Factors associated with the most frequent multimorbidities in Brazilian older adults

Melo, Laércio Almeida de; Lima, Kenio Costa de

doi:10.1590/1413-812320202510.35632018

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ARTICLE • Ciênc. saúde coletiva 25 (10) • Oct 2020 • https://doi.org/10.1590/1413-812320202510.35632018 copy

Factors associated with the most frequent multimorbidities in Brazilian older adults

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to identify an association between the most frequent multimorbidities in Brazilian older adults and socioeconomic and lifestyle variables. National Health Survey’s data were used. The Chi-square test and the Poisson multiple regression were used to analyze data. A total of 5,575 older adults with multimorbidity and mean age of 70.3 years participated in the study. Most of them are female (66.3%), white (56.1%), are sedentary (75.3%), with low schooling (40%), no health plan (65.3%), did not consume alcohol (78.7%) and did not smoke (90.1%). The most prevalent multimorbidities were hypertension and high cholesterol (31.3%), hypertension and stroke (30.9%) and hypertension and diabetes (23.3%). There was an association of the first condition with females, younger adults and no tobacco use. On the other hand, the second condition was associated with females and low level of schooling. The third group was associated with low schooling, sedentary lifestyle and no tobacco use. We can conclude that multimorbidity in Brazilian older adults is a frequent condition in women, younger seniors and those socioeconomically disadvantaged. Also, socioeconomic conditions and lifestyle influenced the prevalence of primary multimorbidities.

Key words
Multimorbidity; Elderly; Chronic diseases

Variable	Category	Presence of Hypertension and High Cholesterol	Absence of Hypertension and High Cholesterol	PR	95% CI	p	PR_ADJ	95% CI _ADJ	p^* * P-value adjusted from the Poisson multiple regression.
Variable	Category	%	%	PR	95% CI	p	PR_ADJ	95% CI _ADJ
Gender	Male	23.8	76.2	0.68	0.58-0.78	< 0.001	0.94	0.93-0.96	< 0.001
Gender	Female	35.2	64.8
Age	60-69 years	31.9	68.1	1.00	-	0.024	1.00	-	< 0.001
	70-79 years	18.3	81.7	0.58	0.50-0.66		0.91	0.90-0.92
	80 years and over	12.7	87.3	0.40	0.33-0.49		0.94	0.93-0.95
Skin color or ethnicity	White	31.4	68.6	1.00	-	0.566
	Black	14.2	85.8	0.45	0.35-0.58
	Brown	15.8	84.2	0.50	0.44-0.58
	Other	17.7	82.3	0.56	0.35-0.89
Marital status	Single	32.7	67.3	1.00	-	0.643
	Married	16.0	84.0	0.49	0.41-0.59
	Separated/divorced	14.7	85.3	0.45	0.36-0.57
	Widower	17.4	82.6	0.53	0.44-0.64
Schooling	Illiterate	30.1	69.9	1.00		0.155
	Incomplete primary school	17.9	82.1	0.59	0.52-0.68
	Primary school completed and over	14.6	85.4	0.48	0.41-0.56
Health plan	Yes	32.9	67.1	1.08	0.95-1.21	0.232
Health plan	No	30.5	69.5
Alcohol use	Yes	28.9	71.1	0.90	0.77-1.06	0.194
Alcohol use	No	32.0	68.0
Tobacco use	Yes	24.1	75.9	0.75	0.59-0.94	0.010	0.97	0.95-0.99	0.005
Tobacco use	No	32.1	67.9
Physical activity	Yes	30.7	69.3	0.97	0.85-1.11	0.712
Physical activity	No	31.5	68.5

Variable	Category	Presence of Hypertension and Stroke	Absence of Hypertension and Stroke	PR	95% CI	p	PR_ADJ	95% CI_ADJ	p^* * P-value adjusted from the Poisson multiple regression.
Variable	Category	%	%	PR	95% CI	p	PR_ADJ	95% CI_ADJ
Gender	Male	27.7	72.3	0.85	0.75-0.97	0.014	0.98	0.96-0.99	0.001
Gender	Female	32.6	67.4
Age	60-69 years	29.5	70.5	1.00	-	0.316
	70-79 years	18.0	82.0	0.61	0.53-0.70
	80 years and over	16.5	83.5	0.56	0.46-0.68
Skin color or ethnicity	White	32.0	68.0	1.00	-	0.184
	Black	16.9	83.1	0.53	0.42-0.66
	Brown	14.4	85.6	0.45	0.39-0.52
	Other	9.2	90.8	0.29	0.15-0.55
Marital status	Single	27.0	73.0	1.00	-	0.062
	Married	16.2	83.8	0.60	0.49-0.74
	Separated/divorced	13.4	86.6	0.50	0.39-0.63
	Widower	18.0	82.0	0.66	0.55-0.80
Schooling	Illiterate	33.3	66.7	1.00		0.003	1.00	-	< 0.001
	Incomplete primary school	17.5	82.5	0.52	0.45-0.61		0.92	0.90-0.93
	Primary school completed and over	12.7	87.3	0.38	0.32-0.45		0.94	0.94-0.95
Health plan	Yes	31.5	68.5	1.03	0.91-1.17	0.661
Health plan	No	30.6	69.4
Alcohol use	Yes	29.5	70.5	0.94	0.81-1.09	0.416
Alcohol use	No	31.3	68.7
Tobacco use	Yes	30.5	69.5	0.98	0.80-1.21	0.874
Tobacco use	No	31.0	69.0
Physical activity	Yes	28.9	71.1	0.91	0.80-1.04	0.177
Physical activity	No	31.6	68.4

Variable	Category	Presence of Hypertension and Diabetes	Absence of Hypertension and Diabetes	PR	95% CI	p	PR_ADJ	95% CI_ADJ	p^* * P-value adjusted from the Poisson multiple regression.
Variable	Category	%	%	PR	95% CI	p	PR_ADJ	95% CI_ADJ
Gender	Male	22.2	77.8	0.93	0.79-1.09	0.364
Gender	Female	23.8	76.2
Age	60-69 years	21.8	78.2	1.00	-	0.064
	70-79 years	14.4	85.6	0.66	0.56-0.78
	80 years and over	11.3	88.7	0.52	0.41-0.66
Skin color or ethnicity	White	23.5	76.5	1.00	-	0.332
	Black	14.0	86.0	0.59	0.49-0.73
	Brown	10.8	89.2	0.46	0.39-0.55
	Other	10.6	89.4	0.45	0.26-0.78
Marital status	Single	23.2	76.8	1.00	-	0.831
	Married	11.5	88.5	0.49	0.39-0.62
	Separated/divorced	12.1	87.9	0.52	0.41-0.67
	Widower	13.4	86.6	0.58	0.46-0.72
Schooling	Illiterate	23.3	76.7	1.00		0.003	1.00	-	0.020
	Incomplete primary school	13.9	86.1	0.60	0.51-0.70		0.93	0.92-0.95
	Primary school completed and over	9.5	90.5	0.41	0.34-0.49		0.96	0.95-0.97
Health plan	Yes	22.0	78.0	0.92	0.77-1.09	0.314
Health plan	No	24.0	76.0
Alcohol use	Yes	14.9	85.1	0.58	0.47-0.72	< 0.001
Alcohol use	No	25.5	74.5
Tobacco use	Yes	17.3	82.7	0.72	0.55-0.94	0.013	0.96	0.94-0.98	< 0.001
Tobacco use	No	23.9	76.1
Physical activity	Yes	19.4	80.6	0.79	0.65-0.95	0.011	0.97	0.95-0.98	< 0.001
Physical activity	No	24.6	75.4

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[1] Collaborations

LA Melo worked on the collection and interpretation of data, on the design and final writing of the manuscript. KC Lima worked on the orientation of the study, data analysis, critical analysis and writing of the manuscript.