Prevalence of Multimorbidity of Chronic Noncommunicable Diseases in Brazil: Population-Based Study

Background Multimorbidity is the co-occurrence of two or more chronic diseases. Objective This study, based on self-reported medical diagnosis, aims to investigate the dynamic distribution of multimorbidity across sociodemographic levels and its impacts on health-related issues over 15 years in Brazil using national data. Methods Data were analyzed using descriptive statistics, hypothesis tests, and logistic regression. The study sample comprised 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from the two latest cross-sectional, multiple-cohort, national-based studies: the National Sample Household Survey (PNAD) of 1998, 2003, and 2008, and the Brazilian National Health Survey (PNS) of 2013. Results Overall, the risk of multimorbidity in adults was 1.7 times higher in women (odds ratio [OR] 1.73, 95% CI 1.67-1.79) and 1.3 times higher among people without education (OR 1.34, 95% CI 1.28-1.41). Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). Seniors with multimorbidity had more than twice the likelihood of receiving health assistance in community services or clinics (OR 2.16, 95% CI 2.02-2.31) and of being hospitalized (OR 2.37, 95% CI 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years. Conclusions Our study shows little variation in the prevalence of the multimorbidity of chronic diseases in Brazil over time, but there are differences in the prevalence of multimorbidity across different social groups. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management.

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Prevalence of Multimorbidity of Chronic Noncommunicable Diseases in Brazil: Population-Based Study (Preprint)

10.2196/preprints.29693 ◽

2021 ◽

Author(s):

Xin Shi ◽

Simone Maria da Silva Lima ◽

Caroline Maria de Miranda Mota ◽

Ying Lu ◽

Randall S Stafford ◽

...

Keyword(s):

Chronic Diseases ◽

Household Survey ◽

Well Being ◽

National Sample ◽

Population Based ◽

Community Services ◽

Noncommunicable Diseases ◽

Subjective Well Being ◽

Cross Sectional ◽

Multiple Chronic Diseases

BACKGROUND Multimorbidity is the co-occurrence of two or more chronic diseases. OBJECTIVE This study, based on self-reported medical diagnosis, aims to investigate the dynamic distribution of multimorbidity across sociodemographic levels and its impacts on health-related issues over 15 years in Brazil using national data. METHODS Data were analyzed using descriptive statistics, hypothesis tests, and logistic regression. The study sample comprised 679,572 adults (18-59 years of age) and 115,699 elderly people (≥60 years of age) from the two latest cross-sectional, multiple-cohort, national-based studies: the National Sample Household Survey (PNAD) of 1998, 2003, and 2008, and the Brazilian National Health Survey (PNS) of 2013. RESULTS Overall, the risk of multimorbidity in adults was 1.7 times higher in women (odds ratio [OR] 1.73, 95% CI 1.67-1.79) and 1.3 times higher among people without education (OR 1.34, 95% CI 1.28-1.41). Multiple chronic diseases considerably increased with age in Brazil, and people between 50 and 59 years old were about 12 times more likely to have multimorbidity than adults between 18 and 29 years of age (OR 11.89, 95% CI 11.27-12.55). Seniors with multimorbidity had more than twice the likelihood of receiving health assistance in community services or clinics (OR 2.16, 95% CI 2.02-2.31) and of being hospitalized (OR 2.37, 95% CI 2.21-2.56). The subjective well-being of adults with multimorbidity was often worse than people without multiple chronic diseases (OR=12.85, 95% CI: 12.07-13.68). These patterns were similar across all 4 cohorts analyzed and were relatively stable over 15 years. CONCLUSIONS Our study shows little variation in the prevalence of the multimorbidity of chronic diseases in Brazil over time, but there are differences in the prevalence of multimorbidity across different social groups. It is hoped that the analysis of multimorbidity from the two latest Brazil national surveys will support policy making on epidemic prevention and management.

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Self-perceived quality of health and satisfaction by elderly seen by the Family Health Strategy team

Einstein (São Paulo) ◽

10.1590/s1679-45082017ao3972 ◽

2017 ◽

Vol 15 (4) ◽

pp. 428-434

Author(s):

Lilian Rigo ◽

Raíssa Rigo Garbin ◽

José Lucas Sani de Alcântara Rodrigues ◽

Laerte Ribeiro Menezes-Júnior ◽

Luiz Renato Paranhos ◽

...

Keyword(s):

Health Status ◽

Chronic Diseases ◽

Family Health ◽

Well Being ◽

Population Based ◽

Self Medication ◽

Cross Sectional ◽

Health Strategy ◽

Family Health Strategy

ABSTRACT Objective: To verify the profile of elderly followed up by Family Health Strategy teams and the influence of self-reported chronic diseases on demographic variables, describing self-perception and satisfaction with quality of health. Methods: This is a cross-sectional population- based study carried out with 301 elderly residents in two areas of a city in southern Brazil. Data were collected through a questionnaire based on the Health, Well-Being, and Aging Study adapted by researchers, and a playful scale to assess satisfaction with health. For the statistical analysis, the χ2 test was used (p<0.05). Results: Regarding cognitive assessment, the majority was classified as independent (86.4%), not requiring caregiver assistance to answer the questionnaire. The population was predominantly female (55.8%), White (64.8%), married (51.2%), and catholic (82.1%). A total of 47.5% considered their current health status as regular. Regarding satisfaction with health, 72.4% were happy, even reporting having at least one chronic health problem (58.5%). Conclusion: The presence of chronic diseases was reported by most respondents, and the practice of self-medication is significantly more frequent among the aged. Nevertheless, the degree of satisfaction with their health status was predominantly positive, both related to the previous year and compared to others of the same age.

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Chewing Difficulty Should be Included as a Geriatric Syndrome

Nutrients ◽

10.3390/nu10121997 ◽

2018 ◽

Vol 10 (12) ◽

pp. 1997 ◽

Cited By ~ 11

Author(s):

Jean Woo ◽

Cecilia Tong ◽

Ruby Yu

Keyword(s):

Primary Care ◽

Chronic Diseases ◽

Well Being ◽

Geriatric Syndrome ◽

Subjective Well Being ◽

Geriatric Syndromes ◽

Care Needs ◽

Cross Sectional ◽

Poor Vision ◽

Automated Methods

Recent studies have noted an association between chewing difficulties and frailty. In a pilot survey of primary care needs of older people living in the community using automated methods, we examined the prevalence of chewing difficulties and the cross-sectional association with other geriatric syndromes, chronic diseases, and the use of hospital services. A brief multi-domain geriatric assessment was administered to 2259 men and women using a mobile device, the data uploaded to the cloud and analyzed. A total of 37.8% had chewing difficulties, which were associated with older age, poor vision, frailty, sarcopenia, memory complaints, low subjective well-being, incontinence, and stroke. The results suggest that chewing difficulties should be included as a geriatric syndrome and should be included in primary care screening of geriatric syndromes as well as chronic diseases.

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Prevalence of mental ill health, traumas and postmigration stress among refugees from Syria resettled in Sweden after 2011: a population-based survey

BMJ Open ◽

10.1136/bmjopen-2017-018899 ◽

2017 ◽

Vol 7 (12) ◽

pp. e018899 ◽

Cited By ~ 68

Author(s):

Petter Tinghög ◽

Andreas Malm ◽

Charlotta Arwidson ◽

Erika Sigvardsdotter ◽

Andreas Lundin ◽

...

Keyword(s):

Interpersonal Violence ◽

Well Being ◽

Population Based ◽

Subjective Well Being ◽

Post Traumatic Stress ◽

Cross Sectional ◽

Hopkins Symptom Checklist ◽

Potentially Traumatic Events ◽

Harvard Trauma Questionnaire ◽

Anxiety Depression

ObjectivesTo estimate the prevalence of and associations between anxiety, depression, post-traumatic stress disorder (PTSD), low subjective well-being (SWB), potential traumas and postmigration stress among refugees from Syria resettled in Sweden.DesignA cross-sectional and population-based questionnaire study based on a known and complete sample frame. The survey included multiple measures of mental ill health and factors of particular relevance for refugees. Weighted analyses were conducted to calculate representative prevalence rates and associations. Associations were investigated through a series of logistic regression analyses. All analyses were supplemented with robust 95% CIs.SettingSweden.ParticipantsA random sample of 1215 individuals (response rate 30.4%) from Syria aged 18–64 years that were granted residency in Sweden on grounds of asylum between 2011 and 2013.Main outcome measuresAnxiety, depression, PTSD and low SWB were assessed through Hopkins Symptom Checklist, Harvard Trauma Questionnaire and WHO-5 Well-being Index, using established cut-offs.ResultsA majority of the participants met the criteria for at least one of the studied types of mental ill health, and the comorbidity was high. Depression was the most the common type with 40.2% (95% CI 36.9% to 43.3%), followed by low SWB with 37.7% (95% CI 34.8% to 40.1%), anxiety with 31.8% (95% CI 29.2% to 34.7%) and PTSD with 29.9% (95% CI 27.2% to 32.6%). Refugee-related potentially traumatic events (PTEs) experienced before or during migration was common as was substantial levels of postmigration stress. Most types of refugee-related PTEs, especially being exposed to interpersonal violence, and postmigration stress were associated with increased risks for anxiety, depression, low SWB and PTSD.ConclusionsMental ill health, in terms of anxiety, depression, low SWB and PTSD, are highly elevated and comorbid among refugees from Syria. Increased attention from multiple societal sectors to adequately support Syrian refugees’ mental health needs, promoting recovery and reducing postmigration stress are needed.

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Factors associated with low adherence to medicine treatment for chronic diseases in Brazil

Revista de Saúde Pública ◽

10.1590/s1518-8787.2016050006150 ◽

2016 ◽

Vol 50 (suppl 2) ◽

Cited By ~ 4

Author(s):

Noemia Urruth Leão Tavares ◽

Andréa Dâmaso Bertoldi ◽

Sotero Serrate Mengue ◽

Paulo Sergio Dourado Arrais ◽

Vera Lucia Luiza ◽

...

Keyword(s):

Health Care ◽

Drug Treatment ◽

Chronic Diseases ◽

Household Survey ◽

Wald Test ◽

Population Based ◽

P Value ◽

Cross Sectional ◽

Factors Associated ◽

Probabilistic Sample

ABSTRACT OBJECTIVE To analyze factors associated with low adherence to drug treatment for chronic diseases in Brazil. METHODS Analysis of data from Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - Brazilian Survey on Access, Use and Promotion of Rational Use of Medicines), a population-based cross-sectional household survey, based on a probabilistic sample of the Brazilian population. We analyzed the association between low adherence to drug treatment measured by the Brief Medication Questionnaire and demographic, socioeconomic, health, care and prescription factors. We used Poisson regression model to estimate crude and adjusted prevalence ratios, their respective 95% confidence interval (95%CI) and p-value (Wald test). RESULTS The prevalence of low adherence to drug treatment for chronic diseases was 30.8% (95%CI 28.8-33.0). The highest prevalence of low adherence was associated with individuals: young adults; no education; resident in the Northeast and Midwest Regions of Brazil; paying part of the treatment; poor self-perceived health; three or more diseases; reported limitations caused by a chronic disease; using five drugs or more. CONCLUSIONS Low adherence to drug treatment for chronic diseases in Brazil is relevant, and regional and demographic differences and those related to patients’ health care and therapy regime require coordinated action between health professionals, researchers, managers and policy makers.

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Bullying among adolescents in a Brazilian urban center – “Health in Beagá” Study

Revista de Saúde Pública ◽

10.1590/s0034-8910.2015049005188 ◽

2015 ◽

Vol 49 (0) ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Michelle Ralil da Costa ◽

César Coelho Xavier ◽

Amanda Cristina de Souza Andrade ◽

Fernando Augusto Proietti ◽

Waleska Teixeira Caiaffa

Keyword(s):

Household Survey ◽

Well Being ◽

Health Risk Behaviors ◽

Population Based ◽

Subjective Well Being ◽

Urban Centers ◽

High Prevalence ◽

Three Stages ◽

Parents Involvement ◽

Robust Poisson Regression

<sec><title>OBJECTIVE</title> To analyze the prevalence of bullying and its associated factors in Brazilian adolescents.</sec><sec><title>METHODS</title> Data were used from a population-based household survey conducted by the Urban Health Observatory (OSUBH) utilizing probability sampling in three stages: census tracts, residences, and individuals. The survey included 598 adolescents (14-17 years old) who responded questions on bullying, sociodemographic characteristics, health-risk behaviors, educational well-being, family structure, physical activity, markers of nutritional habits, and subjective well-being (body image, personal satisfaction, and satisfaction with their present and future life). Univariate and multivariate analysis was done using robust Poisson regression.</sec><sec><title>RESULTS</title> The prevalence of bullying was 26.2% (28.0% among males, 24.0% among females). The location of most bullying cases was at or on route to school (70.5%), followed by on the streets (28.5%), at home (9.8%), while practicing sports (7.3%), at parties (4.6%), at work (1.7%), and at other locations (1.6%). Reports of bullying were associated with life dissatisfaction, difficulty relating to parents, involvement in fights with peers and insecurity in the neighborhood.</sec><sec><title>CONCLUSIONS</title> A high prevalence of bullying among participating adolescents was found, and the school serves as the main bullying location, although other sites such as home, parties and workplace were also reported. Characteristics regarding self-perception and adolescent perceptions of their environment were also associated with bullying, thus advancing the knowledge of this type of violence, especially in urban centers of developing countries.</sec>

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The Association Between Happiness and Self-Rated Physical Health of African American Men: A Population-Based Cross-Sectional Study

American Journal of Men s Health ◽

10.1177/1557988318780844 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1615-1620 ◽

Cited By ~ 4

Author(s):

George Mwinnyaa ◽

Tichelle Porch ◽

Janice Bowie ◽

Roland J. Thorpe

Keyword(s):

African American ◽

Physical Health ◽

African American Men ◽

Well Being ◽

Population Based ◽

Cross Sectional Study ◽

Subjective Well Being ◽

Cross Sectional ◽

Logistic Regression Models ◽

Fair Poor

Happiness and self-rated physical health are included in national surveys to assess health perceptions and subjective well-being among individuals. Studies have reported that happiness impacts physical health; however, little is known about the association between happiness and self-rated physical health among African American men (AAM). The objective of this study is to examine this relationship. Participants were 1,263 AAM aged 18+ years from the National Survey of American Life who rated their happiness and physical health. Interviews were conducted between 2001 and 2003. Self-rated physical health was defined as how individuals rated their own physical health and happiness as how individuals perceived their subjective well-being. Three multivariate logistic regression models were used to examine the relationships between happiness and self-rated physical health. It was observed that AAM who were happy were more likely to be married, to be employed, and earn more than $30,000 annually compared to AAM who were not happy. AAM who were happy were less likely to rate their physical health as fair/poor relative to AAM who were not happy. When controlling for demographic and socioeconomic factors, AAM who reported being happy had lower odds of rating their physical health as fair/poor compared to AAM who reported not being happy. Findings suggest that AAM who are happy report better physical health than those who report not being happy. Public health promotion strategies focusing on AAM should consider happiness as a promising influence that may positively impact physical health.

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Conflict Avoidance in Old Age

GeroPsych ◽

10.1024/1662-9647/a000168 ◽

2017 ◽

Vol 30 (2) ◽

pp. 61-70 ◽

Cited By ~ 4

Author(s):

Lia Oberhauser ◽

Andreas B. Neubauer ◽

Eva-Marie Kessler

Keyword(s):

Social Support ◽

Perceived Social Support ◽

Well Being ◽

Cross Sectional Study ◽

Conflict Avoidance ◽

Subjective Well Being ◽

Sectional Study ◽

Cross Sectional ◽

Adult Lifespan ◽

Set Up

Abstract. Conflict avoidance increases across the adult lifespan. This cross-sectional study looks at conflict avoidance as part of a mechanism to regulate belongingness needs ( Sheldon, 2011 ). We assumed that older adults perceive more threats to their belongingness when they contemplate their future, and that they preventively react with avoidance coping. We set up a model predicting conflict avoidance that included perceptions of future nonbelonging, termed anticipated loneliness, and other predictors including sociodemographics, indicators of subjective well-being and perceived social support (N = 331, aged 40–87). Anticipated loneliness predicted conflict avoidance above all other predictors and partially mediated the age-association of conflict avoidance. Results suggest that belongingness regulation accounts may deepen our understanding of conflict avoidance in the second half of life.

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Individual differences and changes in lifestyle behaviours predict decreased subjective well-being during COVID-19 restrictions in an Australian sample

Journal of Public Health ◽

10.1093/pubmed/fdab040 ◽

2021 ◽

Author(s):

Emily Brindal ◽

Jillian C Ryan ◽

Naomi Kakoschke ◽

Sinead Golley ◽

Ian T Zajac ◽

...

Keyword(s):

Life Satisfaction ◽

Individual Differences ◽

Online Survey ◽

Protective Factor ◽

Health Behaviours ◽

Well Being ◽

Subjective Well Being ◽

Cross Sectional ◽

Social Distancing ◽

Australian Sample

Abstract Background Due to the coronavirus disease 2019 (COVID-19) pandemic, social distancing practices were introduced to curb infection rates in many countries. The purpose of this study was to assess the effects of these restrictions on behaviours and well-being and whether individual differences predict changes in well-being. Methods Australian adults participated in a cross-sectional, online survey during May 2020. The survey captured demographic information; health behaviours; personality traits; life satisfaction and COVID-19-related attitudes, financial concerns, perceived risks and impacts. Results In total, 3745 (86.8% of 4313) participants completed all items. Participants were mostly female (85.7%) and 56.4 years (standard deviation [SD] = 12.6) on average. Over 95.0% of the sample indicated they had been social distancing or isolating. Health behaviours and well-being had generally worsened, with social connections being the most negatively affected. Life satisfaction was significantly lower since restrictions. For changes in life satisfaction, extroversion was a risk factor and openness to experience was a protective factor. Conclusions Overall, well-being was negatively impacted by the COVID-19 pandemic and associated social distancing particularly in this sample containing mainly older women. In future, it will be crucial to understand why and who may be differentially affected, to encourage behaviours that are protective of well-being.

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Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Healthcare ◽

10.3390/healthcare9040404 ◽

2021 ◽

Vol 9 (4) ◽

pp. 404

Author(s):

Alejandro José Casanova-Rosado ◽

Juan Fernando Casanova-Rosado ◽

Mirna Minaya-Sánchez ◽

José Luís Robles-Minaya ◽

Juan Alejandro Casanova-Sarmiento ◽

...

Keyword(s):

Angina Pectoris ◽

Mental Disorders ◽

Chronic Diseases ◽

Population Based ◽

Self Report ◽

World Health ◽

Complex Nature ◽

Cluster Sampling ◽

World Health Survey ◽

Cross Sectional

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

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