Factors related to low social participation in older adults: findings from the Fibra study, Brazil

Pinto, Juliana Martins; Neri, Anita Liberalesso

doi:10.1590/1414-462X201700030300

Brasil

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Artigos Originais • Cad. saúde colet. 25 (3) • July-Sept 2017 • https://doi.org/10.1590/1414-462X201700030300 linkcopy

Factors related to low social participation in older adults: findings from the Fibra study, Brazil

Fatores relacionados à baixa participação social em idosos: resultados do estudo Fibra, Brasil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective To investigate the factors related to low social participation in older adults.

Method A hierarchical model was drawn using data from 2,251 participants of the Fibra study, aged 65 years or more, without cognitive impairment suggestive of dementia, who were living in seven Brazilian cities. Three blocks of variables were considered: macrostructural, socioeconomic and health conditions.

Results Factors related to low social participation were low perceived social support (OR:2.18;CI:0.73-1.53; <0.001), vision impairment (OR:2.04; CI:1.16-3.61;0.014), age over 80 years (OR:2.03;CI:1.22-3.38;0.006), depressive symptoms (OR:1.86;CI:1.29-2.68; <0.001), low cognitive status (OR:1.85;CI:1.20-2.85;0.005) and slowness (OR:1.83;CI:1.26-2.65;0.001). Older adults with those conditions have higher odds to be less socially engaged than their counterparts.

Conclusion Personal conditions, such as socioeconomic and health status were predictors of low social participation in older adults. Initiatives aiming at active aging promotion should focus primarily on vulnerable elderly, especially those with health and/or social disadvantages.

Keywords: health of the elderly; aging; social behavior; socioeconomic factors; social support

Variables	Categories	%
Access to medical service	Public	60.1
Access to medical service	Private	39.8
Access to dental service	Public	38.2
Access to dental service	Private	61.8
Number of medical consultations (year)	0	9.3
	1-2	29.5
	3-5	34.3
	>=6	26.7
Number of dental consultations (year)	0	64.5
	1-2	25.4
	3-5	6.7
	>=6	3.3
Age	65-69	37.8
	70-74	31.2
	75-79	18.9
	80+	11.9
Gender	Male	34.2
Gender	Female	65.7
Family income	<=3 MS	59.3
	3-5 MS	22
	>5 MS	18.6
Illiteracy	Yes	77.6
Illiteracy	No	22.3
Perceiveid social support	High	36.3
	Moderate	30
	Low	33.6
Number of chronic diseases	0	11.3
	1-2	49.4
	>=3	39.2
Number of health problems	0	10.5
	1-2	41
	>=3	48.4
Weakness	Sim	17.3
Weakness	Não	82.6
Slowness	Yes	17
Slowness	No	82.9
Depressive symptoms	Yes	20.4
Depressive symptoms	No	79.5
Cognitive status	Low	29.3
	Moderate	34.7
	High	35.9
Self-rated health	Regular/fair	65.4
Self-rated health	Good/very good	34,5
Visual impairment	No	52.4
	Yes with glasses	38.7
	Yes without glasses	8.7
Hearing impairment	No	73.7
	Yes with aid	3.1
	Yes without aid	23.1
Low social participation	Yes	25.4
Low social participation	No	74.5

	Low social participation
		No (%)	Yes (%)	p ^* * x2 significant <0.05
Access to medical services	Public	57.5	67.7	<0.001
Access to medical services	Private	42.4	32.2	<0.001
Access to dental services	Public	35.5	45.9	<0.001
Access to dental services	Private	64.4	54	<0.001
Number of medical visits (year)	0	9.2	9.4	0.403
	1-2	30	28.2
	3-5	34.8	33
	>=6	25.8	29.2
Number of dental visits (year)	0	61.5	73.2	<0.001
	1-2	27.3	19.9
	3-5	7.3	4.8
	>=6	3.7	2

	Low social participation
		No (%)	Yes (%)	p ^* * x2 significant <0.05
Age	65-69	39.7	32.3	<0.001
	70-74	31.8	29.3
	75-79	18.3	20.7
	80+	10	17.5
Gender	M	33.4	36.6	0.143
Gender	F	66.5	63.3	0.143
Family income	<=3SM	56.7	67	<0.001
	3-5SM	22.7	20
	>5SM	20.5	12.9
Illiteracy	No	80.3	69.8	<0.001
Illiteracy	Yes	19.6	30.1	<0.001
Perceiveid Social support	High	39.5	26.8	<0.001
	Moderate	31.2	26.6
	Low	29.2	46.5

	Low social participation
		No (%)	Yes (%)	^* * x2 significant <0.05 p
Number of chronic diseases	No one	11.9	9.5	0.044
	1-2	50.1	47.4
	>=3	37.9	42.9
Number of health problems	No one	11.8	6.4	<0.001
	1-2	41.7	38.9
	>=3	46.3	54.5
Weakness	No	83.9	79	0.005
Weakness	Yes	16	20.9	0.005
Slowness	No	85.7	74.6	<0.001
Slowness	Yes	14.2	25.3	<0.001
Depressive symptoms	No	83.8	66.8	<0.001
Depressive symptoms	Yes	16.1	33.1	<0.001
Cognitive status	Low	26	39	<0.001
	Moderate	34.6	34.9
	High	39.3	26
Self-rated health	Regular/fair	62.8	72.9	<0,001
Self-rated health	Good/very good	37.1	27	<0,001
Visual impairment	No	55.1	44.5	<0.001
	Yes with glasses	37.6	41.9
	Yes without glasses	7.1	13.4
Hearing impairment	No	74.8	70.3	0.072
	Yes with aid	3	3.4
	Yes without aid	22	26.2

Independent variables	Block 1		Block 2		Block 3
Independent variables	p	OR ^* * OR=Odds Ratio; (CI 95%)	p	OR ^* * OR=Odds Ratio; (CI 95%)	p	OR ^* * OR=Odds Ratio; (CI 95%)
Macrostrutural
Access to medical services
Private		1.00		1.00		1.00
Public	0.008	1.47 (1.10-1.95)	0.070	1.32 (0.98-1.79)	0.197	1.23 (0.90-1.69)

Socioeconomic
Perceiveid social support
High (20)				1.00		1.00
Moderate (16-19)			0.426	1.16 (0.81-1.66)	0.765	1.06 (0.73-1.53)
Low (<=15)			<0.001	2.56 (1.80-3.64)	<0.001	2.18 (1.51-3.13)
Age
65-69				1.00		1.00
70-74			0.664	1.08 (0.76-1.54)	0.963	0.99 (0.69-1.43)
75-79			0.016	1.63 (1.09-2.44)	0.155	1.35 (0.89-2.06)
80+			<0.001	2.44 (1.50-3.96)	0.006	2.03 (1.22-3.38)
Illiteracy
No				1.00		1.00
Yes			0.011	1.58 (1.11-2.24)	0.708	0.92 (0.60-1.42)

Health status
Depressive symptoms
No						1.00
Yes					<0.001	1.86 (1.29-2.68)
Slowness
No						1.00
Yes					0.001	1.83 (1.26-2.65)
Cognitive status
High (>27)						1.00
Moderate (24-26)					0.492	1.14 (0.78-1.66)
Low (<23)					0.005	1.85 (1.20-2.85)
Visual impairment
No						1.00
Yes with glasses					0.051	1.38 (0.99-1.89)
No without glasses					0.014	2.04 (1.16-3.61)

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x² significant <0.05