Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern
Abstract Background Despite the advancements in knowledge about health care for older adults, essential gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of moderate and severe function...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Public Health |
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| Online Access: | https://doi.org/10.1186/s12889-023-17564-w |
| _version_ | 1797355454666375168 |
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| author | Wanderley Matos Reis Júnior Luciano Nery Ferreira Cynthia Goulart Molina-Bastos José Patrício Bispo Júnior Helca Franciolli Teixeira Reis Bárbara Niegia Garcia Goulart |
| author_facet | Wanderley Matos Reis Júnior Luciano Nery Ferreira Cynthia Goulart Molina-Bastos José Patrício Bispo Júnior Helca Franciolli Teixeira Reis Bárbara Niegia Garcia Goulart |
| author_sort | Wanderley Matos Reis Júnior |
| collection | DOAJ |
| description | Abstract Background Despite the advancements in knowledge about health care for older adults, essential gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of moderate and severe functional dependence in Brazilian older adults and its association with chronic diseases and verify the multimorbidity patterns by dependence status. Methods This cross-sectional analytical study used data from 11,177 community-dwelling Brazilian older adults from the 2013 National Health Survey conducted in Brazil. The dependent variables were moderate and severe functional dependence in basic activities of daily living (BADLs) and instrumental ADLs (IADLs). The independent variables were defined based on the questions applied to measure each morbidity in a self-reported manner and asked, "Has a doctor ever diagnosed you as having (each disease)? Multimorbidity was simultaneously considered present for older adults with ≥ 2 chronic morbidities. The association between functional dependence on BADLs and IADLs separately by severity and the independent variables was verified from crude and adjusted estimates of the point prevalence ratios and their 95% confidence intervals using the regression model Poisson with robust variance. To group diseases into patterns, exploratory factor analysis was used. Results The prevalences of moderate and severe BADL dependence were 10.2% (95% CI, 9.6–10.7) and 4.8% (95% CI, 4.4–5.2), respectively. Moderate and severe IADL dependence prevalences were 13.8% (95% CI, 13.1–14.4) and 15.6% (95% CI, 14.9%–16.2), respectively. When changing the condition from moderate to severe dependence in BADLs, in the presence of other mental illnesses and stroke, the probability of dependence increased more than four times in the case of other mental illnesses and more than five times for stroke. There was a linear trend for dependence severity, both moderate and severe, whereas, for severe dependence on IADLs, this same factor maintained a linear trend toward an increase in probability as the number of diseases simultaneously increased. Conclusions Chronic diseases are associated with functional dependence, with greater emphasis on mental illnesses and stroke in severe disability, considering their acute adverse effects. |
| first_indexed | 2024-03-08T14:11:27Z |
| format | Article |
| id | doaj.art-ad9d5f22cc24499ca876467b6cc06fd2 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-08T14:11:27Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-ad9d5f22cc24499ca876467b6cc06fd22024-01-14T12:41:10ZengBMCBMC Public Health1471-24582024-01-0124111410.1186/s12889-023-17564-wPrevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity patternWanderley Matos Reis Júnior0Luciano Nery Ferreira1Cynthia Goulart Molina-Bastos2José Patrício Bispo Júnior3Helca Franciolli Teixeira Reis4Bárbara Niegia Garcia Goulart5Department of Health 1, State University of Southwest BahiaDepartment of Health 1, State University of Southwest BahiaDepartment of Social Medicine, Federal University of Rio Grande Do Sul, Rio Grande Do SulFederal University of Bahia, Multidisciplinary Health InstituteFederal University of Bahia, Multidisciplinary Health InstituteDepartment of Health 1, State University of Southwest BahiaAbstract Background Despite the advancements in knowledge about health care for older adults, essential gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of moderate and severe functional dependence in Brazilian older adults and its association with chronic diseases and verify the multimorbidity patterns by dependence status. Methods This cross-sectional analytical study used data from 11,177 community-dwelling Brazilian older adults from the 2013 National Health Survey conducted in Brazil. The dependent variables were moderate and severe functional dependence in basic activities of daily living (BADLs) and instrumental ADLs (IADLs). The independent variables were defined based on the questions applied to measure each morbidity in a self-reported manner and asked, "Has a doctor ever diagnosed you as having (each disease)? Multimorbidity was simultaneously considered present for older adults with ≥ 2 chronic morbidities. The association between functional dependence on BADLs and IADLs separately by severity and the independent variables was verified from crude and adjusted estimates of the point prevalence ratios and their 95% confidence intervals using the regression model Poisson with robust variance. To group diseases into patterns, exploratory factor analysis was used. Results The prevalences of moderate and severe BADL dependence were 10.2% (95% CI, 9.6–10.7) and 4.8% (95% CI, 4.4–5.2), respectively. Moderate and severe IADL dependence prevalences were 13.8% (95% CI, 13.1–14.4) and 15.6% (95% CI, 14.9%–16.2), respectively. When changing the condition from moderate to severe dependence in BADLs, in the presence of other mental illnesses and stroke, the probability of dependence increased more than four times in the case of other mental illnesses and more than five times for stroke. There was a linear trend for dependence severity, both moderate and severe, whereas, for severe dependence on IADLs, this same factor maintained a linear trend toward an increase in probability as the number of diseases simultaneously increased. Conclusions Chronic diseases are associated with functional dependence, with greater emphasis on mental illnesses and stroke in severe disability, considering their acute adverse effects.https://doi.org/10.1186/s12889-023-17564-wPrevalence studiesChronic diseaseFunctional statusOlder adults |
| spellingShingle | Wanderley Matos Reis Júnior Luciano Nery Ferreira Cynthia Goulart Molina-Bastos José Patrício Bispo Júnior Helca Franciolli Teixeira Reis Bárbara Niegia Garcia Goulart Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern BMC Public Health Prevalence studies Chronic disease Functional status Older adults |
| title | Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern |
| title_full | Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern |
| title_fullStr | Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern |
| title_full_unstemmed | Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern |
| title_short | Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern |
| title_sort | prevalence of functional dependence and chronic diseases in the community dwelling brazilian older adults an analysis by dependence severity and multimorbidity pattern |
| topic | Prevalence studies Chronic disease Functional status Older adults |
| url | https://doi.org/10.1186/s12889-023-17564-w |
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