Associated factors to self-rated health among hypertensive
          and/or diabetic elderly: results from Bambuí project

Loyola Filho, Antônio Ignácio de; Firmo, Josélia de Oliveira Araújo; Uchôa, Elizabeth; Lima-Costa, Maria Fernanda

doi:10.1590/S1415-790X2013000300001

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Original Articles • Rev. bras. epidemiol. 16 (03) • Sept 2013 • https://doi.org/10.1590/S1415-790X2013000300001 copy

Associated factors to self-rated health among hypertensive and/or diabetic elderly: results from Bambuí project

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

This study investigated the associated factors with negative self-rated health among hypertensive and/or diabetic elderly.

Methods:

All the participants of Bambuí Project elderly cohort who suffered from hypertension and/or diabetes and who answered the questionnaire without the help of a close informant were selected for this (n = 942). Covariates encompassed sociodemographic characteristics, social support, health behaviors, health status and use of health services.

Results:

Negative self-rated health showed positively associated with dissatisfaction with social relations (PR = 1.98, 95%CI 1.42 - 2.76), attendance at religious services less than once a month (PR = 1.96, 95%CI 1.44 - 2.68; be smokers (PR = 1.64, 95%CI 1.24 - 2.17), presence of arthritis (PR = 1.35, 95%CI 1.07 - 1.71), depressive symptoms (PR = 1.81, 95%CI 1.37 - 2.39) and insomnia (PR = 1.37, 95%CI 1.06 - 1.78), having consulted the doctor two or more times in the last twelve months (PR = 2.18; 95%CI 1.14 - 4.19 and PR = 3.96; 95%CI 2.10 - 7.48, respectively for "2 - 3" and "4+" visits), and have hypertension and diabetes (compared to the isolated presence of hypertension)

Conclusions:

Our results confirmed the multidimensional nature of self-rated health and were consistent with that observed in other national and international studies.

Aged; Hypertension; Diabetes; Health self-assesment

Variables	Self-rated health				p-value^a
Variables	Negative		Positive		p-value^a
	n	%	n	%
Socio-demographic characteristics
Gender
Male	62	19.1	262	80.9
Female	127	20.6	491	79.5	0.607
Age (years)
60 – 69	118	21.2	439	78.8
70 – 79	54	18.0	246	82.0
≥ 80	17	20.0	68	80.0	0.540
Marital status
Married / Living with partner	84	18.7	366	81.3
Widowed	79	22.9	266	77.1
Single / Separated	26	17.7	121	82.3	0.247
Education (in years of school attendance)
None	82	28.3	208	71.7
1 – 3	58	18.7	252	81.3
4 or +	49	14.3	293	85.7	< 0.001
Family income (in number of Minimum Wages)b
< 2	82	30.9	183	69.1
2 – 3.9	68	19.3	285	80.7
≥ 4	37	11.6	282	88.4	< 0.001
Social resources
Level of satisfaction with social relations
Satisfied	153	18.3	685	81.7
Indifferent	13	25.0	39	75.0
Dissatisfied	23	44.2	29	55.8	< 0.001
Attendance to religious cults
Once a week or more	57	14.2	345	85.8
1 – 3 times a month	72	21.0	271	79.0
Less than once a month	58	30.7	131	69.3	< 0.001

Health-related behaviors	Self-rated health				p-value^a
Health-related behaviors	Negative		Positive		p-value^a
	n	%	n	%
Frequency of physical exercise in leisure time in the past 90 days
< 3 times a week	174	21.6	633	78.4	0.005
≥ 3 times a week	15	11.1	120	88.9	0.005
History of tobacco consumption
Never smoked	99	17.1	480	82.9	< 0.001
Former smoker	41	19.0	175	81.0
Current smoker	49	33.8	96	66.2
History of alcohol consumption in the last 12 months
Did not drink / never drank	162	21.4	594	78.6	0.030
< 3 times a week	15	11.5	116	88.6
≥ 3 times a week	12	21.8	43	78.2

Variables	Self-rated health				p-value^a
Variables	Negative		Positive		p-value^a
	n	%	n	%
Coronary diseaseb
No	156	19.2	656	80.8	0.180
Yes	30	24.4	93	75.6	0.180
Arthritis and rheumatism
No	108	17.1	523	82.9	0.001
Yes	81	26.1	229	73.9	0.001
Presence of antibodies to Trypanosoma cruzi
No	95	16.4	484	83.6	0.001
Yes	84	25.9	241	74.2	0.001
Depression and anxiety symptoms in the last 15 days
No	69	11.9	511	88.1	< 0.001
Yes	118	32.8	242	67.2	< 0.001
Insomnia in the last 30 days
No	81	14.7	471	85.3	< 0.001
Yes	106	27.3	282	72.7	< 0.001
Presence of cognitive dysfunction
No	129	17.0	628	83.0	< 0.001
Yes	58	31.9	124	68.1	< 0.001
Number of prescribed drugs consumed in the last 90 days
None	16	11.6	122	88.4	< 0.001
1	13	10.8	107	89.2
2 – 4	73	17.4	347	82.6
5 or more	87	33.0	177	67.1
Inability to perform at least one activity of daily living
No	151	18.0	686	82.0	< 0.001
Yes	37	35.9	66	64.1	< 0.001
Participant status in relation to hypertension and diabetes
Only hypertension	137	18.8	593	81.2	0.129
Only diabetes	13	21.0	49	79.0
Hypertension and diabetes	39	26.0	111	74.0

Health-related behaviors	Self-rated health				p-value^a
Health-related behaviors	Negative		Positive		p-value^a
	n	%	n	%
History of hospitalization in the last 12 months
No	117	16.1	609	83.9	< 0.001
Yes	72	33.3	144	66.7	< 0.001
Number of medical visits in the last 12 months
None	9	6.1	138	93.9	< 0.001
1	29	14.4	173	85.6
2 – 3	48	17.8	221	82.2
4 or more	103	31.8	221	68.2
Health plan coverage
No	165	22.2	578	77.8	0.002
Yes	24	12.1	175	87.9	0.002
Main problem faced when in need of medical services
None	37	11.7	279	88.3	< 0.001
Distance, price, queue	113	25.8	325	74.2
Other	38	20.5	147	79.5

Characteristics	PR	95%CI
Family income in Minimum Wagesa
< 2	1.00
2 – 3.9	0.68	0.53 – 0.88
≥ 4	0.52	0.36 – 0.73
Level of satisfaction with social relations
Satisfied	1.00
Indifferent	1.10	0.72 – 1.66
Dissatisfied	1.98	1.42 – 2.76
Attendance to religious cults
Once a week or more	1.00
1 – 3 times a month	1.28	0.93 – 1.76
Less than once a month	1.96	1.44 – 2.68
History of tobacco consumption
Never smoked	1.00
Former smoker	1.06	0.78 – 1.45
Current smoker	1.64	1.24 – 2.17
Arthritis or rheumatism
No	1.00
Yes	1.35	1.07 – 1.71
Depression and anxiety symptoms in the last 15 days
No	1.00
Yes	1.81	1.37 – 2.39
Insomnia in the last 30 days
No	1.00
Yes	1.37	1.06 – 1.78
Number of medical visits in the last 12 months
None	1.00
1	1.81	0.90 – 3.62
2 – 3	2.18	1.14 – 4.19
4 or more	3.96	2.10 – 7.48
Status in relation to hypertension and diabetes
Only hypertension	1.00
Only diabetes	1.11	0.71 – 1.73
Hypertension and diabetes	1.43	1.07 – 1.92

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[1] Corresponding author: Antônio Ignácio de Loyola Filho Avenida Augusto de Lima 1715, 6o andar CEP: 30190-003, Belo Horizonte, MG, Brazil E-mail: aloy@cpqrr.fiocruz.br