Activity Limitations in Brazilian Institutionalized Older Adults

Jerez-Roig, Javier; Medeiros, Jéssica Fernandes; Fidelis, Kalyne do Nascimento Moreira; Filho, Bartolomeu Fagundes de Lima; Oliveira, Nayara Priscila Dantas de; Andrade, Fabienne Louise Juvêncio Paes de; Ferreira, Lidiane Maria de Brito Macedo; Souza, Dyego Leandro Bezerra de; Lima, Kênio Costa de

doi:10.1519/jpt.0000000000000101

Cited by 9 publications

(7 citation statements)

References 26 publications

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“…Higher functional decline in older adults that had private health plans, higher education levels and shorter institutionalization times follows the characteristic profile of private NH residents, who are generally institutionalized with a more advanced impairment process [27]. …”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, sociodemographic variables such as age and the female gender, despite presenting lower rates of functional maintenance, were not associated with higher risks of functional decline in the final model. Higher functional decline in older adults that had private health plans, higher education levels and shorter institutionalization times follows the characteristic profile of private NH residents, who are generally institutionalized with a more advanced impairment process [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

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Functional decline in nursing home residents: A prognostic study

et al. 2017

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AimTo verify the probability of maintaining functional capacity in basic activities of daily living and identify the prognostic factors of functional decline in institutionalized older adults.MethodsA longitudinal study is presented herein, with 5 waves every 6 months, throughout 2 years (2013–2015), conducted with individuals ≥60 years old in 10 nursing homes in the city of Natal-RN (Brazil). Functional capacity was assessed by the items ‘eating’, ‘personal hygiene’, ‘dressing’, ‘bathing’, ‘transferring’, ‘toileting’ and ‘walking’, through a 5-item Likert scale. Sociodemographic, institution-related and health-related variables were considered to establish the baseline. Time dependent variables included continence decline, cognitive decline, increase in the number of medication, and incidences of falls, hospitalizations and fractures. The actuarial method, the log-rank test and Cox's regression were applied as statistical methods.ResultsThe cumulative probability of functional maintenance was 78.2% (CI 95%: 72.8–82.7%), 65.1% (CI 95%: 58.9–70.5%), 53.5% (CI 95%: 47.2–59.5%) and 44.0% (CI 95%: 37.7–50.2%) at 6, 12, 18 and 24 months, respectively. Predicting factors for functional decline were: severe cognitive impairment (HR = 1.96; p = 0.001), continence decline (HR = 1.85; p = 0.002) and incidence of hospitalizations (HR = 1.62; p = 0.020), adjusted by the incidence of depression, age, education level, presence of chronic diseases and low weight.ConclusionsThe cumulative probability of maintaining functional capacity in institutionalized older adults was only 44% at the 2-year follow-up. Prognostic factors for functional decline included severe cognitive impairment, continence decline and incidence of hospitalizations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional decline in nursing home residents: A prognostic study

et al. 2017

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“…This autonomy is linked to its interdependence with the integral memory related to the individual's capacity to take care of themselves, to perform tasks that allow them to adapt psychosocially and to be responsible for their own actions 16 . According to the study by Javier et al 27 which addressed the prevalence of functional disability among the institutionalized elderly, using the same sample as the present study, there was a relationship between institutionalization and the functional disability of elderly persons institutionalized due to the absence of an informal caregiver in the community. Disability explains the dependence of the elderly and their subsequent higher mortality.…”

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confidence: 86%

Cognitive impairment and associated factors among institutionalized elderly persons in Natal, Rio Grande do Norte, Brazil

Andrade

Lima

Fidelis

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: To identify the prevalence of cognitive impairment and associated factors among institutionalized elderly persons. Methods: A cross-sectional study was conducted from October to December 2013 in Long-Term Care Facilities for the elderly in Natal, Rio Grande do Norte, Brazil, featuring 326 elderly persons of both genders. The assessment of cognitive decline was classified using the Pfeiffer test. Information on sociodemographic conditions and health status was also recorded. Nutritional status was assessed by applying the Mini Nutritional Assessment tool and functional capacity with the Katz Index. To identify the factors associated with the presence of moderate or severe cognitive impairment multiple logistic regression analysis of variables with a p value >0.20 was performed, using the Stepwise Forward method. Results: It was observed that 83.6% (95% CI: 78.9 to 87.3%) of the elderly persons had cognitive impairment. The final model, adjusted for type of LTCF, showed that being 83 years old or older was considered a risk factor for moderate or severe cognitive impairment. However, having systemic arterial hypertension (SAH) and having been institutionalized through their own choice were considered protective factors for moderate or severe cognitive impairment. Conclusion: the variables age, having SAH and having been institutionalized through their own choice are directly associated, as risk or protection factors, with the presence of severe or moderate cognitive impairment of the elderly population. The early diagnosis of these factors can lead to greater focus in setting goals for prevention and health care, thus improving the quality of life of these individuals.

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“…Among the reasons of institutionalization, the lack of caregiver (strongly associated with frailty) indicated limited social support of residents, who often have advanced functional limitation, which increases the demand for care 41 . Besides, with the progression of age, there is a higher risk of functional limitations, as well as higher burden of chronic diseases and hospitalizations, which increases the demand for care, sometimes overloading the family 7 .…”

Section: Frailtymentioning

confidence: 99%