Negative self-rated health in older people associated with socioeconomic conditions and health: a population survey in Rio Branco, Acre

Usnayo, Rodolfo Esteban Kelca; Monteiro, Gina Torres Rego; Amaral, Cledir de Araújo; Vasconcellos, Maurício Teixeira Leite de; Amaral, Thatiana Lameira Maciel

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Revista Brasileira de Geriatria e Gerontologia

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Original Articles • Rev. bras. geriatr. gerontol. 23 (5) • 2020 • https://doi.org/10.1590/1981-22562020023.200267 copy

Negative self-rated health in older people associated with socioeconomic conditions and health: a population survey in Rio Branco, Acre

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To estimate the prevalence of negative self-rated health and its association with socioeconomic conditions, depressive symptoms, self-reported functionality, and morbidities in older people in Rio Branco, Acre.

Method

This is a survey carried out with data from Estudo das Doenças Crônicas em Idosos (EDOC-I - Study of Chronic Diseases in Older People), a household survey carried out with people aged 60 and over living in Rio Branco, Acre, Brazil, in 2014 (n=1,016). Negative self-rated health was defined by the “bad” and “very bad” strata. The scales of geriatric depression and activities of daily living and instrumental activities of daily living were applied. As a measure of association between negative self-rated health and variables of interest, the multiple logistic regression technique was used.

Results

The prevalence of negative self-rated health was 15.4%, with a statistically significant association with females (OR: 1.72; 95%CI:1.17-2.51), low education (OR:2.33; 95%CI:1.37-3.97), sedentary lifestyle (OR:1.84; 95%CI:1.08-3.14), and medication use (OR:3.01; 95%CI:1.52-5,95). An association was also detected with depressive symptoms (OR:2.55; 95%CI:1.74-3.73), presence of multimorbidities (OR:1.73; 95%CI:1.15-2.61), and total dependence on instrumental activities of daily living (OR:2.42; 95%CI:1.40-4.17). The morbidities associated with the negative perception of health were asthma/bronchitis (OR:2.74; 95%CI:1.61-4.67), insomnia (OR:1.80; 95%CI:1.25-2.58), and heart problems (OR:1.77; 95%CI:1.18-2.68).

Conclusion

Therefore, the negative self-rated health of older people is influenced by socioeconomic and health conditions, being a useful indicator for the design of health strategies to favor aging with independence and physical and emotional well-being.

Keywords
Health of the Elderly; Self-evaluation; Depression; Frail Elderly; Serveys and Questionnaire; Measures of Association

Variables	Total	Negative Self-rated Health		p- value ^a
Variables	N	n	N (%)	p- value ^a
Total	23,416	1,016	3,610 (15.4)
Age (years)				0.081
60-79	20,081	842	2,905 (14.5)
80 and over	3,335	174	705 (21.2)
Gender				0.009
Male	10,896	418	1,283 (11.8)
Female	12,520	598	2,327 (18.6)
Marital status*				0.453
Common-law marriage	9,086	376	1,271 (14.0)
No common-law marriage	14,172	633	2,277 (16.1)
Skin color				0.591
White	5,614	250	931 (16.6)
Not white	17,802	766	2,679 (15.0)
Education*				0.001
High school and higher education	3,789	156	299 (7.9)
Up to elementary school	19,434	852	3,287 (16.9)
Physical activity*				0.003
Yes	3,577	151	293 (8.2)
No	19,839	865	3,317 (16.7)
Smoking*				0.882
Non-smoking	6,763	294	1,020 (15.1)
Smoker / ex-smoker	16,653	722	2,590 (15.6)

Variables	Total	Negative Self-rated Health		p-value ^a
Variables	N	n	N (%)	p-value ^a
Use of medication				<0.001
No	5,871	237	332 (5.7)
Yes	17,545	779	3,278 (18.7)
BMI (kg/m²)*				0.100
<22	2,789	128	583 (20.9)
22 to 27	10,042	432	1,292 (12.9)
>27	9,204	397	1,568 (17.0)
Central obesity (CC)*				0.410
CC≤102M or ≤88F	14,381	610	2,120 (14.7)
CC> 102M or> 88F	7,871	357	1,364 (17.3)
Hospitalization in the last 12 months*				0.003
No	18,868	818	2,614 (13.9)
Yes	3,746	162	823 (22.0)
Arterial hypertension*				0.251
No	5,458	235	1,002 (18.4)
Yes	17,385	759	2,584 (14.9)
Diabetes*				0.226
No	18,843	820	2,740 (14.5)
Yes	3,834	166	705 (18.4)
Dyslipidemia*				0.930
No	4,585	198	696 (15,2)
Yes	18,031	785	2.782 (15,4)
Self-reported morbidities
Asthma/bronchitis				<0.001
No	21,067	913	2,853 (13.5)
Yes	2,275	100	725 (31.9)
Insomnia*				0.001
No	15,333	658	1,904 (12.4)
Yes	8,039	356	1,706 (21.2)
Poor circulation				0.047
No	2,018	632	2,018 (13.6)
Yes	8,437	379	1,518 (18.0)
Heart problems*				<0.001
No	19,843	858	2,547 (12.8)
Yes	3,245	144	880 (27.1)
Encephalic Vascular Accident*				0.513
No	22,313	967	3,480 (15.6)
Yes	1,026	46	130 (12.7)
Osteoporosis*				0.007
No	19,473	829	2,703 (13.9)
Yes	3,453	164	775 (22.4)
Depression (GDS)*				<0.001
No	15,666	671	1,658 (10.6)
Yes	7,558	337	1,908 (25.2)
Multimorbidity*
No	10,019	419	1,112 (11.1)	0.002
Yes (≥2)	13,398	597	2,498 (18.6)	0.002
No	14,786	627	1,708 (11.6)	<0.001
Yes (≥3)	8,630	389	1,902 (22.0)	<0.001
ADL*				0.898
Independent	17,539	760	2,684 (15.3)
Partial dependence	4,000	176	584 (14.6)
Total dependence	1,771	75	299 (16.9)
IADL				< 0.001
Independent	11,908	490	1,309 (11.0)
Partial dependence	9,079	412	1,657 (18.3)

Variables	OR_Crude (95%CI)	OR_Adjust (95%CI)
Distal level
Age (≥80 vs. 60-79)	1.59 (0.94 - 2.68)	1.47 (0.86 - 2.51)
Gender (female vs. male)	1.71 (1.15 - 2.55)	1.72 (1.17 – 2.51)
Education (up to element. vs. ≥ high school)	2.37 (1.40 – 4.01)	2.33 (1.37 – 3.97)
Intermediate level
Physical activity (sedentary vs. active)	2.25 (1.33 – 3.78)	1.84 (1.08 – 3.14)
BMI (kg/m²)*
< 22 vs. 22 – 27	1.79 (1.15 – 2.79)	1.58 (0.99 – 2.52)
> 27 vs. 22 – 27	1.39 (0.87 – 2.22)	1.31 (0.82 – 2.10)
Proximal Level
Use of medication (yes vs. no)	3.84 (2.11 – 6.98)	3.01 (1.52 – 5.95)
Hospitalization (yes vs. no)	1.75 (1.22 – 2.51)	1.31 (0.83 – 2.09)
Asthma/Bronchitis (yes vs. no)	2.98 (1.82 – 4.89)	2.74 (1.61 – 4.67)
Insomnia (yes vs. no)	1.90 (1.30 – 2.78)	1.80 (1.25 – 2.58)
Poor circulation (yes vs. no)	1.39 (1.00 – 1.94)	1.05 (0.76 – 1.45)
Heart problems (yes vs. no)	2.53 (1.73 – 3.70)	1.77 (1.18 – 2.68)
Osteoporosis (yes vs. no)	1.79 (1.18 – 2.74)	1.19 (0.73 – 1.96)

Variables	OR_Crude (95%CI) (model 1)*	OR_Adjust (95%CI) (model 2)**	OR_Adjust (95%CI) (model 3)***
Depression (GDS) Yes vs. No	2.85 (1.91 – 4.26)	2.69 (1.85 – 3.93)	2.55 (1.74 – 3.73)
Instrumental activities of daily living
Partially dependent vs. Independent	1.81 (1.23 – 2.65)	1.71 (1.12 – 2.60)	1.63 (1.06 – 2.51)
Totally dependent vs. Independent	2.82 (1.71 – 4.65)	2.64 (1.51 – 4.62)	2.42 (1.40 – 4.17)
Multimorbidity (≥2) Yes vs. No	1.84 (1.26 – 2.68)	1.69 (1.14 – 2.51)	1.73 (1.15 – 2.61)
Multimorbidity (≥3) Yes vs. No	2.16 (1.63 – 2.87)	1.97 (1.44 – 2.72)	1.93 (1.37 – 2.72)

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[1] Correspondence Thatiana Lameira Maciel Amaral thatianalameira27@gmail.com

Brasil

Brasil

Negative self-rated health in older people associated with socioeconomic conditions and health: a population survey in Rio Branco, Acre

Abstract

﻿Objective

Method

Results

Conclusion

Objective