Abstract
Estimate the magnitude of the income inequality in the prevalence of functional dependency for basic and instrumental activities of daily life (BADLs, IADLs) and the abandonment of advanced activities (AADLs). This was a cross-sectional, population-based study, developed using sample data of 986 elderly people from a health survey carried out in the municipality of Campinas, São Paulo, in 2014/15. The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita. A multiple regression Poisson analysis was developed to estimate the prevalence ratio (PR) adjusted by gender and age. There was no significant association between income and functional dependency for BADLs. Of the seven IADLs analyzed, five presented a higher prevalence of dependency in the lower-income stratum, with special highlight to using the phone (PR = 3.50), controlling medication usage (PR = 2.44), and use of transportation (PR = 2.35). The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77). The broad inequality detected among income stratum regarding the functional capability for the IADLs and abandonment of the AADLs emphasize the importance of fully implementing and maintaining the policies and programs directed toward the social protection of elderly adults. The focus should be on the most socially vulnerable segments, with the aim of achieving a population that is more equal, active, independent, and involved in participatory ageing.
Highlights
The prevalence of functional dependency in BADLs and IADLs and of abandonment of the AADLs was estimated according to monthly family income per capita
There was no significant association between income and functional dependency for BADLs
The abandonment of AADLs was higher among low-income elderly people in all activities analyzed, with the greatest inequalities observed in making contact by letter, phone and e-mail (PR = 3.76), using the Internet (PR = 3.34), driving vehicles (PR = 2.85) and visiting family (PR = 2.77)
Summary
Pesquisas têm evidenciado associações significativas entre capacidade funcional e diferentes indicadores de nível socioeconômico[10,11,12] analisando as ABVDs13-15 ou as AIVDs7,16. O estudo teve como objetivo estimar a magnitude das desigualdades de renda nas prevalências de dependência funcional em ABVD e AIVD, bem como no abandono de AAVD, entre idosos residentes em um município do Sudeste brasileiro. Em relação à dependência funcional para ABVD (Tabela 2), não foram verificadas diferenças significativas para a realização de nenhuma das atividades nas comparações entre as categorias de renda. Já em relação à dependência funcional nas AIVDs, a prevalência de idosos dependentes foi maior entre os pertencentes ao segmento de menor renda, em comparação aos de renda superior, em cinco atividades, sendo as maiores desigualdades detectadas em: usar o telefone (RP = 3,50), usar transporte (RP = 2,35) e controlar o próprio uso de medicamentos (RP = 2,40).
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