a significant trendp < 0.0001
Further, subgroup analysis based on the different assessments of IADL showed a significant trend toward higher difficulty in IADL in studies that used self-reported assessment (OR = 2.07, 95% CI 1.72–2.49, p < 0.0001, I 2 = 97%, p < 0.0001) compared with studies that objectively assessed IADL (OR = 1.60, 95% CI 1.28–2.00, p < 0.0001, I 2 = 81%, p < 0.0001) (test for subgroup difference: Chi 2 = 3.05, p = 0.08) ( Fig 13 ).