Clinical Interventions in Aging (Nov 2019)
Decreased Autonomy In Community-Dwelling Older Adults
Abstract
Sergio Sánchez-García,1 Carmen García-Peña,2 Eliseo Ramírez-García,1 Karla Moreno-Tamayo,1 Guillermo Rafael Cantú-Quintanilla3 1Epidemiological Research Unit and Health Services, Aging Area, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico; 2Research Division, Instituto Nacional de Geriatría, Mexico City, Mexico; 3Interdisciplinary Centre for Bioethics, Universidad Panamericana, Mexico City, MexicoCorrespondence: Sergio Sánchez-GarcíaEpidemiological Research Unit and Health Services, Aging Area, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Avenida Cuauhtémoc No. 330. Edificio CORSE, Tercer Piso. Col. Doctores, Alcaldía Cuauhtémoc, Ciudad de México 06720, MéxicoTel/fax +52 55 5627-6900 ext. 21846, 21847Email [email protected]: The present study aims to explore characteristics associated with low perception of autonomy among community-dwelling older adults.Patients and methods: This original research was derived from a cross-sectional study based on the study COSFOMA with information from 1,252 (60 years and older) community-dwelling older adults whose data was obtained through a questionnaire that included sociodemographic characteristics, as well as different scales of geriatric assessment. The perception of autonomy was evaluated with the autonomy sub-scale of the Quality of Life Scale of Older Adults from the World Health Organization (World Health Organization Quality of Life of Older Adults, WHOQOL-OLD).Results: The mean (SD) age of the 1,252 community-dwelling older adults participating in the study was 68.5 (7.2) years. The average perception of autonomy was 65.3 (18.2) points out of 100. In the final logistic regression model, schooling <6 years (Odds Ratio, OR = 2.1, 95% Confidence Interval, CI = 1.5–2.9), low social support (OR = 1.6, 1.2–2.2), low spirituality (OR = 2.6, 95% CI = 1.9–3.4), presence of cognitive impairment (OR = 1.9, 95% CI = 1.4–2.5), anxiety (OR = 1.7, 95% CI = 1.2–2.5), and limitation in activities of daily living (ADL) (OR = 1.6, 95% CI = 1.1–2.2) were statistically associated with the presence of low autonomy in older adults.Conclusion: The perception of autonomy among community-dwelling older adults is moderate. Social support and spirituality, as well as cognitive impairment, anxiety, and limitations in ADL, play a significant role for degree of perceived autonomy in this population. Health professionals can use this information to promote participation in decision-making processes through programs that improve quality of life.Keywords: elderly, bioethics, Quality of Life, activities of daily living, social support
