DIFICULDADE FUNCIONAL EM IDOSOS, CUIDADO E PADRÃO DE UTILIZAÇÃO DE SERVIÇOS DE SAÚDE

Abstract

Aging with quality represents a current challenge, and the scarcity of diseases no longer confers an exclusive parameter of health protection. In this way, the present study sought to analyze factors with a high degree of association with functional difficulties among Brazilian elderly. This is a cross-sectional, quantitative study with data from the National Health Survey - 2013, considering the total sample of individuals aged 60 years or older (n = 23,815). For the analysis, we considered two dependent variables that came to the grouping of questions related to Functional Difficulty (DF): Functional Difficulty for Basic Activities of Daily Living (DF-ABVD) and Functional Difficulty for Instrumental Activities of Daily Living (DF-AIVD). In the pre-exploration phase, the independent variables were selected to be followed by two analyzes: first considering socio-demographic conditions, general health, oral health and health services utilization; and the second considering general conditions, standards of care and use of oral health care services. The Waikato Environment for Knowledge Analysis software was used to perform the data analysis; the steps performed in its environment were: data set balancing through the Resample algorithm; 10-fold crossvalidation method employed to perform dimensionality reduction; later, the variables related to the dependent variables were evaluated through logistic regression. In the first analysis, the variables that presented a strong relation with DF for ABVD and AIVD were: age, with emphasis on 80 or more years (DF-ABVD OR = 2.25; DF-AIVD OR = 2.81); poor perception of the general health condition (DF-ABVD OR = 4.77; DF-AIVD OR = 2.86); need for emergency care at home (DF-ABVD OR = 3.39; DF-AIVD OR = 3.21); and hospital admission (DF-ABVD OR = 2.42; DF-AIVD OR = 2.25). The second analysis showed a direct association between the DF of the elderly and aspects of oral health, such as: presence of difficulty to feed due to problems with teeth or prostheses (DF-ABVD OR = 1.73; DFAIVD OR = 1.59) (DF-ABVD OR = 1.69) and absence of natural teeth (DF-AIVD OR = 1.64). The data allow the strengthening of planning and execution of strategies geared to the demands of the Brazilian elderly population, as well as the orientation of investments for actions aimed at the preservation and maintenance of functional capacities.