Incapacidade Funcional De Idosos Com Demência

Abstract

Resumo: Introdução: A demência corresponde a uma das principais causas de incapacidade e dependência na velhice e pode repercutir na capacidade funcional em todas as áreas de desempenho ocupacional, incluindo as atividades básicas e instrumentais de vida diária (ABVD e AIVD), o lazer, a participação social e outras. Objetivos: Caracterizar o nível de incapacidade funcional de idosos com demência e verificar a existência de correlação entre a funcionalidade e o estágio ou tipo de demência. Método: Estudo quantitativo, exploratório, de corte transversal, com amostra constituída por 25 cuidadores de idosos com demência. Para a caracterização dos participantes foram utilizados questionários estruturados e para avaliação da incapacidade funcional, a Escala de Avaliação de Incapacidade em Demência -DAD (Disability Assessment for Dementia) foi aplicada. Resultados: Identificou-se maior incapacidade no subitem AIVD. Tal achado é compatível com a literatura que discorre sobre a hierarquização do declínio funcional em idosos, iniciando-se pelas AIVD, enquanto as ABVD permanecem preservadas por um período maior de tempo.Não houve correlação significativa entre o tipo de demência, idade ou sexo e incapacidade funcional. Verificou-se por meio do coeficiente de spearman (rho = 0,87), correlação significativa de alta magnitude entre incapacidade funcional e estágio da demência (p=0,0001). Conclusão: Tais achados reiteram a relevância de priorizar a detecção precoce e prevenção do declínio funcional, que representa a manifestação de vulnerabilidade entre os idosos. Palavras-chave: Idoso, Demência, Atividades Cotidianas, Pessoas com Deficiência. Functional disability in elderly with dementiaAbstract: Introduction: Dementia represents one of the major causes of disability and dependence in old age and can affect functional capacity in all areas of occupational performance, including basic and instrumental activities of daily living (BADL and IADL, respectively), leisure, social participation and others. Objectives: To characterize the functional disability level in elderly people with dementia and verify the existence of correlation between functionality and the stage or type of dementia. Method: Quantitative, exploratory, cross-sectional study, with a sample of 25 caregivers of elderly with dementia. For the characterization of the participants were used structured questionnaires and to assess functional disability, the Disability Assessment Scale for Dementia -DAD was applied.Results: Greater incapacity was observed in the IADL sub item. This finding is compatible with the literature on the hierarchy in functional decline in the elderly: decline begins in IADL, while BADL remain unaffected for a longer period. There was no significant correlation between the type of dementia, age or gender and disability.It was verified through the Spearman coefficient (rho = 0.87), a significant correlation of high magnitude between functional disability and stage of dementia (p = 0.0001). Conclusion: Such findings reiterate the importance of ...

Accuracy of the Brazilian version of the Functional Activities Questionnaire in the screening of dementia

“…Therefore, although the instruments for measuring functional ability may be used in detecting and predicting dementia in the elderly (Barberger-Gateau et al, 1999;Juva et al, 1997), in the case of the FAQ-BR, this is not applicable. Nevertheless, it is worth emphasizing that, in evaluating the dimensional structure of the FAQ-BR (Jomar et al, 2018), three items proved to be capable of capturing one of the areas of functional ability in the elderly: Memory/Cognition (Fagundes et al, 2017;Paixão Junior & Reichenheim, 2005). Scores on the FAQ-BR showed high and statistically significant correlations with scores on the MMSE and the IQCODE-BR.…”

“…This aspect should be highlighted since it is known that, in general, it is necessary to have more than one evaluation to establish a clinical diagnosis of dementia, since, in this way, the cognitive areas affected are thoroughly described, as well as the severity of the dysfunction, the functional damage and the etiology of dementia in order to establish the appropriate treatment (Parmera & Nitrini, 2015). Another aspect that helps explain the reason for the results not being in favor of the FAQ-BR's validity of predictive criteria for dementia is the fact that the concepts (constructs) of dementia and functional capacity are not equivalent, although the important interaction between the functional status of the elderly and the cognitive area is acknowledged, since a change in this dimension entails some functional impairment (Fagundes et al, 2017;Paixão Junior & Reichenheim, 2005;WHO, 2017). Therefore, although the instruments for measuring functional ability may be used in detecting and predicting dementia in the elderly (Barberger-Gateau et al, 1999;Juva et al, 1997), in the case of the FAQ-BR, this is not applicable.…”

“…Although some tools have been developed to determine the functional ability of the elderly, the clinical diagnosis of dementia is still considered the gold standard. Characterized by the persistent cognitive decline, where primarily memory is compromised, dementia interferes significantly with the functional ability of the elderly, since its progression compromises the fulfillment of daily activities, giving rise to disabilities and functional dependency (Fagundes, Pereira, Bueno, & Assis, 2017;World Health Organization [WHO], 2017). In this way, tools that measure the functional ability of the elderly may be used to detect and predict dementia (Barberger-Gateau, Fabrigoule, Helmer, Rouch, & Dartigues, 1999;Juva et al, 1997), since the functional status interacts in such a way with the cognitive dimension that any change in this dimension involves some functional impairment (Fagundes et al, 2017;Paixão Junior & Reichenheim, 2005;WHO, 2017).…”

“…Characterized by the persistent cognitive decline, where primarily memory is compromised, dementia interferes significantly with the functional ability of the elderly, since its progression compromises the fulfillment of daily activities, giving rise to disabilities and functional dependency (Fagundes, Pereira, Bueno, & Assis, 2017;World Health Organization [WHO], 2017). In this way, tools that measure the functional ability of the elderly may be used to detect and predict dementia (Barberger-Gateau, Fabrigoule, Helmer, Rouch, & Dartigues, 1999;Juva et al, 1997), since the functional status interacts in such a way with the cognitive dimension that any change in this dimension involves some functional impairment (Fagundes et al, 2017;Paixão Junior & Reichenheim, 2005;WHO, 2017). Since knowing the diagnostic properties of the FAQ's Brazilian version (FAQ-BR) is essential to apply it to epidemiological studies -in the case of elderly absence, their inability to respond, or if there is a concern that their self-reporting is not trustworthy -this study aimed to evaluate the accuracy of FAQ-BR in screening for dementia, based on the informant's report on the elderly.…”

“…Recent studies (Jomar, Lourenço, & Lopes, 2017;Jomar, Lourenço, & Lopes, 2018) presented evidence that this version shows appropriate construct validity, bidimensional structure and internal consistency for gauging the functional ability of the elderly based on an informant's report. In evaluating its dimensional structure, in particular, the 10 items were able to capture different areas of functional ability of the elderly (Jomar et al, 2018), which are: Autonomy/Independence (Sposito, Neri, & Yassuda, 2016) and Memory/ Cognition (Fagundes et al, 2017;Paixão Junior & Reichenheim, 2005).…”