Mattos Inês Echenique, do Carmo Cleber Nascimento, Santiago Lívia Maria, Luz Laércio Lima
National School of Public Health/Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480/817 - Manguinhos, Rio de Janeiro, Brazil.
BMC Geriatr. 2014 Apr 15;14:47. doi: 10.1186/1471-2318-14-47.
The increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors.
This is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p <0.05) as a rule for progressing to the next level.
A population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems.
Sociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals' autonomy.
老年人口的增加和慢性病的高患病率使得功能能力作为一个全球公共卫生问题变得越来越重要。本研究旨在评估机构养老老年人的功能能力，并对其相关因素进行探索性分析。
这是一项针对巴西机构养老老年人的横断面研究。使用日常生活活动能力的Katz指数（ADL）和工具性日常生活活动能力的Lawton量表（IADL）评估功能能力。描述了依赖个体的特征，并针对两个量表建立了逻辑回归模型。使用分层方法建立了包含所有选定变量的多个模型。我们将Wald检验的结果（p<0.05）作为进入下一层级的规则。
共纳入760名老年人。ADL依赖的患病率为50.3%，IADL依赖的患病率为81.2%。我们观察到ADL依赖与以下因素之间存在关联：中风的自我报告、行走400米困难、认知测试中与时间定向部分相关问题的总分较低以及经常感到心烦的自我报告。IADL依赖与教育水平、癌症的自我报告、行走400米困难、眼镜使用情况以及自我报告的记忆问题有关。
社会人口统计学和健康状况与机构养老老年人的功能丧失有关。基于这些发现，我们强调慢性病的预防和治疗以及社会支持在维持个体自主性方面的重要性。
