Prevalência e fatores associados à capacidade funcional de idosos na Estratégia Saúde da Família em Montes Claros, Minas Gerais, Brasil

Association between functional capacity and family functionality with frailty in older adults with cardiovascular risk in southwestern Colombia

Introduction

The changes associated with aging are multidimensional and multifactorial, with the geriatric syndrome of frailty being its most problematic and complex expression. This syndrome leads to vulnerability, disproportionate changes in health status, and functional decline, making its effective identification and comprehensive management necessary.

Objective

To describe the sociodemographic, clinical, and functional characteristics of older adults with cardiovascular risk in Southwestern Colombia.

Materials and methods

This study has an observational, cross-sectional, and analytical design. The selected population included older adults enrolled in a cardiovascular and metabolic risk program in Popayán (Cauca). A multivariate analysis explored the relationship between frailty and certain sociodemographic, clinical, and functional variables.

Results

A total of 293 older adults participated, primarily women (69.6%), with an average age of 71.23 years. Among them, 77.1% were classified as independent in basic activities and 56.3% in instrumental activities of daily living, with autonomy being more prevalent among men. Additionally, 71.1% of women and 43.8% of men were classified as prefrail. The bivariate analysis identified a relationship between frailty and variables such as sex, age, marital status, educational level, occupation, calf circumference, functional capacity, instrumental capacity, and family functionality. The multivariate analysis showed a higher frailty/prefrailty prevalence (55%) in women.

Conclusions

Most participants were classified as prefrail; dependency and frailty were more prevalent in women, suggesting the need for preventive strategies and interventions from a gender-differentiated approach.

Quedas, medo de cair e capacidade funcional

Objetivo: avaliar a capacidade funcional e o medo de cair em idosos cadastrados em uma unidade de saúde da família. Método: estudo descritivo e transversal, com abordagem quantitativa, realizado em janeiro de 2019, no domicílio de 157 idosos cadastrados em uma unidade de saúde da família do município de João Pessoa, Paraíba, Brasil. Para a coleta foi utilizado um instrumento semiestruturado, composto de questões sociodemográficas, histórico de quedas, o índice de Barthel e a Escala Internacional de Eficácia em Quedas. A análise foi efetivada pela estatística descritiva e inferencial, utilizando-se o teste de correlação de Spearman. Resultados: houve correlação entre atividades que compõem a análise da capacidade funcional e o medo de cair, em que se observou significância estatística entre elas, verificando-se que quanto menor a capacidade funcional, maior será o medo de cair. Considerações Finais: concluiu-se que, frente ao declínio fisiológico, social e psicológico oriundos do envelhecimento humano, é importante o planejamento de intervenções que abordem o medo de cair em idosos, com vistas a preservar sua capacidade funcional.

Factors associated with functional capacity in the elderly enrolled in the Family Health Strategy

The study investigated the prevalence of functional capacity decline and its associated factors in the older people enrolled in the Family Health Strategy (ESF) in a city in the south of Minas Gerais. This is an observational, cross-sectional, population-based study with 406 elderly (70.49 years ± 6.77). The functional capacity was evaluated by the Short Physical Performance Battery (SPPB), and its associated factors were evaluated by a structured questionnaire including sociodemographic, economic, clinical and physical aspects. The analysis of plasma levels of inflammatory mediators was performed by the ELISA method. Multiple linear regression was used for the analyses (p < 0.05). The prevalence of functional decline in the sample was 57.6% and factors associated with functional capacity were advanced age, female gender, number of medications, depressive symptoms, high plasma concentrations of the soluble receptor of tumor necrosis factor alpha 1 (sTNFR1) and low handgrip strength. The results demonstrated that functional capacity was associated with a network of multidimensional factors. This study contributes to the practice of ESF professionals by indicating the main factors that can guide actions to promote and prevent the decline of functional capacity in the elderly population.

Factors Associated with Cognitive and Functional Performance in Indigenous Older Adults of Nariño, Colombia

INTRODUCTION

Ethnicity in Latin America is a factor of poverty and social exclusion. Like in developed countries, demographic, medical, psychosocial, global cognitive, and functional variables interact in a complex relationship on the elderly population. Such interaction should be considered to determine cognitive and functional performance using screening tests. The aim of this study was to evaluate the demographic, medical, and psychosocial factors affecting global cognitive performance as well as functional activities.

METHODS

The study was conducted in a Colombian elderly indigenous population which included a sample of 518 adults. This research employed a structural model of latent factors to assess the effects of demographic, medical, and psychosocial factors on cognitive and functional performance. The model was estimated by least squares and used a maximum-likelihood procedure, and it was determined RMSEA, TLI, and CFI to assess the model's goodness of fit. The categorical variables used in the model were as follows: (1) demographics, (2) psychosocial factors, (3) medical condition, (4) global cognition, and (5) functional factors.

RESULTS

Demographics, in addition to medical and psychosocial factors, were related to global cognition and functional factors (RMSEA = 0.051, CI 90% 0.045-0.057, CFI = 0.901, and TLI = 0.881).

CONCLUSION

These results provide strong evidence about the complex relationships among demographics, medical conditions, and psychosocial factors and their influence on global cognition and functional performance in Colombian indigenous elderly population.

Functional Dependence among older adults receiving care from Family Health Strategy teams

Abstract Objective : To evaluate functional dependence among older adults receiving care from Family Health Strategy (FHS) teams, in Montes Claros, Minas Gerais, Brazil, identifying associated factors. Methods : A cross-sectional and analytical study with randomly selected older adults was performed. The instrument used was BOMFAQ (the Brazilian Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire). Data collection was performed by trained staff in the homes of the older adults. Sociodemographic, economic data, living habits, health care, morbidities and Activities of Daily Living (ADL) were evaluated. In addition to descriptive analysis, factors associated with functional dependence were identified using the chi-square test, followed by hierarchical multiple analysis using Poisson regression with robust variance. Results : 1,750 older adults were evaluated. The group was predominantly female, with low schooling. The proportion of the sample considered dependent was 57.0%. The variables associated with functional dependence were: female gender (PR=1.19); age ≥70 years (PR=1.33); schooling ≤4 years (PR=1.19); being unemployed (PR=1.43); not performing physical activity (PR=1.19) or walking (PR=1.15); not listening to the radio as a leisure activity (PR=1.13); not having the habit of reading (PR=1.17); presenting depressive symptoms (PR=1.15); hospitalization in the last six months (PR=1.18); cognitive impairment (PR=1.16); insomnia (PR=1.13); obesity (PR=1.18); falls in the last year (PR=1.11); cataracts (PR=1.09), spinal problems (PR=1.19); urinary incontinence (PR=1.25); poor circulation (PR=1.09) and a negative self-perception of health (PR=1.22). Conclusion : Functional dependence is multifactorial, but is influenced mainly by the health conditions of older adults.

Temporal analysis of the functional status of older people in the state of Paraíba, Brazil

OBJECTIVE

To verify the profile and the functional status of older people living in the state of Paraíba, Brazil, from a temporal perspective.

METHOD

This was a descriptive study with secondary analysis of data from the Health Indicator and Aging Policy Monitoring system (SISAP-Idoso - Sistema de Indicadores de Saúde e Acompanhamento de Políticas do Idoso) between 2000 and 2010.

RESULTS

Over the analyzed period, there was a growth of older women, people older than 85 years, residents of urban areas, older people who live alone and who are not responsible for the household. There was also a decrease of illiterate older people, with monthly income of up to one minimum wage and in poverty situations. Concerning the functional status, the proportion of older people who reported any permanent mental, motor, visual or hearing disabilities has increased.

CONCLUSION

We suggest that the assistance must be directed towards environmental variables that can influence the functional state, such as illiteracy, low income and disabilities that contribute to the weakening of older people and must be overcome.

Profile and prevalence of hearing complaints in the elderly

INTRODUCTION

Hearing is essential for the processing of acoustic information and the understanding of speech signals. Hearing loss may be associated with cognitive decline, depression and reduced functionality.

OBJECTIVE

To analyze the prevalence of hearing complaints in elderly individuals from Rio Grande do Sul and describe the profile of the study participants with and without hearing complaints.

METHODS

7315 elderly individuals interviewed in their homes, in 59 cities in the state of Rio Grande do Sul, Brazil, participated in the study. Inclusion criteria were age 60 years or older and answering the question on auditory self-perception. For statistical purposes, the chi-square test and logistic regression were performed to assess the correlations between variables.

RESULTS

139 elderly individuals who did not answer the question on auditory self-perception and 9 who self-reported hearing loss were excluded, totaling 7167 elderly participants. Hearing loss complaint rate was 28% (2011) among the elderly, showing differences between genders, ethnicity, income, and social participation. The mean age of the elderly without hearing complaints was 69.44 (±6.91) and among those with complaint, 72.8 (±7.75) years. Elderly individuals without hearing complaints had 5.10 (±3.78) years of formal education compared to 4.48 (±3.49) years among those who had complaints. Multiple logistic regression observed that protective factors for hearing complaints were: higher level of schooling, contributing to the family income and having received health care in the last six months. Risk factors for hearing complaints were: older age, male gender, experiencing difficulty in leaving home and carrying out social activities.

CONCLUSIONS

Among the elderly population of the state of Rio Grande do Sul, the prevalence of hearing complaints reached 28%. The complaint is more often present in elderly men who did not participate in the generation of family income, who did not receive health care, performed social and community activities, had a lower level of schooling and were older.

Functional capacity and reported morbidities: a comparative analysis in the elderly

Abstract Objective: To evaluate the influence of chronic morbidities on the functional capacity of elderly persons living in the municipal region of Herval d’ Oeste, in the state of Santa Catarina, Brazil. Methods: An analytical cross-sectional study was carried out with a sample of 272 elderly people registered in the Family Health Strategy of the municipality of Herval d’ Oeste, Santa Catarina. A socio-demographic questionnaire, Katz’s Basic Activities of Daily Living Scale and Lawton’s Instrumental Activities of Daily Living Scale (IALD) were used as instruments to gather data. The socio-demographical variables were estimated in frequencies and percentages. The associations were analyzed through the chi-square test. Results: Significant statistical associations for dependence were only found in the IADL assessments. Hypertension and Diabetes Mellitus were not found to influence the dependence of the elderly. However, a greater number of elderly persons who reported pathologies of the gastrointestinal system were classified as dependent. While the number of morbidities did not influence dependence in IADL, there was a smaller percentage difference between dependent and independent individuals among those with more than three morbidities. Conclusion: No relationship was found between the number of morbidities and the functional and instrumental capacity of the elderly. However, diseases of the gastrointestinal system demonstrated an influence on the dependence of elderly persons of Herval d'Oeste, Santa Catarina.

Postural balance and functional independence of elderly people according to gender and age: cross-sectional study

CONTEXT AND OBJECTIVE:

Aging causes changes in men and women. Studies have shown that women have worse postural balance and greater functional dependence than men, but there is no consensus regarding this. The aim of this study was to compare the balance and functional independence of elderly people according to sex and age, and to evaluate the association between postural balance and the number of drugs taken.

DESIGN AND SETTING:

Cross-sectional at a state university.

METHODS:

202 elderly people were evaluated regarding balance (Berg Scale), independence (Barthel Index), age, sex, number of medications and physical activity.

RESULTS:

The subjects comprised 117 women (70.2 ± 5.6 years old) and 85 men (71.1 ± 6.9 years old). For balance, there was no significant difference regarding sex, but there was a difference regarding age (P < 0.0001). For functional independence, there was a difference regarding sex (P = 0.003), but not regarding age. The variables of age, medications and physical activity were significant for predicting the Berg score. For the Barthel index, only age and sex were significant. Elderly people who took three or more medications/day showed higher risk of falling than those who took up two drugs/day (odds ratio = 5.53, P < 0.0001, 95% confidence interval, 2.3-13.0).

CONCLUSIONS:

There was no sexual difference in relation to postural balance. However, people who were more elderly presented a high risk of falling. Functional dependence was worse among females. There was an association between the number of medication drugs and risk of falling.