High prevalence of functional dependence among older adults receiving long-term care at the primary health care level: A cross-sectional observational study in kazakhstan

Introduction: Population ageing increases the demand for long-term care (LTC) and systematic functional assessments within primary health care (PHC). This study aimed to describe the prevalence of functional dependence among older adults receiving LTC at the PHC level in Aktobe, Kazakhstan, and to examine differences in geriatric screening indicators.Methods: This cross-sectional observational study included 216 adults aged 60 years and older receiving LTC or regular dispensary follow-up from March to May 2024. Functional independence was assessed using the Barthel Index. Additional screening tools included FRAIL for frailty, MNA for nutrition, SARC-F for sarcopenia risk, Mini-Cog for cognitive status, and FRAX for fracture risk. Statistical analysis was conducted using Jamovi 2.6.Results: Complete or severe functional dependence was identified in 140 participants (64.8%), while 76 (35.2%) exhibited moderate or mild dependence with a mean sample age of 80.0 ± 7.44 years. No significant differences between groups were found for age, BMI, or high FRAX fracture risk which was 82.4% total (p=0.608). However, statistically significant differences were observed for positive frailty screening with 82.1% in complete/severe versus 98.7% in moderate/mild groups (p<0.001), malnutrition risk (56.4% vs 71.1%, p=0.035), sarcopenia risk (8.6% vs 77.6%, p<0.001), and potential cognitive impairment (32.1% vs 46.1%, p=0.043).Conclusion: Functional dependence is highly prevalent (64.8%) among older adults receiving LTC at the PHC level in Kazakhstan. The Barthel Index serves as a practical, standardized tool for ADL assessment, supporting care planning and nursing-patronage stratification. Due to the cross-sectional design, these findings reflect clinical associations rather than direct causal relationships.