Sociodemographic Factors and Risk Indicators for Functional Impairment in Elderly Patients in Primary Care Settings: A Cross-sectional Study
Alejandra Sandoval-Morales
Clínica de Medicina Familiar “División del Norte”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Daniel Lopez-Hernandez *
Clínica de Medicina Familiar “División del Norte”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Emmanuel Melgarejo-Estefan
Delegación Regional Zona Poniente, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México.
Hector Isaac Rocha-Gonzalez
Sección de Estudios de Posgrado e Investigación (SEPI). Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.
Leticia Brito-Aranda
Centro de Investigación y de Educación Continua, S.C. Estado de México, México.
Diana Cecilia Lara-Almaraz
Clínica de Medicina Familiar “Villa Álvaro Obregón”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Liliana Grisel Liceaga-Perez
Clínica de Medicina Familiar “Guerrero”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Rita Gabriela Leon-Jimenez
Clínica de Especialidades “Indianilla”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Armando Segura-Gonzalez
Hospital Regional “Presidente Benito Juárez”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Oaxaca, México.
Guadalupe Jacqueline Flores-Morales
Centro de Investigación y de Educación Continua, S.C. Estado de México, México.
Perla Veronica Salinas-Palacios
Centro Médico Nacional “20 de noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Berenice Mancilla-Del-Alto
Clínica de Medicina Familiar “División del Norte”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Luis Beltran-Lagunes
Centro de Investigación y de Educación Continua, S.C. Estado de México, México.
Dora Orquidea Gamboa-Martinez
Clínica de Medicina Familiar “División del Norte”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Brenda Mariana Zambrano-Molina
Clínica de Medicina Familiar “Dr. Javier Domínguez Estrada” Chapultepec, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Yadira Guadalupe Viveros Alanis
Clínica de Medicina Familiar “División del Norte”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Edgar Esteban Torres-García
Subdirección de Prevención y Protección a la Salud, Dirección Médica, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Cuidad de México, México.
Abraham Espinoza-Perdomo
Centro de Investigación y de Educación Continua, S.C. Estado de México, México.
Rebeca Martinez-Salinas
Hospital General de Zona 2A, Órgano de Operación Administrativa Desconcentrada Distrito Federal Sur, Instituto Mexicano del Seguro Social, Ciudad de México, México.
*Author to whom correspondence should be addressed.
Abstract
Aims: To identify and describe sociodemographic characteristics of elderly subjects with functional impairment and their associated factors.
Study Design: it was designed a descriptive, and cross-sectional study with an analytical approach.
Place and Duration of Study: Ambulatory Care Medical Unit. The study was conducted from July 1st to December 31st, 2024, with Mexican elderly patients who attended outpatient consultations in the Family Medicine Specialty and General Medicine departments at the "División del Norte" Family Medicine Clinic, ISSSTE, in Mexico City, Mexico. The data was collected from October to December, 2024.
Methodology: The data collection was conducted using six questionnaires: 1) a sociodemographic factors questionnaire, 2) the AMAI questionnaire, 3) the Barthel Index for Activities of Daily Living, 4) the Katz Index for Activities of Daily Living, 5) the Lawton and Brody for Activities of Daily Living Scale, and 6) the Geriatric Depression Scale of Yesavage. The questionnaires were interviewer-administered. The protocol was approved by two committees (The Research Committee and the Ethics Committee in Research of the Family Medicine Clinic "División del Norte"). All participants signed the informed consent form.
Results: We included 55 patients, mainly females (58.2%). The median age was higher in female patients (76.0 years old, IQR=68.5-85.75) compared to male patients (75.0 years old, IQR=70-81; p=0.767, Median Test between independent groups), but without a statistically significant difference. Females are better represented at the basic education level, while males are more inclined to hold higher education degrees and postgraduate qualifications. Males are more represented in higher socioeconomic levels, particularly Levels A/B, whereas females are more concentrated in Levels C- and E. Less than 10% of participants experienced moderate to severe functional impairment. (3.6% severe functional impairment, and 5.5% moderate functional impairment). At least 90% can bathe themselves, dress independently, use the toilet without assistance, show independence in mobility and all participants are independent in feeding themselves. For instrumental activities of daily living, less than 2% of participants exhibit maximum dependence, 85% maintain some degree of autonomy, and less than 40% achieve full independence. Sedentarism was highly prevalent (58.2%), and healthy eating habits were reported by 83.6%. Hypertension (65.5%), Type 2 Diabetes (56.4%), Overweight/Obesity (50.9%), and Dyslipidaemia (12.7%) demonstrate a significant burden of cardiovascular and metabolic diseases. The regression model indicates that the likelihood of functional dependency increases with age (beta=0.157, OR=1.170; CI 95%= 1.029-1.329, p=0.016). Additionally, elderly individuals with an alcoholism history (beta=2.359, OR=10.576; CI 95% 1.340-83.491, p=0.025) are significantly more likely to experience functional dependency. Similarly, hearing loss (beta=2.255, OR=9.536; CI 95% 1.282-70.923, p=0.028) is a risk factor of functional dependency.
Conclusion: Gender disparities are evident in education and socioeconomic status. While most participants maintain functional independence, instrumental activities of daily living present greater challenges. Sedentarism is highly prevalent, despite a majority reporting healthy eating habit. Moreover, cardiovascular and metabolic diseases impose a significant burden on diseases. Functional dependency is strongly associated with increasing age, an history, and hearing loss as well, emphasising the need for targeted interventions to promote healthy ageing and prevent disability.
Keywords: Functional impairment, non-communicable diseases, primary care