitations were more common in low- and middle-income countries than in high-income countries, including two times higher gait impairment and five times higher visual impairment.

“Current data on activity limitations and how they affect health around the world are limited,” said Raed Joundi, first author of the study and a scientist at the Population Health Research Institute (PHRI), a joint research institute of McMaster University and Hamilton Health. Sciences. “Our research aimed to fill this gap by looking at the prevalence of limitations in basic activity, resource use and health outcomes in 25 countries.”

The study is part of the ongoing Prospective Urban Rural Epidemiological (PURE) study, coordinated by PHRI and led by Salim Yusuf, senior scientist at PHRI. Published in The Lancet on July 25, 2024, the study collected data from participants aged 35 to 70 years old using standardized questionnaires and followed them for an average of 11 years to 20 years.

Activity limitations in daily life can be alleviated or eliminated by using inexpensive devices such as walking sticks or glasses. However, the study found that despite the much higher percentage of people with activity limitations in low- and middle-income countries, the use of simple devices such as walking sticks or walkers, glasses and hearing aids was less than half that in high-income countries. .

“Having access to assistive devices when needed, such as glasses and walking aids, is essential for achieving a person’s potential despite their disability and improving quality of life,” said Yusuf. “Limited access to resources in low- and middle-income countries represents an important opportunity for health policy and interventions.”

Movement restrictions were associated with serious health problems. For example, problems walking were associated with a higher risk of death and other health problems, including cardiovascular disease, pneumonia and falls.

“The striking differences between high-income countries and low- and middle-income countries in our study highlight the need for policies and programs to ensure that people with disabilities have access to simple assistive devices and other resources needed to maintain their health,” said Joundi.

“We also need to better understand the factors that contribute to these activity restrictions and develop public health strategies to prevent them from happening in the first place so people can live longer, healthier and happier lives.”