The 15-years trajectory of the Health, Well-being and Aging (SABE) study in São Paulo State, Brazil

The Health, Well-being and Aging (SABE - Saúde, Bem-estar e Envelhecimento) study was developed by the Pan American Health Organization (OPAS/OMS) to provide information on the living conditions of the elderly. The multi-center survey on health and well-being of the elderly was carried out in seven urban areas in Latin America and the Caribbean. The study took place between October 1999 and December 2000 in Argentina, Barbados, Brazil, Chile, Cuba, Mexico, and Uruguay. In 2006, only in Brazil, the SABE Study became a longitudinal and multiple cohort study with the aid of the São Paulo Research Foundation (FAPESP) and the Ministry of Health. In each cohort (2006, 2010 and 2015), data was collected among the elderly who were participants in 2000, and new 60 to 64-year-old subjects were inserted. The probabilistic sample of the participating individuals was obtained through the method of multi-stage conglomerates sampling by stratifying the primary units. We also considered the socioeconomic strata of the municipality urban area. The baseline for carrying out the sample calculation was the population count of the Brazilian Institute of Geography and Statistics (IBGE). Data was collected by trained interviewers. They used a standardized questionnaire to retrieve information regarding, for example, cognitive assessment, health status, and use and access to services. At the moment, the SABE Study follows 1,224 elderly individuals. The information collected from the SABE Study is available through the electronic address <http://hygeia3.fsp.usp.br/sabe/>. The aging process occurs differently when factors such as sex and socioeconomic aspects are considered. Thus, accompanying the elderly over time and knowing their living conditions are essential for proposing public policies according to reality. Key messages The Health, Well-being and Aging (SABE) study has been monitoring elderly people since 2000 in the city of São Paulo and provides information on their living conditions. The monitoring of the elderly enables the development of public policies that are more focused on the needs presented.

Prevalence of Systemic Arterial Hypertension Diagnosed, Undiagnosed, and Uncontrolled in Elderly Population: SABE Study

Systemic arterial hypertension is the most prevalent chronic noncommunicable disease among older people. This study aimed to estimate the prevalence of hypertension in the elderly and to analyze factors associated with diagnosed, undiagnosed, and uncontrolled hypertension. This is a cross-sectional study of data from the SABE study—Health, Well-Being, and Aging Survey—a multiple-cohort study, obtained in 2010, composed of a probabilistic sample representative of the population of the São Paulo city aged ≥60 years. Hypertension was self‐reported or defined by increased blood pressure. Multinomial regression assessed factors associated with diagnosis and lack of diagnosis of hypertension (reference: no hypertension), and logistic regression assessed factors associated with uncontrolled hypertension (reference: controlled). The prevalence of hypertension was 79.5%, and in 51% of individuals with the condition, hypertension was uncontrolled. Undiagnosed hypertension was associated with nonwhite skin color (OR: 1.89, CI: 1.11–3.19), being uninsured (OR: 1.77, CI: 1.04–3.03), overweight (OR: 2.38, CI: 1.09–5.19), higher education (OR: 0.46, CI: 0.22–1.94), and ≥1 chronic disease (OR: 0.28; CI: 0.13–0.58). Diagnosed hypertension was associated with age between 70 and 79 years (OR: 2.02, CI: 1.34–3.05), age ≥80 (OR: 2.73, CI: 1.72–4.31), nonwhite skin color (OR: 1.48, CI: 1.01–2.18), being uninsured (OR: 1.70, CI: 1.18–2.47), at least one medical consultation in the last year (OR: 1.86, CI: 1.06–3.25), obesity (OR: 2.50, CI: 1.61–3.88), and ≥1 chronic disease (OR: 2.81, CI: 1.94–4.08). Among those with hypertension, being uncontrolled was associated with widowhood (OR: 1.73, CI: 1.23–2.43), being uninsured (OR: 1.38, CI: 1.02–1.87), and female gender (OR: 0.61, CI: 0.43–0.87). The prevalence of hypertension was high in this population, and its diagnosis and control were associated with socioeconomic, demographic, and healthcare access factors.

Objectively Measured Physical Activity and Healthcare Expenditures Related to Arterial Hypertension and Diabetes Mellitus in Older Adults: SABE Study

Research using questionnaires has shown that physical activity level (PAL) is associated with healthcare costs. The purpose of this study was to examine the association between objectively measured PAL and healthcare costs among hypertensive and diabetic noninstitutionalized Brazilian older people. The method consisted of a cross-sectional study forming part of the SABE Study, composed of 377 older people interviewed in 2010. Expenditures were estimated taking into account self-reported medicine prescription, outpatient service, and hospitalizations, with the highest quartile of expenditures considered as a risk category. PAL was estimated using an Actigraph accelerometer. Associations were expressed as odds ratios and 95% confidence intervals, adjusted for covariates. Overall expenditures were higher in the sedentary group. The insufficiently active group presented greater odds for higher total, outpatient, and hospitalization expenditure. It was concluded that healthcare expenditures were lower in more active hypertensive and diabetic older people. The promotion of physical activity could be relevant in the attenuation of the burden of chronic diseases in economic losses.