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. © 2023, Emerald Publishing Limited.