Prevalence and factors associated with functional dependency in homebound elderly people in Brazil

Introduction: Population ageing is a worldwide reality that requires attention, and a concern for healthy and functional ageing is increasingly the focus of government policies and programmes. Objective: To identify the prevalence of homebound elderly people, and the influence of sociodemographic and economic characteristics on their functional dependency. Methods: Cross-sectional study with 178 homebound elderly people assisted by a family healthcare unit in Vitoria, ES, Brazil. Functional independence was measured by the Functional Independence Measure (FIM) and the sociodemographic and economic variables were collected by a questionnaire developed by the authors. Binary logistic regression was used to determine the influence of the sociodemographic and economic characteristics on the risk of being functionally dependent. Results: Forty-eight percent of the participants were functional dependents, 80% were female, 72% belonged to the fourth age, 74% were white, 63% were widowed, 78% had retired, 90% had children, 83% had a caregiver, 52% had low education and 40% had low income. Logistic regression indicated that having a caregiver increased by 40 times the chance of being functionally dependent (OR = 40.2; 95%CI 4.8–355.4) and having between one to eight years of education decreased the chance of functional dependency (OR = 0.2; 95%CI 0.04-0.9). Conclusions: The prevalence of functional dependency was very high in this sample, and since the presence of a caregiver was the strongest and significant predictor of functional dependency, we suggest that guidance and support should be offered to caregivers, followed   by a family healthcare strategy,  to make consistent efforts with the objective of improving  functional recovery and independence of homebound elderly.