O objetivo deste trabalho foi determinar os fatores associados à incapacidade funcional entre idosos na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. O modelo teórico adotado foi baseado em características predisponentes (sócio-demográficas), fatores extra-individuais (apoio social, uso de serviços de saúde) e intra-individuais (condições de saúde). Participaram do estudo 1.786 idosos (> 60 anos) selecionados por meio de amostra probabilística. A variável dependente foi a incapacidade funcional, definida como incapacidade leve ou moderada (alguma dificuldade) e grave (total dependência) para realizar atividades da vida diária. A prevalência da incapacidade foi de 16% (8% leve e 8% grave). Idade e pior auto-avaliação da saúde apresentaram associações positivas e independentes com ambos os níveis de incapacidade. Hipertensão e artrite apresentaram associações com incapacidade leve ou moderada, enquanto diabetes e acidente vascular cerebral apresentaram associações com incapacidade grave. Associação negativa com incapacidade grave foi observada para visita de amigos nos últimos trinta dias. Esses resultados mostram que as condições crônicas associadas à incapacidade na população estudada são passíveis de prevenção e que o apoio social externo à família é menor em idosos com incapacidade grave.

O presente trabalho investigou a associação entre a capacidade funcional e utilização de serviços de saúde entre idosos residentes na Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil. Participaram do estudo 1.624 idosos (≥ 60 anos) selecionados por meio de amostra probabilística. A variável dependente foi a utilização de serviços de saúde, baseada em três descritores: número de consultas médicas, consultas domiciliares e hospitalizações. A variável independente de interesse foi a capacidade funcional, medida pelo relato de dificuldade em realizar atividades instrumentais (AIVD) e básicas (ABVD) de vida diária. A primeira esteve associada apenas à hospitalização (RP = 1,62; IC95%: 1,16-2,26) e a segunda apresentou-se associada à hospitalização (RP = 1,73; IC95%: 1,24-2,42) e à consulta domiciliar (RP = 8,54; IC95%: 4,22-17,27). Os resultados mostraram maior utilização de serviços de saúde, sobretudo aqueles mais onerosos, entre idosos com incapacidade funcional, e que a dimensão funcional não tem sido balizadora da atuação dos serviços, ainda condicionada à presença de doenças.

The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios (α = 0.05). Prevalence rates were 46.3% for prefrailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

OBJECTIVE To investigate the prevalence of demand and provision of care for the Brazilian population with functional disabilities in activities of daily living.METHODS This is a quantitative and descriptive study using baseline data from ELSI-Brazil (Brazilian Longitudinal Study of Aging), a cohort study with a representative sample of the Brazilian population aged 50 years or older (n = 9,412). We considered the demand for care from the self-report of having some difficulty to perform at least one activity of daily life (eating, bathing, going to the toilet, dressing, moving in a room [ambulation], and transferring from chair [transfer]). Care supply was measured by having some help to perform the activity of daily living.RESULTS Approximately a quarter of the individuals evaluated (23.2%) reported difficulty in at least one activity of daily living, especially regarding transfer and dressing. Age, schooling, and number of chronic diseases were significantly associated with the difficulty in activities of daily living. Among those who reported difficulty, 35.1% received help of others and 11.8% did not receive (lack of care). The activities with greater lack of care were bathing (13.3%) and transfer (11.7%), which reveals an undignified survival condition. Care remains a family (94.1%) and female (72.1%) issue; despite the important changes that have taken place in society, there is still a lack of care policies. Of the total caregivers, 25.8% reported stopping working or studying to perform this role and only 9.2% were paid (hired ones or family members).CONCLUSIONS The ELSI-Brazil results reveal the expressive care demand of the Brazilian population aged 50 years or older with functional disabilities on activities of daily living and the lack of care policies aimed at this public.

The prevalence of frailty varies greatly and has received insufficient attention in developing countries. This study aimed to identify the prevalence of frailty and associated factors among the elderly in Belo Horizonte, Minas Gerais State, Brazil. Clinical, functional, and socio-demographic factors were analyzed. An ordinal regression model was used to verify conditions associated with frailty and to determine odds ratios ( α= 0.05). Prevalence rates were 46.3% for pre-frailty was 8.7% for weakness. Pre-frail and frail elderly, respectively, showed higher and increasing odds ratios for dependency in instrumental activities of daily living; restrictions in advanced activities of daily living; use of walking aids; comorbidities; falls; depressive symptoms; lower self-efficacy in preventing falls; hospitalization; and advanced age. The study identified a high percentage of frail states associated with higher odds of adverse health conditions, especially related to disability.

The objective of this study was to determine the prevalence and factors associated with the needs of caregivers for older adults living in the community. All residents (n = 1,742) of Bambuí, Minas Gerais State, Brazil (15,000 inhabitants) aged > or = 60 years were selected. Of these, 92% were interviewed and 86% were examined. The dependent variable "need for a caregiver" was defined as the inability to perform at least one of the basic activities of daily living and/or a Mini Mental score under 13. Some 23% of the elderly required caregivers. After adjustment for confounding, independent and positive associations with the need for a caregiver were found for: age, single marital status, history of alcohol abuse, hypertension, obesity, and use of > or = 2 prescription drugs. Independent and negative associations were found for: level of schooling, familiar income, living alone, total cholesterol > 240 mmHg, and having a private health plan. Those requiring caregivers presented evidence of worse socioeconomic and health status. The study provides evidence that care of the dependent elderly is a public health problem.

This paper investigates the characteristics of caregiving and the experience of women that care for their elderly husbands in Bambuí, Minas Gerais, Brazil. Among the elderly population in this community, the authors interviewed ten wives, using a survey exploring the main themes on the subject of caregiving. The data were interpreted based on an anthropological model of analysis. This model places the interaction between the individual and the context in the center of the interpretative process, underlying the construction and expression of diverse forms of human experience. The results of the survey highlighted the role, responsibilities, and obligations of women in Brazilian society with respect to caregiving for dependent elders. Women are seen as "natural" caregivers, whereby it is their given obligation to take care of their husbands, providing all kinds of support. Both the individual in need of care and the caregiver live the reality of functional disability in a society lacking the proper mechanisms to provide for the elderly population. The current study clearly shows the need to systematize home caregiving in Brazilian society.

O luto antecipado diante da consciência da finitude: a vida entre os medos de não dar conta, de dar trabalho e de morrerThe anticipated grieving before the awareness of finitude: life and the fear of "not being able to cope," "giving too much trouble" and dying