Redução da capacidade funcional de idosos residentes em comunidade: estudo longitudinal

Abstract

Resumo O objetivo deste estudo foi identificar a incidência e fatores de risco para a redução da capacidade funcional de idosos residentes em comunidade. Foi conduzido estudo de coorte prospectivo em duas fases, 2011 e 2014. A população do estudo foi composta por 202 idosos inicialmente independentes para as atividades básicas da vida diária. Utilizou-se como medida de associação o risco relativo (RR) e seus respectivos intervalos de confiança (IC) 95%, que foram estimados por regressão log-binomial com variância robusta. A incidência da redução de capacidade funcional foi de 15,3%. Os fatores de risco para o declínio funcional foram: estado civil sem união (RR aj = 2,75; IC95%: 1,15 – 6,57) e presença de sintomas de depressão (RR aj = 2,41; IC95%: 1,15 – 5,06), mesmo após ajuste por sexo, faixa etária, renda familiar per capita, diabetes, uso de medicamentos e nível de atividade física. A elevada incidência da redução de capacidade funcional e sua associação com aspectos da relação conjugal e de saúde mental revela a necessidade de considerar tais fatores no planejamento de ações em saúde voltadas à manutenção e recuperação da capacidade funcional dos idosos.

Factors influencing the condition of vulnerability among the elderly

“…Among elderly patients with heart problems, depression has been found to be very common, with a major impact upon independence and also upon the quality of life of these people 13 . Another study carried out in Lafaiete Coutinho, in the Brazilian state of Bahia, showed that elderly people with prior symptoms of depression ran a greater risk of becoming dependent on others, even for the most basic activities of daily living, regardless of their gender, age bracket, per-head family income, presence of diabetes, use of medication, or level of physical activities 3 .…”

“…Measures to appraise vulnerability are important for identifying elderly people at an increased risk of deterioration of health, who are an important target for interdisciplinary intervention. Identifying people aged 60 or over who are in a situation of vulnerability, with risk of functional decline and incapacity a large and significant step towards the construction and prioritization of adequate care for these patients 2,3 .…”

“…The identification of health and living conditions related to the loss of functionality in the elderly person, represents an important contribution to the planning of public policies and interventions, which help people aged 60 or over live with more independence and less functional loss 3 . The health professional responsible for caring for the elderly person, when making an early identification of the factors that lead to functional disability, can also instigate interventions that would otherwise likely not have been considered.…”

Falls among the elderly: environmental limitations and functional losses

“…Another issue pertinent to intrinsic factors concerns the reduction of the functional capacity of the body, which inevitably leaves the individual susceptible to the influence of disorders in balance stabilizers, representing postural instability, as well as the senility-based reduction in muscle mass, an example of sarcopenia, with consequent loss of strength, firmness and endurance 20,21 .…”

“…Thus, psychosocial issues related to quality of life during old age also have a significant relationship with reduced muscle strength 20 . It was observed in the study that the fear of suffering further falls limited the basic activities of daily living of the elderly, making them sedentary and predisposing them to a decline in functional capacity, increasing the risk of future falls.…”