Assessing Functional Independence and Associated Factors in Older Populations of Kazakhstan: Implications for Long-Term Care
Yeskazina G. Yeshmanova A. Temirova G. Myrzakhmet E. Alibekova M. Tazhiyeva A. Ryspekova S. Abdykulova A. Nuftieva A. Abdirova T. Mombiyeva Z. Omarova I.
August-1 2025Multidisciplinary Digital Publishing Institute (MDPI)
Healthcare (Switzerland)
2025#13Issue 15
Background/Objectives: Accurately assessing the independence level of older adults using useful assessment tools is an important step toward providing them with the necessary care while preserving their dignity. These tools allow older adults to receive effective, personalized home care, which improves their quality of life. This study aimed to clarify the current prevalence of severe and complete functional dependence and associated factors among Kazakhstan’s older adults aged >60 years. Methods: This cross-sectional study was conducted in several polyclinics and geriatric service care centers in two cities of Kazakhstan from March to May 2024. Functional status was assessed by the Barthel Index. We combined the selection into two categories: total dependency and severe dependency in the category “dependent”, and moderate dependency, slight dependency, and total independence in the category “active patients”. Results: Among the 642 older people in this study, 43.3% were dependent patients, and 56.7% were active patients. The odds of severe and total functional dependence are significantly higher for frail participants (adjusted odds ratio (AOR) = 2.96, 95% confidence interval (CI) [1.70, 5.16], p < 0.001) compared to those that are not frail; eleven times higher for those at home (AOR =11.90, 95% CI [5.77, 24.55], p < 0.001) than those in nursing homes; two times higher for participants with sarcopenia (AOR =2.61, 95% CI [1.49, 4.55], p < 0.001) compared to those with no sarcopenia; and three times higher for participants with high risk of fracture (AOR =3.30, 95% CI [1.94, 5.61], p < 0.001) compared to those with low risk. The odds of having severe and total functionaldependence are significantly higher for participants with low dynamometry (AOR =1.05, 95% CI [1.03, 1.07], p < 0.001) compared to those with normal dynamometry. Conclusions: Old age, low dynamometry (for men ≤ 29 kg, for women ≤ 17 kg), frailty, being at home, high risk of fracture and osteoporosis, and sarcopenia were associated with increased risk of severe and total functional dependence.
Barthel Index , functional dependence , long-term care , risk factors
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Faculty of Medicine and Health Care, Department of Health Policy and Public Health, Kazakh National University Named After Al-Farabi, Al-Farabi 71, Almaty, 050069, Kazakhstan
Department of Nursing, Aktobe Higher Medical College Named After Hero of the Soviet Union Manshuk Mametova, Aktobe, 030006, Kazakhstan
Department of Simulation Center, Marat Ospanov West Kazakhstan Medical University, Aktobe, 030006, Kazakhstan
Department of General Medical Practice, Kazakh National Medical University Named After S.D. Asfendiyarov, 94 Tole bi, Almaty, 050069, Kazakhstan
Department of Histology, Marat Ospanov West Kazakhstan Medical University, 68 Maresieva Street, Aktobe, 030006, Kazakhstan
Department of Nursing, Kazakh National University Named After Al-Farabi, Al-Farabi 71, Almaty, Almaty, 050069, Kazakhstan
Department of Oncology, Marat Ospanov West Kazakhstan Medical University, 68 Maresieva Street, Aktobe, 030006, Kazakhstan
Department of Normal Physiology, Kazakh National Medical University Named After S.D. Asfendiyarov, 94 Tole bi, Almaty, 050069, Kazakhstan
Department of Clinical Disciplines, International Medical School, University of International Business Named After K. Sagadiev, Almaty, 050069, Kazakhstan
Department of Physical Medicine and Rehabilitation, Sports Medicine, Kazakh National Medical University Named After S.D. Asfendiyarov, 94 Tole bi, Almaty, 050069, Kazakhstan
Faculty of Medicine and Health Care
Department of Nursing
Department of Simulation Center
Department of General Medical Practice
Department of Histology
Department of Nursing
Department of Oncology
Department of Normal Physiology
Department of Clinical Disciplines
Department of Physical Medicine and Rehabilitation
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