Universidade Federal de Santa Catarina, Florianópolis, Brasil.
Rev Saude Publica. 2011 Aug;45(4):685-92. doi: 10.1590/s0034-89102011000400007.
To identify risk factors for functional capacity loss in elderly people.
Epidoso (Epidemiology of the Elderly) cohort study with elderly people living in São Paulo (Southeastern Brazil). A total of 326 participants in the first interview (1991-1992) who were independent or had mild dependence (one or two activities of daily living) were selected. Those who presented functional loss in the second (1994-1995) or third interviews (1998-1999) were compared to those who did not present it. The incidence of functional loss was calculated according to sociodemographic variables, life habits, cognitive status, morbidity, hospitalization, self-rated health, tooth loss, social support and leisure activities. Crude and adjusted relative risks with 95% confidence intervals were estimated through bivariate and multiple analyses with Poisson regression. The criterion for the inclusion of the variables in the model was p < 0.20 and for exclusion, p > 0.10.
The incidence of functional loss was 17.8% (13.6; 21.9). The risk factors in the final model were: age group 70-74 years RR=1.9 (0.9;3.9); age group 75-79 years RR=2.8 (1.4;5.5); age group 80 years or older RR=5.4 (3.0;9.6); score in the mini-mental state examination <24 RR=1.8 (1.1;2.9); asthma RR=2.3 (1.3;3.9); hypertension RR=1.7 (1.1;2.6); and diabetes RR=1.7 (0.9;3.0). The protective factors were: paid work RR=0.3 (0.1;1.0); monthly relationship with friends RR=0.5 (0.3;0.8); watching TV RR=0.5 (0.3;0.9); and handcrafting RR=0.7 (0.4;1.0).
The prevention of functional loss should include adequate control of chronic diseases, like hypertension, asthma and diabetes, as well as cognitive stimulation. Work, leisure and relationships with friends should be valued due to their protective effect.
确定老年人功能能力丧失的风险因素。
这项在巴西东南部圣保罗市进行的老年人流行病学(Epidoso)队列研究纳入了在第一次访谈（1991-1992 年）中生活自理或仅有轻度依赖（一到两项日常生活活动）的 326 名参与者。将第二次（1994-1995 年）或第三次访谈（1998-1999 年）中出现功能丧失的参与者与未出现功能丧失的参与者进行比较。根据社会人口学变量、生活习惯、认知状态、发病率、住院情况、自我报告的健康状况、牙齿缺失、社会支持和休闲活动计算功能丧失的发生率。采用泊松回归的双变量和多变量分析来估计功能丧失的发生率，并计算粗相对风险比和调整相对风险比及其 95%置信区间。纳入模型的变量标准为 p<0.20，排除标准为 p>0.10。
功能丧失的发生率为 17.8%（13.6；21.9）。最终模型中的风险因素为：70-74 岁年龄组 RR=1.9（0.9；3.9）；75-79 岁年龄组 RR=2.8（1.4；5.5）；80 岁及以上年龄组 RR=5.4（3.0；9.6）；简易精神状态检查得分<24 分 RR=1.8（1.1；2.9）；哮喘 RR=2.3（1.3；3.9）；高血压 RR=1.7（1.1；2.6）；糖尿病 RR=1.7（0.9；3.0）。保护因素为：有薪工作 RR=0.3（0.1；1.0）；每月与朋友交往 RR=0.5（0.3；0.8）；看电视 RR=0.5（0.3；0.9）；手工艺 RR=0.7（0.4；1.0）。
预防功能丧失应包括对高血压、哮喘和糖尿病等慢性病的充分控制，还应进行认知刺激。工作、休闲和与朋友的关系应受到重视，因为它们具有保护作用。
