Author(s): Silva,Adriana Letícia de Andrade ; Chaimowicz,Flávio ; Dias,Rosângela Correa ; Freitas,Sílvia Nascimento ; Nascimento,Raimundo Marques ; Machado-Coelho,George Luiz Lins
Date: 2008
Origin: Oasisbr
Subject(s): Elderly, functional assessment, dependency, Health Assessment Questionnaire, Brazilian version of the Multidimensional Functional Assessment Questionnaire.
BACKGROUND: Independence level of elderly persons is highly associated to the ability to overcome deficits in cognition, humor, mobility and communication capacity domains and can be measured by instruments which appraise need of help to perform daily living activities.
OBJECTIVE: To assess characteristics of the Brazilian version of Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire (BOMFAQ) and the version in Portuguese of the Health Assessment Questionnaire (HAQ) to identify functional dependency.
METHODS: Cross-sectional study of a random sample of community-dwelling older people (aged 60 and over) in Ouro Preto, 2002. The elderly people with "much difficulty" or "unable" to perform at least one activity of daily living were considered dependent. The causes of dependence were grouped into the following domains: mobility, mental health, sense organs according to medical examination and weight gain. Statistical analysis was made through the Chi-square test.
RESULTS: 102 elderly persons were assessed through medical examination, with 89 of them classified as dependent and 13 as controls, i.e., independent. The HAQ and the BOMFAQ presented sensitivity of 58% and 83%, specificity of 85% and 69%, positive prediction values of 79% and 73% and negative of 67% and 81%, respectively. The HAQ showed good sensitivity, specificity and prediction values to identify dependency in the mobility domain. The BOMFAQ demonstrated good or excellent sensitivity, but low specificity and positive prediction values in every domain. The tests presented good intra-observer accuracy, but low inter-observer accuracy.
CONCLUSION: The HAQ is adequate for identifying functional dependency in the mobility domain in a general population of elderly persons. Due to its low specificity, the BOMFAQ can overestimate the prevalence of dependency. Low inter-observer accuracy must be considered in the planning of the studies that use these instruments.
