Sigrist Antonia de Azevedo Falcão, Oliveira Ana Claudia Becattini, Fichman Helenice Charchat
Psychology Department, Pontifícia Universidade Católica do Rio de Janeiro - Rio de Janeiro, RJ, Brazil.
Clinical Medicine Department, School of Medicine, Universidade de São Paulo - São Paulo, SP, Brazil.
Dement Neuropsychol. 2021 Jul-Sep;15(3):366-372. doi: 10.1590/1980-57642021dn15-030009.
The ability to perform instrumental activities of daily living (IADLs) is an important marker within the aging process, as it reflects the level of independence to perform in the real world. However, there is a scarcity of studies that investigate the different performance profiles among older adults.
To investigate the heterogeneity present in the community of elderly people, grouping them based on characteristics and patterns observed through an objective performance-based assessment.
Participants were selected according to the following inclusion criteria: fluency in Portuguese, 60 years, regular participation in a social program offered by the government of Rio de Janeiro, and absence of a caregiver. The evaluation of IADLs was determined by the total and brief version of the University of California, San Diego Performance-Based Skills Assessment (UPSA) and the Lawton and Brody IADL scale. The Brief Cognitive Screening Battery and the Mini-Mental State Examination were used to characterize the sample, in addition to the Geriatric Depression Scale. A total of 61 elderly people with an average age of 72.5 years, predominantly females (85.2%), and average education of 11.2 were evaluated and grouped according to their performance at UPSA through clustering analysis.
The analysis revealed three grouping patterns, subdividing the sample into subgroups that differed significantly in terms of age, education, global cognition, and all instrumental activities assessed by UPSA - planning, finance, communication, transportation, and household chores.
This study was able to identify the heterogeneity present between the elderly people in the different factors that compose the IADLs through a performance-based assessment.
进行日常生活工具性活动（IADLs）的能力是衰老过程中的一个重要标志，因为它反映了在现实世界中独立生活的水平。然而，针对老年人不同表现特征的研究却很匮乏。
通过基于客观表现的评估所观察到的特征和模式，对老年人社区中的异质性进行调查，并据此对他们进行分组。
根据以下纳入标准选择参与者：葡萄牙语流利、60岁及以上、定期参加里约热内卢政府提供的社会项目且无照料者。IADLs的评估由加利福尼亚大学圣地亚哥分校基于表现的技能评估（UPSA）的完整版和简版以及劳顿和布罗迪IADL量表来确定。除老年抑郁量表外，还使用简易认知筛查量表和简易精神状态检查表对样本进行特征描述。通过聚类分析，对61名平均年龄为72.5岁、以女性为主（85.2%）、平均受教育年限为11.2年的老年人进行了评估，并根据他们在UPSA中的表现进行分组。
分析揭示了三种分组模式，将样本细分为在年龄、教育程度、整体认知以及UPSA评估的所有工具性活动（计划、财务、沟通、交通和家务）方面存在显著差异的亚组。
本研究能够通过基于表现的评估，识别出构成IADLs的不同因素在老年人之间存在的异质性。
