scholarly journals Prevalence and patterns of multimorbidity in Amazon Region of Brazil and associated determinants: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023398 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Bruno P Nunes ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of multimorbidity and to identify factors associated with it in the adult population from the metropolitan region of Manaus.DesignCross-sectional population-based study.SettingInterviews conducted between May and August of 2015 in eight cities that compose the metropolitan region of Manaus, Amazonas, Brazil.Participants4001 adults aged ≥18 years.Primary outcome measuresMultimorbidity, measured by the occurrence of ≥2 and ≥3 chronic diseases, was the primary outcome. The associated factors were investigated by calculating the prevalence ratio (PR) obtained by Poisson regression, with robust adjustment of the variance in a hierarchical model. A factor analysis was conducted to investigate multimorbidity clusters.ResultsHalf of the interviewees were women. The presence of a chronic disease was reported by 57.2% (95% CI 56.6% to 59.7%) of the interviewees, and the mean morbidity was 1.2 (1.1–1.2); 29.0% (95% CI 27.6% to 30.5%) reported ≥2 morbidities and 15.2% (95% CI 14.1% to 16.4%) reported ≥3 chronic conditions. Back pain was reported by one-third of the interviewees. Multimorbidity was highest in women, PR=1.66 (95% CI 1.50 to 1.83); the elderly, PR=5.68 (95% CI 4.51 to 7.15) and individuals with worse health perception, PR=3.70 (95% CI 2.73 to 5.00). Associated factors also included undergoing medical consultations, hospitalisation in the last year, suffering from dengue in the last year and seeking the same healthcare service. Factor analysis revealed a pattern of multimorbidity in women. The factor loading the most strength of association in women was heart disease. In men, an association was identified in two groups, and lung disease was the disease with the highest factorial loading.ConclusionMultimorbidity was frequent in the metropolitan region of Manaus. It occurred most often in women, in the elderly and in those with worse health perception.

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017966 ◽  
Author(s):  
Maria Elizete A Araujo ◽  
Marcus T Silva ◽  
Tais F Galvao ◽  
Mauricio G Pereira

ObjectivesTo estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access.DesignCross-sectional population-based study.SettingA survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil.Participants4001 adults ≥18 years of age.Primary outcomes measuresPhysician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes. Associated factors were investigated through the calculation of prevalence ratio (PR) obtained by hierarchical Poisson regression modelling.Results4001 adults were included in the study, 53% of whom were women. The self-reported prevalence of medical visits was 77% (95% CI 75% to 77%); dentist visits, 36% (95% CI 34% to 37%) and hospital admission, 7% (95% CI 6% to 7%). Physician visits were higher in women PR=1.18 (95% CI 1.14 to 1.23), the elderly PR=1.18 (95% CI 1.10 to 1.26) and people with health insurance PR=1.14 (95% CI 1.10 to 1.19). Dentist visits declined with older age PR=0.38 (95% CI 0.30 to 0.49), lower education level PR=0.62 (95% CI 0.51 to 0.74) and lower economic class PR=0.65 (95% CI 0.57 to 0.75). Hospitalisations were found to be twice as frequent for women than for men and three times as frequent among those who reported very poor health status. Among the individuals who did not receive medical attention in the previous 2 weeks, 58% reported lack of facilities or appointment unavailable and 14% reported lack of doctors.ConclusionWhile more than half visited the doctor in the last year, a lower proportion of people with socioeconomic inequities visited the dentist. Organisational and service policies are needed to increase equity in health services in the region.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e026202 ◽  
Author(s):  
Yan Qiu ◽  
Wen Ren ◽  
Ying Liu ◽  
Pei Yin ◽  
Jingjing Ren

ObjectiveTo determine the prevalence, degree of trust and usefulness of the online health information seeking source and identify associated factors in the adult population from the rural region of China.DesignA cross-sectional population-based study.SettingA self-designed questionnaire study was conducted between May and June 2015 in four districts of Zhejiang Province.Participants652 adults aged ≥18 years (response rate: 82.8%).Primary outcome measuresThe prevalence, degree of trust and usefulness of online health information was the primary outcome. The associated factors were investigated by χ2test.ResultsOnly 34.8% of participants had faith in online health information; they still tended to select and trust a doctor which is the first choice for sources of health information. 36.7% of participants, being called ‘Internet users’, indicated that they had ever used the internet during the last 1 year. Among 239 internet users, 40.6% of them reported having sought health information via the internet. And 103 internet users responded that online health information was useful. Inferential analysis demonstrated that younger adults, individuals with higher education, people with a service-based tertiary industry career and excellent health status used online health information more often and had more faith in it (p<0.001).ConclusionsUsing the internet to access health information is uncommon in the rural residential adult population in Zhejiang, China. They still tend to seek and trust health information from a doctor. Internet as a source of health information should be encouraged.


2014 ◽  
Vol 35 (4) ◽  
pp. 35-41 ◽  
Author(s):  
Joana Darc Chaves Cardoso ◽  
Rosemeiry Capriata de Souza Azevedo ◽  
Annelita Almeida Oliveira Reiners ◽  
Cecília Victorazzo Louzada ◽  
Mariano Martinez Espinosa

The purpose of this study was to examine the prevalence of bad self-rated health in the elderly and associated demographic and socioeconomic factors. This was an epidemiological, cross-sectional study. Data were collected through interviews using the BOAS (Brazil Old Age Schedule) questionnaire. The study included 573 elderly residents in the urban area of Cuiabá-MT, Brazil. The adopted measure of association was the prevalence ratio. For multivariate analysis, multiple Poisson regression was used. The prevalence of poor/very poor self-rated health was 30.9% and the associated factors were income, number of morbidities and urinary incontinence. The association of demographic and socioeconomic factors with poor/very poor self-rated health among the elderly in this study shows the need for assistance and policies that minimize the impact of these factors on the lives and health of the elderly.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.


2002 ◽  
Vol 58 (3) ◽  
Author(s):  
G. M. Chigali ◽  
M. Marais ◽  
R. M. B. Mpofu

The aim of this study was to investigate the experiences which impact on aspects of the lives and sense of well-being of elderly people in a township in South Africa in order to make recommendations for future service delivery. A cross- sectional, qualitative survey was carried out in Mfuleni Township, a part of the Cape Metropolitan Region in the Western Cape.  Sixteen people of ages ranging from 60-82 years were conveniently selected from a group of elderly people who meet regularly at a community centre. Data were collected through focused  group discussions and unstructured interviews. Analysis of data revealed three main categories namely, psychological/ emotional, socio-economic and health, under which different themes emerged. The experiences of individuals in a given society may vary, but somehow, their basic rights tend to be universal as revealed by the literature. Loneliness and isolation, lack of recreation facilities, loss of dignity and respect, poor health services and lack of shelter are some of the experiences expressed by the elderly people in this sample. These experiences highlight the need for clearly stated policies andcommitment by governmental and non-governmental structures, appropriate health service strategies and improved socio-economic standards supported by properly researched data.


2015 ◽  
Vol 28 (3) ◽  
pp. 231-240 ◽  
Author(s):  
Ana Luísa Moreira dos Santos ◽  
Teresa Maria de Serpa Pinto Freitas do Amaral ◽  
Nuno Pedro Garcia Fernandes Bento Borges

OBJECTIVE: To evaluate the prevalence of undernutrition in older adults aged >75 years living in communities and to identify the main factors independently associated with undernutrition. METHODS: A cross-sectional study was conducted using a random sample of family physicians' medical records of 86 older adults aged >75 years living in the community studied. Their nutritional status was evaluated using the Mini Nutritional Assessment. RESULTS: A total of 10.5% of the elderly were undernourished and 41.9% were at undernutrition risk. According to the logistic regression multivariable model, the following characteristics: being widowed (OR=6.7; 95%CI=1.8-24.6); being institutionalized (OR=12.6; 95%CI=1.7-90.5); or having a negative self-perception of health (OR=15.0; 95%CI=3.3-69.1) were independently associated with a significant increase of undernutrition risk. CONCLUSION: The current study shows that undernutrition is highly prevalent in Portuguese older adults aged >75 years living in communities. The major factors independently associated with their undernutrition are being widowed and institutionalized and having negative self-perception of health. The results obtained show that undernutrition and its associated factors are very serious problems for older adults and a challenge in their health care.


Author(s):  
Vandana Ganganapalli ◽  
Sujatha N. ◽  
Bhaskar Kurre

Background: Globally, more than 300 million people of all ages suffer from depression. With an ageing population, depression among the elderly is likely to increase in the coming years, with higher prevalence among the elderly people than that in the general adult population. This study was intended to know the prevalence of depression and factors associated with depression among elderly people.Methods: A cross-sectional study was conducted in the urban field practice area of Navodaya Medical College, Raichur. A pre-designed and pre-tested questionnaire was used to interview the elderly person, after taking verbal consent. Depression was assessed using geriatric depression scale (short version). The study duration was from 1st September 2018 – 31st December, 2018 with 360 sample size.Results: Out of 360 elderly people, the prevalence of depression was found to be 31.4 %. The prevalence of depression was more in females 31.9% (63 out of 197). Significant association of depression was noted with age, socio-economic status, marital status, type of family, education and occupation with p<0.05.Conclusions: Around 1/3rd of the study participants were found to be suffering from depression. Depression was significantly associated with age, illiteracy, nuclear family, dependent on family members. Family support to the elderly population may prevent depression.


2020 ◽  
pp. 1-11
Author(s):  
Tais Freire Galvao ◽  
Gustavo Magno Baldin Tiguman ◽  
Bruno Vianei Real Antonio ◽  
Raquel Rodrigues Ferreira Rocha de Alencar ◽  
Leila Posenato Garcia ◽  
...  

2018 ◽  
Vol 21 (4) ◽  
pp. 419-427
Author(s):  
Adriana Nancy Medeiros dos Santos ◽  
Dulcinéia Rebecca Cappelletti Nogueira ◽  
Caroline Ribeiro de Borja-Oliveira

Abstract Objective: to identify the prevalence of self-medication, the therapeutic classes used without medical prescription, the symptoms treated with such medication and associated factors among participants of an Open University of the Third Age (OU3A). Method: a cross-sectional, descriptive and analytical study was carried out, the sample of which was composed of 138 OU3A attendees. To estimate the association between the variables, prevalence ratios (PR), confidence intervals (95% CI), the chi-squared test and Fisher's exact test were used. Results: the majority were aged 60-69 years (61.6%), were female (75.4%), had a health plan (63%) and claimed to self-medicate (59.4%, 95% CI, 0-64.8). The most frequently mentioned therapeutic classes were analgesics (31.9%), muscle relaxants (13.8%), anti-inflammatories (13.0%) and first-generation antihistamines (7.2%). The most commonly reported self-medication symptoms were muscle and joint pain (21.0%), headaches (10.1%) and colds and flu (8.7%). There was a significant association (p = 0.049) among those who self-medicated more frequently and anti-inflammatory use (PR = 1.46, 95% CI = 1.10-1.99). The complaint of muscular and articular pain exhibited a significant association with the diagnosis of arthrosis (p = 0.003, RP = 3.75, 95% CI = 2.07-6.76) and hypothyroidism (p = 0.002, RP = 2.77 ; 95% CI = 1.50-5.10). Conclusion: the most frequently mentioned reasons for self-medicating were previous experience using the drug and the certainty that it is safe. Most of the above medications are potentially inappropriate for the elderly. However, the elderly consider them safe and are unaware of the risks to which they expose them. They may also be unaware that pain treated by self-medication may be related to pre-existing diseases, which require the appropriate professional and treatment.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Neda Esmailzadeh Bruun-Rasmussen ◽  
George Napolitano ◽  
Allan Kofoed-Enevoldsen ◽  
Stig Egil Bojesen ◽  
Christina Ellervik ◽  
...  

Abstract Background This study aimed to investigate prevalence and risk factors for prediabetes, undiagnosed diabetes mellitus, poorly and potentially sub-controlled diabetes in a rural-provincial general adult population in Denmark. Methods Using cross-sectional data from the Lolland-Falster Health Study, we examined a total of 10,895 individuals aged 20 years and above. Results Prevalence of prediabetes was 5.8% (men: 6.1%; women: 5.5%); of undiagnosed diabetes 0.8% (men: 1.0%; women: 0.5%); of poorly controlled diabetes 1.2% (men: 1.5%; women: 0.8%); and of potentially sub-controlled diabetes 2% (men: 3.0%; women: 1.3%). In total, 9.8% of all participants had a diabetes-related condition in need of intervention; men at a higher risk than women; RR 1.41 (95% CI 1.26–1.58); person aged + 60 years more than younger; RR 2.66 (95% CI 2.34–3.01); obese more than normal weight person, RR 4.51 (95% CI 3.79–5.38); smokers more than non-smokers, RR 1.38 (95% CI 1.19–1.62); persons with self-reported poor health perception more than those with good, RR 2.59 (95% CI 2.13–3.15); low leisure time physical activity more than those with high, RR 2.64 (95% CI 2.17–3.22); and persons with self-reported hypertension more than those without, RR 3.28 (95% CI 2.93–3.68). Conclusions In the Lolland-Falster Health Study, nearly 10% of participants had prediabetes, undiagnosed diabetes, poorly controlled, or potentially sub-controlled diabetes. The risk of these conditions was more than doubled in persons with self-reported poor health perception, self-reported hypertension, low leisure time physical activity, or measured obesity, and a large proportion of people with diabetes-related conditions in need of intervention can therefore be identified relatively easily.


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