Functional dependence and diabetes mellitus in the elderly affiliated to the Social Health Insurance of Peru: Secondary analysis of the ENSSA-2015

Abstract

Objectives. Estimate the prevalence of functional dependence, as well as assess its association with diabetes mellitus in older adults affiliated with the Social Health Security (EsSalud) in 2015. Materials and methods. Secondary analysis of the data of the National Socioeconomic Survey of Access to Health of the EsSalud Insured 2015 (ENSSA-2015), a household survey with two-stage probabilistic sampling, nationally representative of the EsSalud affiliate population. We include seniors (60 years and older) affiliated with EsSalud. Functional dependence was assessed using the Katz index (≥ 1 point). Diabetes mellitus was assessed by participant self-reporting. We estimated adjusted prevalence ratios (aPR) for potential confounding factors using multiple log-Poisson regression. We report 95% confidence intervals (95%CI) and p values. All analyzes considered the complex sampling of ENSSA-2015. Results. We included 10,985 participants from 12,805 eligible in the analysis. The prevalence of partial and severe functional dependence was 12.9% (95%CI: 11.9%-13.8%) and 6.0% (95%CI: 5.3%-6.7%), respectively. The prevalence of functional dependence (partial or severe) in diabetics was 23% higher than that of non-diabetics, after controlling for potential confounding factors (aPR = 1.23; 95%CI 1.04-1.44; p = 0.013). An alternative model showed consistent results. Conclusions. About one in five older adults affiliated with EsSalud had some degree of functional dependence (partial or severe). Likewise, diabetes was associated with a higher probability of having functional dependence in this population.