Ghimire Saruna, Paudel Grish, Mistry Sabuj Kanti, Parvez Mahmood, Rayamajhee Binod, Paudel Pravash, Tamang Man Kumar, Yadav Uday Narayan
Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, 45056, Oxford, OH, USA.
Centre for Research Policy and Implementation, Biratnagar, Nepal.
BMC Geriatr. 2021 May 25;21(1):335. doi: 10.1186/s12877-021-02286-8.
The high burden of chronic conditions, coupled with various physical, mental, and psychosocial changes that accompany the phenomenon of aging, may limit the functional ability of older adults. This study aims to assess the prevalence of poor functional status and investigate factors associated with poor functional status among community-dwelling older adults in rural communities of eastern Nepal.
Data on 794 older adults aged ≥ 60 years from a previous community-based cross-sectional study was used. Participants were recruited from rural municipalities of Morang and Sunsari districts of eastern Nepal using multi-stage cluster sampling. Functional status was assessed in terms of participants' ability to perform activities of daily living using the Barthel Index. Covariates included sociodemographic characteristics, lifestyle factors, and self-reported chronic conditions. A binary logistic regression model was used to investigate factors associated with poor functional status.
The overall prevalence of poor functional status was 8.3 % (male: 7.0 % and female: 9.6 %), with most dependence noted for using stairs (17.3 %), followed by dressing (21.9 %) on Barthel Index. In the adjusted model, oldest age group (odds ratio [OR] = 2.83, 95 %CI: 1.46, 5.50), those unemployed (OR = 2.41, 95 %CI: 1.26, 4.65), having memory/concentration problems (OR = 2.32, 95 %CI: 1.30, 4.13), depressive symptoms (OR = 2.52, 95 %CI: 1.28, 4.95), and hypertension (OR = 1.78, 95 %CI: 1.03, 3.06) had almost or more than two times poor functioning.
One in 12 older adults had poor functional status as indicated by their dependency on the items of the Barthel Index; those in the oldest age bracket were more likely to exhibit poor functional status. We suggest future studies from other geographies of the country to supplement our study from the rural setting for comprehensive identification of the problem, which could guide the development of prevention strategies and comprehensive interventions for addressing the unmet needs of the older adults for improving functional status.
慢性病的高负担，再加上与老龄化现象相伴的各种身体、心理和社会心理变化，可能会限制老年人的功能能力。本研究旨在评估尼泊尔东部农村社区居家老年人功能状态不佳的患病率，并调查与功能状态不佳相关的因素。
使用了来自之前一项基于社区的横断面研究的794名年龄≥60岁老年人的数据。参与者通过多阶段整群抽样从尼泊尔东部莫朗和孙萨里县的农村市招募。使用巴氏指数根据参与者进行日常生活活动的能力来评估功能状态。协变量包括社会人口学特征、生活方式因素和自我报告的慢性病。采用二元逻辑回归模型来调查与功能状态不佳相关的因素。
功能状态不佳的总体患病率为8.3%（男性：7.0%，女性：9.6%），在巴氏指数上，使用楼梯方面的依赖最为明显（17.3%），其次是穿衣（21.9%）。在调整模型中，最年长年龄组（比值比[OR]=2.83，95%置信区间：1.46，5.50）、失业者（OR=2.41，95%置信区间：1.26，4.65）、有记忆/注意力问题者（OR=2.32，95%置信区间：1.30，4.13）、有抑郁症状者（OR=2.52，95%置信区间：1.28，4.95）以及高血压患者（OR=1.78，95%置信区间：1.03，3.06）功能不佳的可能性几乎是或超过两倍。
每12名老年人中就有1名功能状态不佳，这表现为他们对巴氏指数项目的依赖；最年长年龄组的人更有可能表现出功能状态不佳。我们建议该国其他地区开展未来研究，以补充我们在农村地区的研究，从而全面识别该问题，这可为制定预防策略和综合干预措施提供指导，以满足老年人在改善功能状态方面未得到满足的需求。
