Reduced functional capacity of community-dwelling elderly: a longitudinal study

Matos, Fernanda Souza; Jesus, Cleber Souza de; Carneiro, José Ailton Oliveira; Coqueiro, Raildo da Silva; Fernandes, Marcos Henrique; Brito, Thais Alves

doi:10.1590/1413-812320182310.23382016

Brasil

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FREE THEMES • Ciênc. saúde colet. 23 (10) • Oct 2018 • https://doi.org/10.1590/1413-812320182310.23382016 linkcopy

Reduced functional capacity of community-dwelling elderly: a longitudinal study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to identify the incidence and risk factors for the reduced functional capacity of community-dwelling elderly. A prospective, two-stage cohort study was conducted in 2011 and 2014. The study population consisted of 202 initially independent older adults for the basic activities of daily living. The relative risk (RR) and its respective 95% confidence intervals (CI) were used as a measure of association and were estimated by log-binomial regression with robust variance. The incidence of lower functional capacity was 15.3%. The risk factors for the functional decline were unmarried status (RRadj = 2.75; 95%CI: 1.15–6.57) and depressive symptoms (RRadj = 2.41; 95%CI: 1.15–5.06), even after adjusting for gender, age group, per capita household income, diabetes, use of medication and level of physical activity. The high incidence of reduced functional capacity and its association with marital status and mental health aspects reveals the need to consider such factors in the planning of health actions aimed at maintaining and restoring the functional capacity of the seniors.

Elderly health; Aging; Daily activities; Functional disaos bility

Variables	Functional capacity				p-value

	Independent		Dependent

	N	%	N	%
Gender					0.989
Male	77	45.0	14	45.2
Female	94	55.0	17	54.8
Age group					0.003*
≥ 60 to ≤ 79	136	79.5	17	54.8
≥ 80	35	20.5	14	45.2
Schooling					0.513
Reads and writes	60	35.1	9	29.0
Doesn’t read/write	111	64.9	22	71.0
Marital status					0.003*
Married	110	64.3	11	35.5
Unmarried	61	35.7	20	64.5
Religious activity					0.820
Participates	164	95.9	30	96.8
Does not participate	7	4.1	1	3.2
Per capita household income (R$)††					0.182
> 510.00	100	59.9	13	46.4
≤ 510.00	67	40.1	15	53.6
Physical activity					0.204
Active	103	60.6	15	48.4
Insufficiently active	67	39.4	16	51.6
Alcohol use					0.964
No	154	90.1	28	90.3
Yes	17	9.9	3	9.7
Tobacco use
Never smoke	80	46.8	13	41.9	0.542
Former smoker	72	42.1	16	51.6
Currently smokes	19	11.1	2	6.5
Working					0.462
Yes	20	11.8	5	16.7
No	149	88.2	25	83.3

Variables	Functional capacity				p-value

	Independent		Dependent

	N	%	N	%
Depressive symptoms					0.002*
No	143	86.7	17	63.0
Yes	22	13.3	10	37.0
Cognitive status					0.348
Not compromised	118	70.7	16	61.5
Compromised	49	29.3	10	38.5
Self-perceived health					0.328
Positive	82	48.2	12	38.7
Negative	88	51.8	19	61.3
Hospitalization					0.407
None	138	80.7	23	74.2
One or more	33	19.3	8	25.8
Diabetes					0.130
No	148	89.7	24	80.0
Yes	17	10.3	6	20.0
Hypertension					0.391
No	63	37.1	9	29.0
Yes	107	62.9	22	71.0
Falls					0.465
No	136	80.0	23	74.2
Yes	34	20.0	8	25.8
Use of medicines					0.111
None or one	70	40.9	8	25.8
Two or more	101	59.1	23	74.2
BMI					0.778
Adequate	87	51.8	14	45.2
Underweight	36	21.4	8	25.8
Overweight	45	26.8	9	29.0

Variables	N		Functional capacity

			RR*	CI 95%†
Gender
Male	91	15.4	1.00
Female	111	15.3	0.99	(0.51 - 1.90)
Age group
≥ 60 to ≤ 79	153	11.1	1.00
≥ 80	49	28.6	2.57	(1.37 - 4.82)
Schooling
Reads and writes	69	13.0	1.00
Doesn't read/write	133	16.5	1.26	(0.61 - 2.60)
Marital status
Married	121	9.1	1.00
Unmarried	81	24.7	2.71	(1.37 - 5.36)
Religious activity
Participates	194	15.5	1.00
Does not participate	8	12.5	0.80	(0.12 - 5.20)
Per capita household income (R$) ‡
> 510.00	113	11.5	1.00
≤ 510.00	82	18.3	1.59	(0.80 - 3.15)
Physical activity
Active	118	12.7	1.00
Insufficiently active	83	19.3	1.51	(0.79-2.89)
Alcohol use
No	182	15.4	1.00
Yes	20	15.0	0.97	(0.32-2.92)
Tobacco use
Never smoke	93	14.0	1.00
Former smoker	88	18.2	1.30	(0.66 - 2.54)
Currently smokes	21	9.5	0.68	(0.16 - 2.79)
Working
Yes	25	20.0	1.00
No	174	14.4	0.71	(0.30 - 1.70)

Variables	N	%	Functional capacity

			RR*	CI 95%†
Depressive symptoms
No	160	10.6	1.00
Yes	32	31.3	2.94	(1.48 - 5.82)
Cognitive status
Not compromised	134	11.9	1.00
Compromised	59	16.9	1.41	(0.68 - 2.94)
Self-perceived health
Positive	94	12.8	1.00
Negative	107	17.8	1.39	(0.71 - 2.71)
Hospitalization
None	161	14.3	1.00
One or more	41	19.5	1.36	(0.66 - 2.82)
Diabetes
No	172	14.0	1.00
Yes	23	26.1	1.87	(0.85 - 4.08)
Hypertension
No	72	12.5	1.00
Yes	129	17.1	1.36	(0.66 - 2.80)
Falls
No	159	14.5	1.00
Yes	42	19.0	1.31	(0.63 - 2.73)
Use of medicines
None or one	78	10.3	1.00
Two or more	124	18.5	1.80	(0.85 - 3.84)
BMI
Adequate	101	13.9	1.00
Underweight	44	18.2	1.31	(0.59 - 2.90)
Overweight	54	16.7	1.20	(0.55 - 2.59)

Model*	RR†	CI 95% ‡
Female	0.67	(0.31 - 1.41)
Age group ≥ 80	1.61	(0.75 - 3.43)
Marital status unmarried	2.75	(1.15 - 6.57)
Per capita household income ≤ 510.00 (R$) §	1.24	(0.56 - 2.72)
With depressive symptoms	2.41	(1.15 - 5.06)
With diabetes	1.88	(0.75 - 4.70)
Use of two or more medicines	1.96	(0.61 - 6.32)
Inactive for physical activity	0.70	(0.33 - 1.49)

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[TFN1001] * p < 0.05; †† Referring to the Brazilian minimum wage, in Reals, 2011.