Angelina Lázaro Alquézar

Enfermedades cronicas y deterioro funcional para las actividades de la vida diaria en poblacion mayor no institucionalizada

OBJECTIVE To analyze the influence of chronic medical conditions on functional performance of activities of daily living, both basic (BADL) and instrumental (IADL), among the socially-active older population. METHODS We performed a cross-sectional study of 380 individuals aged over 64 years old who regularly attended community centers in the city of Zaragoza. The Older Americans Resources and Services (OARS) questionnaire was completed in a personal interview. A multivariate logistic regression model was used to analyze functional capacities for BADL and IADL as dependent variables, and socio-demographic variables and chronic medical conditions as predictive variables. RESULTS The risk of showing dependence for BADL significantly increased in the presence of mild and severe mental illness (OR=4.02; 95% CI=1.81-8.95; and OR=10.61; 95% CI=4.68-24.05, respectively), heart disease (OR=2.79; 95%CI=1.32-5.91), rheumatism/osteoarthritis (OR=2.75; 95% CI=1.42-5.33) and age 75 years or older (OR=2.70; 95% CI=1.42-5.13). For IADL, these risks increased with mild and severe mental illness (OR=2.11; 95% CI=1.10-4.04; and OR=4.50; 95% CI=2.27-8.90, respectively), age 75 years or older (OR=3.06; 95% CI=1.78-5.25) and heart disease (OR=2.64; 95% CI=1.35-5.16). CONCLUSION There was greater level of independence for BADL than for IADL. The factor creating most dependence was mental illness, followed by heart disease and rheumatism/osteoarthritis. A declining ability to perform IADL should prompt early assessment of dependence, as it is the first sign to appear. Prevention is fundamental for independent functioning in older people.