[Chronic diseases and functional limitation in older adults: a comparative study in seven cities of Latin America and the Caribbean]

Abstract

Objective: To identify the relationship between selected chronic diseases and the presence of disability in inhabitants 60 years old or older in seven cities of Latin America and the Caribbean.

Methods: In 2000 and 2001 a descriptive cross-sectional study was conducted with a sample of 10 891 persons 60 or older in seven cities: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. This research was part of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) project (known as the "SABE project"). The dependent variables in the study were difficulty in performing basic activities of daily living, and difficulty in performing instrumental activities of daily living. Compiled from self-reports, the independent variables were: age, sex, educational level, living alone or with other person(s), self-assessed health, and the presence or not of hypertension, diabetes mellitus, cancer, chronic obstructive pulmonary disease, ischemic heart disease, cerebrovascular diseases, and osteoarthritis. The presence of depression and cognitive impairment in the participants was evaluated, and body mass index was also calculated. To compare the degree of influence of the different variables on disability, a standardized coefficient for each association was calculated.

Results: In the seven cities studied, the variables that showed a direct association with difficulty in carrying out basic activities of daily living and instrumental activities of daily living were: suffering from a higher number of noncommunicable diseases, from cerebrovascular diseases, from osteoarthritis, or from depression; being older; being female; rating one's own health as bad; and experiencing cognitive impairment. In general the strongest associations were between difficulty in carrying out instrumental activities of daily living and depression, being older, reporting one's health as bad, and the presence of cerebrovascular diseases, osteoarthritis, or cognitive impairment.

Conclusions: Our research provides the first systematized description of the associations between disability and chronic noncommunicable diseases in older adults in Latin America and the Caribbean. Difficulties that older adults have in carrying out instrumental activities of daily living are the first ones to appear. Therefore, follow-up mechanisms should be established that make possible the early detection of this type of disability.