Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 67
Filtrar
Mais filtros










Intervalo de ano de publicação
1.
Cad Saude Publica ; 35(7): e00091018, 2019 Jul 22.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31340334

RESUMO

This study aimed to measure the contribution of selected health behaviors to the prevalence of hypertension control in Brazilian adults 50 years or older, based on data from the ELSI-Brasil study. The study included 4,318 individuals 50 years or older who reported having received a medical diagnosis of hypertension and were taking antihypertensive medication. The selected health behaviors were: physical activity, healthy diet, not consuming excessive alcohol, and never having smoked. The contribution of each health behavior to prevalence of hypertension control was estimated by the attribution method, via adjustment of the binomial additive hazards model, stratified by sex. Prevalence of hypertension control was 50.7% (95%CI: 48.2; 53.1). Overall, health behaviors made a larger contribution to hypertension control in women (66.3%) than in men (36.2%). Moderate alcohol consumption made the largest contribution in both sexes, but particularly in women (52.7% in women versus 19% in men). Physical activity contributed 12.6% in women and 10.7% in men. The other behaviors were more relevant in men: never having smoked (3.4%) and regular consumption of vegetables, legumes, and fruits (3.1%). These results underline the need for measures to promote the adoption of healthy behaviors by hypertensive individuals to reduce blood pressure levels, improve the effectiveness of antihypertensive medication, and decrease their cardiovascular risk.

2.
Rev Bras Epidemiol ; 21Suppl 02(Suppl 02): e180012, 2019 Feb 04.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30726357

RESUMO

INTRODUCTION: The use of dental prosthesis and the tooth loss in elderly people are associated with significant impact on the overall health and quality of life. Continuous assessment of oral health profile in this population is important for planning the actions and policies of the area. OBJECTIVES: The aims of this study were to assess the prevalence of tooth loss and use of dental prosthesis among the elderly people in different periods, to evaluate the association between functional dentition (20 teeth or more) and socioeconomic factors, and to evaluate the impact of tooth loss and use of dental prosthesis on self-rated oral health. METHODS: Thesample consisted of people aged 60 years and older who participated in the Health, Well-Being, and Aging Study (SABE). Data from the years 2000, 2006, and 2010 were used to assess the prevalence of tooth loss and use of dental prosthesis. Analysis of the factors associated with the functional dentition and self-rated oral health was based on the data collected in 2010. Comparison of oral health profile over the 3 years was done through descriptive analysis and comparison of confidence intervals. Multiple logistic regression models were used to assess the factors associated with functional dentition and self-rated oral health. RESULTS: The prevalence of tooth loss and use of dental prosthesis remained constant over the three periods analyzed. Functional dentition was significantly associated with education, sex, and race/gender. Individuals in need of dental prosthesis and with periodontal pocket were more likely to report poor oral health. CONCLUSION: There was no reduction in the prevalence of tooth loss and in the use of dental prosthesis over 10 years. Functional dentition is associated with socioeconomic inequalities. Self-rated oral health is associated with the need of dental prosthesis.


Assuntos
Prótese Dentária/estatística & dados numéricos , Autoavaliação Diagnóstica , Vida Independente/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Perda de Dente/epidemiologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos Transversais , Inquéritos de Saúde Bucal/métodos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Perfil de Impacto da Doença , Fatores Socioeconômicos , Fatores de Tempo
3.
Rev Bras Epidemiol ; 21Suppl 02(Suppl 02): e180021, 2019 Feb 04.
Artigo em Português, Inglês | MEDLINE | ID: mdl-30726366

RESUMO

INTRODUCTION: Frailty is a preventable and reversible syndrome characterized by a cumulative decline of physiological systems, causing greater vulnerability to adverse conditions. OBJECTIVE: To describe the prevalence of frailty among older adults and analyze its associated factors and progression. METHOD: This is a longitudinal study that used the Health, Well-being, and Aging Study (Saúde, Bem-Estar e Envelhecimento - SABE) database of 2006 and 2010. Five components identified the frailty syndrome: weight loss; fatigue; decreased strength, low physical activity, and reduced walking speed. Older adults were classified as "pre-frail" (1-2 components) and "frail" (3 or more). We used a hierarchical multiple multinomial regression to analyze associated factors. RESULTS: Out of the total number of older adults (n = 1,399), 8.5% were frail, and the associated factors were age, functional impairment, cognitive decline, hospitalization, and multimorbidity. In four years, 3.3% of non-frail and 14.7% of pre-frail older adults became frail. CONCLUSION: Identifying the prevalence of frailty and its associated factors can help to implement adequate interventions early to improve the quality of life of older adults.


Assuntos
Disfunção Cognitiva/epidemiologia , Idoso Fragilizado/estatística & dados numéricos , Fragilidade/epidemiologia , Fragilidade/etiologia , Atividades Cotidianas , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Disfunção Cognitiva/fisiopatologia , Progressão da Doença , Feminino , Fragilidade/fisiopatologia , Avaliação Geriátrica/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Multimorbidade , Prevalência , Qualidade de Vida , Fatores de Risco , Distribuição por Sexo , Fatores Socioeconômicos , Perda de Peso/fisiologia
4.
Cad. Saúde Pública (Online) ; 35(7): e00091018, 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1011714

RESUMO

Resumo: O objetivo foi quantificar a contribuição de comportamentos em saúde selecionados para a prevalência do controle da hipertensão junto a adultos brasileiros com 50 ou mais anos de idade. Foram analisados os dados do ELSI-Brasil. Foram incluídos, no estudo, 4.318 indivíduos com 50 anos ou mais, que relataram ter recebido diagnóstico médico de hipertensão arterial e faziam tratamento medicamentoso para ela. Os comportamentos em saúde selecionados foram: prática de atividade física, adoção de dieta saudável, não consumir de forma excessiva bebida alcoólica e nunca ter fumado. A contribuição de cada comportamento em saúde estudado para a prevalência do controle da hipertensão arterial foi estimada pelo método da atribuição, por meio do ajuste do Modelo Binomial de Riscos Aditivos, estratificado por sexo. A prevalência do controle da hipertensão foi de 50,7% (IC95%: 48,2; 53,1). De maneira geral, os comportamentos em saúde tiveram uma maior contribuição para o controle da hipertensão nas mulheres (66,3%) do que nos homens (36,2%). O consumo moderado de álcool foi o que mais contribuiu em ambos os sexos (52,7% em mulheres; 19% em homens), sendo destacada a sua contribuição para as mulheres. A prática de atividade contribuiu com 12,6% em mulheres e 10,7% em homens. Os demais comportamentos apresentaram maior relevância entre os homens: nunca ter fumado (3,4%) e consumo regular de verduras, legumes e frutas (3,1%). Esses resultados reforçam a necessidade de medidas que promovam a adoção de comportamentos saudáveis entre hipertensos para reduzir os níveis pressóricos, melhorar o efeito dos anti-hipertensivos e diminuir o risco cardiovascular.


Resumen: El objetivo fue cuantificar la contribución de comportamientos de salud, seleccionados para la prevalencia del control de la hipertensión, entre adultos brasileños con 50 o más años de edad. Se analizaron los datos de ELSI-Brasil. Se incluyeron en el estudio a 4.318 individuos, con 50 años o más, que informaron haber recibido un diagnóstico médico de hipertensión arterial y contaban con un tratamiento médico para la misma. Los comportamientos de salud seleccionados fueron: práctica de actividad física, adopción de una dieta saludable, no consumir de forma excesiva bebidas alcohólicas y no haber fumado nunca. La contribución de cada comportamiento de salud estudiado para la prevalencia del control de la hipertensión arterial se estimó mediante el método de la atribución, a través del ajuste del modelo binomial de riesgos añadidos, estratificado por sexo. La prevalencia del control de la hipertensión fue de un 50,7% (IC95%: 48,2; 53,1). De manera general, los comportamientos de salud tuvieron una mayor contribución para el control de la hipertensión en las mujeres (66,3%) que en los hombres (36,2%). El consumo moderado de alcohol fue lo que más contribuyó en ambos sexos (52,7% en mujeres; 19% en hombres), siendo destacada su contribución en el caso de las mujeres. La práctica de actividad contribuyó con un 12,6% en mujeres y un 10,7% en hombres. Los demás comportamientos presentaron mayor relevancia entre los hombres: no haber fumado nunca (3,4%) y consumo regular de verduras, legumbres y frutas (3,1%). Esos resultados refuerzan la necesidad de medidas que promuevan la adopción de comportamientos saludables entre hipertensos para reducir los niveles presóricos, mejorar el efecto de los antihipertensivos y disminuir el riesgo cardiovascular.


Abstract: This study aimed to measure the contribution of selected health behaviors to the prevalence of hypertension control in Brazilian adults 50 years or older, based on data from the ELSI-Brasil study. The study included 4,318 individuals 50 years or older who reported having received a medical diagnosis of hypertension and were taking antihypertensive medication. The selected health behaviors were: physical activity, healthy diet, not consuming excessive alcohol, and never having smoked. The contribution of each health behavior to prevalence of hypertension control was estimated by the attribution method, via adjustment of the binomial additive hazards model, stratified by sex. Prevalence of hypertension control was 50.7% (95%CI: 48.2; 53.1). Overall, health behaviors made a larger contribution to hypertension control in women (66.3%) than in men (36.2%). Moderate alcohol consumption made the largest contribution in both sexes, but particularly in women (52.7% in women versus 19% in men). Physical activity contributed 12.6% in women and 10.7% in men. The other behaviors were more relevant in men: never having smoked (3.4%) and regular consumption of vegetables, legumes, and fruits (3.1%). These results underline the need for measures to promote the adoption of healthy behaviors by hypertensive individuals to reduce blood pressure levels, improve the effectiveness of antihypertensive medication, and decrease their cardiovascular risk.

5.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 6s, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30379279

RESUMO

OBJECTIVE: To characterize healthcare access and utilization among older Brazilians. METHODS: Data are from the baseline wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is a nationally representative, population-based cohort study of persons aged 50 years and older conducted in 2015/2016 (n = 9,412). The prevalence of barriers to primary care and number and type of doctor visits in the past 12 months are compared by three main sources of healthcare (private, Family Health Strategy, traditional public clinics). Two-part multivariable hurdle analyses assess the relation between healthcare utilization, primary care problems, and source of healthcare, while controlling for healthcare determinants. RESULTS: Females comprised 54% of the sample, with a mean age of 63 years. There were no demographic differences by source of healthcare. Nearly 83% had at least one doctor visit in the past 12 months, with higher use among private health plan holders. Private health plan holders most frequently visited specialists, while those using the public system were more likely to visit a general practitioner. Primary care barriers averaged 3.5 out of 12 and were the highest among those using traditional health posts. A greater number of primary care problems was negatively associated with all types of healthcare utilization. CONCLUSIONS: By international standards, access to basic healthcare among older Brazilians is relatively high. Nevertheless, different levels of primary care problems between the public and private sectors and resulting utilization patterns suggest the need to continue working to close remaining gaps.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência
6.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 5s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379280

RESUMO

OBJECTIVE: To describe the prevalence of the practice of physical activity (PA) among older Brazilian adults and associated factors. In addition, potential effect modifiers of the association between PA and age were investigated. METHODS: We have analyzed data from 8,736 participants (92.8%) aged 50 and older from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Physical activity was measured using the short version of the International Physical Activity Questionnaire. The outcome variable was defined as at least 150 minutes of weekly activities in all domains. The exploratory variables were age, sex, education, ethnicity, marital status, number of chronic diseases and medical appointments, and knowledge about or participation in public programs that encourage physical activity. Logistic regression and estimates of predicted probabilities were performed. RESULTS: The prevalence of recommended levels of physical activity was 67.0% (95%CI 64.3-69.5). Physical activity was associated with age [odds ratio (OR) = 0.97; 95%CI 0.96-0.98], higher educational level (OR = 1.27; 95%CI 1.11-1.45 for 4-7 years and OR = 1.52; 95%CI 1.28-1.81 for eight years or more), participants who were married/ in a long term relationship (OR = 1.22; 95%CI 1.08-1.38), and those who reported knowledge about (OR = 1.34; 95%CI 1.16-1.54) or participation in (OR = 1.78; 95%CI 1.34-2.36) a program aimed at the practice of physical activity. Women and those with lower educational level (p value for interaction < 0.05) reported lower physical activity levels. CONCLUSIONS: In addition to the association with marital status and health promotion programs, there were significant sex and educational level inequalities in physical activity decline later in life. These findings help the identification of groups more vulnerable to decreased physical activity levels with aging, as well as the planning of health promotion strategies, especially in older groups.


Assuntos
Exercício , Fatores Etários , Idoso , Brasil , Feminino , Promoção da Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos
7.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 16s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379281

RESUMO

OBJECTIVE: To identify factors associated with perceived quality of life in a representative national sample of the population aged 50 or over. METHODS: Data from 7,651 participants of the baseline ELSI-Brazil (Brazilian Longitudinal Study of Aging), conducted between 2015 and 2016, were used. The perceived quality of life was measured by the CASP-19 scale - (CASP - control, autonomy, self-fulfillment and pleasure), considering the highest tertile as good quality of life. The independent variables included socio-demographic characteristics, mobility, loneliness, and indicators of sociability (social network, social support and social participation). The associations were tested using multivariate Poisson regression. RESULTS: The best perceived quality of life showed a positive and independent association with the frequency of contacts with friends (PR = 1.25 for at least once every 2-3 months and PR = 1.36 for at least once a week), instrumental support from spouse or partner in the household (PR = 1.69), and emotional support from other relatives (PR = 1.45), children or children in law (PR = 1.41) and spouse or partner (PR = 1.33). Negative associations were observed for participants aged 80 and over (RP = 0.77), with 4 to 7 or 8 or more years of schooling (PR = 0.78 and 0.75, respectively) and with difficulty in mobility (PR = 0.83). CONCLUSIONS: In addition to age and schooling, mobility, sociability and instrumental and emotional support are associated with perceived quality of life among older Brazilian adults. These characteristics must be considered when actions are taken, aiming to promote quality of life in this population.


Assuntos
Nível de Saúde , Percepção , Qualidade de Vida/psicologia , Participação Social/psicologia , Apoio Social , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Prevalência , Fatores Socioeconômicos
8.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 17s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379282

RESUMO

OBJECTIVE: To estimate the prevalence of frailty and to evaluate the associated factors in the non-institutionalized Brazilian population aged 50 years or older. METHODS: The analyses were conducted in 8,556 participants of the baseline survey of the Longitudinal Study of Health of the Brazilian Elderly (ELSI-Brazil) conducted in 2015 and 2016. Frailty was defined based on five characteristics: weight loss, weakness, slowness, exhaustion and low level of physical activity. Participants with three or more characteristics were classified as frail. A Poisson regression model was used to examine the association between frailty and sociodemographic and health factors. RESULTS: The prevalence of frailty was 9.0% (95%CI 8.0-10.1) among participants aged 50 years or over. Among the older adults aged 60 or over, the prevalence was 13.5% (95%CI 11.9-15.3) and 16.2% (95%CI 14.3-18.3) among those 65 aged years or over. Factors associated with higher prevalence of frailty were low schooling, residence without a partner, health conditions (poor self-rated health and two or more chronic diseases) and limitation to perform basic activities of daily living. CONCLUSIONS: The prevalence of frailty among Brazilians aged 65 years or older is similar to their European counterparts. Poor health conditions, functional limitation and low schooling emerge as the factors most strongly associated with the frailty in this population.


Assuntos
Idoso Fragilizado/estatística & dados numéricos , Fragilidade/epidemiologia , Avaliação Geriátrica/métodos , Idoso , Brasil/epidemiologia , Doença Crônica , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos
9.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 14s, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30379283

RESUMO

OBJECTIVE: To evaluate the magnitude of wealth-related inequalities in basic activities of daily living among community-dwelling Brazilian older adults and to determine the contribution of demographic, socioeconomic, and health conditions to the inequality. METHODS: We used data from the 2015 Brazilian Longitudinal Study of Aging (ELSI-Brazil) with a nationally representative sample of adults aged 50 years or older. We assessed wealth-related inequalities in basic activities of daily living by the concentration index. Concentration index was decomposed to determine the contribution of demographic, health, and socioeconomic factors to wealth-related inequalities in basic activities of daily living. RESULTS: The prevalence of disability in the sample was 15.7% (95%CI 14.9-17.6). The concentration index was -0.145 (95%CI -0.194- -0.097), which indicates that disability is concentrated in the poorest individuals in Brazil. Inequalities in basic activities of daily living disability are primarily explained by socioeconomic status (wealth and own education) not by demographic or health factors. CONCLUSIONS: There are avoidable wealth-related inequities for those with a disability in Brazil. The strong contribution of the socioeconomic status highlights the need for new public health policies that promote equity, universality, and integrality, in addition to the expansion of home nursing public services.


Assuntos
Atividades Cotidianas , Pessoas com Deficiência/estatística & dados numéricos , Disparidades nos Níveis de Saúde , Idoso , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Classe Social
10.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 8s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379284

RESUMO

OBJECTIVE: To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS: Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS: The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2-4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60-79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS: Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse.


Assuntos
Uso de Medicamentos/economia , Adesão à Medicação/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Uso de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos
11.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 7s, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30379285

RESUMO

OBJECTIVE: To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS: This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS: Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS: These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.


Assuntos
Prótese Dentária/estatística & dados numéricos , Boca Edêntula/epidemiologia , Saúde Bucal/estatística & dados numéricos , Fatores Socioeconômicos , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
12.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 4s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379286

RESUMO

OBJECTIVE: To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older. METHODS: Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding. RESULTS: Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency. CONCLUSIONS: There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.


Assuntos
Cognição/fisiologia , Transtornos da Memória/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Escolaridade , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos da Memória/epidemiologia , Transtornos da Memória/fisiopatologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , População Rural , População Urbana
13.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 12s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379287

RESUMO

OBJECTIVE: To assess the prevalence and factors associated with falls in a nationally representative sample of older Brazilians residing in urban areas. METHODS: Data from 4,174 participants (60 years or older) from the baseline of ELSI-Brazil, conducted between 2015 and 2016, were used. The outcome variable was the reporting of one or more falls in the last 12 months. The exploratory variables were sociodemographic characteristics, factors related to the urban environment, and health conditions. Statistical analysis was performed using Poisson regression. RESULTS: The prevalence of falls was 25.1%. Of these, 1.8% resulted in a hip or femur fracture and, among them, 31.8% required surgery for prosthesis placement. Statistically significant associations (p < 0.05) with falls were observed for females [prevalence ratio (PR) = 1.26], age group of 75 years or older (PR = 1.21), fear of falling due to defective sidewalks (PR = 1.47), fear of crossing streets (PR = 1.22), diabetes (PR = 1.17), arthritis or rheumatism (PR = 1.29), and depression (PR = 1.53). No significant associations were found for educational level, marital status, hypertension, and perception of violence in the neighborhood. CONCLUSIONS: The factors associated with falls among older adults are multidimensional, comprising individual characteristics and the urban environment, which indicates the need for intra and intersectoral actions to prevent falls in this population.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Idoso , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Prevalência , Fatores Socioeconômicos , População Urbana
14.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 10s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379288

RESUMO

OBJECTIVE: To evaluate the occurrence and factors associated with multimorbidity among Brazilians aged 50 years and over. METHODS: This is a cross-sectional study in a nation-based cohort of the non-institutionalized population in Brazil. Data were collected between 2015 and 2016. Multimorbidity was assessed from a list of 19 morbidities, which were categorized into ≥ 2 and ≥ 3 diseases. The analysis included the calculation of frequencies and the most frequent 10 pairs and triplets of combinations of diseases. The crude and adjusted analyses evaluated the demographic, socioeconomic, behavioral, and contextual variables (area of residence, geopolitical region, and coverage of the Family Health Strategy) using Poisson regression. RESULTS: From the total of 9,412 individuals, 67.8% (95%CI 65.6-69.9) and 47.1% (95%CI 44.8-49.4) showed ≥ 2 and ≥ 3 diseases, respectively. In the adjusted analysis, women, older persons, and those who did not consume alcohol had increased multimorbidity. There were no associations with race, area of residence, geopolitical region, and coverage of the Family Health Strategy. The 10 pairs (frequencies observed between 11.6% and 23.2%) and the 10 triplets (frequencies observed between 4.9% and 9.5%) of the most frequent diseases mostly included back problems (15 times) and systemic arterial hypertension (11 times). All combinations were statistically higher than expected by chance. CONCLUSIONS: The occurrence of multimorbidity was high even among younger individuals (50 to 59 years). Approximately two in three (≥ 2 diseases) and one in two (≥ 3 diseases) individuals aged 50 years and over presented multimorbidity, which represents 26 and 18 million persons in Brazil, respectively. We observed high frequencies of combinations of morbidities.


Assuntos
Multimorbidade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos
15.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 3s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379289

RESUMO

OBJECTIVE: To examine the factors associated with hospital use and their frequency in a nationally representative sample of the Brazilian population aged 50 years or older. METHODS: Data from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015-2016, were used. Predisposing, enabling and need factors for the use of health services were considered. The analyzes were based on the Hurdle regression model and on estimates of population attributable risks. RESULTS: Among 9,389 participants, 10.2% had been hospitalized in the previous 12 months. After adjusting for potential confounding variables, statistically significant associations (p < 0.05) were observed for need factors (previous medical diagnosis for chronic diseases and limitation to perform basic activities of daily living) and for enabling factors (living in a rural area and in the North and Midwest regions of the country). The analysis of population attributable risks (PAR) showed a hierarchy of the need factors for the occurrence of hospitalizations, with higher contributions by stroke (PAR = 10.7%) and cardiovascular disease (PAR = 10.0%), followed by cancer (PAR = 8.9%), difficulty to perform basic activities of daily living (PAR = 6.8%), depression (PAR = 5.5%), diabetes (PAR = 4.4% ) and hypertension (PAR = 2.2%). CONCLUSIONS: Four of the major diseases associated with hospitalizations (stroke, cardiovascular disease, diabetes and hypertension) are part of the Brazilian list of primary care-sensitive hospitalizations. These results show that there is a window of opportunity to reduce unnecessary hospitalizations among older Brazilian adults through effective primary care actions.


Assuntos
Hospitalização/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos
16.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 13s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379290

RESUMO

OBJECTIVE: To estimate the prevalence of adequate control of hypertension among older adults and to examine its association with predisposing and enabling factors and the need to use health services. METHODS: The analysis was carried out with 4,148 participants (≥ 50 years) from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), who reported being hypertensive and using antihypertensive medication. Adequate control of hypertension was defined as systolic and diastolic blood pressure below 140 mmHg and 90 mmHg, respectively. The following exploratory variables were included: age, sex, health behaviors, and body mass index (predisposing factors); region of residence, rural or urban residence, education level, socioeconomic status of the household, and coverage by private health plan (enabling factors); and medical diagnosis of diabetes (need). The multivariate analysis was performed using Poisson regression and binary logistic regression. RESULTS: The prevalence of adequate control of hypertension was equal to 51.1% (95%CI 48.5-53.6). After adjusting for potential confounders, we observed statistically significant associations (p < 0.05) for education level > 4 years [prevalence ratio (PR) = 1.12 in relation to the lowest level], highest quintile of the socioeconomic status (PR = 1.22 in relation to the lowest quintile), coverage by private health plan (PR = 1.13), residence in the South (PR = 1.19) and Midwest regions (PR = 1.20) in relation to the Southeast region, and obesity (PR = 1.10). CONCLUSIONS: Half of the population studied had adequate control of hypertension. The improvement of this control is an important challenge, which should consider overcoming social and regional inequalities associated with it.


Assuntos
Hipertensão/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Brasil , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Fatores Socioeconômicos
17.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 18s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379291

RESUMO

OBJECTIVE: To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults. METHODS: The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression. RESULT: Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93-0.98) among both women (PR = 0.96; 95%CI 0.92-0.99) and men (PR = 0.94; 95%CI 0.90-0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91-0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation. CONCLUSIONS: Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.


Assuntos
Envelhecimento , Características de Residência/estatística & dados numéricos , Participação Social , Apoio Social , Atividades Cotidianas , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , População Urbana
18.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 11s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379292

RESUMO

OBJECTIVE: To examine factors associated with perception of work ability in a nationally representative sample of Brazilians aged 50 years and over. METHODS: We used data from 8,903 participants of the baseline survey of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The dependent variable was self-rated work ability (good or very good versus fair, poor, or very poor). Independent variables included factors that operate at the beginning, middle, and current stage of life. Multivariate analysis was based on prevalence ratios (PR) and 95% confidence intervals (95%CI) estimated by Poisson regression. RESULTS: Good work ability was reported by 49% of \ participants (49.4% among men and 48.6% among women). Results of the multivariate analysis showed that, for both men and women, good work ability showed positive and statistically significant associations (p < 0.05) with good health up to 15 years of age (PR = 1.22 and 1.18 , respectively), educational level ≥ 8 years (PR = 1.19 and 1.21, respectively), and current good self-rated health (PR = 1.88 and 1.94, respectively). Negative associations were observed for current age (PR = 0.99 for each increase of one year among men and women), medical diagnosis of depression (PR = 0.70 for men and PR = 0.87 for women), and having one or more at least chronic diseases (PR = 0.88 for men and 0.91 for women). Only for men, positive associations for the age at which they started working (PR = 1.14 and 1.12 for 11-17 and ≥ 18 years, respectively) and living with a spouse (PR = 1.09) were found. CONCLUSIONS: Work ability in older ages is built over the life course, particularly by the health conditions in childhood and adolescence, age at which men begin working, educational level, and health conditions in older ages. Policies aimed at increasing longevity in the labor market must take these factors into account.


Assuntos
Qualidade de Vida , Avaliação da Capacidade de Trabalho , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Fatores Sexuais , Fatores Socioeconômicos
19.
Rev Saude Publica ; 52Suppl 2(Suppl 2): 15s, 2018 Oct 25.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30379294

RESUMO

OBJECTIVE: To describe the prevalence of receipt of pensions and associated factors in a nationally representative sample of the Brazilian population aged 50 years and over. METHODS: We used data from 9,130 participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline survey. The outcome variable was receipt of pensions from any source. The exploratory variables were age, gender, residence by region and by urban/rural area, household arrangements, schooling, household assets, perception of income sufficiency, age when started working, number of chronic diseases, and functional limitation. The analyses were based on the Poisson and binary logistic regressions. RESULTS: The prevalence of the receipt of pension was 54.3%. In the multivariate analysis, the following factors showed statistically significant (p < 0.05) associations with the outcome: age [Prevalence Ratio (PR) = 2.59 and 3.24 for 60-69 and 70 years], rural residence (PR = 1.23 ), residence in the Northeast, South and Southeast compared to the North (PR ranging from 1.18 to 1.23), living arrangements (PR = 1.07 and 1.15 for living with one person and living alone), perception of income sufficiency (PR = 1.08 and 1.15 for sometimes and always), functional limitation (PR = 1.13) and having 1 and ≥ 2 chronic diseases (PR = 1,09 and 1,17). Negative association was observed for 5-8 years of education. No association between age when the individual started working and the outcome was observed. Younger participants (50-59 years old) with ≥ 2 diseases or functional limitation were 31% and 63% more likely to receive pensions, respectively; the strength of these associations declined with age. CONCLUSIONS: The results suggest that health conditions are important determinants of early retirement. Discussions to increase age to the retirement cannot be separated from those on improvements in the health conditions of the Brazilian population.


Assuntos
Atividades Cotidianas , Doença Crônica/epidemiologia , Pensões/estatística & dados numéricos , Idoso , Brasil/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , População Rural , Fatores Socioeconômicos
20.
Cad Saude Publica ; 34(10): e00202017, 2018 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-30329004

RESUMO

The objective of this research was to evaluate trends in socioeconomic inequalities in the prevalence of functional dentition among community-dwelling older adults in Brazil. This was a cross-sectional study with data from the last two SBBrasil Project surveys conducted in 2003 and 2010. Functional dentition was defined as the presence of 20 or more natural teeth and was assessed during the clinical examination of dentition status. Schooling was used as the socioeconomic position measure. Socioeconomic inequality was measured using two complex measures; the slope index of inequality (SII) and the relative index of inequality (RII). The prevalence of functional dentition was 10.8% (95%CI: 8.1-14.2) in 2003 and 13.6% (95%CI: 11.1-16.5) in 2010. The prevalence of functional dentition increased significantly over the educational rank in both years. Absolute inequalities were significant for both years and remained unaltered between 2003 and 2010. Significant relative inequality in the prevalence of functional dentition was found in both years of the survey. Socioeconomic inequalities in the prevalence of functional dentition among older adults in Brazil persisted significantly between both national oral health surveys.


Assuntos
Escolaridade , Renda/estatística & dados numéricos , Saúde Bucal/tendências , Perda de Dente/epidemiologia , Idoso , Brasil/epidemiologia , Estudos Transversais , Inquéritos de Saúde Bucal , Dentição , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Saúde Bucal/estatística & dados numéricos , Prevalência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA