Elderly functionality and its associated factors in a rural context of Colombia: a structural equations model

Abstract

Purpose The purpose of this study was to determine the factors associated with functionality, a clinical criterion that could predict frailty in the elderly people in a rural context. Design/methodology/approach This project is a cross-sectional descriptive analysis of 342 adults of age >60 years who are residents of Putumayo province in Colombia. Information regarding demographic characteristics, medical history, health perception and current illness was collected. The Mini-Mental State Examination (MMSE) protocol was used to perform cognitive evaluation; the Yesavage Geriatric Depression Scale was used to establish depressive symptoms; and the Hamilton Rating Scale was used to assess anxiety level. Questionnaire was used to evaluate performance on instrumental activities of daily living that lead to functional independence [daily life questionnaire (DLQ)]. The medical outcomes study scale was used to assess social parameters. Findings A moderate and negative correlation was found between the DLQ score and age (r = −0.49; 95% CI: −0.57 to −0.47), whereas a positive correlation was found with education (r = 0.17; 95% CI: 0.07–0.27). Older adults with economic independence achieved a higher score in functional performance than those with economic dependence (standardized mean difference = 0.55; 95% CI: 0.33–0.77). This study observed a moderate correlation a moderate correlation between the MMSE cognitive performance (r = 0.56; 95% CI: 0.48−0.63) and the depressive symptomatology of Yesavage Scale (r = −0.36, 95% CI: −0.44 to −0.26). Finally, the structural model determined that age (r = −0.37), economic dependence (r = −0.383) and cognitive state (r = 0.309) determine the functional component. Research limitations/implications This study provides empirical support about older adults living in rural contexts, around the functionality variable from a multidimensional approach, highlighting the sociodemographic and cognitive variables. Consequently, the policy of social support in older adults must be oriented toward the development of a range of divergent intervention strategies. Originality/value The study deals with the assessment of functionality in the elderly people from an interdisciplinary approach in the rural setting which presents a greater risk of physical and socioeconomic vulnerability. Therefore, the community, the health professionals and the government entities should help implement active aging programs for this population.