Factors associated with the social, individual and programmatic vulnerability of older adults living at home

Abstract

Objective: To verify the occurrence and factors associated to social, individual and programmatic vulnerability among older adults. Method: A household and cross-sectional survey conducted with 701 community-dwelling older adults. For evaluation of the individual component, we used the frailty phenotype; for the social component, the social vulnerability index was implemented; and for the programmatic component, the Index of access and use of health services. Descriptive and bivariate statistical analyzes and multinomial logistic regression were also carried out (p≤ 0.05). Results: It was verified that 15.7% of the older adults lived in areas of high social vulnerability, 31.8% were physically frail and had a moderate programmatic vulnerability score. Older people of a lower age, having lower education and income levels were more likely to live in areas of high or very high social vulnerability. The female gender and the high age groups increased the chances of the frailty condition. It was also observed that the older adults in the 70├ 80-year age group and having lower education were more likely to have medium programmatic vulnerability. Conclusion: The importance of primary care professionals to consider the multidimensional aspect of vulnerability in identifying older adults who need to be prioritized in health care is evidenced.

Vulnerability and Primary Health Care: An Integrative Literature Review

“…In the thematic category in which the use of the concept of vulnerability classified individuals, groups, and families, there was the possibility of its use to measure the degree of family vulnerability 14 , 22 and of specific groups, such as older adults, people with mental illness and women, 15 , 25 , 26 , 28 and for the development of instruments for measuring social vulnerability correlated with multimorbidity and the classification of families with older adult members. 16 , 17…”

“…Nine Brazilian articles 14 , 16 - 20 , 22 , 26 , 27 presented the concept of vulnerability supported by the theoretical framework of Ayres et al 32 , 36 characterized by the interactions between individual, social, and programmatic dimensions and the context where people live.…”

“…Of the selected articles, 8 14 - 17 , 22 , 25 , 26 , 29 used the vulnerability concept to classify individuals, groups, or families, with 5 of these studies carried out in Brazil. 14 , 16 , 17 , 22 , 26 …”

Trend of fall-related mortality among the elderly

“…The results also suggest a higher frequency of fall-related deaths among women with no partner. These women probably fall more frequently as a consequence of using a higher dose and variety of medication (16)(17)(18) and presenting equilibrium problems (13,16) and higher social vulnerability (19) . The fact that they live alone exposes these women to a higher risk of falling due to having no help with some daily chores which are considered a risk for this age group.…”

Elderly vulnerability: concept development

“…By recognizing the individual and collective needs of the elderly population, it is possible to understand the different dimensions and specificities that influence the health-disease process. From this perspective, authors emphasize that it will be up to health professionals to add this knowledge to care practices, through a comprehensive care plan that incorporates social, programmatic and individual aspects (14) .…”