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老年人的功能依赖:一项横断面研究,对象为巴西南部农村地区的人口。

Functional dependence among older adults: a cross-sectional study with a rural population of southern Brazil.

机构信息

Federal University of Rio Grande, Postgraduate Programmes in Public Health and Health Sciences, Rio Grande do Sul, Rio Grande, Brazil

Federal University of Rio Grande, Postgraduate Programme in Public Health, Rio Grande do Sul, Rio Grande, Brazil

出版信息

Rural Remote Health. 2020 Oct;20(4):5985. doi: 10.22605/RRH5985. Epub 2020 Oct 1.


DOI:10.22605/RRH5985
PMID:33002364
Abstract

INTRODUCTION: Brazil has a rapidly aging population, yet little is known about the occurrence of functional dependence in the rural older adult population. The objective of this study was to estimate the prevalence of functional dependence and its associated factors among community-dwelling older adults in the rural area of the municipality of Rio Grande, Rio Grande do Sul state, Brazil. METHODS: This was a cross-sectional, population-based study. A systematic random sampling of households was used. Eighty percent of households in the rural area were selected, which included 1131 older adults. The outcome analyzed in this study was functional dependence. This was measured by and data were collected using the Katz Index for Activities of Daily Living (ADL) and Lawton and Brody's Scale for Instrumental Activities of Daily Living (IADL). Descriptive analysis was used to estimate the prevalence of functional dependence in ADL and IADL and to describe the sample. Crude and adjusted analysis was performed by Poisson regression with robust adjustment of variance. Prevalence ratios (PRs) and 95% confidence intervals (95%CIs) were reported. RESULTS: A total of 1029 older adults took part in this study, corresponding to an 8.9% rate of losses and refusals. Prevalence of functional dependence in ADL was 8.1% (95%CI 6.4-9.7), while prevalence of functional dependence in IADL was 32.4% (95%CI 29.5-35.2). The occurrence of functional dependence in one or more of ADL or IADL was 6.7% (95%CI 5.2-8.2). The following categories were associated with functional dependence in ADL: female sex (PR=1.70; 95%CI 1.10-2.62), age group 80 years or more (PR=3.68; 95%CI 2.20-6.16), no schooling (PR=2.61; 95%CI 1.26-5.37) and 1-4 years of schooling (PR=2.49; 95%CI 1.28-4.84), having diabetes (PR=1.85; 95%CI 1.21-2.83), depression in the previous year (PR=1.90; 95%CI 1.09-3.31), urinary incontinence (PR=3.26; 95%CI 2.06-5.16), history of stroke (PR=2.26; 95%CI 1.35-3.76) and poor/very poor self-rated health (PR=2.36; 95%CI 1.29-4.32). The following categories were associated with functional dependence in IADL: female sex (PR=1.40; 95%CI 1.19-1.65), age groups of 70-79 years (PR=1.92; 95%CI 1.51-2.43) and 80 years or more (PR=3.80; 95%CI 3.07-4.72), no schooling (PR=1.87; 95%CI 1.46-2.41) and 1-4 years of schooling (PR=1.55; 95%CI 1.22-1.96), medical diagnosis of diabetes (PR=1.33; 95%CI 1.10-1.60), urinary incontinence (PR=1.40; 95%CI 1.17-1.68), history of stroke (PR=1.41; 95%CI 1.10-1.81) and regular self-rated health (PR=1.27; 95%CI 1.06-1.52) or poor/very poor self-rated health (PR=1.80; 95%CI 1.41-2.30). CONCLUSION: Older adults in rural areas have a high prevalence of functional dependence. Knowledge of functional dependence and associated factors in rural populations is necessary for the planning and developing actions, especially in the routine of primary care, which promote health and prevent or postpone the decline in functional capacity.

摘要

简介:巴西人口老龄化迅速,然而,关于农村老年人中功能依赖的发生情况知之甚少。本研究的目的是评估巴西南里奥格兰德州里奥格兰德市农村地区社区居住的老年人中功能依赖的发生率及其相关因素。

方法:这是一项横断面、基于人群的研究。采用系统随机抽样对家庭进行抽样。农村地区选择了 80%的家庭,其中包括 1131 名老年人。本研究分析的结果是功能依赖。通过 Katz 日常生活活动(ADL)指数和 Lawton 和 Brody 的工具性日常生活活动(IADL)量表进行测量和数据收集。使用描述性分析来估计 ADL 和 IADL 中功能依赖的发生率,并描述样本。使用泊松回归进行了粗分析和调整分析,并对方差进行了稳健调整。报告了患病率比(PR)和 95%置信区间(95%CI)。

结果:共有 1029 名老年人参加了这项研究,损失和拒绝率为 8.9%。ADL 中功能依赖的发生率为 8.1%(95%CI 6.4-9.7),而 IADL 中功能依赖的发生率为 32.4%(95%CI 29.5-35.2)。一项或多项 ADL 或 IADL 中发生功能依赖的比例为 6.7%(95%CI 5.2-8.2)。以下类别与 ADL 中的功能依赖相关:女性(PR=1.70;95%CI 1.10-2.62),80 岁及以上年龄组(PR=3.68;95%CI 2.20-6.16),未接受过教育(PR=2.61;95%CI 1.26-5.37)和接受过 1-4 年教育(PR=2.49;95%CI 1.28-4.84),患有糖尿病(PR=1.85;95%CI 1.21-2.83),去年患有抑郁症(PR=1.90;95%CI 1.09-3.31),尿失禁(PR=3.26;95%CI 2.06-5.16),有中风史(PR=2.26;95%CI 1.35-3.76)和自我报告的健康状况较差/非常差(PR=2.36;95%CI 1.29-4.32)。以下类别与 IADL 中的功能依赖相关:女性(PR=1.40;95%CI 1.19-1.65),70-79 岁年龄组(PR=1.92;95%CI 1.51-2.43)和 80 岁及以上年龄组(PR=3.80;95%CI 3.07-4.72),未接受过教育(PR=1.87;95%CI 1.46-2.41)和接受过 1-4 年教育(PR=1.55;95%CI 1.22-1.96),医学诊断为糖尿病(PR=1.33;95%CI 1.10-1.60),尿失禁(PR=1.40;95%CI 1.17-1.68),中风史(PR=1.41;95%CI 1.10-1.81)和自我报告的健康状况较好/非常好(PR=1.27;95%CI 1.06-1.52)或较差/非常差(PR=1.80;95%CI 1.41-2.30)。

结论:农村地区的老年人功能依赖发生率较高。了解农村人口的功能依赖及其相关因素对于规划和制定行动方案是必要的,特别是在初级保健的常规工作中,这有助于促进健康,预防或延缓功能能力的下降。

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