Positive self-rated health in the elderly: a population-based study in the South of Brazil

Association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people: a cross-sectional study

PURPOSE

To verify the association between participation restriction due to hearing loss and self-perception of health, social support, and quality of life in elderly people.

METHODS

This is a cross-sectional, observational, and descriptive study with a quantitative data approach. A database with information collected in a medium-sized Brazilian municipality was used. The study was conducted with 235 elderly people registered in five Family Health Strategy Units. Sociodemographic and health information and the results of the following questionnaires were used: Hearing Handicap Inventory for the Elderly - Screening Version (HHIE-S), Medical Outcomes Study (MOS) Social Support Survey, Subjective Health Assessment, and Short-Form 6-Dimension (SF-6D) Health and Quality of Life Index. Groups with and without participation restriction were compared according to sociodemographic, health, social support, and quality of life variables. A multivariate binary logistic regression method was employed to evaluate the associations between the independent variables and participation restriction.

RESULTS

The group with participation restriction is composed of older individuals with lower quality of life and poorer self-perception of health. Poorer self-perception of health was the only predictor of participation restriction related to hearing loss.

CONCLUSION

Participation restriction is associated with poorer self-perception of health. The study highlights the importance of assessing individuals' self-perception regarding biopsychosocial issues, in addition to considering the environmental context to understand the social and emotional impacts caused by hearing loss.

Leisure Attitude, Self-Rated Health, and Psychological Well-Being in Older Adults: A Moderated Mediation Model

Purpose

A positive leisure attitude among older adults may have a beneficial effect on psychological well-being, both directly and indirectly by fostering a more positive perception of one's health. This paper presents a correlational design that explores associations among leisure attitude, self-rated health, and psychological well-being, and analyzes the potential moderating role of gender in these relationships.

Patients and Methods

The sample was selected using simple random probability sampling (N= 409; 61.9% female; Mean age = 72.9; SD = 8.43¸ Range of age 53 to 93 years). Diverse sociodemographic information was collected, and leisure attitudes, self-perceived health, and psychological well-being (positive affect and emotional ties) were assessed.

Results

The results revealed a positive effect of leisure attitude on self-rated health and psychological well-being, with self-rated health fully mediating the association between the behavioral component of leisure attitude and psychological well-being. Furthermore, the moderating effect of gender on the relationship between self-rated health and psychological well-being was stronger among men.

Conclusion

Positive cognitive and emotional perceptions of leisure among older adults seem to benefit psychological well-being and improve self-rated health, thereby contributing to healthy ageing.

Digital health care service reform and health inequity for older people: a quasi-natural experiment in China

Objective

Addressing health inequity (HI) for older people is a pivotal global public health concern, as it impedes the process of healthy ageing. The digital health care service reform (DHSR) emerges as a progressive public health approach to enhance the health and well-being of older adults by providing comprehensive and equitable medical services. This study elucidates the association between DHSR and HI for older individuals to augment comprehension of DHSR implementation.

Methods

The initiation of the action plan for smart health and eldercare (SHE) in 2017 serves as a quasi-natural experiment. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) in 2015 and 2018, a propensity score matching (PSM) method was used to select samples, and a difference-in-differences (DID) regression was used to ascertain the net effect of DHSR on HI for older individuals in China. This methodology mitigates selection bias and segregates the DHSR effect from temporal shifts or other occurrences.

Results

The PSM-DID analysis reveals that DHSR reduced the HI index for older individuals by 0.301 (p < 0.01). Heterogeneity analyses indicate that the effect of DHSR was more pronounced in older males (-0.333, p < 0.01) than females (-0.251, p < 0.05). The impact of DHSR was notably higher for older population in the western (-0.557, p < 0.01) and central regions (-0.318, p < 0.05) compared to the eastern region, where the relationship was statistically non-significant.

Conclusion

The results demonstrate that DHSR plays a vital role in diminishing HI, fostering inclusive growth in public health. The study underscores the imperative of sustained DHSR endeavours and allocating resources to key older demographics to substantially mitigate HI.

Built environment and its association with self-rated health in Brazilian elderly: National Health Survey 2013

The present study aims to investigate the association between the built environment and positive self-rated health among older adults from Brazilian capitals. It is a cross-sectional population-based study, which collected data from the National Health Survey 2013 and the Observatório das Metrópoles. The outcome was a positive self-rated health. The built environment was investigated by the Urban Wellbeing Index (IBEU, in Portuguese). Analyses were performed by multilevel logistic regression (95%CI). Among the 4,643 elderly individuals evaluated in this study, 51.5% reported a positive self-rated health (95%CI: 50.0-52.9). Elderly people living in capitals with higher IBEU terciles were more likely to have a positive self-rated health (OR: 1.42; 95%CI: 1.08-1.86 (T2); OR: 1.78; 95%CI: 1.35-2.33 (T3)). As for the dimensions of the IBEU, the following were associated with the outcome: urban infrastructure (OR: 1.56; 95%CI: 1.13-2.16), urban environmental conditions (OR: 1.49; 95%CI: 1.10-2.04), urban housing conditions (OR: 1.45; 95%CI: 1.05-1.99), and urban collective services (OR: 1.72; 95%CI: 1.30-2.27). A positive association was found between better conditions of the built environment and one's perception of health, regardless of individual characteristics. Promoting changes in the built environment can be effective in improving health levels, thus favoring healthy aging.

Perceived Characteristics of the Built Neighborhood Environment and Negative Self-Rated Health in Brazilian Community-Dwelling Older Adults

INTRODUCTION

Research indicates that self-rated health is associated with worse health outcomes in older adults. Thus, it is important to assess the association between built neighborhoods and self-rated health to establish strategies to improve the quality of life in the older adult population.

OBJECTIVE

To evaluate the association between the perceived characteristics of the built neighborhood and the negative self-rated health in Brazilian community-dwelling older adults.

METHODS

A cross-sectional study for finite random samples was performed with older adults who used the municipal public health service. The outcome was negative self-rated health using the question "How do you perceive your health?" The regular, bad, and very bad responses were grouped as negative self-perception. The exposure variables were the perceived characteristics of the built neighborhood, which was evaluated by the adapted version of the Neighborhood Environment Walkability Scale.

RESULTS

A total of 308 older adults were analyzed. Living close to food establishments (OR: 0.46; 95% CI: 0.25;0.85), fitness/bodybuilding gyms and/or clubs (OR: 0.51; 95% CI: 0.28;0.93), and safety to walk during the day (OR: 0.37; 95% CI: 0.16;0.87) and night (OR: 0.47; 95% CI: 0.26;0.84) were protective against negative self-rated health.

CONCLUSION

Therefore, living in neighborhoods with better characteristics was less associated with negative self-rated health, demonstrating the importance of promoting strategies to improve the neighborhood infrastructure and this population's perception of health.

Impact of smart device use on objective and subjective health of older adults: findings from four provinces in China

Background

The digital divide has grown because of the deepening digitalization of the Chinese society and the intersection between high-end technology and the age structure. Older adults show an increasing level of weakness in digital life integration. What digital development can bring to older adults is a pressing concern.

Objective

This study aims to investigate how smart device use affects older adults' health status and offers an empirical reference for improving their digital literacy and health.

Methods

The data in this study were collected from an offline survey conducted from December 2021 to April 2022, which obtained 1110 valid samples of older adults This study used a multivariate ordered logit model, mediating effect model, and heterogeneity test to analyze the impact of smart device use on the health status of older adults.

Results

Smart device use has a significant positive effect on the self-rated, physical, and psychological health of older adults, and this positive effect is more pronounced among older adults living in urban areas or with a higher age. The average net effect of smart devices on each health status of older adults is 0.161 for self-rated health, 0.155 for physical health, and 0.071 for psychological health. In-depth research found that older adults' attitudes toward smart devices played a mediating role in the influence of smart device use on self-rated and psychological health respectively.

Conclusions

The study found that smart device use had a positive effect on the health status of older adults and that the performance expectations and individualized needs of older adults exhibited an effective linkage between smart devices and health status. Smart device use could improve the overall health of older adults, especially the urban and low-age older adults. Promoting the understanding of the practicality of smart devices for older adults and the aging-oriented transformation of smart devices is an effective way to improve the health status of older adults. The findings provide theoretical support for the wide application of smart devices in older adults, and can effectively help eHealth practitioners implement accurate geriatric health support strategies.

Self-perception of health and physical activity among adults before and amidst the COVID-19 pandemic: United States, 2019-2020

The compounded impact of the COVID-19 lockdowns on self-perception of health (SPoH) and physical activity (PA) levels among U.S. adults remains to be explored. We sought to: (1) describe the SPoH and PA levels among U.S. adults; (2) explore the relationship between SPoH and PA before and amidst the COVID-19 pandemic. We analyzed data from the 2019 and 2020 Health Information National Trends Survey (HINTS). COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. This date was chosen to demarcate the responses as before and amidst the COVID-19 pandemic. Weighted prevalence estimates were presented alongside adjusted odds ratios from multivariable logistic regression of general SPoH and PA levels for U.S. adults before and amidst COVID-19 pandemic. We analyzed data for 9328 participants. Over half of the U.S. adult population reported performing no muscle strengthening exercise in 2019. The number of inactive people has slightly increased in 2020 (27.8%), compared to 2019 (26.5%). Overall, levels of PA for active people were comparable in 2020 pre and post the WHO pandemic declaration date (36.4% and 39.8%; respectively). Higher odds of negative SPoH were observed among black individuals, current cigarettes smokers, with annual income less than $35,000, physically inactive individuals, people who do not perform muscle-strengthening exercise, and who were very obese. Negative SPoH were associated with lack of moderate exercise, and lack of muscle-strengthening training among U.S. adults before and amidst the pandemic. Pandemic policies and recommendations should include and facilitate PA, specifically among vulnerable populations.

Quedas, medo de cair e capacidade funcional

Objetivo: avaliar a capacidade funcional e o medo de cair em idosos cadastrados em uma unidade de saúde da família. Método: estudo descritivo e transversal, com abordagem quantitativa, realizado em janeiro de 2019, no domicílio de 157 idosos cadastrados em uma unidade de saúde da família do município de João Pessoa, Paraíba, Brasil. Para a coleta foi utilizado um instrumento semiestruturado, composto de questões sociodemográficas, histórico de quedas, o índice de Barthel e a Escala Internacional de Eficácia em Quedas. A análise foi efetivada pela estatística descritiva e inferencial, utilizando-se o teste de correlação de Spearman. Resultados: houve correlação entre atividades que compõem a análise da capacidade funcional e o medo de cair, em que se observou significância estatística entre elas, verificando-se que quanto menor a capacidade funcional, maior será o medo de cair. Considerações Finais: concluiu-se que, frente ao declínio fisiológico, social e psicológico oriundos do envelhecimento humano, é importante o planejamento de intervenções que abordem o medo de cair em idosos, com vistas a preservar sua capacidade funcional.

Negative Self-Assessment of Health in Women: Association with Sociodemographic Characteristics, Physical Inactivity and Multimorbidity

Introduction: Women present a higher prevalence of negative self-assessment of health (NSAH) when compared to men. However, there is a gap in the literature of factors associated with NSAH in women from developing countries such as Brazil. In addition, few studies have assessed the magnitude of the association between multimorbidity and NSAH in this population. Thus, the aim of this study was to evaluate the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity in women from the Midwest region of Brazil. Methods: A study based on data from the National Health Survey, a household survey that investigated health situation, lifestyle and risk factors for chronic diseases in the adult population of Brazil, was held. Sampling was performed in multiple stages. The selected women answered a standardized questionnaire on sociodemographic data, self-assessment of health and potential determinants. Poisson regression was used to analyze the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity. A significance level of 0.05% was established. Results: The study included 4233 women. The prevalence of NSAH found was 6.0% (95% Confidence Interval [95% CI]: 5.1–7.0%). There was an association between NSAH and advancing age, low schooling, physical inactivity and multimorbidity. Furthermore, there was an association between NSAH and diseases/disorders such as chronic back pain, systemic arterial hypertension, mental disorders, depression, cardiovascular diseases, stroke, cancer, hypercholesterolemia and diabetes mellitus. Conclusion: The prevalence of NSAH was low. A strong association was found between this variable and multimorbidity. In addition, increased age, low schooling and physical inactivity were predictors of NSAH in women.

Autopercepção de saúde em idosos de baixa escolaridade: fatores demográficos, sociais e de comportamentos em saúde relacionados

Resumo Objetivo Verificar a relação entre a autopercepção de saúde positiva (AS positiva) em idosos de baixa escolaridade com variáveis demográficas, de participação social e comportamentais. Método Tratou-se de um estudo transversal (n=12.367), com idosos de mais de 60 anos de ambos os sexos, com até quatro anos de estudo de diversas cidades do Brasil entrevistados pela Pesquisa Nacional de Saúde do ano de 2019. Para a análise de dados, inicialmente, realizou-se a descrição das prevalências e, posteriormente, construíram-se três modelos de regressão de Poisson com ajuste robusto para variância, sendo as análises estratificadas por sexo. Resultados A prevalência de AS positiva foi de 38,8% nos homens e 34,8% nas mulheres. No último modelo de regressão construído foram encontradas associações com menores prevalências de AS positiva nas mulheres pretas ou pardas, enquanto maiores prevalências foram encontradas nas solteiras, com renda mais elevada, que participam de alguma associação, de atividades religiosas, iam ao médico com mais frequência, eram fisicamente ativas e consumiam regularmente frutas e hortaliças. Nos homens, foram encontradas menores prevalências nos pretos ou pardos e nos viúvos, já maiores prevalências foram encontradas naqueles que participavam de atividades religiosas e iam ao médico mais frequentemente. Conclusões O estudo reforça a importância de políticas para a melhoria de renda, bem como para promoção de comportamentos saudáveis e estímulo a participação social.

Self-perceived health in older adults with low education: demographic, social and health-related behavior factors

Abstract Objective To verify the relationship between positive self-perception of health (positive SPH) in less-educated older adults and demographic, social participation, and behavioral variables. Methods This was a cross-sectional study (n=12,367), with elderly people over 60 years old of both sexes, with up to four years of study from several cities in Brazil, interviewed by the National Health Survey of the year 2019. For the analysis of data, the prevalence was initially described, and later, three Poisson regression models with robust adjustment for variance were constructed, with the analyzes being stratified by sex Results The prevalence of positive SPH was 38.8% in men and 34.8% in women. The last regression model built revealed associations with a lower positive SPH prevalence in black or brown women. In contrast, higher prevalence levels were found in single women, with higher income, participating in some associations, engaged in religious activities, visiting the doctor more often, physically active, and regularly consuming fruits and vegetables. In men, relationships with lower prevalence were found in blacks or browns and widowers, and higher prevalence levels were found in those engaging in religious activities and visiting the doctor more often. Conclusions The study reinforces the importance of policies aimed at improving income, promoting healthy behaviors and encouraging social participation.

Positive self-perception of health among non-long-lived and long-lived older adults and associated factors

This work aimed to identify the prevalence of positive self-perceived health among non-long-lived and long-lived older adults and associated factors. This is a study with older adults in the Family Health Strategy of Montes Claros. The Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire was used. Bivariate and multiple analyses were performed using Poisson Regression. A total of 1,750 older adults participated in the study, of which 1,420 were non-long-lived older adults, and 330 were long-lived older adults. Positive self-perception was reported among 71.9% of the non-long-lived older adults and 67.8% of the long-lived older adults. Among the non-long-lived, positive self-perceived health was associated with five years of schooling (PR=1.12); household income from two to less than three minimum wages (PR=1.13) and ≥three minimum wages (PR=1.12); preserved vision (PR=1.13); proper chewing (PR=1.16); preserved sleep (PR=1.23); absence of polypathologies (PR=1.29); absence of diabetes (PR=1.15); falls in the last year (PR=1.13); and physical activity (PR=1.11). Among the long-lived older adults, it was associated with the use of prosthesis, sleeping disorders, and polypathologies and physical activities. Positive self-perception of health is associated with social and health determinants.

Clima familiar e autopercepção de saúde de idosos(as)

Investigou-se a coesão, o apoio, a hierarquia e o conflito relativos ao clima familiar percebido por idosos em sua relação com a autopercepção de saúde. Participaram 134 idosos do Recôncavo Baiano, a maioria composta por negros e mulheres, entrevistados em domicílio, utilizando-se Questionário de doenças e de sinais e sintomas autorrelatados, Questionário de autoavaliação de saúde e o Inventário do Clima Familiar. Foram feitas análises estatísticas descritivas e bivariadas. Os dados desta pesquisa mostraram que a maioria dos idosos fez uma avaliação mais negativa do clima familiar e da autopercepção atual da saúde; maior apoio e coesão e menor hierarquia familiar estão associadas a uma melhor saúde percebida. Os dados podem ajudar a compreender como o clima familiar do idoso pode impactar na saúde subjetiva e como a deterioração da saúde pode moldar os relacionamentos na família bem como podem colaborar com intervenções clínicas e sociais.

Income Inequality and Self-Reported Health Among Older Adults in Brazil

This study analyzes the association between income inequality and self-reported health (SRH) in older adults, and separately for the young-old and very-old groups, residing in each of the 27 Brazilian capitals. The sample consisted of 4,912 individuals aged 60 or older residing in Brazilian capitals in 2013. Bayesian multilevel models were applied to the whole sample and separately for individuals aged 60 to 79 (young-old), and 80 or more (very-old). Our results show significant associations between income inequality and SRH, even after controlling for individual and contextual factors. We found greater odds of poor SRH among older adults living in areas with medium (odds ratio [OR] = 1.66, 95% confidence interval [CI]: 1.49-1.86) and high-income inequality (OR = 2.21, 95% CI: 2.05-2.38). The negative association between income inequality and health, independently of the individual and contextual characteristics, suggests that living in unequal areas can have a detrimental effect on the health of older adults.

[Changes in health-related behaviors as predictors of changes in health self-perception: longitudinal study (2011-2015)]

Health self-perception is recognized as an interesting health indicator, due to its capacity to predict morbimortality, among others. Studies that investigate its association with health-related behaviors are more recent and, for the most part, cross-sectional, which indicates that this relationship may be better understood in longitudinal studies. This article sought to verify the relationship between changes in health-related behaviors and the incidence of positive and negative health self-perception. We carried out a prospective, population-based cohort study with 883 individuals aged 40 years or more interviewed in 2011 and 2015. We verified the incidence of negative and positive health self-perception according to changes in four health-related behaviors: leisure-time physical activity, fruit and vegetable consumption, abusive alcohol consumption and smoking - using crude and adjusted Poisson regression. The incidence of negative health self-perception was of 27.2%, and was higher, after adjusting for demographic, health, and other behavioral variables, among individuals with negative changes in leisure-time physical activity (RR = 1.88; 95%CI: 1.17-3.05) and in fruit and vegetable consumption (RR = 1.95; 95%CI: 1.15-3.28). The incidence of positive health self-perception was 33.2% and was higher among those who had a positive change in smoking (RR = 8.37; 95%CI: 2.79-25.09) and lower among those who had a negative change in fruit and vegetable consumption (RR = 0.51; 95%CI: 0.29-0.90). We conclude that some changes in health-related behaviors have a possible impact on health self-perception, which reinforces the importance of policies related to health-related behaviors, going beyond their relationship with morbimortality.

Autoavaliação negativa da saúde em pessoas idosas associada a condições socioeconômicas e de saúde: inquérito populacional em Rio Branco, Acre

Resumo Objetivo Estimar a prevalência de autoavaliação negativa da saúde e sua associação com condições socioeconômicas, sintomas depressivos, funcionalidade e morbidades autorreferidas em pessoas idosas de Rio Branco, Acre. Método Trata-se de uma pesquisa realizada com dados do Estudo das Doenças Crônicas em Idosos (EDOC-I), um inquérito domiciliar realizado com pessoas a partir de 60 anos residentes em Rio Branco, Acre, Brasil, em 2014 (n=1.016). A autoavaliação negativa da saúde foi definida pelos estratos “ruim” e “muito ruim”. Foram aplicadas as escalas de depressão geriátrica e das atividades da vida diária e instrumentais da vida diária. Como medida de associação da autoavaliação negativa da saúde com variáveis de interesse foi empregada a técnica de regressão logística múltipla. Resultados A prevalência de autoavaliação negativa da saúde foi de 15,4%, apresentando associação estatisticamente significativa com sexo feminino (OR:1,72; IC95%:1,17-2,51), baixa escolaridade (OR:2,33; IC95%:1,37-3,97), sedentarismo (OR:1,84; IC95%: 1,08-3,14) e uso de medicamentos (OR:3,01; IC95%:1,52-5,95). Também se detectou associação com sintomas depressivos (OR:2,55; IC95%:1,74-3,73), presença de multimorbidades (OR:1,73; IC95%:1,15-2,61) e dependência total nas atividades instrumentais da vida diária (OR:2,42; IC95%:1,40-4,17). As morbidades associadas à percepção negativa da saúde foram: asma/bronquite (OR:2,74; IC95%:1,61-4,67), insônia (OR:1,80; IC95%:1,25-2,58) e problemas cardíacos (OR:1,77; IC95%:1,18-2,68). Conclusão Assim, a autoavaliação negativa da saúde das pessoas idosas sofre influência das condições socioeconômicas e de saúde, sendo um indicador útil para o delineamento de estratégias em saúde que favoreçam o envelhecimento com independência e bem-estar físico e emocional.

Self-perceived health in a group of older adults covered by a health insurance plan

INTRODUCTION: Self-perceived health reported by older adults is a tool of great importance for the health care system as it provides an indicator representing physical, cognitive, and emotional aspects of health. OBJECTIVE: To report how a group of older adults covered by a health insurance plan evaluate their self-perceived health and which variables influence their perception. METHOD: This quantitative cross-sectional study included 148 older adults living in the city of São Paulo, Brazil, in 2017. The study variables were sex, age, marital status, performance in basic activities of daily living and instrumental activities of daily living, sleep quality, leisure activity, number of diseases, and use of continuous medication. Statistical analysis was performed using Student’s t-test, χ2 test, or Fisher’s exact test, and logistic regression was used. RESULTS: Significant relationships were observed between poor self-perceived health and the following variables: being female, polypharmacy, number of diseases, sleep quality, and performance in instrumental activities of daily living. Dependence on the instrumental activities of daily living made these older adults 5.33 times more likely to have poor self-perceived health. Each comorbidity added to the health status of this group increased the chance of poor self-perceived health by 1.39 times. CONCLUSION: Self-perceived health in this group of older adults is influenced by several variables; however, degree of dependence and number of diseases were those with the greatest impact.

Risk of hospitalization of elderly rural workers in the state of Rio Grande do Sul

Abstract Objective : To analyze the risk of hospitalization of elderly rural workers in the state of Rio Grande do Sul, Brazil. Method : A cross-sectional, population-based study was carried out of retired rural workers (N=604), over 60 years of age, of both genders, selected by clusters. In order to evaluate the risk of hospitalization, the Probability of Repeated Hospitalization (or PIR) instrument validated and evaluated for Brazil was used. Risk of hospitalization was calculated through logistic regression analysis, and was classified into the following strata: low (<0.300); medium (0.300-0.399); medium-high (0.400-0.499) and high (≥0.500). Results : The rural elderly persons surveyed had a low risk of hospitalization (n=553; 91.6%). There was a predominance of men among the medium to high risk categories (n=42; 82.3%), distributed mainly in the Santa Maria, Sul and Camaquã regions. Conclusion: The results of the present study suggest a low risk of hospitalization among this population, however, there is a need for improved, more profound and robust research into the identification of factors associated with the health specificities of this population.

Functional Dependence among older adults receiving care from Family Health Strategy teams

Abstract Objective : To evaluate functional dependence among older adults receiving care from Family Health Strategy (FHS) teams, in Montes Claros, Minas Gerais, Brazil, identifying associated factors. Methods : A cross-sectional and analytical study with randomly selected older adults was performed. The instrument used was BOMFAQ (the Brazilian Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire). Data collection was performed by trained staff in the homes of the older adults. Sociodemographic, economic data, living habits, health care, morbidities and Activities of Daily Living (ADL) were evaluated. In addition to descriptive analysis, factors associated with functional dependence were identified using the chi-square test, followed by hierarchical multiple analysis using Poisson regression with robust variance. Results : 1,750 older adults were evaluated. The group was predominantly female, with low schooling. The proportion of the sample considered dependent was 57.0%. The variables associated with functional dependence were: female gender (PR=1.19); age ≥70 years (PR=1.33); schooling ≤4 years (PR=1.19); being unemployed (PR=1.43); not performing physical activity (PR=1.19) or walking (PR=1.15); not listening to the radio as a leisure activity (PR=1.13); not having the habit of reading (PR=1.17); presenting depressive symptoms (PR=1.15); hospitalization in the last six months (PR=1.18); cognitive impairment (PR=1.16); insomnia (PR=1.13); obesity (PR=1.18); falls in the last year (PR=1.11); cataracts (PR=1.09), spinal problems (PR=1.19); urinary incontinence (PR=1.25); poor circulation (PR=1.09) and a negative self-perception of health (PR=1.22). Conclusion : Functional dependence is multifactorial, but is influenced mainly by the health conditions of older adults.

Factors associated with negative self-rated health in menopausal women

The scope of this study was to investigate the prevalence and factors associated with negative self-rated health in menopausal women registered with the Family Health Strategy in a Brazilian urban center. It is a cross-sectional study with a random sample of menopausal women. A validated instrument addressing sociodemographic and behavioral data related to self-rated health status was used. The association between the variables studied and negative self-rated health was assessed by bivariate analysis followed by Poisson regression with robust variance, in a hierarchical model. The prevalence of negative self-rated health among the population studied was 41.6%, among 761 women. Among women aged 52-65 years old, 49.2% had negative self-rated health. Age corresponding to post-menopause, education up to eight years of study, having a partner, not having a formal job, current tobacco use and physical inactivity were associated with negative self-rated health. The presence of menopausal symptoms, overweight and obesity, the current use of medication and the presence of chronic diseases were also associated with negative self-rated health in the final model. The associations observed point to the need for health promotion activities aimed at menopausal women.

Sociodemographic, behavioral, and health factors associated with positive self-perceived health of long-lived elderly residents in Florianópolis, Santa Catarina, Brazil

The objective of this study was to identify the factors associated with positive self-perceived health of long-lived elderly (80+) individuals. This cross-sectional study was conducted in the city of Florianópolis, Santa Catarina, Brazil, and included 239 elderly participants from the EpiFloripa Ageing Project. We used collection instruments to verify sociodemographic and economic data, self-reported health status, falls, and lifestyle. Then, we identified factors associated with positive self-perceived health using a Poisson regression adjusted for sex. We found that a positive self-reported health status was more prevalent among the long-lived elderly who were not depressed (PR = 0.49), and among those who consumed alcohol (PR = 1.99). Understanding which variables may interfere in the self-perceived health of the long-lived elderly can result in better health options for this population, mainly, new methods to prevent depression. Additionally, this information can help reduce costs associated with hospitalizations, medications and health treatments, all of which are very common among the long-lived elderly.

Factors associated with the hospitalization of the elderly: a national study

Abstract Objective :to analyze the factors associated with hospitalization among the Brazilian elderly based on multidimensional methodology. Method: a cross-sectional, quantitative study was performed with data from the National Health Survey (2013) population-based study. The sample was composed of 23,815 individuals over the age of 60 years. Hospitalization was considered the outcome variable and 53 independent variables were included, relating to: sociodemographic characteristics; limitations and illness; difficulties in performing basic and instrumental activities of daily living; use of health services and medical emergencies. Results: it was found that 10% of the elderly were hospitalized in the previous year. This event was related to: a negative self-perception of health (OR = 1.35); stopping performing any of their usual activities due to health reasons (OR = 2.14); difficulty going to the doctor (OR = 1.65) or walking alone (OR = 1.55); a recent search for a site, service or health professional for health-related care (OR = 1.47); increased frequency of annual medical visits (OR = 2.93) and household emergency (OR = 5.40). Conclusion: the results reinforce the fact that multiple factors are associated with the hospitalization of the elderly. The analysis of these associations has the potential to make health professionals and administrators aware of the need to improve health care for the elderly and to assist in the organization and planning of the actions of the entire health service network.

Assessment of health/functioning of older adults who consume psychoactive substances

OBJECTIVE

To assess the health/functioning of the older adult who consumes psychoactive substances through the International Classification of Functioning, Disability and Health, considering the theory of complexity.

METHOD

Qualitative case study, with 11 older adults, held between December 2015 and February 2016 in the state of Rio Grande do Sul, using interviews, documents and non-systematic observation. It was approved by the ethics committee. The analysis followed the propositions of the case study, using the complexity of Morin as theoretical basis.

RESULTS

We identified older adults who consider themselves healthy and show alterations - the alterations can be exacerbated by the use of psychoactive substances - of health/functioning expected according to the natural course of aging such as: systemic arterial hypertension; depressive symptoms; dizziness; tinnitus; harmed sleep/rest; and inadequate food and water consumption. Final consideration: The assessment of health/functioning of older adults who use psychoactive substances, guided by complex thinking, exceeds the accuracy limits to risk the understanding of the phenomena in its complexity.

Factors determining the negative perception of the health of Brazilian elderly people

Abstract Objective: To identify factors that determine the negative perception of the health of the Brazilian elderly, considering sociodemographic conditions, functional limitations and illness, patterns of utilization of health services and oral health condition. Method: A cross-sectional study with data from the National Health Survey (2013), involving 23,815 elderly persons was carried out. Once the database was treated, dimensionality reduction was performed using the Waikato Environment for Knowledge Analysis. The variables related to health perception were evaluated through logistic regression to measure the magnitude of the associations. Health perception and 36 independent variables were considered as outcome variables. Results: The variables most strongly related to the negative perception of the health of the elderly were illiteracy (OR=1.48), low educational level, total difficulty in performing instrumental activities of daily living (OR=2.04), impossibility of performing any activity (OR=3.20), presence of a diagnosis of physical or mental illness (OR=2.44), negative self-perception of oral health (OR=1.92), an increased need for health services in recent weeks (OR=1.16), medical visits and hospitalization in the last 12 months (OR=1.40). Conclusion: The use of multidimensional methodologies can identify the influence of determinants of a negative perception of health among Brazilian elderly persons, and can support the formulation of public health policies aimed at the elderly population.

LETRAMENTO EM SAÚDE E FATORES ASSOCIADOS EM ADULTOS USUÁRIOS DA ATENÇÃO PRIMÁRIA

Resumo O objetivo da pesquisa foi investigar o letramento em saúde e associação com fatores sociodemográficos, autopercepção da saúde e qualidade de vida em adultos. Tratou-se de estudo transversal com adultos entre 20 e 59 anos, usuários da atenção primária à saúde, realizado em unidades básicas de saúde, de fevereiro a maio de 2015 – amostra probabilística. O letramento em saúde foi avaliado pelo Short Assessment of Health Literacy for Portuguese-Speaking Adults. Realizou-se análise estatística descritiva, análise bivariada (p ≤ 0,20) e regressão logística múltipla (p ≤ 0,05). O letramento em saúde inadequado foi frequente e inicialmente associado a sexo, escolaridade, última série cursada com aprovação, estudo formal mínimo, Critério de Classificação Econômica Brasil, plano de saúde, arranjo familiar, importância atribuída à saúde, nota atribuída à própria saúde, frequência de comparecimento à unidade básica de saúde e aos domínios relações sociais e ambiental do teste World Health Organization Quality of Life. No modelo final da regressão logística, somente a escolaridade permaneceu associada ao letramento em saúde, e indivíduos com menor escolaridade tiveram mais chance de ter letramento em saúde inadequado. Os achados sugerem a necessidade do desenvolvimento de estratégias de educação em saúde para os adultos usuários da atenção primária.

Aging and quality of life of elderly people in rural areas

ABSTRACT Objective: To evaluate the quality of life and health of elderly in rural areas of Minas Gerais State’s center-west. Method: Cross-sectional study, in four municipalities of Minas Gerais State, by interviewing elderly people. Associations between socio-demographic and quality of life variables were tested, separated into “satisfactory”/“unsatisfactory” with values from the median of positive answers. It was used the chi-square test, Fisher’s test and regression. Results: 182 elderly answered the questions and showed a relation with the “satisfactory” quality of life - bivariate (p < 0.05): age by 69 years (61.6%), married (61.7%), living by 54 years in rural areas (68%), with no financial support (59.5%), living with someone else (61%), non-smoker (60%), presenting good health (76.7%), satisfied with life (69.6%); regression: not having financial support, living with someone else and not smoking. Conclusion: Elderly people in rural areas present good quality of life/health in the cognitive aspect, access to services, goods, habits, but awareness must be constant due to their weakness.

Factors affecting the self-rated health of elderly individuals living alone: a cross-sectional study

Objective

In Japan, the number of elderly individuals living alone is continuing to increase as society ages. Although studies have considered quality of life, life expectancy, and gender differences in elderly individuals living alone, only a few have considered the health and lifestyle of these individuals. Therefore, we aimed to investigate the factors that affect the self-rated health of elderly individuals living alone to understand this group and how best to offer them support.

Results

We include 113 individuals. There was a significant difference (P < 0.05) in some characteristics (e.g., age, chronic illness, frequency of hospital visits in 1 month, and caregivers), activities of daily living (e.g., motor tasks), and instrumental activities of daily living (e.g., household affairs, heavy housework, outdoor household, and outdoor activities).

University of the Third Age: the impact of continuing education on the quality of life of the elderly

Abstract Objective: To verify, among elderly participants of the University of the Third Age (UnATI) of PUC Goiás, Goiania, Brazil, whether quality of life was higher or lower among veteran or first-year participants of the UnATI, and to evaluate if there was a statistically significant difference between the quality of life of men and women or first-years and veterans. Method: An observational case-control study with a quantitative approach was performed with 100 elderly individuals from the UnATI. Fifty first-years and fifty veterans were involved. Two questionnaires were applied, one with sociodemographic data and the other using the World Health Organization Quality of Life - Old (WHOQOL-OLD) scale, which evaluates the quality of life of the elderly. Variance analysis (ANOVA) and multivariate variance analysis (MANOVA) were performed, with p≤0.05 applied to the relevant statistics. Result: The vast majority of the sample were women (90%), aged between 60 and 86 years old (average of 68.37±5.28 years old). The overall quality of life score was 3.68±0.50 (first-years) and 3.87±0.55 (veterans). There was a statistically significant difference in the areas: sensory functioning (veterans =4.28±0.65 and first-years =3.95±0.80) (p=0.025) and past, present and future activity (veterans =4.0±0.72 and first-years =3.59±0.79) (p=0.008). Multivariate variance analysis identified that the overall quality of life scores of both men (veterans =3.15 and first-years =4.21) and women (veterans =3.78 and first-years =3.86), were highest after they became veteran students (p=0.007). Conclusion: Veterans had a higher quality of life than first-years. The continuing education provided by UnATI has a positive impact on the quality of life of the elderly.

Prevalence of fear of falling, in a sample of elderly adults in the community

Abstract Objectives: To investigate the prevalence of fear of falling among a sample of elderly persons in the community, and to analyze its correlation with age, self-perceived health, difficulty walking, use of an assistive device for walking, history of falls, and functional capacity. Method: A cross-sectional study of 314 non-institutionalized elderly individuals, living in the city of Juiz de Fora in the state of Minas Gerais) in 2015, was carried out. A household survey was conducted and fear of falling was assessed using the Falls Efficacy Scale - International - Brazil (FES-I-BRASIL). The Spearman correlation was used to verify the correlation of the independent variables with the fear of falling. The significance level for the study was 5%. Results: The prevalence of fear of falling among the elderly was 95.2% (95% CI= 92.3; 97.3). Fear of falling was significantly correlated with all the variables analyzed: age (r= 0.199), self-perceived health (r=0.299), difficulty walking (r= -0.480), use of an assistive device for walking (r=0.337), history of falls (r= -0.177), and functional capacity (r = -0.476) . Conclusions: A high prevalence of fear of falling was observed, with a significant correlation between the outcome and the variables studied. These findings point to the need for rehabilitation, prevention, and health promotion strategies that enable healthy aging.

ATTITUDE TOWARD LEISURE AMONG THE COMMUNITY-DWELLING ELDERLY: AN INTERFACE FOR HEALTH PROMOTION

ABSTRACT A cross-sectional study with quantitative approach carried out with 387 community-dwelling elderly to identify their attitudes toward leisure activities in the cognitive, affective and behavioral dimensions. Data were analyzed using descriptive statistics, Fisher's association test and Spearman's correlation. Most participants were female, aged up to 80 years, married and had up to four years of schooling. The elderly had a predominantly positive attitude toward leisure in the three subscales, with a lower mean for the behavioral subscales, which indicated that some elders had a negative attitude. This was significantly associated with age, educational attainment, smoking status and functional capacity. In conclusion, a positive attitude and greater involvement in leisure activities allows health professionals to raise a critical reflection in the elderly, especially in their behavioral attitude to rethink the planning, opportunities and resources for leisure.