Incidência de incapacidade funcional em idosos: um estudo de base domiciliar em um município do norte do RS

Abstract

Understanding the human aging process involves multidimensional aspects with characteristics and approaches related to functional, physiological, emotional, social and cultural issues. Considering the functional aspects and, specifically, neuromuscular issues, the functional capacity of elderly people becomes an important element for their autonomy and independence. It can be understood as the efficiency that a person has to meet the demands of daily life, from the most basic to the most complex activities for an autonomous and independent life. In this context, this thesis aimed to analyze the incidence of functional incapacity with the health conditions of elderly people in the community. The specific objectives are: a) To determine functional capacity; b) To verify the association of functional capacity with demographic and socioeconomic indicators; c) To identify the association of functional capacity with lifestyle; d) To present the association of functional capacity with nutritional status; e) To compare the functional capacity of elderly people born between 1940 and 1950 and elderly people born between 1951 and 1961; f) Verify the change in the functional capacity of elderly people over a period of 11 years. The study is characterized by being a dynamic cohort (cohort A 2010 and cohort B 2021) having as baseline the study "Census of living and health conditions of elderly people in the municipality of Coxilha- RS". The second data collection was carried out in 2021 through a household survey using a standardized and pre-coded questionnaire. . The thesis responded to the objectives through two scientific productions. Scientific production I consisted of identifying the incidence of functional disability and associated factors of elderly people in a municipality in the southern region of Brazil. Among the results, the incidence of dependence for basic activities of daily living (BADL) of 12.6% and for instrumental activities of daily living (IADL) of 34.5% in the 11-year period stood out. For BADLs, the incidence was higher among those who were malnourished or at risk of malnutrition and with low handgrip strength (HGS). For IADLs, the highest incidence was among elderly people with low handgrip strength. Scientific production II described the functional capacity of elderly people born between 1940 and 1950 and elderly people born between 1951 and 1961 in a municipality in the southern region of Brazil. A prevalence of 9.5% of dependence was found for BADLs in 2010, rising to 5.1% in 2021. For IADLs, in 2010, the prevalence of dependence was 56.1%, rising to 23.8% in 2021. In 2010, the prevalence of dependence for BADLs was higher among elderly women with a family income of up to 2 minimum wages (p<0.05). In 2021, the prevalence of dependence for BADLs was higher among elderly people with a family income of up to 2 minimum wages and who lived in urban areas (p<0.05). The prevalence of dependence for IADLs was higher among elderly women who lived without a partner, who had a family income of up to 2 minimum wages and who lived in urban areas (p<0.05). Finally, the main factors associated with dependence were female gender, low income and low education level. It was also found that in a decade, functional capacity improved for females, as well as income and education. Considering the findings, it is clear that functional incapacity was associated with socioeconomic and demographic determinants. Thus, it is believed that more effective public policies in the spheres of education, income and health can improve the quality of life of elderly people in order to guarantee their autonomy and independence for longer and may also be key to preventing functional impairment between generational transitions.