Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil
Abstract Background The global phenomenon of population ageing is creating new challenges in both high and middle income countries, as functional limitations are expected to increase with age. The attribution method has been proposed to identify which conditions contribute most to disability using c...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Archives of Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13690-017-0235-3 |
| _version_ | 1831688997470994432 |
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| author | Renata T.C. Yokota Wilma J. Nusselder Jean-Marie Robine Jean Tafforeau Patrick Deboosere Lenildo Moura Silvânia S. C. A. Andrade Shamyr S. Castro Herman Van Oyen |
| author_facet | Renata T.C. Yokota Wilma J. Nusselder Jean-Marie Robine Jean Tafforeau Patrick Deboosere Lenildo Moura Silvânia S. C. A. Andrade Shamyr S. Castro Herman Van Oyen |
| author_sort | Renata T.C. Yokota |
| collection | DOAJ |
| description | Abstract Background The global phenomenon of population ageing is creating new challenges in both high and middle income countries, as functional limitations are expected to increase with age. The attribution method has been proposed to identify which conditions contribute most to disability using cross-sectional data. Although the original method was based on binary outcomes, we recently proposed an extension to multinomial responses, since different disability levels are often investigated in surveys. This is the first application of the extended method to evaluate differences in the contribution of chronic conditions to functional limitations in the older population of Brazil and Belgium. Methods Representative data from individuals aged ≥65 years who participated in the 2008 or 2013 Health Interview Surveys in Belgium (N = 4521) or in the 2008 National Household Sample Survey in Brazil (N = 28,437) were analysed. Individuals were classified as without, moderate or severe functional limitations, based on three activities of daily living: eating, showering, and toileting. Six chronic conditions common to the surveys – diabetes, heart diseases, musculoskeletal conditions, depression, chronic respiratory diseases, and cancer – were included in the analysis. Separate multinomial additive hazards models by gender for each country were fitted. Results The prevalence of moderate functional limitations was larger in men in Brazil (8.4%) compared to Belgium (6.0%) and similar in women (approximately 12.0%). Conversely, the severe prevalence in men was similar in the two countries (around 8.0%) and higher in women from Belgium (16.6%) than from Brazil (9.1%). Musculoskeletal conditions were the main contributors to the prevalence of functional limitations in men and women in Belgium but only in men and women with moderate functional limitations in Brazil. Depression and heart diseases contributed most to the severe prevalence of functional limitations in men and women in Brazil, respectively. Conclusions Our findings provide a better understanding of differences in the prevalence of different levels of functional limitations in Brazil and Belgium. These differences can be related to differences in socioeconomic conditions, health care access and quality, disease diagnosis, stage of epidemiology transition, life expectancy, and the prevalence of lifestyle risk factors in the two countries. |
| first_indexed | 2024-12-20T10:39:47Z |
| format | Article |
| id | doaj.art-185f64b610f547779073518e51457877 |
| institution | Directory Open Access Journal |
| issn | 2049-3258 |
| language | English |
| last_indexed | 2024-12-20T10:39:47Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Archives of Public Health |
| spelling | doaj.art-185f64b610f547779073518e514578772022-12-21T19:43:33ZengBMCArchives of Public Health2049-32582017-12-0175111210.1186/s13690-017-0235-3Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and BrazilRenata T.C. Yokota0Wilma J. Nusselder1Jean-Marie Robine2Jean Tafforeau3Patrick Deboosere4Lenildo Moura5Silvânia S. C. A. Andrade6Shamyr S. Castro7Herman Van Oyen8Department of Public Health and Surveillance, Scientific Institute of Public HealthDepartment of Public HealthFrench Institute of Health and Medical Research (INSERM)Department of Public Health and Surveillance, Scientific Institute of Public HealthInterface Demography, Department of SociologyUnit for Health risks, Noncommunicable Diseases and Mental Health, Pan-American Health OrganizationDepartment of Noncommunicable Disease Surveillance and Health Promotion, Ministry of HealthDepartment of Physiotherapy, Federal University of CearáDepartment of Public Health and Surveillance, Scientific Institute of Public HealthAbstract Background The global phenomenon of population ageing is creating new challenges in both high and middle income countries, as functional limitations are expected to increase with age. The attribution method has been proposed to identify which conditions contribute most to disability using cross-sectional data. Although the original method was based on binary outcomes, we recently proposed an extension to multinomial responses, since different disability levels are often investigated in surveys. This is the first application of the extended method to evaluate differences in the contribution of chronic conditions to functional limitations in the older population of Brazil and Belgium. Methods Representative data from individuals aged ≥65 years who participated in the 2008 or 2013 Health Interview Surveys in Belgium (N = 4521) or in the 2008 National Household Sample Survey in Brazil (N = 28,437) were analysed. Individuals were classified as without, moderate or severe functional limitations, based on three activities of daily living: eating, showering, and toileting. Six chronic conditions common to the surveys – diabetes, heart diseases, musculoskeletal conditions, depression, chronic respiratory diseases, and cancer – were included in the analysis. Separate multinomial additive hazards models by gender for each country were fitted. Results The prevalence of moderate functional limitations was larger in men in Brazil (8.4%) compared to Belgium (6.0%) and similar in women (approximately 12.0%). Conversely, the severe prevalence in men was similar in the two countries (around 8.0%) and higher in women from Belgium (16.6%) than from Brazil (9.1%). Musculoskeletal conditions were the main contributors to the prevalence of functional limitations in men and women in Belgium but only in men and women with moderate functional limitations in Brazil. Depression and heart diseases contributed most to the severe prevalence of functional limitations in men and women in Brazil, respectively. Conclusions Our findings provide a better understanding of differences in the prevalence of different levels of functional limitations in Brazil and Belgium. These differences can be related to differences in socioeconomic conditions, health care access and quality, disease diagnosis, stage of epidemiology transition, life expectancy, and the prevalence of lifestyle risk factors in the two countries.http://link.springer.com/article/10.1186/s13690-017-0235-3Chronic conditionsFunctional limitationsADLSurveyMultinomialBrazil |
| spellingShingle | Renata T.C. Yokota Wilma J. Nusselder Jean-Marie Robine Jean Tafforeau Patrick Deboosere Lenildo Moura Silvânia S. C. A. Andrade Shamyr S. Castro Herman Van Oyen Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil Archives of Public Health Chronic conditions Functional limitations ADL Survey Multinomial Brazil |
| title | Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil |
| title_full | Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil |
| title_fullStr | Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil |
| title_full_unstemmed | Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil |
| title_short | Contribution of chronic conditions to functional limitations using a multinomial outcome: results for the older population in Belgium and Brazil |
| title_sort | contribution of chronic conditions to functional limitations using a multinomial outcome results for the older population in belgium and brazil |
| topic | Chronic conditions Functional limitations ADL Survey Multinomial Brazil |
| url | http://link.springer.com/article/10.1186/s13690-017-0235-3 |
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