Factors associated with instrumental activities of daily living dependence in the elderly: a case-control study

Lini, Ezequiel Vitorio; Lima, Alisson Padilha de; Cardoso, Fabricio Bruno; Portella, Marilene Rodrigues; Doring, Marlene

doi:10.1590/1413-812320202511.03432019

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FREE THEMES • Ciênc. saúde coletiva 25 (11) • Nov 2020 • https://doi.org/10.1590/1413-812320202511.03432019 copy

Factors associated with instrumental activities of daily living dependence in the elderly: a case-control study

Fatores associados à dependência para atividades instrumentais da vida diária em idosos: estudo caso-controle

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The main goal of the study was to determine the factors associated with dependence to perform instrumental activities of daily living in the elderly. A population-based case-control study was conducted, with 180 elderly people from Passo Fundo-RS, 2014. The cases were represented by 60 individuals aged ≥ 60 years, dependents to perform instrumental activities of daily living residents of the urban area of the city. The controls were represented by 120 individuals, not dependents to perform instrumental activities of daily living, residents of the urban area of the city. Crude and multivariate analysis using Poisson regression were performed to test the association between the outcome and the independent variables, estimating the crude and adjusted odds ratios (OR) and calculating the 95% confidence intervals respectively. All the variables with p ≤ 0.20 were included in the final model. Remained statistically significant after adjusted analysis: being aged 80 years or more (OR = 1.76; CI95%: 1.01-3.08), having studied from 1 to 4 years (OR = 2.36; CI95%: 1.35-4.14), being illiterate (OR = 2.98; CI95%: 1.52-5.84), having Parkinson’s disease (OR = 2.44; CI95%: 1.39-4.29) and the presence of cognitive impairment (OR = 1.88; CI95%: 1.30-2.72).

Key words
Daily activities; Motor Activity; Population ageing

Variables	Cases		Controls		Total		p^* * p value < 0.050 obtained by the Pearson's chi-square test.
Variables	n	%	n	%	n	%
Gender
Female	37	61.7	72	60.0	109	60.6	0.829
Male	23	38.3	48	40.0	71	39.4
Age group
60 to 69 years	34	56.7	113	94.2	147	81.7	<0.001
70 to 79 years	21	35.0	7	5.8	28	15.6
≥ 80 years	5	8.3	0	0.0	5	2.8
Educational level
Illiterate	15	25.0	6	5.0	21	11.7	<0.001
From 1 to 4 years	36	60.0	67	55.8	103	57.2
5 or more	9	15.0	47	39.2	56	31.1
Marital status
With a partner	38	63.3	53	44.2	91	50.6	0.015
Without a partner	22	36.7	67	55.8	89	49.4

Variables	Cases		Controls		Total		p^* * Value of p < 0.050 obtained by Pearson's chi-square test;
Variables	n	%	n	%	n	%
Physical activitiy
Yes	23	38.3	78	65.0	101	56.1	0.001
No	37	61.7	42	35.0	79	43.9
Walking dependence
Yes	40	66.7	117	97.5	157	87.2	<0.001
No	20	33.3	3	2.5	123	12.8
Parkinson's desease
Yes	3	5.0	1	0.8	4	2.2	0.074
No	57	95.0	119	99.2	176	97.8
EVA motor sequelae
Yes	3	5.0	2	1.7	5	2.8	0.200
No	57	95.0	118	98.3	175	97.2
Arterial hypertension
Yes	46	76.7	82	68.3	128	71.1	0.245
No	14	23.3	38	31.7	52	28.9
Diabetes mellitus
Yes	14	23.3	24	20.0	38	21.1	0.605
No	46	76.7	96	80.0	142	78.9
Arthritis/Arthrosis
Yes	9	15.0	21	17.5	30	16.7	0.671
No	51	85.0	99	82.5	150	83.3
Medication^ Number of medications used per day, some elderly did not provide information on the use of medications; EVA: Encephalic vascular accident.
From 1 to 5	38	70.4	80	79.2	118	76.1	0.219
6 or more	16	29.6	21	20.8	37	23.9
Cognitive impairment
Yes	20	33.3	5	4.2	25	13.9	<0.001
No	40	66.7	115	95.8	155	86.1
Health evaluation
Excellent/good	26	43.3	69	57.5	95	52.8	0.073
Regular/poor/very poor	34	56.7	51	42.5	85	47.2

Variables	OR* (IC95%)	p	OR (IC95%)	p
Gender
Male	1.00
Female	0.95 (0.62-1.46)	0.830
Age group
60-69 years	1.00		1.00
70-79 years	3.24 (2.25-4.67)	<0.001	1.49 (0.93-2.40)	0.099
≥ 80 years	4.32 (3.22-5.80)	<0.001	1.76 (1.01-3.08)	0.047
Educational level
5 or more	1.00		1.00
From 1 to 4 years	2.17 (1.31-4.18)	0.020	2.36 (1.35-4.14)	0.003
Illiterate	4.44 (2.30-8.57)	<0.001	2.98 (1.52-5.84)	0.001
Marital status
With a partner	1.00		1.00
Without a partner	1.69 (1.09-2.61)	0.018
Physical activity practice
Yes	1.00		1.00
No	2.06 (1.34-3.16)	0.001	1.43 (0.95-2.16)	0.083
Walking dependence
Yes	1.00		1.00
No	3.41 (2.50-4.66)	<0.001	1.33 (0.91-1.94)	0.136
Parkinson's desease
No	1.00		1.00
Yes	2.32 (1.26-4.24)	0.006	2.44 (1.39-4.29)	0.002
EVA motor sequelae
No	1.00
Yes	1.84 (0.87-3.88)	0.109
Arterial hypertension
No	1.00
Yes	1.33 (0.81-2.21)	0.261
Diabetes mellitus
No	1.00
Yes	1.14 (0.70-1.84)	0.599
Arthritis/arthrosis
No	1.00
Yes	0.88 (0.49-1.59)	0.678
Medication^ Number of medications used per day; some elderly did not provide information on the use of medications.
From 1 to 5	1.00
6 or more	1.34 (0.85-2.11)	0.202
Cognitive impairment
No	1.00		1.00
Yes	3.10 (2.23-4.32)	<0.001	1.88 (1.30-2.72)	0.001
Health evaluation
Excellent/good	1.00		1.00
Regular/poor/very poor	1.46 (0.96-2.22)	0.075	1.26 (0.87-1.83)	0.225

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[1] Collaborations

EV Lini participated in all stages of this work since the conception of the study. AP Lima participated in the analysis of the data and the final writing of the article. MR Portella participated in all stages of this work and supervised the final writing. M Doring supervised all stages of this work and assisted in the writing of the article. FB Cardoso participated in the writing and correction of the final version of the manuscript.