Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population

Guerra, Ricardo Oliveira; Alvarado, Beatriz; Zunzunegui, María Victoria

doi:10.1007/bf03324748

Cited by 60 publications

(57 citation statements)

References 53 publications

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“…This finding is consistent with the increased sensitivity described in validation studies, which has allowed for the use of the MMMSE and PFAQ in similar population studies (15,19) . Unlike other studies that observed higher rates of cognitive impairment in women (26,27) , neither the MMMSE nor the combination of the two screening measures showed a significant difference in cognitive decline by gender in the present study. The superior schooling of Chilean women, as well as their prolonged interactions with family members, might stimulate cognitive function (28,29) .…”

Section: Discussioncontrasting

confidence: 99%

Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults

Castillo-Lancellotti

Margozzini

Valdívia

et al. 2015

Public Health Nutr.

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Objective: To analyse the relationship between serum folate (SF), vitamin B 12 and impaired cognitive function in the Chilean elderly. Design: We analysed the relationships between impaired cognitive function and age, SF (µg/l) and vitamin B 12 (pg/ml) with Student's t test, as well as between impaired cognitive function and gender, educational level, residence area, diabetes and hypertension with the χ 2 test. Multiple logistic regressions with interactions were estimated to assess the impact of SF on impaired cognitive function according to these methods. Setting: Chile. Subjects: Older adults (>65 years, n 1051), drawn from representative households of a national prevalence study, assessed using the Modified Mini Mental Status Examination (MMMSE). Individuals with altered MMMSE scores (≤13 points) were sequentially assessed using the Pfeffer Functional Activities Questionnaire (PFAQ). Results: Multivariate models using the MMMSE demonstrated an increased risk of impaired cognitive function for seniors who had hypertension, diabetes and higher vitamin B 12 levels. SF and its square (SF 2 ) were statistically significant, indicating that this predictor of impaired cognitive function displays a U-shaped distribution. The interaction between SF and vitamin B 12 was not statistically significant. Models using the MMMSE plus PFAQ suggested that urban residence decreased the risk of impaired cognitive function, whereas male gender, older age, vitamin B 12 levels and hypertension increased this risk. The variables SF and SF 2 and the SF × vitamin B 12 interaction were statistically significant (P < 0.05). The risk of impaired cognitive function depended on different combinations of SF and vitamin B 12 levels. When SF was low, a one-unit increase in SF (1 µg/l) diminished the risk. When SF was elevated, a further increase in SF raised the risk, especially at low vitamin B 12 levels. Conclusions: The relationship between folate, vitamin B 12 and impaired cognitive function warrants further study.

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Section: Discussioncontrasting

confidence: 99%

Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults

Castillo-Lancellotti

Margozzini

Valdívia

et al. 2015

Public Health Nutr.

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“…These characteristics are common in the group of people with disabilities in ADLs. [19][20][21][22] The comparisons between the results with previous research are complicated due to the considerable differences in the study populations and the heterogeneity of the definitions of homebound status. 6 Not surprisingly, increasing age was significantly associated with being a homebound person, consistent with previous research conducted with older people.…”

Section: Discussionmentioning

confidence: 98%

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Celeiro

Santos-del-Riego

Muñiz

2017

Disability and Health Journal

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Background. Homebound status is associated with poor health, comorbidity, and mortality and represents a major challenge for health systems. However, its prevalence among people with disabilities in the basic activities of daily living (ADLs) is unknown. Objectives. The objectives were to: (1) examine the prevalence of the homebound status among middle-aged and older adults with disabilities in ADLs, and (2) identify its clinical, functional, and environmental determinants.Methods. This study included 221 community-dwelling subjects, aged ≥50 years, who applied for long-term care services at the Office for Legal Certification of Long-term Care Need of Coruña (Spain). Each subject had a disability in ADLs and was interviewed by a trained examiner in the subject's home. The participants were considered homebound if they remained inside their home during the previous week. Measures. Demographic, clinical, functional, and environmental factors. Multiple logistic regression was used to determine the factors associated with homebound status. Results. The prevalence of homebound status was 39.8%. A multivariate analysis revealed that the presence of architectural barriers at the home entrance (stairs [OR: 6.67, p < 0.001] or a heavy door [OR: 2.83, p = 0.023]), walking ability limitations (OR: 3.26, p = 0.006), and higher age (OR: 1.05, p = 0.04) were associated with homebound status. Conclusions. Homebound status is a highly prevalent problem among middle-aged and older adults with disabilities in ADLs. Architectural factors in the home and walking ability limitations seem to be important predictors, suggesting that health care interventions should target home adaptations and mobility skills as a means to preventing or decreasing homebound status.

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“…[43][44][45][46][47][48][49][50][51][52][53][54][55][56] Guralnik et al 51 studied 1,122 elderly individuals and also found that the subjects with higher LLMS evaluated through FTSST presented greater functional independence, a conclusion that was obtained after four years of study. The study by Rosa et al 47 which investigated the determining factors of functional independence among elderly individuals, identified that females and individuals with advanced age presented greater probability of developing functional dependence (P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study

Batista¹,

Gomes

D’Elboux

et al. 2014

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: Muscle strength and functional independence are considered to be determinants of frailty levels among elderly people. The aim here was to compare lower-limb muscle strength (LLMS) with functional independence in relation to sex, age and number of frailty criteria, and to ascertain the influence of these variables on elderly outpatients' independence. DESIGN AND SETTING: Quantitative cross-sectional study, in a tertiary hospital. METHODS:The study was conducted on 150 elderly outpatients of both sexes who were in a cognitive condition allowing oral communication,

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Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population

Abstract: Decreasing social inequalities during childhood and adulthood will reduce socio-economic inequalities in disability in old age, especially among men.

Cited by 60 publications

References 53 publications

Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults

Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study

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Life course, gender and ethnic inequalities in functional disability in a Brazilian urban elderly population

Abstract: Decreasing social inequalities during childhood and adulthood will reduce socio-economic inequalities in disability in old age, especially among men.

Cited by 60 publications

References 53 publications

Serum folate, vitamin B12 and cognitive impairment in Chilean older adults

Serum folate, vitamin B12 and cognitive impairment in Chilean older adults

Homebound status among middle-aged and older adults with disabilities in ADLs and its associations with clinical, functional, and environmental factors

Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study

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Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults

Serum folate, vitamin B₁₂ and cognitive impairment in Chilean older adults