Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador / Factores socioeconómicos y de estilo de vida asociados con las afecciones crónicas en los adultos mayores del Ecuador

Objective. To explore socioeconomic and lifestyle factors associated with the prevalence of self-reported chronic conditions among older adults in Ecuador. Methods. The sample was drawn from the nationally representative observational cross-sectional data of the Health, Well-Being, and Aging survey conducted in Ecuador in 2009. Logistic regression models were used to explore the association between socioeconomic and lifestyle factors and the prevalence of selected chronic conditions. Results. Older women in Ecuador are more likely than men to have been previously diagnosed with diabetes, heart disease, high blood pressure, and arthritis. Results suggest no difference by education or health insurance on number and type of self-reported chronic conditions. However, older adults who resided in the coastal area were more likely to report having diabetes, heart disease, high blood pressure, and stroke than those in the highlands. Living in rural areas was associated with lower odds of having diabetes and high blood pressure. Compared to white older adults, indigenous older adults were less likely to report having high blood pressure, but more likely to report having arthritis. Conclusions. Older age in Ecuador is marked by low educational levels and poverty. Female gender and living in coastal areas were associated with higher risks of self-reported chronic conditions.

Objetivo. Explorar los factores socioeconómicos y de estilo de vida asociados con la prevalencia de afecciones crónicas autonotificadas en adultos mayores del Ecuador. Métodos. La muestra se obtuvo de los datos transversales de observación, representativos a escala nacional, de la Encuesta de Salud, Bienestar y Envejecimiento, llevada a cabo en el Ecuador el año 2009. Se utilizaron modelos de regresión logística para explorer la asociación entre los factores socioeconómicos y de estilo de vida y la prevalencia de las afecciones crónicas seleccionadas. Resultados. Las mujeres mayores del Ecuador presentan mayores probabilidades que los hombres de haber sido diagnosticadas previamente de diabetes, cardiopatía, hipertensión y artritis. Los resultados indican que no hay diferencias según el nivel de formación o la cobertura por seguro de enfermedad en cuanto al número y tipo de afecciones crónicas autonotificadas. Sin embargo, la notificación de antecedentes de diabetes, cardiopatía, hipertensión y accidente cerebrovascular era más probable en los adultos mayores residentes en la zona costera que en los que vivían en los altiplanos. La residencia en zonas rurales se asociaba con menores probabilidades de padecer diabetes e hipertensión. En comparación con los adultos mayores blancos, era menos probable que los adultos mayores indígenas notificaran antecedentes de hipertensión, pero era más probable que notificaran antecedentes de artritis. Conclusiones. En el Ecuador, en las personas mayores se observa pobreza y un escaso nivel de formación. Pertenecer al sexo femenino y residir en las zonas costeras se asociaban con mayores riesgos de autonotificación de afecciones crónicas.

Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador / Factores socioeconómicos y de estilo de vida asociados con las afecciones crónicas en los adultos mayores del Ecuador

OBJECTIVE: To explore socioeconomic and lifestyle factors associated with the prevalence of self-reported chronic conditions among older adults in Ecuador. METHODS: The sample was drawn from the nationally representative observational cross-sectional data of the Health, Well-Being, and Aging survey conducted in Ecuador in 2009. Logistic regression models were used to explore the association between socioeconomic and lifestyle factors and the prevalence of selected chronic conditions. RESULTS: Older women in Ecuador are more likely than men to have been previously diagnosed with diabetes, heart disease, high blood pressure, and arthritis. Results suggest no difference by education or health insurance on number and type of self-reported chronic conditions. However, older adults who resided in the coastal area were more likely to report having diabetes, heart disease, high blood pressure, and stroke than those in the highlands. Living in rural areas was associated with lower odds of having diabetes and high blood pressure. Compared to white older adults, indigenous older adults were less likely to report having high blood pressure, but more likely to report having arthritis. CONCLUSIONS: Older age in Ecuador is marked by low educational levels and poverty. Female gender and living in coastal areas were associated with higher risks of self-reported chronic conditions.

OBJETIVO: Explorar los factores socioeconómicos y de estilo de vida asociados con la prevalencia de afecciones crónicas autonotificadas en adultos mayores del Ecuador. MÉTODOS: La muestra se obtuvo de los datos transversales de observación, representativos a escala nacional, de la Encuesta de Salud, Bienestar y Envejecimiento, llevada a cabo en el Ecuador el año 2009. Se utilizaron modelos de regresión logística para explorar la asociación entre los factores socioeconómicos y de estilo de vida y la prevalencia de las afecciones crónicas seleccionadas. RESULTADOS: Las mujeres mayores del Ecuador presentan mayores probabilidades que los hombres de haber sido diagnosticadas previamente de diabetes, cardiopatía, hipertensión y artritis. Los resultados indican que no hay diferencias según el nivel de formación o la cobertura por seguro de enfermedad en cuanto al número y tipo de afecciones crónicas autonotificadas. Sin embargo, la notificación de antecedentes de diabetes, cardiopatía, hipertensión y accidente cerebrovascular era más probable en los adultos mayores residentes en la zona costera que en los que vivían en los altiplanos. La residencia en zonas rurales se asociaba con menores probabilidades de padecer diabetes e hipertensión. En comparación con los adultos mayores blancos, era menos probable que los adultos mayores indígenas notificaran antecedentes de hipertensión, pero era más probable que notificaran antecedentes de artritis. CONCLUSIONES: En el Ecuador, en las personas mayores se observa pobreza y un escaso nivel de formación. Pertenecer al sexo femenino y residir en las zonas costeras se asociaban con mayores riesgos de autonotificación de afecciones crónicas.

Socioeconomic and lifestyle factors associated with chronic conditions among older adults in Ecuador.

OBJECTIVE: To explore socioeconomic and lifestyle factors associated with the prevalence of self-reported chronic conditions among older adults in Ecuador. METHODS: The sample was drawn from the nationally representative observational cross-sectional data of the Health, Well-Being, and Aging survey conducted in Ecuador in 2009. Logistic regression models were used to explore the association between socioeconomic and lifestyle factors and the prevalence of selected chronic conditions. RESULTS: Older women in Ecuador are more likely than men to have been previously diagnosed with diabetes, heart disease, high blood pressure, and arthritis. Results suggest no difference by education or health insurance on number and type of self-reported chronic conditions. However, older adults who resided in the coastal area were more likely to report having diabetes, heart disease, high blood pressure, and stroke than those in the highlands. Living in rural areas was associated with lower odds of having diabetes and high blood pressure. Compared to white older adults, indigenous older adults were less likely to report having high blood pressure, but more likely to report having arthritis. CONCLUSIONS: Older age in Ecuador is marked by low educational levels and poverty. Female gender and living in coastal areas were associated with higher risks of self-reported chronic conditions.

Correlates of the incidence of disability and mortality among older adult Brazilians with and without diabetes mellitus and stroke.

BACKGROUND: The combined effect of diabetes and stroke on disability and mortality remains largely unexplored in Brazil and Latin America. Previous studies have been based primarily on data from developed countries. This study addresses the empirical gap by evaluating the combined impact of diabetes and stroke on disability and mortality in Brazil. METHODS: The sample was drawn from two waves of the Survey on Health and Well-being of the Elderly, which followed 2,143 older adults in São Paulo, Brazil, from 2000 to 2006. Disability was assessed via measures of activities of daily living (ADL) limitations, severe ADL limitations, and receiving assistance to perform these activities. Logistic and multinomial regression models controlling for sociodemographic and health conditions were used to address the influence of diabetes and stroke on disability and mortality. RESULTS: By itself, the presence of diabetes did not increase the risk of disability or the need for assistance; however, diabetes was related to increased risks when assessed in combination with stroke. After controlling for demographic, social and health conditions, individuals who had experienced stroke but not diabetes were 3.4 times more likely to have ADL limitations than those with neither condition (95% CI 2.26-5.04). This elevated risk more than doubled for those suffering from a combination of diabetes and stroke (OR 7.34, 95% CI 3.73-14.46). Similar effects from the combination of diabetes and stroke were observed for severe ADL limitations (OR 19.75, 95% CI 9.81- 39.76) and receiving ADL assistance (OR 16.57, 95% CI 8.39-32.73). Over time, older adults who had experienced a stroke were at higher risk of remaining disabled (RRR 4.28, 95% CI 1.53,11.95) and of mortality (RRR 3.42, 95% CI 1.65,7.09). However, risks were even higher for those who had experienced both diabetes and stroke. Diabetes was associated with higher mortality. CONCLUSIONS: Findings indicate that a combined history of stroke and diabetes has a great impact on disability prevalence and mortality among older adults in São Paulo, Brazil.

Gender differences in life expectancy and disability-free life expectancy among older adults in São Paulo, Brazil.

BACKGROUND: research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in São Paulo, Brazil; and discuss the implications for public policies. METHODS: the sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in São Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. FINDINGS: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives-twice the percentage for men-with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. CONCLUSION: among older adults in São Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs.