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Baracaldo-Campo HA, Pizarro-Mena RA, Cadena-Sanabria MO, Serrano-Gómez SE. A Gerontological Analysis of Functional Dependence and Socio-Familial Risk in Older Adults in Bucaramanga, Colombia. Hacia Promoc. Salud [Internet]. 2025 Sep. 1 [cited 2026 Apr. 18];30(3):21-32. Available from: https://revistasojs.ucaldas.edu.co/index.php/hacialapromociondelasalud/article/view/11760
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Abstract
Objective: To examine patterns and interconnections between functional dependence and socio-familial risk in older adults and identify critical co-occurrence patterns through network analysis within a gerontological framework. Materials and methods: A cross-sectional analysis was conducted using data from the ARENA study involving 196 older adults in Bucaramanga, Colombia. Functional status was assessed using the Barthel and Lawton indexes, while socio-familial risk was measured using the Gijón Socio-Familial Assessment Scale. Basic and instrumental activities of daily living with the highest dependency rates were cross-referenced with five social risk domains. A co-occurrence matrix was constructed and visualised using VOSviewer. Results: Functional limitations were observed in 59.69% of participants for basic activities of daily living, and in 44.90% for instrumental activities of daily living. Socio-familial risk was present in 47.45% of participants, particularly in the domains of economic hardship and limited social support. Network analysis identified three functionalsocial clusters, with stair use, telephone use and bladder control emerging as central nodes linked to multiple social risks. These intersections suggest that functional decline is embedded within broader structures of social vulnerability. Conclusion: Functional assessment of older adults should incorporate socio-environmental factors intervention and informing complexity-based approaches in gerontology and geriatrics. The findings support the integration of interdisciplinary, context-sensitive strategies to promote autonomy and dignity in ageing.
References
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22. Villarreal-Amarís G, Month-Arrieta E. Social and family, health care and functional conditions of elderly people over 65 year old in two neighborhoods of Sincelejo (Colombia). Salud Uninorte 2012;28:75–87.
23. Tamayo-Giraldo F, Baracaldo-Pinzón L, Valencia-Almonacid S, Ortega-Lenis D, Giraldo-Cárdenas M. Índice de envejecimiento activo en Colombia: análisis basado en la Encuesta Nacional de Salud, Bienestar y Envejecimiento (SABE Colombia 2015). Revista Panamericana de Salud Pública 2021;45:e69. https://doi.org/10.26633/RPSP.2021.69.
24. Li J, Zhu L, Yang Y, Li Y, Fu P, Yuan H. Prevalence and potential influencing factors for social frailty among communitydwelling older adults: a systematic review and meta-analysis. BMC Geriatr 2024;24:762. https://doi.org/10.1186/s12877-024-05365-8.
25. Wulff D, Hills T, Mata R. Structural differences in the semantic networks of younger and older adults. Sci Rep 2022;12:21459. https://doi.org/10.1038/s41598-022-11698-4.
26. Chen S, Wang T, Bao Z, Lou V. A Path Analysis of the Effect of Neighborhood Built Environment on Public Health of Older Adults: A Hong Kong Study. Front Public Health 2022;10:861836. https://doi.org/10.3389/fpubh.2022.861836.
27. Gripko M, Joseph A. The Role of the Built Environment in Supporting Older Adults’ Engagement: A Narrative Literature Review. HERD: Health Environments Research & Design Journal 2024;17:329–53. https://doi.org/10.1177/19375867241250320.
28. Wilson G, Gates J, Vijaykumar S, Morgan D. Understanding older adults’ use of social technology and the factors influencing use. Ageing Soc 2023;43:222–45. https://doi.org/10.1017/S0144686X21000490.
29. Baracaldo-Campo H, Martínez-Contreras L. Contextos con perspectiva social en el envejecimiento. In: Pérez-Sanabria O, Flores-Cerqueda S, Quintero-Romero S, Alzate-Peralta L, editors. Enfoques transdisciplinarios sobre el envejecimiento y la agenda 2030: para el desarrollo sostenible en Iberoamérica, vol. Volumen II. Primera Edición, Guayaquil, Ecuador: Instituto Superior Universitario Bolivariano de Tecnología; 2022, p. 335–428.
30. Ostaszkiewicz J, Dickson-Swift V, Hutchinson A, Wagg A. A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC Geriatr 2020;20:266. https://doi.org/10.1186/s12877-020-01673-x.
31. Swan L, Warters A, O’Sullivan M. Socioeconomic Disadvantage is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Findings from the English Longitudinal Study of Ageing. J Frailty Aging 2022;11:398–406. https://doi.org/10.14283/jfa.2022.32.
32. Ho L, Malden S, McGill K, Shimonovich M, Frost H, Aujla N, et al. Complex interventions for improving independent living and quality of life amongst community-dwelling older adults: a systematic review and meta-analysis. Age Ageing 2023;52:1–21. https://doi.org/10.1093/ageing/afad132.
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34. Lindner-Rabl S, Singler K, Polidori M, Herzog C, Antoniadou E, Seinost G, et al. Effectiveness of multi-professional educational interventions to train Comprehensive Geriatric Assessment (CGA) – a Systematic Review. Int J Integr Care 2023;23:9-1–13. https://doi.org/10.5334/ijic.7549.
35. Lee K, Fields N, Cassidy J, Kusek V, Feinhals G, Calhoun M. Caring callers: the impact of the telephone reassurance program on homebound older adults during COVID-19. Home Health Care Serv Q 2021;40:247–61. https://doi.org/10.1080/01621424.2021.1997861.
36. Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatr 2022;22:601. https://doi.org/10.1186/s12877-022-03279-x.
2. Jiang Y, Shi H, Kang Y, Shen J, Li J, Cui J, et al. Impact of age-friendly living environment and intrinsic capacity on functional ability in older adults: a cross-sectional study. BMC Geriatr 2023;23:1–9. https://doi.org/10.1186/s12877-023-04089-5.
3. Moreno-Agostino D, Prina M, Chua K, Jotheeswaran A, Sadana R, Officer A, et al. Measuring functional ability in healthy ageing: a nationwide cross-sectional survey in the Philippine older population. BMJ Open 2021;11:e050827. https://doi.org/10.1136/bmjopen-2021-050827.
4. Zhou Y, Ma L. Intrinsic Capacity in Older Adults: Recent Advances. Aging Dis 2022;13:353–9. https://doi.org/10.14336/AD.2021.0818.
5. Lahti A-M, Mikkola T, Tirkkonen A, Eriksson JG, von Bonsdorff M. Associations between social vulnerability and functioning in older age, and the moderating role of optimism and self-efficacy. Aging Clin Exp Res 2025;37:173. https://doi.org/10.1007/s40520-025-03077-6.
6. Waris M, Upadhyay A, Chatterjee P, Chakrawarty A, Kumar P, Dey A. Establishment of Clinical Construct of Intrinsic Capacity in Older Adults and Its Prediction of Functional Decline. Clin Interv Aging 2022;17:1569–80. https://doi.org/10.2147/CIA.S371793.
7. Koffer R, Lee S, Drewelies J. Experiential diversity theory of adult development and aging in daily life. Psychol Aging 2024;39:854–70. https://doi.org/10.1037/pag0000858.
8. Rabelo D, Pinto J. Social support network, functional capacity and mental health in older adults. Psico-USF 2023;28:767–81.https://doi.org/10.1590/1413-82712023280409.
9. Naughton C, Galvin R, McCullagh R, Horgan F. Comprehensive geriatric assessment—where are we now, where do we need to be in the context of global ageing? Age Ageing 2023;52:1–3. https://doi.org/10.1093/ageing/afad210.
10. Pizarro-Mena R, Rotarou E, Chavarro-Carvajal D, Wachholz P, López M, Perdomo-Delgado C, et al. Comprehensive Gerontological Assessment: An Update on the Concept and Its Evaluation Tools in Latin America and the Caribbean—A Literature Review. Int J Environ Res Public Health 2024;21:1697. https://doi.org/10.3390/ijerph21121697.
11. Baracaldo-Campo H, Cadena-Sanabria M, Serrano-Gómez S. How our population is aging. Factors associated with the functional capacity of older adults in Bucaramanga-Colombia: The ARENA Study. MedUNAB 2024;26:464–73. https://doi.org/10.29375/01237047.4695.
12. Ho I, McGill K, Malden S, Wilson C, Pearce C, Kaner E, et al. Examining the social networks of older adults receiving informal or formal care: a systematic review. BMC Geriatr 2023;23:531. https://doi.org/10.1186/s12877-023-04190-9.
13. Baracaldo-Campo HA, Naranjo-Garcia A, Medina-Vargas V. Level of functional dependence of institutionalized older people in welfare centers of Floridablanca (Santander, Colombia). Gerokomos 2019;30:163–6.
14. Carmona-Torres J, Rodríguez-Borrego M, Laredo-Aguilera J, López-Soto P, Santacruz-Salas E, Cobo-Cuenca A. Disability for basic and instrumental activities of daily living in older individuals. PLoS One 2019;14:e0220157. https://doi.org/10.1371/journal.pone.0220157.
15. García-González J, Díaz-Palacios E, Salamea-García A, Cabrera-González D, Menéndez-Caicoya A, Fernández-Sánchez A, et al. An evaluation of the feasibility and validity of a scale of social assessment of the elderly. Aten Primaria 1999;23:434–40.
16. Quintero-González DC, Ocampo JM, Reyes-Ortiz CA. Factores asociados con la letalidad por neumonía en una unidad de atención del paciente geriátrico agudo: una cohorte retrospectiva. Biomédica 2020;40:734–48. https://doi.org/10.7705/biomedica.5244.
17. Lee C, Park Y, Cho B. Leveraging network analysis to determine sex differences in factors associated with frailty among older adults living alone. BMC Geriatr 2023;23:38. https://doi.org/10.1186/s12877-023-03755-y.
18. Gao Y, Du L, Cai J, Hu T. Effects of functional limitations and activities of daily living on the mortality of the older people: A cohort study in China. Front Public Health 2023;10:1098794. https://doi.org/10.3389/fpubh.2022.1098794.
19. Jiao D, Watanabe K, Sawada Y, Matsumoto M, Ajmal A, Tanaka E, et al. Social Relationships and Onset of Functional Limitation among Older Adults with Chronic Conditions. Sultan Qaboos Univ Med J 2023;23:13–21. https://doi.org/10.18295/squmj.5.2022.035.
20. Gómez F, Osorio-García D, Panesso L, Curcio C-L. Healthy aging determinants and disability among older adults: SABE Colombia. Revista Panamericana de Salud Pública 2021;45:e98. https://doi.org/10.26633/RPSP.2021.98.
21. Ballesteros-Rozo S. Factores individuales y colectivos asociados con la prevalencia de limitaciones funcionales del adulto mayor en Colombia. Análisis Multinivel. master’s degree. Universidad del Rosario, 2017.
22. Villarreal-Amarís G, Month-Arrieta E. Social and family, health care and functional conditions of elderly people over 65 year old in two neighborhoods of Sincelejo (Colombia). Salud Uninorte 2012;28:75–87.
23. Tamayo-Giraldo F, Baracaldo-Pinzón L, Valencia-Almonacid S, Ortega-Lenis D, Giraldo-Cárdenas M. Índice de envejecimiento activo en Colombia: análisis basado en la Encuesta Nacional de Salud, Bienestar y Envejecimiento (SABE Colombia 2015). Revista Panamericana de Salud Pública 2021;45:e69. https://doi.org/10.26633/RPSP.2021.69.
24. Li J, Zhu L, Yang Y, Li Y, Fu P, Yuan H. Prevalence and potential influencing factors for social frailty among communitydwelling older adults: a systematic review and meta-analysis. BMC Geriatr 2024;24:762. https://doi.org/10.1186/s12877-024-05365-8.
25. Wulff D, Hills T, Mata R. Structural differences in the semantic networks of younger and older adults. Sci Rep 2022;12:21459. https://doi.org/10.1038/s41598-022-11698-4.
26. Chen S, Wang T, Bao Z, Lou V. A Path Analysis of the Effect of Neighborhood Built Environment on Public Health of Older Adults: A Hong Kong Study. Front Public Health 2022;10:861836. https://doi.org/10.3389/fpubh.2022.861836.
27. Gripko M, Joseph A. The Role of the Built Environment in Supporting Older Adults’ Engagement: A Narrative Literature Review. HERD: Health Environments Research & Design Journal 2024;17:329–53. https://doi.org/10.1177/19375867241250320.
28. Wilson G, Gates J, Vijaykumar S, Morgan D. Understanding older adults’ use of social technology and the factors influencing use. Ageing Soc 2023;43:222–45. https://doi.org/10.1017/S0144686X21000490.
29. Baracaldo-Campo H, Martínez-Contreras L. Contextos con perspectiva social en el envejecimiento. In: Pérez-Sanabria O, Flores-Cerqueda S, Quintero-Romero S, Alzate-Peralta L, editors. Enfoques transdisciplinarios sobre el envejecimiento y la agenda 2030: para el desarrollo sostenible en Iberoamérica, vol. Volumen II. Primera Edición, Guayaquil, Ecuador: Instituto Superior Universitario Bolivariano de Tecnología; 2022, p. 335–428.
30. Ostaszkiewicz J, Dickson-Swift V, Hutchinson A, Wagg A. A concept analysis of dignity-protective continence care for care dependent older people in long-term care settings. BMC Geriatr 2020;20:266. https://doi.org/10.1186/s12877-020-01673-x.
31. Swan L, Warters A, O’Sullivan M. Socioeconomic Disadvantage is Associated with Probable Sarcopenia in Community-Dwelling Older Adults: Findings from the English Longitudinal Study of Ageing. J Frailty Aging 2022;11:398–406. https://doi.org/10.14283/jfa.2022.32.
32. Ho L, Malden S, McGill K, Shimonovich M, Frost H, Aujla N, et al. Complex interventions for improving independent living and quality of life amongst community-dwelling older adults: a systematic review and meta-analysis. Age Ageing 2023;52:1–21. https://doi.org/10.1093/ageing/afad132.
33. Metzelthin S, van Rossum E, de Witte L, Ambergen A, Hobma S, Sipers W, et al. Effectiveness of interdisciplinary primary care approach to reduce disability in community dwelling frail older people: cluster randomised controlled trial. BMJ 2013;347:f5264. https://doi.org/10.1136/bmj.f5264.
34. Lindner-Rabl S, Singler K, Polidori M, Herzog C, Antoniadou E, Seinost G, et al. Effectiveness of multi-professional educational interventions to train Comprehensive Geriatric Assessment (CGA) – a Systematic Review. Int J Integr Care 2023;23:9-1–13. https://doi.org/10.5334/ijic.7549.
35. Lee K, Fields N, Cassidy J, Kusek V, Feinhals G, Calhoun M. Caring callers: the impact of the telephone reassurance program on homebound older adults during COVID-19. Home Health Care Serv Q 2021;40:247–61. https://doi.org/10.1080/01621424.2021.1997861.
36. Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC Geriatr 2022;22:601. https://doi.org/10.1186/s12877-022-03279-x.
