Ferreira Fabiane Ribeiro, César Cibele Comini, Camargos Vitor Passos, Lima-Costa Maria Fernanda, Proietti Fernando Augusto
Programa de Pós-graduação em Saúde Pública. Departamento de Medicina Preventiva e Social, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil.
J Urban Health. 2010 Jan;87(1):54-66. doi: 10.1007/s11524-009-9406-z.
Currently, half of the world population resides in cities. The percentage of world population that is elderly is expected to double from 11% to 22% by 2050 and will be concentrated in urban areas of developing countries. The purpose of this study was to evaluate the functional status of elderly who live in the Belo Horizonte Metropolitan Area, Minas Gerais State, Brazil. The International Classification of Functioning, Disability and Health (ICF) was employed as the theoretical model. Probabilistic sampling was used to select 1,611 elderly persons (defined as >/=60 years) for the study. The response variable "functional performance" was developed by counting the number of basic and instrumental activities of daily living (ADL) that subjects found difficult to carry out. A zero-inflated negative binomial (ZINB) regression model was fitted to the data. The prevalence of disability was 47.1%. Neighborhood self-perception revealed that 84.0% of the elderly were satisfied with their neighborhood, although only 18.4% trusted people around them. Concerns about walking around the neighborhood were: fear of being robbed (78.0%) and fear of falling due to sidewalk defects (48.2%), which caused a 62% increase in the number of ADL carried out with difficulty. It is well known that there is a continuous tendency for functional results to improve as the frequency of walking increases. Thus, urban infrastructure interventions, such as improving public sidewalks, might influence the frequency of elderlies walking in their neighborhoods. Making walking possible-or even pleasant-could increase their social participation and use of services.
目前，世界上一半的人口居住在城市。预计到2050年，世界老年人口比例将从11%翻倍至22%，且将集中在发展中国家的城市地区。本研究旨在评估居住在巴西米纳斯吉拉斯州贝洛奥里藏特大都市区的老年人的功能状况。采用国际功能、残疾和健康分类（ICF）作为理论模型。通过概率抽样选取了1611名老年人（定义为年龄≥60岁）参与本研究。反应变量“功能表现”通过计算受试者难以进行的日常生活基本活动和工具性活动（ADL）的数量来确定。对数据拟合零膨胀负二项式（ZINB）回归模型。残疾患病率为47.1%。邻里自我认知显示，84.0%的老年人对其邻里环境感到满意，尽管只有18.4%的人信任周围的人。在邻里间行走的担忧包括：害怕被抢劫（78.0%）和因人行道缺陷而害怕摔倒（48.2%），这导致难以进行的ADL数量增加了62%。众所周知，随着行走频率的增加，功能结果有持续改善的趋势。因此，城市基础设施干预措施，如改善公共人行道，可能会影响老年人在邻里间行走的频率。使行走成为可能——甚至令人愉悦——可以增加他们的社会参与度和服务利用率。
