Functional disability and associated factors in older adults seen at a primary health care unit

Paulo José Cortez, Paulo Eduardo Aliaga da Silveira, Beatriz Carvalho, João Vitor Medeiros de Abreu, Yan Lyncon, Gerson Souza Santos, Luciano Magalhães Vitorino
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Abstract

Objectives: To assess functional disability and associated factors in older patients cared for at a large Brazilian urban area. Methods: This is a cross-sectional study performed at a primary health care unit in the city of São Paulo, Brazil. Participants were selected via probabilistic sampling of 400 older individuals. We used a sociodemographic and health questionnaire along with instruments for assessing fear of falling (FES-I), cognitive function (MMSE), and depression symptoms (GDS-15). For dependent variables, we used instruments for assessing basic activities (BADL; Katz) and instrumental activities of daily living (IADL; Lawton). Factors associated with functional disability were analyzed via logistic regression models. Results: The mean age of participants was 75.23 (SD = 8.53); 63.20% were female, 27.00% were dependent in BADL and 39.25%, in IADL. Older individuals with better cognitive function and who had not been hospitalized in the previous year were less prone to functional disabilities. Factors such as older age, more depression symptoms, and greater fear of falling were more linked to disabilities in BADL. Factors such as older age, female sex, and greater fear of falling were more linked to disabilities in IADL. Conclusions: The prevalence of disability in BADL and IADL in the studied sample was high. Modifiable and non-modifiable factors were associated with functional disability. These results may help primary health care professionals understand the risk factors for functional disability in the older population.
在初级卫生保健单位看到的老年人的功能残疾及其相关因素
目的:评估巴西某大城市老年患者的功能障碍及其相关因素。方法:这是一项横断面研究,在巴西圣保罗市的初级卫生保健单位进行。参与者是通过400名老年人的概率抽样选择的。我们使用了社会人口学和健康问卷以及评估跌倒恐惧(FES-I)、认知功能(MMSE)和抑郁症状(GDS-15)的工具。对于因变量,我们使用工具来评估基本活动(BADL;Katz)和日常生活工具活动(IADL;劳顿)。通过logistic回归模型分析与功能障碍相关的因素。结果:参与者平均年龄为75.23岁(SD = 8.53);女性占63.20%,BADL占27.00%,IADL占39.25%。认知功能较好且前一年未住院的老年人发生功能性残疾的可能性较小。老年、更多的抑郁症状和更大的跌倒恐惧等因素与BADL中的残疾联系更紧密。年龄较大、女性和更害怕跌倒等因素与IADL中的残疾更相关。结论:研究样本中BADL和IADL的致残率较高。可改变和不可改变的因素与功能障碍相关。这些结果可能有助于初级卫生保健专业人员了解老年人功能残疾的危险因素。
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