scholarly journals Functional disability in Brazilian octogenarians: data from the 2013 National Health Survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P M Stolses Bergamo Francisco ◽  
D de Assumpção ◽  
F Silva Arbex Borim ◽  
A Gomes de Macedo Bacurau ◽  
A M Pita Ruiz ◽  
...  

Abstract Background The impairment of function capacity implies a greater risk of biological and social vulnerability, increasing the demand for healthcare services and caregivers. Objective Estimate the prevalence of functional disability in the performance of basic and instrumental activities of daily living (BADL and IADL) among long-lived Brazilians (≥80 years) according to sociodemographic characteristics and self-rated health. Methods A cross-sectional study was conducted with data from seniors who participated in the 2013 National Health Survey (n = 1498). Functional disability was defined as difficulty performing at least one of the six BADL or five IADL. Independent associations were determined using Poisson multiple regression analysis, with the calculation of prevalence ratios and 95% confidence intervals adjusted for chronic diseases. Results Mean age was 84.8 years (CI95%: 84.5-85.1); 59% were women; 62% were self-declared white; and 63% had no private health insurance. The prevalence of functional disability in BADL and IADL was 33.8% (CI95%: 30.6-37.2) and 66.4% (CI95%: 62.5-70.2), respectively. Only 17.7% participated in organized social activities and only 15.5% rated their health as poor/very poor. Regarding BADL, greater disability was found among those ≥85 years of age, among men and those who rated their health as poor (p < 0.05). Regarding IADL, greater disability was found among those ≥85 years of age, those without a conjugal life, illiterate individuals and those who rated their health as poor (p < 0.05). Conclusions Approximately 1/3 and 2/3 of long-lived Brazilian exhibited restricted skills for maintaining their autonomy and independence regarding the performance of BADL and IADL, respectively. The present findings underscore the importance of family and social support networks to assist older adults in the performance of basic and instrumental activities of daily living as well as activities related to mobility. Key messages The impairment of function capacity increases the demand for healthcare services and caregivers. Approximately 1/3 and 2/3 of long-lived Brazilians have functional disability regarding the performance of basic and instrumental activities of daily living, respectively.

2020 ◽  
Vol 23 ◽  
Author(s):  
Adriano Drummond ◽  
Wendel Rodrigo Teixeira Pimentel ◽  
Valéria Pagotto ◽  
Ruth Losada de Menezes

ABSTRACT: Objective: The aim of this study was to verify the association between types of dependence for basic and instrumental activities of daily living and the occurrence of falls in the elderly. Methods: A cross-sectional, population-based study using data from 23,815 elderly people drawn from the National Health Survey (NHS) in 2013. The NHS, conducted by the Brazilian Institute of Geography and Statistics (IBGE) and the Ministry of Health, presents data collected in 81,767 households in more than 1,600 municipalities. The association between the independent variable (ADL disabilities) and the dependent variable (history of falls) was performed through multiple and crude analyses, regression. Results: There was a greater association between using the toilet and transfers (ABVD) and falls, and between shopping and taking care of finances (IADL) and falls. In addition, the association between Basic Activities of Daily Living and falls was greater for up to four activities, and the Instrumental Activities of Daily Living for up to three activities. Conclusion: Thus, the results obtained in the NHS reinforce the planning of preventive strategies considering the functional dependence.


Author(s):  
Nunes DP ◽  
◽  
Castro DC ◽  
Mota JPN ◽  
Moura BM ◽  
...  

Objective: To identify the prevalence and factors associated with functional disability for Instrumental Activities of Daily Living (IADL) among older people in a Brazilian capital. Methods: This is a cross-sectional study carried out on 927 older people in the city of Goiânia, Goiás, Brazil. Lawton’s scale was used to assess IADL. Functional disability was characterized as difficulty in performing at least one activity. Multiple logistic regression was employed for the analysis of association. Results: A 58.2% prevalence of disability was identified, and the most compromised activities were doing manual work, doing the laundry, and ironing. There was an association between disability and old age, poor/very poor self-rated health, cerebrovascular accident, widowhood, cognitive impairment, musculoskeletal disorder, and living alone. Conclusions: The prevalence of functional disability for IADL was higher than that of national and international studies. We verified associated factors that can be modified by health promotion initiatives, which are configured as priority areas for interventions.


2020 ◽  
Author(s):  
Sofía García-López ◽  
Natalia Llopart-Carles ◽  
Francisco Castro-Domínguez ◽  
Javier Rejas-Gutiérrez

Abstract Background Osteoarthritis (OA) pain is among the leading causes of disability and social isolation worldwide. Since prevalence is high, particularly in adults aged 65 or older, it represents a significant burden for society and national health systems. The objective of this study was to determine whether patient self-reported functioning in key domains of daily living differs by pain severity and analgesic treatment among older OA patients in Spain. Methods The Spanish National Health Survey (ENSE), a large, nationally representative, cross-sectional general health survey administered by trained interviewers to 23,089 adults, was the data source. Subjects of both sexes aged 65 or older with a self-reported physician diagnosis of OA who completed the survey were analyzed. Patients were cross classified by pain severity (no/mild, moderate or severe) and analgesia (treated or untreated). Assessment of daily living included basic and instrumental activities of daily living and mental, social, and cognitive domains. Scores were re-scaled to a 0%-100% standardized metric (0%: no limitation [independence]; 100%: complete limitation [full dependence]). Results A total of 3,526 (3,389 surveys completed [96.1%]) older adults with OA were analyzed (women 73.3%; age 77.4 [standard deviation {SD}: 7.5]). Adjusted means (95% confidence interval [CI]) scores in domains of functioning showed significant association with pain severity (p < 0.001) but not treatment status, except basic and instrumental activities and social functioning, with higher scores in treated patients. Limitations in patients with untreated no/mild pain versus severe treated pain were as follows: in basic activities, 6.5% (5.0–8.0) versus 31.5% (30.1–32.9); in instrumental activities, 9.0% (7.2–10.8) versus 34.1% (32.3–35.8); in mental, 29.1% (27.9–30.3) versus 45.0% (43.9–46.2); in social, 3.0% (0.6–5.4) versus 42.2% (39.9–44.5); and, in cognitive, 10.9% (9.2–12.6) versus 23.4% (21.8–25.1). Conclusions Pain severity was a major driver of functional impairment in all the main domains of functioning analyzed in older OA patients. Regardless of pain severity, treated patients showed poorer functioning in basic, instrumental and social activities versus untreated subjects. Treated patients might have been in later disease stages, which would have affected the results. Existing analgesic treatment strategies do not meet patient needs for adequate pain management.


Author(s):  
Bruna Menezes Aguiar ◽  
Patrícia Oliveira Silva ◽  
Maria Aparecida Vieira ◽  
Fernanda Marques da Costa ◽  
Jair Almeida Carneiro

Abstract Objective: To estimate the prevalence and self-reported socio-demographic and health factors associated with functional disability in basic and instrumental activities of daily living among the elderly. Method: A cross-sectional study was carried out, based on a representative sample of elderly people receiving care at a reference unit in the north of the state of Minas Gerais. The data were collected in 2015. Demographic and socioeconomic variables, morbidity, hospitalizations in the previous year, frailty (Edmonton Frail Scale), geriatric depression (GDS-15), and functional disability (Katz Index, Lawton and Brody Scales) were analyzed. Multiple analysis was performed using Poisson regression with robust variance. Results: 360 elderly people aged 65 years and over participated in the study. The prevalence of functional disability for Basic Activities of Daily Living was 21.4% while for instrumental activities it was 78.3%. Functional disability in basic activities was higher among elderly males (p=0.03) who had suffered strokes (p=0.00) and were frail (p=0.00), while for instrumental activities it was higher among older elderly persons (p=0.04); who were illiterate (p=0.00), had less than five years of schooling (p=0.02); had depressive symptoms (p=0.00) and were frail (p=0.00). It was lower among elderly persons who lived alone. Conclusion: A high prevalence of functional disability was identified among the elderly for instrumental activities of daily living, demonstrating the need for an effective and immediate approach by health professionals, who should employ preventive care in order to tackle this problem.


2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.


2015 ◽  
Vol 24 (2) ◽  
pp. 521-529 ◽  
Author(s):  
Jair Sindra Virtuoso Júnior ◽  
Cristiane Alves Martins ◽  
Liliane Beatriz Roza ◽  
Thais Reis Silva de Paulo ◽  
Maria da Conceição Lopes Ribeiro ◽  
...  

The aim of this study was to estimate the prevalence and factors associated with functional disability in the elderly. The cross-sectional design was used with a sample of 624 individuals, between 60 and 96 years of age. In the assessment of the elderly interviews and physical performance tests were used. In the inferential data analysis, the Poisson regression was used, p≤0.05. The prevalence of disability was 17.6% for Basic Activities of Daily Living and 46.3% for Instrumental Activities of Daily Living. Functional disability for Basic Activities of Daily Living was associated with increasing age, alcohol consumption, depressive symptoms and frailty; the Instrumental Activities of Daily Living were associated with increasing age, illiteracy, multigenerational family arrangement, hospitalization and fragility. The variables that remained in the explanatory model for the decline of functional capacity should be emphasized in proposals for public policies to promote the health of the elderly.


Author(s):  
Darlene Mara dos Santos Tavares ◽  
Paula Berteli Pelizaro ◽  
Maycon Sousa Pegorari ◽  
Mariana Mapelli de Paiva ◽  
Gianna Fiori Marchiori

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n5p499 Population aging may cause impaired functional abilities in the elderly population, with increased rates of functional disability. Early detection of functional disability makes it possible to postpone possible complications and helps with health action planning. The objective of this study was to investigate the factors associated with functional disability in urban elderly. We conducted an analytical and cross-sectional household survey with 1,691 urban elderly individuals in Uberaba (MG), Brazil, in 2012. The questionnaire included socioeconomic and clinical information. We used the following instruments to assessed the participants: Abbreviated Geriatric Depression Scale, Katz Index, and Lawton and Brody Scale. We performed a descriptive bivariate analysis and used a logistic regression model (p<0.05). The prevalence of functional disability in basic activities of daily living was 21.2%; whereas the prevalence of functional disability in instrumental activities of daily living was 65.9%. The following factors were associated with functional disability in basic and instrumental activities of daily living, respectively: age of 80 years old and older [(OR= 2.18; p<0.001), (OR=3.30, p<0.001)]; larger number of self-reported diseases [(OR=1.24, p<0.001), (OR=1.12; p<0.001)]; and symptoms of depression [(OR=1.49; p<0.003), (OR = 1.75, p<0.001)]; whereas no schooling (OR=1.88; p<0.001) was related to functional disability in instrumental activities of daily living. We found significant impairment of functional status, especially in instrumental activities of daily living and in association with socioeconomic and health variables; those aspects support the implementation of actions aimed at monitoring and controlling the factors that interfere with the functional ability of the elderly.


2019 ◽  
Vol 22 (12) ◽  
pp. 2147-2154 ◽  
Author(s):  
Ana Paula Alves de Souza ◽  
Paulo Rogério Melo Rodrigues ◽  
Ana Paula Muraro ◽  
Naiara Ferraz Moreira ◽  
Rosely Sichieri ◽  
...  

AbstractObjectiveTo identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population.DesignCross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive.SettingBrazil.ParticipantsParticipants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years.ResultsCut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location.ConclusionsAll analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.


2017 ◽  
Vol 70 (4) ◽  
pp. 822-829 ◽  
Author(s):  
Ariene Angelini dos Santos-Orlandi ◽  
Tábatta Renata Pereira de Brito ◽  
Ana Carolina Ottaviani ◽  
Estefani Serafim Rossetti ◽  
Marisa Silvana Zazzetta ◽  
...  

ABSTRACT Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Marcello Barbosa Otoni Gonçalves Guedes ◽  
Rodolpho Nunes Araújo ◽  
Lídia Reniê Fernandes da Silva ◽  
Diego Neves Araujo ◽  
Sanderson José Costa de Assis ◽  
...  

AbstractThis study estimated the biopsychosocial factors related to active physical behavior in the Brazilian population with and without chronic non-transmissible disease (NCD). Cross-sectional study of the National Health Survey (NHS) in Brazil, with 60,202 individuals in 2013. Participants were randomly selected by complex sampling. The outcome was physically active behavior measured by performing a minimum of 150 min of physical exercise per week. The independent variables were social and psychological characteristics, lifestyle and health. Cox regression was applied to estimate the prevalence ratio (PR). There are 29,666 (48.3%; 95% CI 47.0–50.0) participants reported having NCD. Not being a smoker or alcoholic, living in an urban area (PR = 1.44; CI95% 1.23–1.68/PR = 1.38; CI95% 1.08–1.75), having informal social support (PR = 1.26; CI95% 1.10–1.44/PR = 1.19; CI95% 1.05–1.34), A social class (PR = 0.43; CI95% 0.25–0.73/PR = 0.46; CI95% 0.26–0.80), high schooling (PR = 0.34; CI95% 0.23–0.51/PR = 0.33; CI95% 0.24–0.46) as well as paid work (PR = 0.87; CI95% 0.78–0.96/PR = 0.89; CI95% 0.79–0.99) are more associated with active lifestyle in both groups. However, only in the group without NCD, the male sex (PR = 1.42; CI95% 1.28–1.57), no having some disability (PR = 1.31; CI95% 1.03–1.66) and having private health insurance (PR = 1.26; CI95% 1.13–1.41) were more associated with active behavior, while in the group with NCD, being elderly (PR = 1.22; CI95% 1.05–1.42), not be white (PR = 0.85; CI95% 0.77–0.95) and not having restful sleep (PR = 1.23; CI95% 1.08–1.40) are associated with active lifestyle. People with and without NCD in Brazil have very close active behavior, however, some biopsychosocial factors such as: sex, age, lifestyle, socioeconomic level are unevenly associated with the active lifestyle in the groups. Thus, therapeutic or preventive proposals as well as public policies for health promotion must observe these distinctions when elaborating their actions.


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