Decreased Autonomy In Community-Dwelling Older Adults

Abstract

Purpose

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

Acknowledgments

The authors wish to thank the older adults who participated in this study, as well as the authorities and staff of the South and North Delegations of the Mexican Institute of Social Security (IMSS) of Mexico City for supporting this study.

Abbreviations

COSFOMA, Cohort of Obesity, Sarcopenia, and Frailty of Older Mexican Adults; WHOQOL-OLD, World Health Organization Quality of Life of Older Adults; ADL, activities of daily living; IADL, instrumental activities of daily living; IMSS, Mexican Social Security Institute; FMU, Family Medicine Unit; MOS-SSS, Medical Outcomes Study-Social Support Survey; FACIT, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being; BIA, bioelectrical impedance analysis; MMSE, Mini-Mental State Examination; CESD-R, Center for Epidemiologic Studies Depression Revised Scale; SAST, Short Anxiety Screening Test; VIFs, Variance Inflation Factors; ROC, Receiver Operating Characteristic.

Ethics Approval And Consent To Participate

The research protocol was initially approved by the National Committee of Scientific Investigation, as well as by the Ethics Committee for Health Investigation (CONBIOÉTICA-09-CEI-009-CEI-009-20160601) of the IMSS with registration number (No.2012-785-067). The written informed consent was obtained from all participants of the COSFOMA study. Additional ethical approval for the current iteration of this study was obtained from the Research Committee of the Interdisciplinary Bioethics Center (registration number CICIBUP0008/17) and from the Research Committee of the Faculty of Health Sciences (registration no. CIB-A-2017-1) of the Pan-American University.

Data Sharing Statement

Data is available upon request. Contact e-mail: [email protected].

Author Contributions

All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.