Evaluar la asociacion que existe en la poblacion mayor de setenta anos entre vivir solo, acompahado o en una residencia con el nivel de salud y la utilizacion de servicios sociales y sanitarios.

Se realizó un estudio transversal domiciliario, encuestando a una muestra aleatoria de 110 ancianos insti-tucionalizados y 290 de la comunidad del municipio de Cas-telldefels. Sujetos o cuidadores respondieron los cuestiona-rios: autopercepcion del estado de salud (SF-36), nivel de autonomi’a (test de Barthel), grado de ansiedad y de depre-sion (HAD), deterioro cognitivo (Short Portable Mental Status Questionnaire), existencia y uso de comodidades cn cl alo jamiento y de recursos sociales y sanitarios.

Respondieron 77,2% de los institucionaliza-dos y el 92,4% de los de la comunidad. 60 vivian solos, 208 acompanados y 85 en residencias. El 67% eran mujeres y la edad de los que vivian solos (77 ± 4,8), o acompanados (78,3 ± 6,4) era menor que la de los institucionalizados (83,1 ± 6,9) (p < 0,01). La disponibilidad de comodidades en la vivienda era similar en los tres grupos, aunque las utilizaban mas los de la comunidad. La proporcion de dependientes se distribuia de forma creciente entre los que vivian solos, acompanados o institucionalizados (13,3%; 19,6%; 86,7%, res-pectivamente, p < 0,01), al igual que el deterioro cognitivo (7,8 %; 15,3%; 20,8%; p < 0,01). La salud subjetiva era pare-cida, unicamente los que vivian en familia mostraban un mejor rol emocional y funcibn social (SF-36). La poblacion no ins-titucionalizada recibfa el soporte basicamente de familiares y amigos y de los servicios de atencion primaria. Los de las residencias eran asistidos sanitariamente de forma mas selec-tiva, pero intensa y dispoman de cuidadores formales.

Las residencias atienden a la poblacion con mayor deterioro cognitivo y mas dependiente. Se evidencia la necesidad de incrementar los cuidados formales en la comunidad, especialmente para las personas que viven solas, y la de reorientar todos los servicios de salud hacia la atencion.

To assess the association between living arrangements (living alone, with company or in a nursing home) and the health status and the use of health and social services among the population over seventy with the purpose to help establishing health policies for the elderly.

A cross sectional survey was performed, interviewing a random sample of 110 institutionalised and 290 community elderly of Castelldefels. Subjects and carers answered the following questionnaires: health status self-perception (SF-36), level of autonomy (test de Barthel), anxiety and depression levels (HAD), cognitive deficit (Short Portable Mental Status Questionnaire), availability and use of housing facilities and social and health resources.

77.2% of the institutionalised, and 92% of those coming from the community answered the questionnaire. 60 lived alone, 208 accompanied and 85 in nursing homes. The 67% were women and those living alone (77 ± 4.8 years), or with company (78.3 ± 6.4 years) where younger than the institutionalised ones (83.1 ± 6.9 years) (p < 0.01). Housing facilities was similar in the three groups, although those living in the community had a higher level of use. The proportion of handicapped grew progressively from those living alone, with company or in institutions (13.3%; 19.6%; 86.7%; p < 0.01), as well as the cognitive deficit (7.8%; 15.3%; 20.8%, p < 0.01). Every group had similar health status, only those living with the family experienced higher socres in the emotional role or social function (SF-36). Non institutionalised population received support from relatives, friends and primary care services. Those institutionalised received health care in a more intensive and selective way, and benefited from formal cares.

Nursing homes host the population with highest level of cognitive deficit and dependence. The need of increasing formal care in the community, in special to people living alone, and of reorienting health services towards elderly care has been identified.