Functional status evaluation of older adults with moderate and severe unit belonging to a family health center

The purpose of this study was to assess the functional status of older adults with moderate and severe dependence from a family health center, applying scales to evaluate activities of daily living, cognitive level, educational level and caregiver burden. We evaluated 55 older adults with moderate and severe dependence. The Katz Index was used to determine the level of dependence, the Functional Independence Measure (FIM) was used for functionality and assistance provided by a third person, the Barthel Index was used to assess the independence, the Mini Mental State Examination (MMSE) was used for cognitive status and the Zarit scale was used for caregiver burden. The mean age was 84.4±7.8 years , and 74.5% of the subjects were female (25.5% male). According to the Barthel Index, 45% were classified with severe dependence; men had higher scores on the Barthel index and FIM. Cognitive impairment was present in 75% of the subjects according to MMSE, with a mean of 7.2±5.3 points. Women represented 85% of caregivers and 49% of these had greater burden. We obtained a significant correlation between motor FIM and Barthel Index (r=0.9710), cognitive FIM and MMSE (r=0.8148), and MMSE and educational level (r=0.6537). There was no correlation between age and cognition or functional independence. According to the data, most older adults with moderate and severe dependence have motor and cognitive impairment, which are correlated to the educational level of the subject.

本研究旨在评估来自家庭健康中心的中重度依赖老年群体的功能状态，通过量表对其日常生活活动能力、认知水平、受教育程度及照料者负担进行评估。本研究共纳入55名中重度依赖老年受试者。本研究采用Katz指数（Katz Index）判定依赖程度，采用功能独立性评定量表（Functional Independence Measure, FIM）评估机体功能及第三方协助需求，采用巴氏指数（Barthel Index）评定独立能力，采用简易精神状态检查表（Mini Mental State Examination, MMSE）评估认知状态，采用扎里特量表（Zarit scale）评估照料者负担。受试者平均年龄为84.4±7.8岁，其中女性占比74.5%，男性占比25.5%。依据巴氏指数结果，45%的受试者被归类为重度依赖；男性在巴氏指数及FIM量表中的得分更高。根据MMSE结果，75%的受试者存在认知障碍，平均得分为7.2±5.3分。照料者中女性占比85%，其中49%的照料者承受较重的照料负担。本研究发现运动功能FIM与巴氏指数呈显著相关（r=0.9710），认知功能FIM与MMSE呈显著相关（r=0.8148），MMSE得分与受教育程度呈显著相关（r=0.6537）。年龄与认知功能或功能独立性之间未发现显著相关性。综上，多数中重度依赖老年群体存在运动及认知功能障碍，且该障碍与受试者的受教育程度显著相关。