INTRODUCTION: Elderly people who are not capable of performing the basic activities of daily living (ADL) represent a fragile population at greater risk for morbidity and mortality. In order to better describe the size and characteristics of the non self-sufficient population in Italy, we evaluated data from the Argento Study, a survey conducted in 2002 in 11 Italian regions. MATERIALS AND METHODS: A sample of 210 non-institutionalised elderly individuals aged >65 years was selected in each region (310 in the Campania region) by the cluster sampling technique. Home interviews were performed using a standardised questionnaire which included 6 questions on ADL. Participants were considered to have a severe level of dependence if unable to perform any of the 6 activities of daily living independently, partially dependent if able to perform only 1-5 activities independently, and self-sufficient if able to perform all of the activities. A multivariate analysis was performed to evaluate risk factors associated with functional dependence. RESULTS: Complete information regarding ADLs was available for 2,355 (99%) of the interviewed subjects. Of these, 78% (95% CI 76-80%) were found to be self-sufficient, 19% (95% CI 18-22%) partially dependent and 3% (95% CI 1.9-3.2%) severely dependent. Twenty percent of self sufficient subjects and 18% of partially dependent subjects lived alone. Multivariate analysis showed a statistically significant association between being either partially or severely dependent and the following factors: age >75 years (OR 2.8), female sex (OR 1.5), having >2 chronic disorders, (OR 2.8), history of ictus (OR 2.8), having a cognitive disorder (OR 2.6), vision problems (OR 2.3) and hearing problems (OR 1.9). DISCUSSION: These results highlight the presence of a substantial number of partially dependent elderly people that live in the community and that have numerous medical problems and a high frequency of cognitive disorders. It is essential that these fragile elderly subjects be identified, through the active involvement of general practitioners, so that the necessary measures may be undertaken to improve quality of life and of emergency interventions (for example, during heat waves).
INTRODUCTION: Elderly people who are not capable of performing the basic activities of daily living (ADL) represent a fragile population at greater risk for morbidity and mortality. In order to better describe the size and characteristics of the non self-sufficient population in Italy, we evaluated data from the Argento Study, a survey conducted in 2002 in 11 Italian regions. MATERIALS AND METHODS: A sample of 210 non-institutionalised elderly individuals aged >65 years was selected in each region (310 in the Campania region) by the cluster sampling technique. Home interviews were performed using a standardised questionnaire which included 6 questions on ADL. Participants were considered to have a severe level of dependence if unable to perform any of the 6 activities of daily living independently, partially dependent if able to perform only 1-5 activities independently, and self-sufficient if able to perform all of the activities. A multivariate analysis was performed to evaluate risk factors associated with functional dependence. RESULTS: Complete information regarding ADLs was available for 2,355 (99%) of the interviewed subjects. Of these, 78% (95% CI 76-80%) were found to be self-sufficient, 19% (95% CI 18-22%) partially dependent and 3% (95% CI 1.9-3.2%) severely dependent. Twenty percent of self sufficient subjects and 18% of partially dependent subjects lived alone. Multivariate analysis showed a statistically significant association between being either partially or severely dependent and the following factors: age >75 years (OR 2.8), female sex (OR 1.5), having >2 chronic disorders, (OR 2.8), history of ictus (OR 2.8), having a cognitive disorder (OR 2.6), vision problems (OR 2.3) and hearing problems (OR 1.9). DISCUSSION: These results highlight the presence of a substantial number of partially dependent elderly people that live in the community and that have numerous medical problems and a high frequency of cognitive disorders. It is essential that these fragile elderly subjects be identified, through the active involvement of general practitioners, so that the necessary measures may be undertaken to improve quality of life and of emergency interventions (for example, during heat waves).