[Dependence and necessities of non-covered services for the elderly in a health sector of Zaragoza].
BACKGROUND
Dependency to carry out the activities of daily living (ADL) and home care needs of older adults depend upon factors which are not well understood. Caregiving is mainly provided by the family. The aim of this study is to estimate the prevalence of ADL dependence and associated factors among older adults and to identify associated factors with unmet home care needs in people over age 75 in Zaragoza (Spain).


METHODS
A cross-sectional study was conducted on a representative sample of the community dwelling population over age, 75 in one Health Care District in Saragossa in 1998 (n = 351). Data were collected during a personal interview. ADL dependency was assessed by the Katz index. Home care needs were assessed using prevalent norms for desired frequency of care. Sources of informal care, socio-demographic characteristics, self-rated health and depression (Yesavage Geriatric Depression Scale) were considered independent variables. Logistic regression was used to identify factors associated with both ADL dependency and unmet home care needs.


RESULTS
Prevalence of ADL dependence is 37.3%. The variables predicting ADL dependence are the perception of poor health, depression, being a female and being over 85 years of age. The prevalence of unmet care needs among ADL dependent individuals is 22.1%. Sources of help are limited to the families. Being a woman and living alone are the stronger risk factors for unmet needs.


CONCLUSIONS
A high percentage of older adults are dependent. Informal support is insufficient and confined to the family. The social and health care system in Spain should provide to the family, emotional, financial and social support and special care for disabled people living alone and with limited material resources.
Tomás Aznar
Concepción
C
Escuela Universitaria de Ciencias de la Salud Universidad de Zaragoza C/Domingo Miral, s/n 50009 Zaragoza. ctomas@posta.unizar.es
Moreno Aznar
L A
LA
Germán Bes
C
C
Alcalá Nalváiz
T
T
Andrés Esteban
E
E
D000368:Aged; D000369:Aged, 80 and over; D002391:Catchment Area, Health; D003153:Community Health Services / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D012944:Social Support; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires