Assessing Activity Limitations and Participation Restrictions Associated with Secondary Conditions

Assessing Activity Limitations and Participation Restrictions Associated with Secondary Conditions in Older Community-Dwelling African American Women using the ICF Framework

Jennifer L. Rowland


The aging process constitutes many changes that can limit involvement in daily activities and restrict participation in life situations for older adults, especially those belonging to minority groups. To address these health concerns, some of which are secondary to the primary condition of aging and could potentially be mitigated or eliminated, it is important to frame them within the context of their potential impact on life activities that impact overall health and function. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) was used to categorize impairments, activity limitations, and participation restrictions and to examine their relatedness to secondary conditions connected to the aging process. The purpose of this study was to examine aging-related secondary conditions, barriers to healthy behaviors, and activity limitations and participation restrictions resulting from these conditions among older community-dwelling African American women in one large urban Midwest city. Six focus groups and a written health survey were conducted to obtain in-depth information about the severity, impact, and contributors to health problems using questions framed within ICF domains. There were 67 focus group participants, all of whom were African American women over age 65 (mean age was 77 yrs + 8.5, range 65-90). Results indicated impairments most commonly reported were pain (50%), fatigue (37.5%), sleep problems (31.4%), and muscle weakness (25%), anxiety (20.8%), feeling isolated or alone (15.3%), and problems making or seeing friends (8.3%). Activity limitations included difficulty with self-care and housework-related tasks. Overall, tiredness/fatigue was the greatest limitation reported (9.7% self care, 20.8% housework). Participation restrictions ranged from lack of accessible and safe transportation options (25%) to relying on family members to facilitate their participation in social and health-promoting activities (ie, senior center functions, exercise classes, 10%). By identifying and exploring the severity and impact of certain secondary conditions and barriers to healthy behaviors for older adults, health promotion interventions can be tailored to better meet the needs of this population.