Knowledge and attitude towards type 2 diabetes among older adults: a population-based study

Lima, Alisson Padilha de; Benedetti, Tânia Rosane Bertoldo; Rech, Cassiano Ricardo; Cardoso, Fabrício Bruno; Portella, Marilene Rodrigues

doi:10.1590/1413-81232020252.14662018

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FREE THEMES • Ciênc. saúde coletiva 25 (2) • Feb 2020 • https://doi.org/10.1590/1413-81232020252.14662018 copy

Knowledge and attitude towards type 2 diabetes among older adults: a population-based study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this study was to identify the factors associated with knowledge and attitude towards type 2 diabetes mellitus among older adults with the disease. A cross-sectional population-based study was conducted on 204 older adults from the public healthcare network of Passo Fundo, RS. Sociodemographic data were collected and the DKN-A, ATT-19 and IPAQ were used for the assessment of diabetes knowledge, psychological attitudes towards diabetes and physical activity, respectively. Logistic regression was applied to evaluate the association with sociodemographic and health variables and indicators of body adiposity. Crude and adjusted analyses were performed with a 95% confidence interval. The results showed that good knowledge is associated with age ≥ 70 years (OR = 0.44; 95%CI: 0.18-1.08), having a positive attitude towards diabetes treatment (OR = 8.9; 95%CI: 4.3-18.9), and being physically active (OR = 10.1; 95%CI: 6.34-20.1). In conclusion, good knowledge and a positive attitude towards diabetes are associated with age older than 70 years and being physically active.

Key words
Health education; Demographic aging; Healthcare levels

Variable	Men		Women
Variable	n	%	n	%	X²	P
Age					4.726	0.030^* * p < 0.05: statistically significant difference.
60 to 69 years	56	73.7	75	58.6
≥ 70 years	20	26.3	53	41.4
Marital status					33.370	< 0.001^* * p < 0.05: statistically significant difference.
Married	64	84.2	55	43.0
Single/widow	12	15.8	73	57.0
Schooling					0.815	0.367
0 to 4 years	39	51.3	74	57.8
≥ 5 years	37	48.7	54	42.2
Occupation					3.233	0.072
With occupation	50	65.8	99	77.3
No occupation	26	34.2	29	22.7
Income					0.112	0.738
Retirement	58	76.3	95	74.2
Pension/others	18	23.7	33	25.8
Smoking					15.854	<0.001^* * p < 0.05: statistically significant difference.
Yes	51	67.1	49	38.3
No	25	32.9	79	61.7
Alcohol consumption					22.869	<0.001^* * p < 0.05: statistically significant difference.
Yes	29	38.2	13	10.2
No	47	61.8	115	89.8
Falls					0.574	0.449
Yes	41	53.9	76	59.4
No	35	46.1	52	40.6
Other diseases					0.390	0.532
Yes	66	86.8	107	83.6
No	10	13.2	21	16.4
PAL					1.457	0.227
Insufficiently active	62	81.6	95	74.2
Active	14	18.4	33	25.8
DM knowledge					0.108	0.742
Poor	51	67.1	83	64.8
Good	25	32.9	45	35.2
Attitude towards DM					1.217	0.270
Negative	61	80.3	94	73.4
Positive	15	19.7	34	26.6
BMI					2.438	0.118
No risk	8	10.5	24	18.8
Risk	68	89.5	104	81.3
Waist circumference					0.450	0.502
No risk	14	18.4	19	14.8
Risk	62	81.6	109	85.2
WHR					4.640	0.031^* * p < 0.05: statistically significant difference.
No risk	39	51.3	46	35.9
Risk	37	48.7	82	64.1
WHtR					0.268	0.605
No risk	5	6.6	11	8.6
Risk	71	93.4	117	91.4
BF%					0.041	0.840
No risk	2	2.6	4	3.1
Risk	74	97.4	124	96.9

Variable	Knowledge				p^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).	Attitude				p^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).
	Poor		Good			Negative		Positive
	n	%	N	%		n	%	n	%
Sex					0.742					0.270
Male	51	67.1	25	32.9		61	80.3	15	19.7
Female	83	64.8	45	35.2		94	73.4	34	26.6
Age					0.002^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).					0.010^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).
60 to 69 years	76	58.0	55	42.0		92	70.2	39	29.8
≥ 70 years	58	70.5	15	20.5		63	86.3	10	13.7
Marital status					0.397					0.638
Married	81	68.1	38	31.9		89	74.8	30	25.2
Single/widow	53	62.4	32	37.6		66	77.6	19	22.4
Schooling					0.087					0.777
0 to 4 years	80	70.8	33	29.2		85	75.2	28	24.8
≥ 5 years	54	59.3	37	40.7		70	76.9	21	23.1
Occupation					0.480					0.655
With occupation	100	67.1	49	32.9		112	75.2	37	24.8
No occupation	34	61.8	21	38.2		43	78.2	12	21.8
Income					0.609					0.219
Retirement	102	66.7	51	33.3		113	73.9	40	26.1
Pension/others	32	62.7	19	37.3		42	82.4	9	17.6
Smoking					0.428					0.508
Yes	63	63.0	37	37.0		78	78.0	22	22.0
No	71	68.3	33	31.7		77	74.0	27	26.0
Alcohol consumption					0.830					0.971
Yes	27	64.3	15	35.7		32	76.2	10	23.8
No	107	66.0	55	34.0		123	75.9	39	24.1
Falls					0.125					0.530
Yes	82	70.1	35	29.9		87	74.4	30	25.6
No	52	59.8	35	40.2		68	78.2	19	21.8
Other diseases					0.279					0.264
Yes	111	64.2	62	35.8		129	74.6	44	25.4
No	23	74.2	8	25.8		26	83.9	5	16.1
PAL					<0.001^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).					<0.001^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).
Insufficiently active	125	79.6	32	20.4		154	98.1	3	1.9
Active	9	19.1	38	80.9		1	2.1	46	97.9
Attitude towards DM					<0.001^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).					<0.001^* * p < 0.05: statistically significant difference (Pearson's chi-squared test).
Negative	122	78.7	33	21.3		122	91.0	12	9.0
Positive	12	24.5	37	75.5		33	47.1	37	52.9
BMI					0.691					0.888
No risk	22	68.8	10	31.3		24	75.0	8	25.0
Risk	112	65.1	60	34.9		131	76.2	41	23.8
Waist circumference					0.352					0.391
No risk	24	72.7	9	27.3		27	81.8	6	18.2
Risk	110	64.3	61	35.7		128	74.9	43	25.1
WHR					0.517					0.599
No risk	58	68.2	27	31.8		63	74.1	22	25.9
Risk	76	63.9	43	36.1		92	77.3	27	22.7
WHtR					0.169					0.481
No risk	8	50.0	8	50.0		11	68.8	5	31.3
Risk	126	67.0	62	33.0		144	76.6	44	23.4
BF%					0.959					0.669
No risk	4	3.0	2	2.9		5	3.2	1	2.0
Risk	130	97.0	68	97.1		150	96.8	48	98.0

Variable	Good knowledge		Crude analysis		Adjusted analysis		Positive attitude		Crude analysis		Adjusted analysis
Variable	n	%	OR	95%CI	OR	95%CI	n	%	OR	95%CI	OR	95%CI
Sex
Male	45	35.2	1		1		15	19.7	1		1
Female	25	32.9	0.90	0.49-1.65	0.91	0.38-2.20	34	26.6	1.47	0.74-2.96	1.45	0.70-2.80
Age
60 to 69 years	55	42.0	1		1		39	29.8	1		1
≥ 70 years	15	20.5	0.35	0.18-0.69	0.44	0.18-1.08	10	13.7	0.37	0.17-0.80	0.35	0.15-0.78
Marital status
Married	38	31.9	1		1		30	25.1	1		1
Single/widow	32	37.6	1.28	0.72-2.30	2.79	1.16-6.69	19	22.4	0.85	0.44-1.64	0.93	0.70-2.49
Schooling
0 to 4 years	33	29.2	1		1		28	24.8	1		1
≥ 5 years	37	40.7	1.66	0.93-2.97	1.86	0.82-4.34	21	23.1	0.91	0.47-1.74	0.47	0.37-3.45
Occupation
With occupation	49	32.9	1		1		37	24.8	1		1
No occupation	21	38.2	1.26	0.66-2.39	1.23	0.52-2.90	12	21.8	0.85	0.40-1.71	0.90	0.41-1.76
Income
Retirement	37	37.0	1		1		22	22.0	1		1
Pension/other	33	31.7	0.79	0.44-1.41	0.54	0.24-1.20	27	26.0	1.24	0.65-2.37	2.10	0.20-4.78
Smoking
Yes	15	35.7	1		1		10	23.8	1		1
No	55	34.0	0.93	0.45-1.88	0.71	0.28-1.83	39	24.1	1.01	0.45-2.25	1.02	0.30-2.40
Alcohol consumption
Yes	35	29.9	1		1		30	25.6	1		1
No	35	49.2	1.58	0.88-2.83	2.58	1.18-5.65	19	21.8	0.81	0.42-1.56	0.76	0.34-1.78
Falls
Yes	62	35.8	1		1		44	25.4	1		1
No	8	25.8	0.62	0.26-1.47	0.70	0.23-2.11	5	16.1	0.56	0.20-1.55	0.27	0.10-1.45
Other diseases
Yes	33	21.3	1		1		12	9.0	1		1
No	37	75.5	11.4	5.35-24.2	10.4	4.20-18.70	37	52.9	11.4	5.35-24.28	8.9	4.30-18.9
PAL
Insufficiently active	32	20.4	1		1		3	1.9	1		1
Active	38	80.9	16.4	7.23-37.5	12.7	6.8-30.10	46	97.9	14.9	8.9-35.9	10.1	6.34-20.1
Attitude towards DM
Negative	10	31.3	1		1
Positive	60	34.9	1.17	0.52-2.65	1.03	0.32-3.33
DM knowledge
Poor							6	18.2	1		1
Good							43	25.1	1.51	0.58-3.90	1.37	0.45-3.45
BMI
No risk	9	27.3	1		1		8	25.0	1		1
Risk	61	35.7	1.47	0.64-3.38	2.81	0.69-11.4	41	23.8	0.93	0.39-2.24	0.87	0.40-2.45
Waist circumference
No risk	27	31.8	1		1		22	25.9	1		1
Risk	43	36.1	1.21	0.67-2.19	1.16	0.51-2.62	27	22.7	0.84	0.44-1.60	1.00	0.60-1.69
WHR
No risk	8	50.0	1		1		5	31.3	1		1
Risk	62	33.0	0.49	0.17-1.37	0.24	0.05-1.12	44	23.4	0.67	0.22-2.03	0.80	0.11-2.39
WHtR
No risk	2	2.9	1		1		1	2.0	1		1
Risk	68	97.1	1.05	0.19-5.86	0.45	0.88-0.96	48	98.0	1.60	0.18-14.03	0.67	1.70-2.64
BF%
No risk	2	2.9	1		1		15	19.7	1		1
Risk	68	97.1	1.05	0.19-5.86	0.45	0.88-0.96	34	26.6	1.47	0.74-2.96	1.45	0.70-2.80

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[1] Collaborations

AP Lima participated in all stages of this work since the conception of the study; TRB Benedetti supervised all stages of this work and assisted in the writing of the article; CR Rech participated in the analysis of the data and the final writing of the article; FB Cardoso participated in the writing and correction of the final version of the manuscript; MR Portella participated in all stages of this work and supervised the final writing.