Predictors of functional status in older people living at home.

OBJECTIVE: to describe changes in functional status of community-dwelling Spanish elderly people, followed for 2 years, and to identify socio-demographic and health characteristics that predict functional change.

METHOD: we have analysed data from the first two waves of the longitudinal study, Ageing in Leganés, from a representative sample of community-dwelling people aged 65 and over (n=1273). Functional status was categorized according to a hierarchical scale as: completely functional, with functional limitations, with instrumental activities of daily living (IADL) disability, with activities of daily living (ADL) disability or deceased. Multinomial logistic regression was used to estimate the predictive value of selected 1993 socio-demographic and health status variables on 1995 functional status.

RESULTS: prevalence of disability based on dependency in any of seven ADL items was 15.5%. Half of the respondents were disabled in at least one of 10 IADLs. Some improved functionally, others deteriorated. Men were more likely to recover function while women were more likely to enter and to remain in the IADL state. Socioeconomic factors were associated to baseline functional status and to functional status change on bivariate analysis. Number of chronic diseases, presence of cognitive problems and depressive symptoms predicted transitions, even after controlling for baseline functional status.

CONCLUSION: although estimates of prevalence of disability among people over 65 are higher in Spain than in other European and North American countries, the pattern of functional changes, both in the direction of improvement and decline, seems to be similar.