Functional Disability For Basic Activities Research Articles

Functional disability and its associated factors among community- dweller older adults living in Gondar Town, Ethiopia: a community-based cross-sectional study

BackgroundFunctional disability is an emerging public health concern that has an impact on the health and quality of life of older adults. If functional disability recognized early, it will be possible to support them to live independently. Although functional disability is extensively researched in developed countries; studies are scarce in Sub-Saharan Africa, particularly Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of functional disability in activities of daily living among older adults in Gondar town, Ethiopia.MethodsA community-based cross-sectional study was conducted from April to June 2022. Multistage sampling techniques were used to recruit 607 older adults aged 60 years and older. A pre-tested interview-administered questionnaire was used to assess functional disability in basic activities of daily living and instrumental activities of daily living using the Katz Index and Lawton scale, respectively. Bivariate and multivariable logistic regression models were employed. The findings of the study were presented by descriptive statistics and an adjusted odds ratio with 95% CI was used to determine statistical significance.ResultsThe prevalence of functional disability in basic activities of daily living and instrumental activities of daily living among older adults was 34.5% and 54.4, respectively. Age 80 and older [AOR = 2.41, CI (1.41–4.10)], low-income status [AOR = 2.58, CI (1.50–4.46)], multimorbidity [AOR = 2.97, CI (1.92–4.60)], depression [AOR = 2.97, CI (1.63–5.40)], and low level of physical activity [AOR = 3.31, CI (2.11–5.17)] were associated with basic activities of daily living. Age 80 and older (AOR = 3.11, CI = 1.94-5.00), multimorbidity [AOR = 3.06, CI (2.10–4.46)], and depression [AOR = 3.52, CI (2.10–4.46)] were associated with instrumental activities of daily living.Conclusion and recommendationsOur study finding revealed that functional disability affects a large number of older adult residents. The age group of 80 years and older, low-income status, a low level of physical activity, multimorbidity, and depression were associated with basic and instrumental activities of daily living. Therefore, health interventions designed to increase older adults’ level of physical activity, management of multimorbidity, and depression, more care for elders 80 years and older, and supporting older adults financially for health insurance coverage could be an important strategy to reduce functional disability among older adults.

Use of structural models to elucidate the occurrence of falls among older adults according to abdominal obesity: a cross-sectional study.

Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. A cross-sectional study in an urban area of Alcobaça, Brazil. Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

Longitudinal association between social capital and functional disability in a cohort of community dwelling older adults

This study aimed to investigate the association between social capital and functional disability, based on a longitudinal perspective, using data from the cohort of older adults from Bambuí, Minas Gerais State, Brazil. The baseline of this study was composed of all surviving and disability-free - up until the seventh year of follow-up (2004) - older adults who were followed up until 2011. The outcome variable was functional disability for basic activities of daily living (ADL) and instrumental activities of daily living (IADL), separately analyzed. Social capital was the exposure of interest, measured through its cognitive (cohesion and social support) and structural (social participation and satisfaction with the neighborhood) components. Sociodemographic variables, health conditions, and lifestyle habits were used for adjustment purposes, and the occurrence of death was considered a competitive event. The hypothesis of association between social capital and functional disability was tested using the competing risk model, which provides hazard ratios (HR) and a 95% confidence interval (95%CI). After multivariate analysis, social capital - in its structural component - was associated with functional disability. Older adults who were dissatisfied with the neighborhood had a higher risk of developing functional disability for IADL (HR = 2.36; 95%CI: 1.31-4.24), in relation to their counterparts. This study results suggest that functional disability is associated with aspects other than health, evidencing the need for the development of policies and interventions that support aspects related to the physical and social environment in which older adults live.

A Community-Based Study on Functional Disability and Its Associated Factors Among Elderly Individuals in a Rural Setting in Northeastern India.

BackgroundFunctional disability in older adults is common and adversely impacts the quality of life. Given the paucity of population-based data, the present analysis attempted to determine the prevalence and factors associated with functional disability in basic activities of daily living (ADLs) among the elderly population in a rural setting of Northeastern state of IndiaMethodsA total of 430 elderly were recruited in a population-based cross-sectional study among elderly individuals (≥60 years) during the period 2013-2016 in rural areas of the Dibrugarh district of Northeastern India. The Barthel index was used to measure ADL. Anyone with a Barthel index score <100 (or having limitations in one or more ADL items) were considered as having a functional disability. The analysis of variance (ANOVA) test and the binary logistic regression analysis were used to examine the factors associated with functional disability.ResultsOverall, 43.7% % (Male 42.9%, Female 44.5%) of the participants had a functional disability. Increasing age, being widowed, having no formal education, being underweight (body mass index (BMI)<18.5 kg/m2), and increasing numbers of morbidities were significantly associated with functional disability among the elderly in this study in age and gender-adjusted logistic regression analysis. Being ≥80 years was associated with a three-fold greater risk (OR=31.72, 95% CI=1.3-6.91) of functional disability than the youngest age group (60-69 years). On the other hand, the presence of more than five morbidities was associated with a nearly 20 times increased risk (OR=19.61, 95% CI=9.01-42.68) than those with zero to two morbidities.ConclusionA high proportion of the rural elderly residents of Dibrugarh had a functional disability. The study provides epidemiological evidence of the risk factors of functional disability in this setting. This epidemiological information may be useful for developing prevention strategies to reduce the burden of functional disability.

Multimorbidity patterns and functional disability in elderly Brazilians: a cross-sectional study with data from the Brazilian National Health Survey

The presence of multimorbidity patterns has been related to functional disability in basic activities (BADLs) and instrumental activities of daily living (IADLs), which are essential for elder individuals' self-care and autonomy. The study thus aimed to estimate the association between multimorbidity patterns and presence of functional disability in elderly Brazilians. This was a cross-sectional study using data from the Brazilian National Health Survey (PNS 2013) in a sample of elderly Brazilians (≥ 60 years). The measures of functional disability were from self-completed questionnaires, categorized in basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). The multimorbidity patterns analyzed here were: (1) cardiorespiratory; (2) vascular-metabolic; and (3) mental-musculoskeletal. The adjustment variables included age, sex, schooling, and region of Brazil. Multivariate logistic regression analyses were performed, estimating crude and adjusted odds ratios (OR) with Stata 16.0. Elderly individuals classified in the mental-musculoskeletal patterns showed the highest odds of disability in BADLs (OR = 2.72; 95%CI: 2.33; 3.18), while those with the cardiopulmonary pattern showed the highest odds of disability in IADLs (OR = 2.65; 95%CI: 1.95; 3.60), compared to those without the same patterns. All the multimorbidity patterns analyzed here were associated with disability in BADLs and IADLs and should thus be considered when planning measures to prevent disabilities in elderly individuals with multimorbidity.

Evaluation of functional disability and associated factors in the elderly

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.

Incapacidade funcional e fatores associados em idosos de área urbana: um estudo de base populacional

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&lt;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&lt;0.001), (OR=3.30, p&lt;0.001)]; larger number of self-reported diseases [(OR=1.24, p&lt;0.001), (OR=1.12; p&lt;0.001)]; and symptoms of depression [(OR=1.49; p&lt;0.003), (OR = 1.75, p&lt;0.001)]; whereas no schooling (OR=1.88; p&lt;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.

Prevalence of disability and associated factors in the elderly

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.

Functional disability among older women with fecal incontinence

The prevalence of functional disability for basic activities of daily living (ADLs) in older women with fecal incontinence (FI) is not well characterized. Our objective was to determine the prevalence of functional disability among community-dwelling older women with FI. We conducted a secondary database analysis of the 2005-2006 National Social Life, Health and Aging Project, a cross-sectional study of community-dwelling older adults that had been conducted by single in-home interviews. FI was defined as an affirmative answer to the question, "Have you lost control of your bowels (stool incontinence or anal incontinence)?" with a frequency of "at least monthly." We then examined functional status. Women were asked about 7 basic ADLs. Statistical analyses with percentage estimates and 95% confidence intervals (CIs) were performed. We included 1412 women in our analysis. FI, at least monthly, was reported by 5.5% of community-dwelling older women (n = 77); 63.2% (95% CI, 50.1-76.4) of the women with FI reported difficulty or dependence with ≥1 ADLs, and 31.2% (95% CI, 18.9-43.6) of the women specifically reported difficulty or dependence with using the toilet. After adjustment for age category, race/ethnicity, education level, women with FI had 2.6 increased odds (95% CI, 1.26-5.35) of difficulty or dependence compared with women with no FI. Other significant risk factors for increased functional difficulty/dependence included obesity (body mass index, ≥30 kg/m(2)) and depressive symptoms. Consistent with other large epidemiologic studies, we found monthly FI was reported by 5.5% of older women (n/N = 77/1412). More than 60% of community-dwelling older women with FI report functional difficulty or dependence with ≥1 ADL and specifically; more than 30% of women with FI report difficulty or dependence using/reaching the toilet. Because of the high prevalence of functional disability in older women with FI, we purpose that initial evaluation and treatment of FI may be improved by considering functional status.

Factors associated with the frailty syndrome in elderly individuals living in the urban area.

OBJECTIVE:to identify the occurrence and factors associated with pre-frailty and frailty conditions among elderly individuals.METHODS: this cross-sectional, observational and analytical household survey was conducted with 958 elderly individuals living in the urban area. The Brazilian version of the Functional Assessment Questionnaire and Multidimensional Scales (Depression, Katz and Lawton brief geriatric versions) were used, together with the Phenotype of Frailty developed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p<0.05). RESULTS: a total of 313 (32.7%) non-frail elderly individuals were found in addition to 522 (55.4%) pre-frail and 128 (12.8%) frail individuals. Factors associated with pre-frailty and frailty, respectively, included: being 70├ 79 years old and 80 years old or older; using 1├ 4 medications and 5 or more; greater number of morbidities, functional disability for instrumental activities of daily life, and negative self-perception. The absence of a partner was associated with pre-frailty while hospitalization in the last year, functional disability for basic activities of daily life and indication of depression were associated with frailty. CONCLUSION: pre-frailty and frailty conditions presented a percentage higher than that reported by Brazilian studies and are associated with health-related variables. These variables can be prevented with interventions directed to the health of elderly individuals.

Velocidade de caminhada como indicador para a incapacidade funcional em idosos

The aim of this study was to analyze the walking speed as a discriminator of functional disability. This was an epidemiological cross-sectional study with a random sample of 622 individuals, in the age group 60-96 years, mean 71.6 years (SD= 7.39) for men and 70.78 years (SD= 7.96) for women. Receiver operating characteristic (ROC) curves were designed and the criterion discriminator of 2.44 meters walking speed (in seconds) were determined in order to predict the absence of functional disability in basic activities of daily living (BADL) and instrumental activities of daily living (IADL). The areas under the ROC curve for the analyzes were higher 0.60 suggesting that the walk test has the potential to discriminate functional impairment, in BADL and IADL in both sexes. Walking time to discriminate functional disability was higher than 3.53 seconds for BADL and 2.47 seconds in IADL for men. For women, it was higher than 3.41 seconds for BADL and 3.19 seconds in IADL. The time of walking speed can be monitored in surveys and interventions population as indicator of functional disability in the elderly.

Dementia as a Predictor of Functional Disability: A Four-Year Follow-Up Study

Background: Prospective studies have shown that cognitive impairment is a strong and consistent risk factor of physical disability. However, cognitive impairment has been based on the result of a single screening tool. Objective: To investigate the role of cognition in the subsequent incidence and decline of functional disability in basic activities of daily living (ADL) and instrumental activities of daily living (IADL) after a full assessment of dementia. Methods: A group of 1,358 Japanese atomic bomb survivors aged 61 years or older who lived in the community or in institutions in Hiroshima City were followed for 4 years. During the baseline survey (1993–1995), subjects were administered a screening test for cognitive impairment. Those suspected of dementia underwent a series of cognitive tests (Hasegawa’s dementia scale, Clinical Dementia Rating) and a neurological examination. The diagnosis of dementia was made according to DSM-III-R criteria. Study subjects were questioned about their reported ADL and their IADL. During the follow-up period, deaths were recorded and a follow-up survey (1997–1999) used to assess ADL and IADL performance. Results: Dementia, even after adjustment for age, sex and history of stroke, was a strong predictor of functional disability, as indicated by ADL (odds ratio, OR = 14.0; confidence interval, CI = 5.4–36.3), IADL (OR = 10.1, CI = 2.2–46.4), and also by assessment of decline in ADL (OR = 9.8, CI = 4.2–22.8) or IADL status (OR = 3.9, CI = 1.8–8.3). Conclusion: Dementia is an important determinant of functional status. Deterioration in ADL is more significant than deterioration in IADL, suggesting that factors other than cognition, such as motivation or perceptual, sensory and motor abilities, may be important in IADL performance. This study confirms previous findings on risk factors that affect functional ability and extends our knowledge by examining several criteria of function that are important in the daily lives of elderly people.