Gender Differences in Predictors of Physical Functioning Limitations Among the Elderly Population in Serbia: A Population-Based Modeling Study

Abstract

Background and Objective: Active aging is influenced by various factors, including chronic diseases, multimorbidity, functional limitations, and disabilities. The presence of these factors might lead to greater dependence on caregivers and could present potential barriers to community engagement. Physical functioning might be considered as one of the vital components for healthier aging experience promotion and support in elderly people. This study aimed to assess self-perceived general health and related health characteristics among the elderly population in Serbia, with a focus on varying degrees of functional limitations, as well as to analyze the predictors of physical functioning limitations in relation to gender. Materials and Methods: This population-based modeling study included a representative sample of 3540 elderly individuals aged above 65 years from Serbia. We employed a dual approach to model the four distinct difficulty levels related to the two groups of limitations of physical functioning (PF1 and PF2) for both genders. The PF1 focused on walking half a kilometer on level ground without the assistance of any mobility aids, and the PF2 navigated a set of 12 steps of ascent and descent: Model 1: inability to execute PF1, Model 2: some/a lot of difficulty in PF1, Model 3: inability to execute PF2, and Model 4: some/a lot of difficulty in PF2. Further variables were evaluated: self-perceived general health, long-lasting health problems, and chronic diseases/chronic conditions. Logistic regression analysis was performed to assess predictors of physical functioning. The models’ performance was presented. Results: Significant predictors were as follows: self-perceived general health (Model 1 (male OR: 8.639; female OR: 3.569); Model 2 (male OR: 2.759; female OR: 2.277); Model 3 (male OR: 24.290; female OR: 5.090); Model 4 (male OR: 3.256; female OR: 2.152)); long-lasting general health (Model 1 (female OR: 2.867); Model 3 (female OR: 3.602)); pulmonary diseases (Model 2 (male OR: 2.036); Model 4 (male OR: 1.976; female OR: 1.756)); musculoskeletal diseases (Model 1 (female OR: 1.537); Model 2 (male OR: 1.397; female OR: 1.410); Model 3 (male OR: 1.954; female OR: 1.739); Model 4 (male OR: 1.531; female OR: 1.483)); and other chronic diseases (Model 3 (male OR: 2.215)). Conclusions: Bad self-perceived general health and pulmonary and musculoskeletal diseases were predictors of functional disability in both genders of elderly individuals, while long-lasting health problems were predictors of functional disability in females and other chronic diseases were predictors in elderly males. © 2025 by the authors.