Keywords: Family medicine, aging, functional independence, frailty, cognitive status

Background:

Increase in elderly population, loss of functional independence and frailty have become significant clinical problems in primary health. Especially in individuals aged 80 and over, these conditions are closely related to cognitive decline, malnutrition, depression, and increased care needs.

Research questions:

1.Is there a relationship between functional independence and frailty in individuals aged 80 and over?

2.Are cognitive status, nutritional status, and depression related to functional independence in individuals aged 80 and over?

Method:

This study is a single-center, descriptive study that retrospectively reviewed the files of individuals aged 80 and over registered at the Van Gürpınar State Hospital Healthy Aging Unit. Functional independence was assessed using Lawton–Brody Activities of Daily Living Scale, frailty using Clinical Frailty Scale, and cognitive status using Mini Mental State Examination. Relationships between functional independence and categorical variables were analyzed using the chi-square test. Continuous or ordinal variables were analyzed using Spearman correlation analysis. Binary logistic regression analysis was performed with Lawton–Brody ADL as dependent variable to determine factors associated with functional independence.

Results:

Functional dependence was found to be statistically significantly associated with cognitive impairment, impaired nutritional status, and depression. Cognitive impairment was present in 71.0% of functionally dependent individuals, while 68.8% of functionally independent individuals had normal cognitive function (p = 0.002). Impaired nutritional status was found in 74.2% of functionally dependent individuals and 25.0% of independent individuals (p < 0.001). A strong negative correlation (r = −0.658; p < 0.001) was found between functional independence and frailty; moderate to strong correlations were observed with cognitive status, nutritional status, and depression.

Conclusions:

This study demonstrates that functional independence loss and frailty are prevalent among individuals aged 80 and older and are closely related to cognitive status. The routine implementation of comprehensive geriatric assessments in primary care is critical for improving early intervention and care outcomes.

Points for discussion: