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Health and functioning of community-dwelling older adults in urban and rural areas of Portugal—What are the implications for physiotherapy care?

dc.contributor.authorReis, Magda
dc.contributor.authorFerreira, Sara
dc.contributor.authorConde, Monserrat
dc.contributor.authorMartins, Anabela Correia
dc.date.accessioned2026-04-07T14:57:08Z
dc.date.available2026-04-07T14:57:08Z
dc.date.issued2025-12-05
dc.description.abstractAgeing leads to physical, cognitive, and social changes that affect people’s functioning and social participation. Health literacy, sociodemographic, and environmental factors influence health outcomes and access to care. This study aimed to characterize the health and functioning of Portuguese adults aged 65 and over, focusing on sociodemographic factors, health status, lifestyle, fall risk, functional capacity, and social participation, and on comparing rural and urban populations. An exploratory, cross-sectional study was conducted using data from older adults who completed the FallSensing screening protocol. Participants were classified by residence type (rural vs. urban), and group comparisons were made. The sample (n = 474) was predominantly female (66.5%) with a mean age of 74.62 (±6.49) years. Rural participants were older (76.87 ± 6.89 vs. 73.50 ± 5.87) and had higher body mass index (BMI) (28.32 ± 4.31 vs. 27.51 ± 4.12), lower educational attainment—for example, 22.9% had no formal education compared to 7.0% of urban participants—and a higher prevalence of hypertension (72.6% vs. 55.4%), whereas urban participants experienced higher rates of osteoporosis (24.4% vs. 14.3%), hearing loss (41.9% vs. 26.9%), and alcohol consumption (12.7% vs. 2.3%) (p ≤ 0.05). Rural residents also demonstrated significantly poorer results for grip strength (21.03 ± 7.36 vs. 23.73 ± 8.61), gait speed (1.17 ± 0.44 vs. 1.45 ± 0.39), and the Timed Up and Go (TUG) test (13.4 ± 10.40 vs. 9.62 ± 4.43), as well as lower exercise self-efficacy (12.83 ± 4.97 vs. 14.28 ± 4.40) (p < 0.001), and more pronounced moderate-to-severe restrictions in social participation (28.0% vs. 15.7%) (p = 0.013). They reported greater use of assistive devices and more severe limitations in social participation. Although falls were reported more often in urban areas, rural residents experienced greater fall frequency. These findings suggest that rural living is associated with lower functional capacity and poorer health, underscoring the need for targeted physiotherapy and primary care strategies in rural settings.eng
dc.identifier.citationReis, M., Ferreira, S., Conde, M., & Martins, A. C. (2025). Health and Functioning of Community-Dwelling Older Adults in Urban and Rural Areas of Portugal—What Are the Implications for Physiotherapy Care? International Journal of Environmental Research and Public Health, NA, 22(12), 1827. https://doi.org/10.3390/ijerph22121827
dc.identifier.doi10.3390/ijerph22121827
dc.identifier.eissn1660-4601
dc.identifier.urihttp://hdl.handle.net/10400.22/32181
dc.language.isoeng
dc.peerreviewedyes
dc.publisherMDPI
dc.relation.hasversionhttps://www.mdpi.com/1660-4601/22/12/1827
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectOlder adults
dc.subjectRural vs. Urban
dc.subjectHealth disparities
dc.subjectFunctional capacity
dc.subjectFall risks
dc.titleHealth and functioning of community-dwelling older adults in urban and rural areas of Portugal—What are the implications for physiotherapy care?eng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.issue12
oaire.citation.titleInternational Journal of Environmental Research and Public Health
oaire.citation.volume22
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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