Declínio da mobilidade e sintomas depressivos e o uso dos serviços de saúde da atenção primária por pessoas idosas

Abstract

Population aging poses important challenges to health systems, particularly regarding the maintenance of functional capacity and mental health among older adults. This study analyzed the association between reduced functional mobility and depressive symptoms with the use of Primary Health Care (PHC) services. This cross-sectional study included 794 older adults participating in the ICOPE-Brazil Feasibility study. Functional mobility was assessed using the Timed Up and Go test (TUG) and depressive symptoms using the Geriatric Depression Scale (GDS-15). Outcomes were dissatisfaction with PHC services and difficulty obtaining medical consultations. Crude and adjusted logistic regression models were performed controlling for sex, age, comorbidities, and social support. In individual models, both reduced mobility and depressive symptoms were associated with higher dissatisfaction and greater difficulty in obtaining consultations. In the fully adjusted model, depressive symptoms remained associated with dissatisfaction with PHC services (OR=1.51; 95%CI 1.01–2.24), whereas reduced mobility remained associated with difficulty obtaining medical consultations (OR=1.58; 95%CI 1.12–2.22). These findings suggest that mobility limitations and depressive symptoms influence PHC service use through distinct mechanisms, highlighting the importance of integrated strategies addressing both functional capacity and mental health in older adults.