Predictors of 10-year mortality in a population of community-dwelling Brazilian elderly: the Bambuí Cohort Study of Aging

We used data on 1,399 participants aged 60 and over from the Bambuí Cohort Study of Aging to examine predictors of mortality in a socioeconomically disadvantaged population. From 1997 to 2007, 599 participants died and 6.2% were lost to follow-up, leading to 12,415 person-years (pyrs) of observation. The death rate was 48.3 per 1,000 pyrs. Age (adjusted hazard ratio [HR] = 1.40), male gender (HR = 1.80), never married (HR = 1.78) or a widow (HR = 1.26), poor self-rated health (HR = 1.31), inability to perform four or more activities of daily living (HR = 3.29), number of cardiovascular risk factors (HR = 1.51 for two and HR = 1.91 for three or more), Trypanosoma cruzi infection (HR = 1.27), and number of medications (HR = 1.06) were each significantly (p < 0.05) and independently associated with mortality. The Mini-Mental State Examination score showed a protective effect (HR = 0.96). Except T. cruzi infection, other predictors of mortality were highly consistent with those found in more affluent elderly populations.

[The influence of proxy respondents on health perception among older adults: a study based on the Brazilian National Household Survey (1998, 2003) and the cohort study in Bambuí, Minas Gerais State, Brazil]

This study was developed to examine whether the use of a proxy respondent influences the distribution and factors associated with health perception among older adults, as well as the mortality relative risk. The study included 28,943 and 35,040 participants from the Brazilian National Household Survey (PNAD) in 1998 and 2003, respectively, and 1,606 members of the cohort from Bambuí, Minas Gerais, Brazil. The results showed that use of proxy in the PNAD 1998 and 2003 did not modify the distribution of health perception or associated factors. The 5-year mortality rate ratio among cohort participants was higher in direct interviews with seniors (RR = 2.40) as compared to those answered by proxies (RR = 1.28), but the direction of the association was the same. These results indicate that health perception data from the PNAD can be used regardless of who answers the interview and that the association between worse health perception and mortality persisted even when perception was inferred from a proxy.

Tendências nas condições de saúde e uso de serviços de saúde entre idosos brasileiros: um estudo baseado na Pesquisa Nacional por Amostra de Domicílios (1998, 2003)

Este trabalho teve por objetivo verificar as tendências das condições de saúde e do uso de serviços de saúde entre idosos brasileiros, utilizando dados da Pesquisa Nacional por Amostras de Domicílios (PNAD). Foram incluídos no estudo 28.943 e 35.042 participantes das PNAD 1998 e 2003 com idade > 60 anos, respectivamente. Os resultados mostraram que houve melhora nas condições de saúde dos idosos nesse período, considerando-se indicadores como percepção da saúde, ter estado recentemente acamado, capacidade para realizar atividades da vida diária e número de doenças crônicas. Os resultados também monstraram que houve aumento do número de consultas médicas e odontológicas entre 1998 e 2003. Tais tendências foram consistentemente observadas em ambos os sexos. Os autores chamam a atenção para a importância do suplemento de saúde da PNAD como fonte de informação para o monitoramento e/ou vigilância das condições de saúde da população idosa brasileira.

[The Bambuí Project: a population-based study of factors associated with regular utilization of dental services in adults]

A cross-sectional study was conducted in Bambuí, Minas Gerais, to identify factors associated with regular use of dental services. Participants were interviewed with a structured questionnaire and previously validated questions. 999/1,221 (81.8%) randomly selected individuals aged > 18 years participated in the Bambuí dental survey. Of these, 654 out of 656 individuals who had at least one natural tooth and had visited a dentist during their lifetime participated in the study. Results adjusted by multiple logistic regression showed that regular use of dental services was significantly related to having > 8 and 4-7 years of schooling (OR = 9.90; 95% CI = 2.90-33.77 and OR = 3.87; 95% CI = 1.11-13.51, respectively), having a preference for restorative treatment rather than extraction (OR = 4.91; 95% CI = 2.23-10.79), having no present need of dental treatment (OR = 4.87; 95% CI = 3.17-7.49), and belief that visiting the dentist prevents tooth decay and gum disease (OR = 1.73; 95% CI = 1.13-2.65). The results show that regular use of dental services was related to factors distributed in the Andersen and Newman model (1973) explaining use of dentistry services.