CORE SET OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH (CIF) AS AN INSTRUMENT OF EVALUATION OF THE PHYSICAL HEALTH OF COMMUNITY-DWELLING OLDER ADULTS
International Classification of Functioning, Disability and Health. Validation Studies. Aging.
Introduction: Population aging causes changes in the morbidity and mortality of the population, among which the physical health impairment is highlighted. From this perspective, there is a need of identifying instruments of evaluation capable of screening older adults potentially at risk of impairments to physical health. The International Classification of Functioning, Disability and Health (ICF) emerges as an important multidimensional assessment strategy, due to its general nature. Based on ICF, the Core Sets raised as instruments formed by categories of the ICF considered essential for the evaluation of a given health condition. In this perspective, Ruaro (2014) developed a Core Set of ICF to evaluate the physical health of the older persons. This instrument is composed of 30 categories of ICF, 14 related to body functions, 4 to body structures, 9 to activities and participation, and 3 to environmental factors. This project aims to evaluate the construct validity of the Core Set of the ICF to evaluate the physical health of the community-dwelling older adults. Methods: This was a cross-sectional study carried out in the city of Santa Cruz - RN, from March to June 2018. The sample consisted of older people living in the community, of both sexes, without cognitive impairments identified in the Leganès Cognitive Examination (PCL). The participants were evaluated in relation to socio-demographic data and anthropometric measures, self-reported health, self-report history of hospitalization and chronic diseases, and depressive symptoms. The ICF Core Set for older adult’s physical health was used to classify those with impairment of functionality in each of the ICF domains. The Mann-Whitney test and the chi-square test were used to compare medians and proportions, respectively, of the independent variables among those with and without impairment of functionality according to the ICF, considering p<0.05 and 95%CI. Results: 101 elderly people participated in the study. In the body function and activity and participation domains, we observed the worst performances, presenting respectively 90.1% and 89.1% of individuals with impairment in at least one of the categories evaluated in each domain. It was observed that for the body structure domain, the group without impairment had a higher proportion of younger people (p = 0.025) and with hupertension (p=0,037) and a lower median number of chronic diseases (p < 0.001). Moreover, the group without impairment in the body function, body structure and activity and participation domains had less depressive symptoms (p = 0.025, <0.001, 0.019, respectively). The group without impairment in the body functions domain has a higher proportion of people reporting good health status (p = 0.001). For the environmental factors, the group with elderly patients who used one or none medications presented a lower proportion of elderly patients with abdominal obesity (p < 0.001), less depressive symptoms (p = 0.038) and less chronic diseases (p < 0.001). Moreover, those classified as having satisfactory access to health services had a lower median of chronic diseases (p = 0.013).