Disability relating to basic and instrumental activities of daily living: a zopulation-based study with elderly in Pelotas, Rio Grande do Sul, Brazil, 2014

Farías-Antúnez, Simone; Lima, Natália Peixoto; Bierhals, Isabel Oliveira; Gomes, Ana Paula; Vieira, Luna Strieder; Tomasi, Elaine

Acessibilidade / Reportar erro

Brasil

Epidemiologia e Serviços de Saúde

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 27 (2) • 2018 • https://doi.org/10.5123/S1679-49742018000200005 copy

Disability relating to basic and instrumental activities of daily living: a zopulation-based study with elderly in Pelotas, Rio Grande do Sul, Brazil, 2014^* * The study was financed with resources of the Consortium of Research Master’s Program in Epidemiology of the Federal University of Pelotas 2013/14 (Program of Academic Excellence/Coordination of Improvement of Higher Level Personnel /Ministry of Education [process: PROEX/CAPES No. 23038.003968/2013-99]; and financial assistance for Educational Project or Research/PROEX/CAPES [process: AUXPE/PROEX No. 1107/2013]).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to estimate the prevalence of disability related to basic and instrumental activities of daily living and its association with socioeconomic, demographic, behavioral and health characteristics in the elderly.

Methods:

population-based cross-sectional study in Pelotas, Brazil, in 2014; Katz and Lawton scales were used to assess the outcomes using Poisson regression.

Results:

the study included 1.451 elderly individuals; the prevalence of disability for basic and instrumental activities was 36.1% and 34.0%, respectively, and 18.1% in both; higher prevalence of functional disability were observed individuals ≥80 years (PR=3.01; 95%CI 2.17;4.18), not working (PR=2.02; 95%CI 1.13;3.60) and those with multiple morbidities (PR=3.28; 95%CI 1.38;7.79); and lower in individuals with ≥12 years of schooling (PR=0.40; 95%CI 0.24;0.66), and that were physically active (PR=0.42; 95%CI 0.21;0.82).

Conclusion:

functional disability was associated to individuals older than 80, with less schooling years and affected by multiple morbidities.

Keywords:
Aged; Activities of Daily Living; Disabled Persons; Cross-Sectional Studies

Variables	N	%^a	95% CI^b
1° Level
Sex
Male	536	37.0	34.9;39.1
Female	912	63.0	60.9;65.1
Age (in full years)
60-69	755	52.3	49.1;55.4
70-79	459	31.8	29.2;34.4
≥80	230	15.9	13.8;18.0
Marital status
Married	762	52.7	49.4;56.0
Single	91	6.3	4.8;7.7
Separated	134	9.3	7.8;10.7
Widowed	458	31.7	29.1;34.3
Economic class (ABEP)
A/ B	482	35.2	30.3;40.1
C	719	52.5	47.9;57.1
D-E	168	12.3	10.1;14.6
Schooling (in full years)
None	194	13.6	11.2;16.0
1-3	337	23.4	20.7;26.2
4-7	445	31.0	28.0;34.0
8-11	143	10.0	8.3;11.6
≥12	316	22.0	17.5;26.5
2° Level
Current Job
No	1,083	80.4	78.2;82.7
Yes	263	19.6	17.3;21.8
3° Level
Alcohol consumption
No	1,138	78.8	76.3;81.2
Yes	307	21.2	18.8;26.7
Physical activity in leisure (IPAQ) ^c
Inactive	823	81.5	79.3;83.6
Active (≥150 minutes/week)	547	18.5	16.4;20.7
4° Level
Nutritional status (kg/m²)
Underweight	25	1.8	1.1;2.5
Appropriate weight	360	26.4	24.0;29.0
Overweight or obesity	979	71.8	69.3;74.2
Morbidities (multimorbities)
None	155	10.7	9.2;12.2
1	332	23.1	20.7;25.4
≥2	952	66.2	63.7;68.7
Outcomes
Inability to Basic ADLs ^d
No	920	63.9	61.4;66.5
Yes	520	36.1	33.5;38.8
Inability to IADLs ^e
No	837	66.0	62.8;69.2
Yes	432	34.0	30.8;37.2
Inability to Basic ADLs ^d and IADLs ^e
No	1,038	81.9	79.6;84.1
Yes	230	18.1	15.9;20.4

Activity	Independents		Partial Assistance		Total aid
Activity	n	%	n	%	N	%
Basic ADLs^a (n=1,440)
Bathing	1,339	93.0	84	5.8	17	1.2
Dressing up	1,314	91.2	80	5.6	46	3.2
Going to the bathroom	1,378	95.7	52	3.6	10	0.7
Lying down and getting out of bed/ chair	1,377	95.6	48	3.3	15	1.0
Eating	1,407	97.7	24	1.7	9	0.6
Urinating/ evacuating^b	974	67.6	412	28.6	54	3.8
IADLs ^c (n=1,269)
Using the phone	1,165	91.8	68	5.4	36	2.8
Using means of transportation	1,057	83.3	169	13.3	43	3.4
Purchasing	1,006	79.3	205	16.2	58	4.6
Tidying the house	1,032	81.3	143	11.3	94	7.4
Washing clothes	1,105	87.1	139	11.0	25	2.0
Taking care of money	1,148	90.5	100	7.9	21	1.6
Taking medications	1,130	89.0	91	7.2	48	3.8

Exposure Variables	Inability to Basic ADLs ^a	Crude analysis		Adjusted analysis^b
Exposure Variables	N (%)	PR^c (95%CI )^d	p-value^e	PR^c (95%CI )^d	p-value^e
1° Level
Sex			<0.001		<0.001
Male	150 (28.1)	1.00		1.00
Female	370 (40.8)	1.45 (1.25;1.67)		1.43 (1.21;1.69)
Age (in full years)			0.001^f		0.001^f
60-69	210 (27.9)	1.00		1.00
70-79	182 (39.8)	1.43 (1.22;1.67)		1.34 (1.13;1.58)
≥80	128 (56.1)	2.01 (1.71;2.36)		1.73 (1.44;2.07)
Marital status			<0.001		0.308
Married	242 (31.8)	1.00		1.00
Single	28 (31.1)	0.98 (0.71;1.35)		0.91 (0.65;1.27)
Separated	36 (27.1)	0.85 (0.61;1.18)		0.81 (0.57;1.15)
Widowed	214 (47.1)	1.48 (1.28;1.70)		1.06 (0.90;1.25)
Economic classification (ABEP)			0.044^f		0.147^f
A/ B	156 (32.5)	1.00		1.00
C	273 (38.1)	1.17 (0.99;1.39)		0.91 (0.77;1.08)
D-E	65 (38.5)	1.18 (0.96;1.46)		0.83 (0.67;1.02)
Schooling (in full years)			0.001^f		0.001^f
None	92 (47.2)	1.00		1.00
1-3	141 (42.1)	0.89 (0.74;1.08)		1.02 (0.84;1.24)
4-7	167 (37.9)	0.80 (0.67;0.96)		0.91 (0.76;1.10)
8-11	50 (35.0)	0.74 (0.58;0.95)		0.89 (0.69;1.15)
≥12	67 (21.3)	0.45 (0.35;0.59)		0.53 (0.40;0.70)
2° Level
Current Job			<0.001		0.057
No	425 (39.4)	1.74 (1.34;2.24)		1.29 (0.99;1.67)
Yes	59 (22.7)	1.00		1.00
3° Level
Alcohol consumption			<0.001		0.200
No	443 (39.2)	1.00		1.00
Yes	76 (24.8)	0.63 (0.52;0.77)		0.87 (0.70;1.08)
Physical activity in leisure (IPAQ)			<0.001		0.006
Inactive	424 (37.6)	1.00		1.00
Active (≥150 min/week)	52 (20.3)	0.54 (0.42;0.70)		0.68 (0.52;0.90)
4° Level
Nutritional status (kg/m²)			0.978^f		0.920^f
Underweight	13 (52.0)	1.51 (1.05;2.18)		1.26 (0.81;1.97)
Appropriate weight	113 (31.4)	0.92 (0.77;1.08)		0.96 (0.82;1.13)
Overweight or obesity	335 (34.3)	1.00		1.00
Morbidity			<0.001^f		<0.001^f
None	27 (17.5)	1.00		1.00
1	69 (20.9)	1.19 (0.79;1.78)		1.28 (0.79;2.07)
≥2	417 (44.1)	2.51 (1.78;3.55)		2.24 (1.48;3.40)

Exposure Variables	Inability to Basic ADLs^a	Crude analysis		Adjusted analysis^b
Exposure Variables	n (%)	PR^c (95%CI^d )	p-value^e	PR^c (95%CI^d )	p-value^e
1° Level
Sex			<0.001		0.476
Male	119 (27.7)	1.00		1.00
Female	313 (37.3)	1.34 (1.13;1.60)		1.07 (0.89;1.28)
Age (in full years)			<0.001^f		<0.001^f
60-69	149 (21.5)	1.00		1.00
70-79	161 (39.9)	1.85 (1.52;2.26)		1.59 (1.30;1.94)
≥80	121 (71.6)	3.33 (2.78;3.99)		2.39 (1.95;2.93)
Marital status			<0.001		<0.001
Married	160 (24.0)	1.00		1.00
Single	22 (27.5)	1.15 (0.76;1.73)		1.18 (0.79;1.76)
Separated	37 (30.8)	1.29 (0.96;1.73)		1.45 (1.08;1.94)
Widowed	212 (53.0)	2.21 (1.84;2.66)		1.61 (1.32;1.97)
Economic classification (ABEP)			<0.001^f		0.463^f
A/ B	103 (25.4)	1.00		1.00
C	229 (35.6)	1.40 (1.14;1.72)		1.02 (0.84;1.26)
D-E	75 (50.3)	1.98 (1.56;2.52)		1.11 (0.87;1.41)
Schooling (in full years)			<0.001^f		<0.001^f
None	106 (61.1)	1.00		1.00
1-3	104 (36.0)	0.57 (0.47;0.69)		0.69 (0.58;0.82)
4-7	135 (34.9)	0.55 (0.46;0.66)		0.72 (0.60;0.86)
8-11	33 (25.6)	0.41 (0.29;0.56)		0.62 (0.46;0.83)
≥12	50 (17.7)	0.28 (0.21;0.38)		0.42 (0.31;0.59)
2° Level
Current Job			<0.001		<0.008
No	358 (37.9)	2.25 (1.69;3.00)		1.42 (1.07;1.88)
Yes	40 (16.8)	1.00		1.00
3° Level
Alcohol consumption			<0.146		0.484
No	368 (37.0)	1.00		1.00
Yes	62 (23.0)	0.62 (0.48;0.81)		0.91 (0.70;1.19)
Physical activity in leisure (IPAQ)			<0.001		0.168
Inactive	352 (35.3)	1.00		1.00
Active (≥150 min/week)	49 (21.5)	0.61 (0.47;0.79)		0.83 (0.63;1.08)
4° Level
Nutritional status (kg/m²)			0.049^f		0.493^f
Underweight	9 (47.4)	1.57 (0.99;2.48)		1.00 (0.63;1.57)
Appropriate weight	108 (35.1)	1.16 (0.24;1.43)		1.08 (0.89;1.31)
Overweight or obesity	267 (30.2)	1.00		1.00
Morbidity			<0.001^f		<0.001^f
None	23 (16.9)	1.00		1.00
1	64 (21.5)	1.27 (0.80;2.03)		1.20 (0.75;1.94)
≥2	339 (41.1)	2.43 (1.61;3.68)		2.04 (1.30;3.20)

Exposure Variables	Inability to both activities	Crude analysis		Adjusted analysis
Exposure Variables	n (%)	PR^c (95%CI^d )	p-value^e	PR^c (95%CI^d )	p-value^e
1° Level
Sex			<0.001		0.020
Male	52 (12.2)	1.00		1.00
Female	178 (21.2)	1.74 (1.31;2.31)		1.46 (1.06;1.99)
Age (in full years)			<0.001^e		<0.001^e
60-69	67 (9.7)	1.00		1.00
70-79	92 (22.8)	2.36 (1.74;3.18)		1.92 (1.40;2.63)
≥80	71 (42.0)	4.35 (3.27;5.77)		3.01 (2.17;4.18)
Marital status			<0.001		0.027
Married	83 (12.4)	1.00		1.00
Single	12 (15.0)	1.21 (0.67;2.16)		1.14 (0.61;2.14)
Separated	14 (11.7)	0.93 (0.56;1.56)		1.00 (0.57;1.75)
Widowed	121 (30.3)	2.44 (1.89;3.14)		1.52 (1.13;2.04)
Economic classification (ABEP)			0.005^e		0.453^e
A/ B	58 (14.4)	1.00		1.00
C	120 (18.7)	1.30 (0.98;1.71)		0.88 (0.64;1.20)
D-E	36 (24.2)	1.68 (1.16;2.44)		0.86 (0.59;1.26)
Schooling (in full years)			<0.00^e		<0.001^e
None	54 (32.1)	1.00		1.00
1-3	66 (22.8)	0.71 (0.55;0.91)		0.93 (0.72;1.21)
4-7	68 (17.6)	0.55 (0.41;0.73)		0.76 (0.58;0.99)
8-11	17 (13.2)	0.41 (0.25;0.69)		0.68 (0.41;1.15)
≥12	23 (8.1)	0.25 (0.16;0.41)		0.40 (0.24;0.66)
2° Level
Current Job			<0.001		0.018
No	201 (21.3)	3.62 (2.03;6.45)		2.02 (1.13;3.60)
Yes	14 (5.9)	1.00		1.00
3° Level
Alcohol consumption			0.893		0.227
No	207 (20.8)	1.00		1.00
Yes	23 (8.5)	0.41 (0.27;0.61)		0.78 (0.51;1.17)
Physical activity in leisure (IPAQ)			<0.001		0.011
Inactive	188 (18.9)	1.00		1.00
Active (> 150 min/week)	12 (5.3)	0.28 (0.15;0.51)		0.42 (0.21;0.82)
4° Level
Nutritional status (kg/m²)			0.778^e		0.829^e
Underweight	5 (26.3)	1.67 (0.80;3.49)		1.01 (0.45;2.26)
Appropriate weight	46 (14.9)	0.95 (0.71;1.27)		1.04 (0.78;1.39)
Overweight or obesity	139 (15.7)	1.00		1.00
Morbidity			<0.001^e		<0.001^e
None	10 (7.4)	1.00		1.00
1	23 (7.7)	1.05 (0.52;2.14)		1.07 (0.40;2.85)
≥2	191 (21.2)	3.15 (1.72;5.78)		3.28 (1.38;7.79)

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Simone Farías-Antúnez - Rua Marechal Deodoro, No. 1160, 3º piso, Centro, Pelotas, RS, Brasil. CEP: 96020-220 / Caixa Postal: 464. E-mail: simonefarias47@gmail.com