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Ghahremani L, Zare E, Karimi M, Nazari M, Khoramaki Z, Dias EN. Psychometric properties of Persian version of the advanced activities of daily living scale: A psychometric study on Iranian older adults. Geriatr Nurs 2024; 60:14-20. [PMID: 39216212 DOI: 10.1016/j.gerinurse.2024.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 08/03/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
This study was conducted to determine the psychometric properties of the Persian version of an AADL scale in Iranian older adults. A total of 237 males and females aged over 60 years old were recruited. Personal information questionnaires, the CASP-19 Quality of Life, and AADL questionnaires were used for data collection. SPSS 24 and IBM AMOS 24 were used for data processing and analysis. Three factors that had eigenvalues higher than one were extracted, which explained 51.2 % of the total variances. The Cronbach α of the total score was 0.76, and it was >0.64 for each extracted factor. The goodness of fit indices indicated an acceptable fit to the data in confirmatory factor analysis. The culturally modified Persian version of the AADL scale has acceptable psychometric properties and is proper for evaluating the advanced activities of daily living in the Iranian population.
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Affiliation(s)
- Leila Ghahremani
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Elahe Zare
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Masoud Karimi
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran.
| | - Mahin Nazari
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Zakieh Khoramaki
- Research Center for Health Sciences, Institute of Health, Department of Health Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, 71645-111, Iran
| | - Ewerton Naves Dias
- University of Porto, Portugal; Department of Biological and Health Sciences, Universities of Guarulhos and Mogi das Cruzes, Brazil
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Pinto JO, Pontes D, Dores AR, Peixoto B, Barbosa F. Activities of Daily Living Inventory (ADLI): Proposal of a new instrument and preliminary data. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-18. [PMID: 38913789 DOI: 10.1080/23279095.2024.2367741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
The evaluation of Activities of Daily Living (ADL) has become a critical issue in neuropsychology, but existing instruments for evaluating ADL have some limitations. This work aims to propose a new instrument to evaluate ADL, the ADL Inventory (ADLI), for which we present preliminary data. The ADLI was developed based on a comprehensive model of the stages of test development and following a combined framework of the World Health Organization's International Classification of Functioning, Disability, and Health and the American Occupational Therapy Association models. Besides sociodemographic information, ADLI includes 144 items, organized into four sections: (a) basic ADL; (b) IADL; (c) advanced ADL; and (d) factors influencing functionality. The main characteristics of ADLI are: having self- and informant-report forms; including items focused on different sensory and neurocognitive functions; individualizing the progression along items considering the person's functionality; considering the impact of several factors on functionality; and using a large response scale. Preliminary data of predictive and convergent validity for ADLI are presented. The preliminary study comprised 15 older adults. The Addenbrooke's Cognitive Examination - III, the Barthel Index, and the Instrumental Activities of Daily Living (IADL) Scale were applied to determine the predictive and convergent validity of ADLI.
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Affiliation(s)
- Joana O Pinto
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Department of Social, Behavioral Sciences of University Institute of Health Sciences- CESPU, Gandra, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
- Lusófona University, Porto, Portugal
| | - Diogo Pontes
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- ESS, Polytechnic of Porto, Porto, Portugal
- Center for Rehabilitation Research, ESS, Polytechnic of Porto, Porto, Portugal
| | - Bruno Peixoto
- Department of Social, Behavioral Sciences of University Institute of Health Sciences- CESPU, Gandra, Portugal
- Associate Laboratory i4HB - Institute for Health and Bioeconomy, University Institute of Health Sciences - CESPU, Porto, Portugal
- UCIBIO - Applied Molecular Biosciences Unit, Translational Toxicology Research Laboratory, University Institute of Health Sciences (1H-TOXRUN, IUCS-CESPU), Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
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Yim THJYZ, Tan KY. Functional Outcomes after Abdominal Surgery in Older Adults - How concerned are we about this? EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108347. [PMID: 38657374 DOI: 10.1016/j.ejso.2024.108347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
Amidst trends of a rapidly ageing population with better surgical outcomes for geriatric patients, it is imperative to consider outcome measures beyond mortality and morbidity rates. In fact, the preservation of one's postoperative function has been cited as a key priority for older adults and is a crucial determinant of postoperative independence and survival. This review aims to examine the prevalence of perioperative function reporting amongst older surgical patients undergoing elective major abdominal surgery for cancer. We systematically reviewed studies from inception to December 2023 for studies which focused on the outcomes of older surgical patients undergoing elective major abdominal surgery for cancer. Relevant citations were screened (title, abstract and full article review) based on the inclusion and exclusion criteria. 103 studies were included, of which only 31 studies consisting of 20885 participants reported perioperative function. While the nominal number of studies which report perioperative function has been on a steady rise since 2018, the proportion of studies which do so remains low. Postoperative function is three times less likely to be reported than preoperative function, suggesting that functional recovery is not sufficiently assessed. This suggests that there is still a poor uptake of functional recovery as an outcome measure amongst surgeons, and any increase in perioperative function reporting is likely due to the increased administration of frailty assessments. These findings should urge greater efforts in quantifying and enabling functional recovery to improve the clinical outcomes and quality of care for older surgical patients.
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Affiliation(s)
| | - Kok Yang Tan
- Department of General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central Singapore 768828.
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Martins VF, Peyré-Tartaruga LA, Haas AN, Kanitz AC, Martinez FG, Gonçalves AK. Observational evidence of the association between physical and psychological determinants of aging with cognition in older adults. Sci Rep 2024; 14:12574. [PMID: 38821915 PMCID: PMC11143211 DOI: 10.1038/s41598-024-58497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/29/2024] [Indexed: 06/02/2024] Open
Abstract
Aging involves physical and cognitive deterioration in older adults. Detecting predictors of dementia early is crucial to identify its onset. This study aimed to associate physical and psychological determinants with cognitive performance in older adults. Observational study with 221 older adults, classified according to cognitive impairment. We evaluated cognitive function by Mini-Mental State Examination. Physical determinants encompassed muscle strength, functional mobility, and cardiorespiratory fitness, while psychological consisted of quality of life and activities of daily living. Multiple linear regression was performed to investigate this relationship. Physical and psychological determinants were significantly linked to cognitive impairment, including lower muscle strength, reduced functional mobility and of cardiorespiratory fitness. The influence of environment, autonomy, and engagement in daily activities on cognitive impairment was also observed. The analysis of physical and psychological determinants could help to aid in distinguishing individuals with cognitive impairment.
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Affiliation(s)
- Valéria Feijó Martins
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Leonardo Alexandre Peyré-Tartaruga
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
- Human Locomotion Laboratory (LocoLab), Department of Public Health, Experimental Medicine and Forensic Sciences, University of Pavia, Pavia, Italy.
| | - Aline Nogueira Haas
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Global Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Ana Carolina Kanitz
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Flávia Gomes Martinez
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Andréa Kruger Gonçalves
- Programa de Pós-Graduação em Ciências do Movimento Humano, Laboratório de Biodinâmica, Centro de Referência do Envelhecimento e Movimento, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Oliveira NGN, Bolina AF, Haas VJ, Tavares DMDS. Exploring the effect of the structural model of active aging on the self-assessment of quality of life among older people: A cross-sectional and analytical study. SAO PAULO MED J 2024; 142:e2022609. [PMID: 38477732 DOI: 10.1590/1516-3180.2022.0609.r1.230523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 05/23/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Although studies have examined the relationship between variables associated with active aging and quality of life (QoL), no studies have been identified to have investigated the effect of a structural model of active aging on QoL in a representative sample of older people in the community. OBJECTIVE To measure the domains and facets of QoL in older people and identify the effect of the structural model of active aging on the self-assessment of QoL. DESIGN AND SETTING This cross-sectional analytical study included 957 older people living in urban areas. Data were collected from households using validated instruments between March and June 2018. Descriptive, confirmatory factor, and structural equation modeling analyses were performed. RESULTS Most older people self-rated their QoL as good (58.7%), and the highest mean scores were for the social relationships domain (70.12 ± 15.4) and the death and dying facet (75.43 ± 26.7). In contrast, the lowest mean scores were for the physical domains (64.41 ± 17.1) and social participation (67.20 ± 16.2) facets. It was found that active aging explained 50% of the variation in self-assessed QoL and directly and positively affected this outcome (λ = 0.70; P < 0.001). CONCLUSION Active aging had a direct and positive effect on the self-assessment of QoL, indicating that the more individuals actively aged, the better the self-assessment of QoL.
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Affiliation(s)
- Nayara Gomes Nunes Oliveira
- PhD. Nurse, specialist in older people health, Hospital de Clínicas, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | | | - Vanderlei José Haas
- PhD. Physicist and Professor, Postgraduate Program in Health Care, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Darlene Mara Dos Santos Tavares
- PhD. Nurse and Associate Professor, Department of Nursing Education and Community Health, Nursing Graduate Program, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
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Simone de Souza Vasconcelos K, de Carvalho Bastone A, Alvarenga Vieira R, Cristina de Souza Andrade A, Correa Dias R, Domingues Dias JM, Rodrigues Perracini M, Oliveira Guerra R, de Souza Moreira B. Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA). Physiother Theory Pract 2023; 39:2454-2469. [PMID: 35659442 DOI: 10.1080/09593985.2022.2079574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 05/09/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND There are many factors associated with functioning and disability in older adults and these relationships are not clear. OBJECTIVE To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF). METHODS This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome. RESULTS Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices. CONCLUSION Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.
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Affiliation(s)
- Karina Simone de Souza Vasconcelos
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Alessandra de Carvalho Bastone
- Postgraduate Program in Rehabilitation and Functional Performance, Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Renata Alvarenga Vieira
- Department of Physical Therapy, School of Physical Therapy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Brazil
| | | | - Rosângela Correa Dias
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - João Marcos Domingues Dias
- Postgraduate Program in Rehabilitation Science, School of Physical Education, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Mônica Rodrigues Perracini
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Sánchez-Rodríguez MA, Zacarías-Flores M, Correa-Muñoz E, Mendoza-Núñez VM. Advanced Activities of Daily Living in Community-Dwelling Older Adults: A Cross-Sectional Study of the Mexican Health and Aging Study (MHAS 2018). Healthcare (Basel) 2023; 11:2107. [PMID: 37510550 PMCID: PMC10378797 DOI: 10.3390/healthcare11142107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/15/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The advanced activities of daily living (AADLs) in old age is a key indicator of the mobility domain for the intrinsic capacity of older adults living in the community; for this reason, it is relevant to know the prevalence and risk factors related to performing fewer AADLs in different populations. AIM To determine the prevalence and factors associated with the ability to perform AADLs in older adults reported in the Mexican Study of Health and Aging (MSHA 2018). METHODS A secondary cross-sectional analysis of the MSHA 2018 data was carried out, including a convenience sample of 6474 subjects ≥ 60 years of age, for both sexes, without cognitive deficits. Nine questions related to AADLs were selected from the database. Multiple logistic regression analysis was performed to determine factors associated with <3 AADLs, including sociodemographic, lifestyle, and health status factors. RESULTS The prevalence of the ability to perform <3 AADLs was 63%. Age is the most important risk factor for <3 AADLs, which increases by the decade, followed by sedentary lifestyle (OR = 2.15, 95% CI: 1.91-2.42, p < 0.0001). CONCLUSIONS Our findings suggest that age, schooling, urban residence, sedentary lifestyle, and comorbidity are the main risk factors for <3 AADLs in older Mexican adults.
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Affiliation(s)
- Martha A Sánchez-Rodríguez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico
| | - Mariano Zacarías-Flores
- Division of Obstetrics and Gynecology, Hospital Gustavo Baz Prada, Institute of Health of the State of Mexico, Nezahualcóyotl 57300, State of Mexico, Mexico
| | - Elsa Correa-Muñoz
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico
| | - Víctor Manuel Mendoza-Núñez
- Research Unit on Gerontology, FES Zaragoza, National Autonomous University of Mexico, Mexico City 09230, Mexico
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Tavares DMDS, Oliveira NGN, da Cruz KCT, Bolina AF. Quality of life in older adults according to race/color: a cross-sectional study. SAO PAULO MED J 2023; 141:67-77. [PMID: 35976370 PMCID: PMC9808993 DOI: 10.1590/1516-3180.2021.0720.r1.29042022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Increased longevity is accompanied by new social and health demands, such as the race/color social construct, indicating the need to identify the specific needs of older adults to maintain and improve their quality of life. OBJECTIVE We aimed to verify the direct and indirect associations of demographic, economic, and biopsychosocial characteristics with self-assessed quality of life in older adults according to race/color. DESIGN AND SETTING This cross-sectional study included 941 older adults living in the urban area of a health microregion in Minas Gerais, Brazil. METHODS Older adults were divided into three groups: white (n = 585), brown (n = 238), and black (n = 102) race/color. Descriptive and trajectory analyses were performed (P < 0.05). RESULTS Among the three groups, worse self-assessed quality of life was directly associated with lower social support scores and greater numbers of depressive symptoms. Worse self-assessed quality of life was also directly associated with a higher number of functional disabilities in basic activities of daily living and the absence of a partner among older adults of brown and black race/color. Lower monthly income and higher numbers of morbidities and compromised components of the frailty phenotype were observed among participants of white race/color, as well as lower levels of education in the brown race/color group. CONCLUSION Factors associated with poorer self-assessed quality of life among older adults in the study community differed according to race/color.
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Affiliation(s)
- Darlene Mara dos Santos Tavares
- PhD. Nurse and Associate Professor, Department of Nursing Education, Postgraduate Program in Community Health Nursing, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Nayara Gomes Nunes Oliveira
- PhD. Nurse and Adjunct Professor, Department of Nursing Education, Undergraduate Program in Community Health Nursing, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba (MG), Brazil
| | - Keila Cristianne Trindade da Cruz
- PhD. Nurse and Adjunct Professor, Department of Nursing, Faculty of Health Sciences, Universidade de Brasília (UnB), Brasília (DF), Brazil
| | - Alisson Fernandes Bolina
- PhD. Nurse and Adjunct Professor, Department of Nursing, Faculty of Health Sciences, Universidade de Brasília (UnB), Brasília (DF), Brazil
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Jesus DASD, Oliveira NGN, Oliveira NN, Bolina AF, Marchiori GF, Tavares DMDS. Social support among older adults understood through structural equation modeling. Rev Bras Enferm 2022; 75Suppl 4:e20220188. [PMID: 36287515 DOI: 10.1590/0034-7167-2022-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 07/02/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES to analyze factors associated, directly and indirectly, with lower social support of older adults, according to sex. METHODS a cross-sectional study, with 941 older adults from a health micro-region in Minas Gerais. Descriptive and trajectory analyzes were carried out (p<0.05). RESULTS in groups of women and men, direct and significant associations were observed between a smaller social network (p<0.001;p<0.001), single-person housing (p=0.046;p<0.001), greater number of depressive symptoms (p<0.001;p=0.010) and lower participation in advanced activities (p<0.001;p=0.005) with lower social support. In women, younger age was directly and significantly associated with outcome (p<0.001). In men, older age, mediated by lower participation in advanced activities, was indirectly associated with outcome. CONCLUSIONS men and women showed less social support associated with social network, housing arrangement, depressive symptoms and participation in advanced activities. Understanding the context of social support among older adults makes it possible to establish more effective measures to improve care.
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Górski M, Buczkowska M, Krzywkowska K, Całyniuk B, Górska K, Buczkowski K, Fojcik J, Grajek M, Polaniak R. Ambulophobia as a Specific Phobia—Defining the Problem Among Patients of Long-Term Care Facilities in Poland. Front Public Health 2022; 10:801109. [PMID: 35480582 PMCID: PMC9035898 DOI: 10.3389/fpubh.2022.801109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 03/10/2022] [Indexed: 12/04/2022] Open
Abstract
Background Ambulophobia is a type of specific phobia that involves a fear of walking. This phobia mainly affects older people, who prefer not to leave their bed or home to avoid walking on uneven surfaces and reduce the risk of falling. The problem seems to be very important in terms of public health and the organization of long-term care, as Poland has one of the highest rates of elderly population growth. Objectives The aim of the study was to determine the prevalence of ambulophobia among patients of long-term care facilities in Poland and to identify factors increasing the risk of this specific phobia in the study group. Material and Methods The study was conducted between January and July 2021. Data collected from 379 patients of 16 long-term care facilities located in Poland were analyzed. The study used the diagnostic criteria for specific phobias according to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, and standardized questionnaires such as MMSE, GDS-16, DOS and ADL. The χ2 test was used to test the significance of differences (p = 0.05). Results The prevalence of ambulophobia in the study group was 30.1%. Ambulophobia significantly more often concerned the female sex (37.7%) and people over 70 years of age (42,1%). Factors such as depression, Parkinson's disease, orthostatic hypotonia, a history of falling or being a witness to another person falling, and disability of at least a moderate degree increased the likelihood of ambulophobia. Conclusions Based on the obtained results, it was found that the protective factors in the development of ambulophobia are male sex, younger age, high independence, fewer drugs used per day and no previous falls or seeing another person fall.
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Affiliation(s)
- Michał Górski
- Doctoral School of the Medical University of Silesia in Katowice, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
- *Correspondence: Michał Górski
| | - Marta Buczkowska
- Department of Toxicology and Health Protection in the Occupational Environment, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Krzywkowska
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Beata Całyniuk
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Karolina Górska
- Institute of Special Pedagogy, School and Teacher Education, Pedagogical University of Cracow, Cracow, Poland
| | - Krzysztof Buczkowski
- Department of General and Oncological Surgery, City Hospital of Siemianowice Śla̧skie, Siemianowice Slaskie, Poland
| | - Joanna Fojcik
- Department of Psychiatric Rehabilitation in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mateusz Grajek
- Department of Public Health, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
| | - Renata Polaniak
- Department of Human Nutrition, Faculty of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland
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Musa Salech G, Lillo P, van der Hiele K, Méndez-Orellana C, Ibáñez A, Slachevsky A. Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia. Front Neurol 2022; 12:734251. [PMID: 35095710 PMCID: PMC8792989 DOI: 10.3389/fneur.2021.734251] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD. Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (<2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology-Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables. Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, p = 0.02) and disinhibition (β = 0.29, p = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, p < 0.001), deficits in executive function (β = -0.36, p = 0.002), and lack of emotion recognition (β = 0.28, p = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, p < 0.001). Conclusions: The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.
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Affiliation(s)
- Gada Musa Salech
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Departamento de Neurología, Clínica Universidad de los Andes, Santiago, Chile
| | - Patricia Lillo
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Neurology South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Unidad de Neurología, Hospital San José, Santiago, Chile
| | - Karin van der Hiele
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | | | - Agustín Ibáñez
- Cognitive Neuroscience Center (CNC), National Scientific and Technical Research Council (CONICET), Universidad de San Andrés, Buenos Aires, Argentina
- The Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
- Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Institute of Biomedical Sciences (ICBM), Neurosciences Department, East Neuroscience Department, Faculty of Medicine, University of Chile, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN), Department of Neurology, Hospital del Salvador & University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Elhassanien MEM, El-Heneedy YAE, Ramadan KM, Kotait MA, Elkholy A, Elhamrawy MY, Bahnasy WS. Gait and balance impairments in patients with subcortical vascular cognitive impairment. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-021-00293-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Subcortical vascular cognitive impairment (SVCI) is a subtype of vascular cognitive impairment associated with extensive cerebral small vessel diseases (CSVDs) imaging biomarkers. The objectives of this work were to study the existence and patterns of gait and balance impairments in patients with SVCI due to CSVDs.
Methods
The study was conducted on 28 newly diagnosed SVCI patients and 22 healthy control subjects (HCS) submitted to the advanced activity of daily living scale (AADLs), Berg balance test (BBT), Montreal Cognitive Assessment Scale (MoCA), computerized dynamic posturography (CDP), vision-based 3-D skeletal data gait analysis, and brain MRI volumetric assessment.
Results
SVCI patients showed a significant decrease in AADLs as well as total cerebral white matter volume, total cerebral cortical volume, and mean cortical thickness which were proportional to the degree of cognitive impairment as measured by the MoCA score. Regarding CDP analysis, patients with SVCI revealed prolongation of cancelation time and spectral power for mid- and high frequencies in dynamic positions. In respect to gait analysis, there were significant decreases in mean stride length and mean cadence as well as increases in mean step width and left to right step length difference in the SVCI group compared to HCS while doing a single task. These variables get highly significant during the dual-task performance with a p value < 0.001 for each one.
Conclusion
Patients with SVCI suffer from gait and balance impairments that are proportional to the severity of their cognitive decline and greatly impair their ADLs.
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Zhang Y, Liu P, Pan Y, Li Y, Zhang L, Li Y, Ma L. Reliability and Validity of the Function Impairment Screening Tool in Chinese Older Adults. Front Med (Lausanne) 2021; 8:720607. [PMID: 34722565 PMCID: PMC8548427 DOI: 10.3389/fmed.2021.720607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Physical function gradually decreases with age in older adults, affecting their independence and quality of life and leaving them prone to adverse outcomes. Despite the importance of assessing function for older adults, most studies have focused on disability and paid less attention to functional impairment. Thus, given the lack of valid and practical methods for evaluating functional impairment for older adults, we developed the function impairment screening tool (FIST) using the Delphi method. Objective: This study aimed to evaluate the reliability and validity of the FIST in Chinese older adults. Methods: A total of 489 participants aged 60 years or older, and who had completed the FIST were included. A subgroup of 50 participants completed the FIST a second time, 1 week after the first round, and the test–retest reliability was evaluated using the intraclass correlation coefficient (ICC). Reliability was tested using Cronbach's alpha. Validity was examined using exploratory factor analysis. Criterion-related validity was assessed using correlations between the FIST and the Barthel Index activities of daily living (ADL), Lawton, and Brody instrumental activities of daily living (LB-IADL). Results: The Cronbach's alpha coefficient for the FIST was 0.930 (P < 0.001). The test–retest reliability was good, with an ICC of 0.928 (95% confidence interval [0.874, 0.960]). Exploratory factor analyses revealed one factor accounting for 60.14% of the scale's variance and the load values of every item were >0.4 (0.489–0.872). The correlation coefficient was 0.572 (P < 0.001) between the FIST score and ADL, and was 0.793 (P < 0.001) between the FIST score and IADL. The FIST score was positively correlated with walking speed (r = 0.475, P < 0.001) and grip strength (r = 0.307, P < 0.001), and negatively correlated with age (r = −0.588, P < 0.001) and Fried frailty phenotype (r = −0.594, P < 0.001). Conclusion: The FIST is a reliable and valid instrument for assessing physical function impairment in older adults.
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Affiliation(s)
- Yaxin Zhang
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Pan Liu
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yiming Pan
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Zhang
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yun Li
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lina Ma
- Department of Geriatrics, China National Clinical Research Center for Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Tavares DMDS, Oliveira NGN, Oliveira NN, Ikegami ÉM. Factors associated with the occurrence of falls among older people with and without cataracts: Structural equation modelling analysis. J Clin Nurs 2021; 30:2634-2645. [PMID: 33434369 DOI: 10.1111/jocn.15640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/11/2020] [Accepted: 12/31/2020] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community-dwelling older adults according to self-reported cataracts. BACKGROUND Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis. DESIGN AND METHOD This is a cross-sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed. RESULTS The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls. CONCLUSION The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts. RELEVANCE TO CLINICAL PRACTICE The expanded understanding of the factors associated with falls among community-dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events.
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Affiliation(s)
- Darlene Mara Dos Santos Tavares
- Department of Nursing Education and Community Health Nursing Undergraduate Program, Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Nayara Gomes Nunes Oliveira
- Department of Nursing Education and Community Health Nursing Undergraduate Program, Federal University of Triângulo Mineiro, Uberaba, Brazil
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Tavares DMDS, Oliveira NGN, Marmo FAD, Meneguci J. Using structural equation modeling in the understanding of functional disability in older adults. Rev Lat Am Enfermagem 2021; 29:e3451. [PMID: 34190942 PMCID: PMC8253352 DOI: 10.1590/1518-8345.4555.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 11/12/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze functional disability and its associated factors among community-dwelling older adults. METHOD a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. RESULTS the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. CONCLUSION the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.
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Affiliation(s)
| | | | - Flavia Aparecida Dias Marmo
- Universidade Federal do Triângulo Mineiro, Departamento de
Enfermagem em Educação e Saúde Comunitária, Uberaba, MG, Brazil
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Eldin AESAMT, Bahnasy WS, Dabees NL, Fayed HAER. Cognitive and balance impairments in people with incidental white matter hyperintensities. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00228-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
White matter hyperintensities (WMHs) is the most frequent type of cerebral small vessel diseases and a common incidental finding in MRI films of the geriatric population. The objectives of this work were to study the existence of occult cognitive and balance impairments in subjects with accidentally discovered WMHs.
Methods
The study was conducted on 44 subjects with accidentally discovered WMHs and 24 non-WMHs subjects submitted to the advanced activity of daily living scale (AADLs), a neurocognitive battery assessing different cognitive domains, Berg balance test (BBT), computerized dynamic posturography (CDP), and brain MRI diffusion tensor tractography (DTT).
Results
WMHs subjects showed a significant decrease in AADLs as well as visual and vestibular ratios of CDP. Regarding the neurocognitive battery, there were significant decreases in MoCA as well as arithmetic test and block design of Wechsler adult intelligence scale-IV in WMHs compared to non-WMHs subjects’ groups (p value < 0.001). Concerning Wisconsin Card Sorting subtests, each preservative response, preservative errors, non-preservative errors and trials to complete the 1st category showed a highly significant increase in WMHs compared to non-WMHs subjects (p values < 0.001). DTT showed a substantial reduction in fractional anisotropy (FA) of each corticospinal tract, thalamocortical connectivity, and arcuate fasciculi.
Conclusion
Subjects with WMHs have lower cognitive performance and subtle balance impairment which greatly impair their ADLs.
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Oliveira NGN, Tavares DMDS. Active ageing among elderly community members: structural equation modeling analysis. Rev Bras Enferm 2020; 73:e20200110. [PMID: 33111807 DOI: 10.1590/0034-7167-2020-0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/05/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to propose a structural model of active ageing among elderly community members based on the World Health Organization's theoretical framework and to identify the most relevant determinants of active ageing to the proposed model. METHODS a cross-sectional and analytical study conducted with 957 elderly community members. Confirmatory factor analysis and structural equation modeling were performed. RESULTS the final measurement model was composed of the six determinants of active ageing: behavioral (R²=0.66); personal (R²=0.74); physical environment (R²=0.70); social (R²=0.77); economic (R²=0.44); and social and health services (R²=0.95). The last one showed good quality of adjustment: χ2/gl=3.50; GFI=0.94; CFI=0.92; TLI=0.90; RMSEA=0.05. By analyzing the trajectories between determinants and active ageing, the most representative was social and health services active ageing (λ=0.97; p<0.001). CONCLUSION satisfaction with access to health services and positive self-assessment of health status were the factors that most contributed to active ageing in this population.
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Assis APM, de Oliveira BTN, Gomes AL, Soares ADN, Guimarães NS, Gomes JMG. The association between nutritional status, advanced activities of daily living, and cognitive function among Brazilian older adults living in care homes. Geriatr Nurs 2020; 41:899-904. [PMID: 32653259 DOI: 10.1016/j.gerinurse.2020.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/18/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
Institutionalized older adults are at greater risk of malnutrition, which is associated with cognitive impairment. This study investigated the association between nutritional status, advanced activities of daily living (AADL), and cognitive function among Brazilian older adults living in care homes. This cross-sectional study was conducted on 95 older adults (73.3 ± 12.5 years). Socio-demographic variables, cognitive function (measured by Mini Mental State Examination - MMSE), AADL, Mini Nutritional Assessment (MNA), and anthropometric variables were assessed. Regarding MNA, 37.8% were malnourished, 47.3% were at risk of malnutrition, and 14.9% were well-nourished. Malnourished participants (37.8%) and those with fewer number of AADL (82.3%) showed cognitive decline (MMSE < 24) (p = 0.000 and 0.030, respectively). Inadequate waist-hip ratio was associated with cognitive decline (OR 9.3; 95% IC, 9.06 - 9.85; p = 0.03). Nutritional status and AADL were associated with cognitive function. Nutritional assessment helps to early identify malnutrition and possibly to prevent cognitive impairment.
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Affiliation(s)
| | | | - Arlindo Leandro Gomes
- Instituto Federal do Sudeste de Minas Gerais, Campus Barbacena, Barbacena, MG, Brazil
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Elhassanien MEM, Rashed KH, Bahnasy WS, El-Heneedy YAE, El-Seidy EAS, Tomoum MO, Ramadan KM, Kotait MA, Amer RAR, ELAhwal SA. Essential tremor: what is beyond the oscillatory monosymptomatic illness? THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2020. [DOI: 10.1186/s41983-020-00200-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Veloso MV, Sousa NFDS, Medina LDPB, Barros MBDA. Desigualdades de renda e capacidade funcional de idosos em município do Sudeste brasileiro. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200093. [DOI: 10.1590/1980-549720200093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivo: Estimar a magnitude das desigualdades de renda nas prevalências de dependência funcional em atividades básicas e instrumentais da vida diária (ABVDs e AIVDs, respectivamente) e no abandono de atividades avançadas (AAVDs). Métodos: Estudo transversal, de base populacional, desenvolvido com dados de amostra de 986 idosos de inquérito de saúde realizado no município de Campinas, São Paulo, em 2014/15. Foram estimadas as prevalências de dependência funcional em ABVDs e AIVDs e de abandono das AAVDs segundo a renda familiar mensal per capita, bem como desenvolvidas análises de regressão múltipla de Poisson para estimar razões de prevalência (RPs) ajustadas por sexo e idade. Resultados: Não houve associação significativa entre renda e dependência funcional em ABVDs. Das sete AIVDs analisadas, cinco apresentaram maior prevalência de dependência no estrato de menor renda, com destaque para o uso de telefone (RP = 3,50), o controle do uso de remédios (RP = 2,40) e o uso de transporte (RP = 2,35). O abandono de AAVDs foi maior entre os idosos de menor renda em todas as atividades analisadas, com maiores desigualdades observadas no contato por carta, telefone e e-mail (RP = 3,76), no uso de internet (RP = 3,34), em dirigir veículos (RP = 2,85) e na visita a familiares (RP = 2,77). Conclusão: As amplas desigualdades detectadas entre estratos de renda quanto à capacidade funcional nas AIVDs e no abandono das AAVDs ressaltam a importância da plena implementação e manutenção de políticas e programas voltados à proteção social de idosos, focando, em especial, os segmentos socialmente mais vulneráveis, na perspectiva de se atingir um patamar populacional mais equânime de um envelhecimento ativo, participativo e independente.
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