Arranjo domiciliar e a evolução da capacidade funcional de idosos: um estudo longitudinal

Abstract

This research aimed to compare the evolution of the functional capacity among elderly people who live alone, accompanied and who had changes in their household arrangements during the period between 2005 and 2012, adjusted for age, sex, marital status, income, education and number of morbidities. We also aim at verifying the determinants of the household arrangements of the elderly. This is a longitudinal study conducted in Uberaba-MG. Data collection occurred in 2005, 2008 and 2012. 623 elderly people participated in this study. The instrument utilized was the Brazilian Multidimensional Functional Assessment Questionnaire (BOMFAQ). A descriptive statistical analysis was performed by means of the distribution of absolute frequencies and percentages. To compare the evolution of the functional capacity scores of the groups, according to the dynamics of their household arrangements, we resorted to the analysis of mixed models, which was also used for the adjustments (p<0.05). To verify the determinants of the household arrangements we used the multinomial logistic regression (p<0.05). Among the elderly respondents: 34 (5.5%) lived alone, 475 (76.2%) lived accompanied and 114 (18.3%) had their household arrangement changed during the period. In both groups, there was a predominance of female individuals, aged between 60 and 70 years having from one to four years of study. Most seniors in the three groups had an income of between one and three minimum wages throughout the period of the research with an increase in the distribution of individuals in this income group during this stretch of time. In the three periods studied, most of the seniors who changed their living arrangements had no partner, unlike those who did not live alone. None of those who lived alone had a partner (100%).Concerning the number of morbidities, in 2005, there was a predominance of individuals with one or two diseases in the three groups. In the subsequent segments, most had more than four comorbidities. It is noteworthy that those who changed their household arrangement had the highest percentage of morbidities. The elderly who lived alone showed the best scores of functional capacity during the period. However, this group had the greatest functional decline compared to those who lived accompanied (p=0.075) and those who changed their household arrangements (p=0.381) even though there was no significant difference. It was discovered that the explanatory variables of the mean decrease in the functional capacity scores were increasing age (p<0.001) and the greater number of morbidities (p<0.001). Regarding the determinants of the household arrangement, it was found that elderly men were approximately 75% less likely to live alone (p = 0.007) and 61% less likely to change their household arrangement when compared to women (p=0.005).The household arrangement of individuals who earn less than the minimum wage are 72% less probable to change than that of the ones who earn more than three minimum wages (p=0.034). Conclusion: the living arrangement did not influence the evolution of the functional capacity of the elderly, being the increase in age and the greater number of diseases the variables that contributed to their functional decline. The determinants of the living arrangements were gender and income. The knowledge obtained from this research could support public health policies that aim to assist the elderly in different contexts in terms of living arrangements.