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

Background. The purpose of this study is to examine gender differences in f unctional ability among older adults in rural Bangladesh in terms of both s elf-reported activities of daily living and observed physical performance a nd to evaluate the extent to which differential reporting by gender contrib utes to disparities between the two measures. Methods. In 1996, the Matlab Health and Socio-Economic Survey collected dat a on self-reported activities of daily living (ADLs) and observed physical performance for 1,893 men and women aged 50 and older in the Matlab Surveil lance area in rural Bangladesh. Gender differences were examined in both se lf-reported ADLs and physical-performance measures. With physical-performan ce measures as the gold standard, logistic regression was used to determine how much of the gender difference in the self-reported function was explai ned by physical-performance ability controlling for age. Results. Older women in this study population consistently had more limitat ions than men in both self-reported ADLs and observed physical performance. For the same level of observed physical performance, however, older women were more likely than men were to report a higher level of ADL limitation. This reported female health disadvantage varied considerably depending on t he nature of the ADLs being examined and the type of scoring system used fo r the ADLs. Conclusions. One has to be somewhat cautious in interpreting gender differe nces in self-reported ADL limitations, as they are affected by the gender-s pecific nature of the reported activity and by gender differences in the pe rception of response categories.