Social factors and older adults' autonomy: An integrative review of the functional and cognitive dimensions
Factores sociales y autonomía de las personas mayores: revisión integradora de las dimensiones funcional y cognitiva
Fatores sociais e autonomia de pessoas idosas: revisão integrativa das dimensões funcional e cognitiva
Adriana Meira Tiburtino Nepomuceno; Raphaely Domingues Bezerra; Luiz Carlos da Silva Bernardo; Josiane Maria Oliveira de Souza; Edilene Araújo Monteiro; Maria Adelaide Silva Paredes Moreira
Abstract
Objective to synthesize diverse evidence on the influence exerted by social factors on older adults' autonomy, considering the Functional and Cognitive dimensions.
Method integrative review conducted between February and March 2025 in five databases, with screening reported according to PRISMA 2020 adapted for integrative reviews. The analysis involved thematic categorization and narrative synthesis.
Results only 30 of the 1,158 studies identified were included: Autonomy – Cognitive dimension (n=18); Functional dimension (n=8); and Functional-Cognitive interconnection (n=4). The protective factors included social support, safe and accessible environments, favorable socioeconomic conditions, healthy habits and social participation; in turn, isolation, physical barriers, pollution and low schooling were associated with higher dependence risks. Multi-component interventions (physical exercise, cognitive stimulation and social support) showed potential but remain infrequent.
Final considerations and implications for the practice autonomy results from the interaction among individual, social and environmental factors. More experimental and quasi-experimental studies are required to test concrete, context-adaptable strategies. Restrictive inclusion criteria and unavailability of full texts may have excluded relevant studies. The causes of the factors identified were not explored in depth, nor were specific strategies proposed to address them. The findings support intersectoral policies and health practices (especially in Nursing) for dignified aging.
Keywords
Resumen
Palabras clave
Resumo
Objetivo: sintetizar evidências sobre a influência de fatores sociais na autonomia de pessoas idosas, considerando as dimensões funcional e cognitiva.
Método: revisão integrativa conduzida em cinco bases de dados entre fevereiro e março de 2025, com triagem demonstrada no PRISMA 2020 adaptado para revisões integrativas. A análise envolveu categorização temática e síntese narrativa.
Resultados: dos 1.158 estudos identificados, 30 foram incluídos: Autonomia – dimensão cognitiva (n=18); funcional (n=8); e interligação funcional-cognitiva (n=4). Apoio social, ambientes seguros e acessíveis, condições socioeconômicas favoráveis, hábitos saudáveis e participação social foram fatores protetores; isolamento, barreiras físicas, poluição e baixa escolaridade associaram-se a maior risco de dependência. Intervenções multicomponentes (exercício físico, estimulação cognitiva e suporte social) mostraram potencial, mas são pouco frequentes.
Considerações finais e implicações para a prática: a autonomia resulta da interação entre fatores individuais, sociais e ambientais. Há necessidade de mais estudos experimentais e quase-experimentais que testem estratégias concretas e adaptáveis a diferentes contextos. Critérios de inclusão restritivos e indisponibilidade de textos completos podem ter excluído estudos relevantes. As causas dos fatores identificados não foram aprofundadas, nem propostas estratégias específicas para seu enfrentamento. Os achados subsidiam políticas intersetoriais e práticas de saúde, especialmente de enfermagem, para um envelhecimento com dignidade.
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References
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Accepted date:
12/28/2025
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