Objective: The objective of the study was to use causal health models to assess the health and functional limitations of an institutionalized elderly population, through the study of relationships between the health dimensions described in the health models
Design: From 1997 to 1999, a prospective study was performed with closed cohort of 83 subjects of 65 or more years residing in a geriatric center in Granada City, Spain, with the average age 81.7 years (females: 83.5 years, males 77 years).
Materials and Methods: A multidimensional questionnaire was used to evaluate comorbidities, cognitive function (SPMQS), depressive symptoms (Center for Epidemiologic Studies-Depression Scale), disability, and functional limitations (Katz Index) in ADL and perceived health.
Analysis: We performed a bivariate analysis with the respective analysis of differences of proportions by the chi square. For the multivariant analysis, an explanatory binary logistic regression model was used having, as dependent variable, Basic Activities of the Daily Life in two categories: dependent and independent, this last one has been considered as a reference category.
Results: The female residents had a higher index of cognitive deficit than the males. The residents showed a high prevalence of depressive symptoms, which was more noticed among the women. A high proportion of subjects reported at least some extremity limitation with a higher incidence among the women and older subjects. On bivariated analysis, the variables: sex (p<0.009), age (p<0.01), comorbidity (p<0.002), cognitive deficit (p<0.0001), and limitations on extremities (p<0.004) were associated to functional status. Through the established associations strategy between the dimensions of health in the causal health models, we have built an explanatory logistic regression model introducing the variables in the form of blocks, staying in the single subsequent explanatory model the variables that resulted in meaningful statistic (p<0.05) in the previous model.
Conclusion: The variables included in the final equation of the logistic regression procedures that indicate as predictor of functional status were the sex (OR = 5.60)(p<0.04), cognitive deficit (OR =15.23) (p<0.001), and limitations on extremities (OR = 3.32) (p<0.05).
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