Positive self-rated health in the elderly: a population-based study
					in the South of Brazil

Confortin, Susana Cararo; Giehl, Maruí Weber Corseuil; Antes, Danielle Ledur; Schneider, Ione Jayce Ceola; d’Orsi, Eleonora

doi:10.1590/0102-311X00132014

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ARTICLE • Cad. Saúde Pública 31 (5) • May 2015 • https://doi.org/10.1590/0102-311X00132014 copy

Positive self-rated health in the elderly: a population-based study in the South of Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

The objective was to identify factors associated with positive self-rated health in the elderly in Florianópolis, Santa Catarina State, in the South of Brazil. This population-based cross-sectional study evaluated 1,705 elderly. Self-rated health was classified as positive (very good or good) or negative (fair, poor, and very poor). Crude and adjusted Poisson regression was used to identify associated factors. Prevalence of positive self-rated health was 51.2%, associated with male gender (PR = 1.13), more than 5 years of schooling, moderate (PR = 1.33) or high alcohol intake (PR = 1.37), leisure-time activity (PR = 1.20), Internet use (PR = 1.21), fewer diseases, mild/moderate dependence (PR = 2.20) or no dependence (PR = 2.67), no falls (PR = 1.19), and non-use of polypharmacy (PR = 1.27). Several modifiable factors were identified that can affect positive self-rated health in the elderly and contribute to the development of strategies to improve their quality of life.

Health of the Elderly; Self-Assessment; Cross-Sectional Studies

Variables	n	% (95%CI)	Positive self-rated health [% (95%CI)]	p-value
Gender [n = 1,656]				< 0.001
Female	1,058	62.5 (59.7 -65.3)	48.9 (45.0-52.7)
Male	598	37.5 (34.7-40.3)	61.1 (55.8-66.1)
Age group (years) [n = 1,656]				0.001
≥ 80	214	12.8 (10.3-15.3)	43.9 (36.7-51.3)
70-79	596	35.5 (32.6-38.4)	48.3 (43.2-53.6)
60-69	846	51.7 (48.8-54.7)	59.3 (53.6-64.8)
Marital status [n = 1,656]				< 0.001
With partner	974	58.89 (55.4-62.4)	57.2 (52.8-61.4)
Without partner	682	41.11 (37.6-44.6)	48.1 (43.8-52.4)
Currently working [n = 1,656]				0.004
No	1,429	86.5 (84.1-88.8)	51.8 (47.6-55.9)
Yes	227	13.5 (11.2-15.8)	64.1 (57.2-70.5)
Schooling (years) [n = 1,648]				< 0.001
No formal schooling	148	7.4 (5.3-9.5)	35.5 (28.0-43.7)
1-4	568	32.6 (27.8-37.3)	39.7 (34.9-44.8)
5-8	315	18.6 (16.0-21.3)	49.6 (43.0-56.2)
9-11	231	16.2 (12.6-19.8)	62.3 (56.0-68.3)
≥ 12	386	25.2 (20.6-29.8)	73.3 (66.8-70.0)
Per capita income (BRL) [n = 1,656]				< 0.001
1st quartile (lowest)	414	22.5 (18.7-26.4)	46.9 (39.8-52.5)
2nd quartile	418	25.2 (21.7-28.8)	41.3 (36.1-46.7)
3rd quartile	414	25.4 (22.4-28.4)	56.5 (50.9-62.0)
4th quartile (highest)	410	26.8 (21.7-32.0)	68.2 (62.6-73.2)
Alcohol consumption [n = 1,656]				< 0.001
None	1,061	63.3 (59.8-66.8)	43.9 (40.2-47.6)
Moderate	315	19.3 (16.0-22.5)	67.2 (60.3-73.3)
High	280	17.5 (14.5-20.3)	73.0 (62.5-57.0)
Smoking [n = 1,656]				0.004
Never smoked	1,004	59.2 (55.9-62.6)	49.9 (45.9-53.8)
Former smoker	511	32.2 (29.0-35.4)	57.1 (51.5-62.6)
Current smoker	141	8.6 (6.6-10.5)	64.2 (54.5-73.0)
Leisure-time physical activity [n = 1,656]				< 0.001
Insufficiently active	1,165	68.5 (63.5-73.6)	48.0 (43.8-52.1)
Active	491	31.5 (26.4-36.4)	65.3 (60.9-69.5)
Internet use [n = 1,656]				< 0.001
No	1,313	76.7 (72.3-81.2)	46.2 (43.0-49.4)
Yes	343	23.3 (18.8-27.7)	77.3 (71.3-82.5)
Number of diseases [n = 1,637]				< 0.001
≥ 3	873	52.0 (48.5-55.5)	36.8 (32.1-41.7)
1 to 2	617	38.5 (35.7-41.4)	70.3 (65.7-74.6)
None	147	9.5 (7.7-11.3)	78.8 (70.5-85.2)
Cognitive status [n = 1,648]				0.028
Cognitive deficit	771	45.7 (40.9-50.4)	49.0 (44.1-53.8)
Normal	877	54.3 (49.6-59.1)	57.1 (51.9-62.1)
Dependence in ADL [n = 1,656]				< 0.001
Moderate/Severe	491	29.9 (26.6-33.2)	22.1 (18.0-26.7)
Mild	707	43.9 (39.7-40.0)	60.2 (54.7-65.4)
Absence of dependence	458	26.2 (22.7-29.8)	77.8 (73.1-81.9)
Fall in previous year [n = 1,656]				< 0.001
Yes	308	17.9 (15.6-20.2)	38.3 (31.2-46.0)
No	1,348	82.1 (79.8-84.4)	56.7 (53.1-60.3)
Health plan [n = 1,656]				< 0.001
Yes	597	34.0 (28.6-39.3)	45.4 (40.1-50.9)
No	1,059	66.0 (60.7-71.4)	57.6 (53.9-61.1)
Hospitalization in previous 6 months [n = 1,656]				0.007
No	128	7.1 (5.8-8.5)	37.2 (26.6-49.3)
Yes	1,528	92.9 (91.5-94.2)	54.7 (51.0-58.3)
Polypharmacy [n = 1,656]				< 0.001
Yes	743	44.6 (40.7-48.5)	36.2 (30.6-42.1)
No	913	55.4 (51.5-59.3)	67.4 (63.6-70.9)

Variables	Crude analysis		Adjusted analysis
Variables	PR (95%CI)	p-value	PR (95%CI)	p-value
Block 1: Demographic and socioeconomic				< 0.001
Gender		< 0.001
Female	1.00		1.00
Male	1.25 (1.14-1.37)		1.13 (1.02-1.26)
Age group (years)		0.001
≥ 80	1.00		1.00
70-79	1.10 (0.88-1.37)		1.07 (0.86-1.34)
60-69	1.35 (1.09-1.68)		1.20 (0.94-1.52)
Marital status		< 0.001
With partner	1.00		1.00
Without partner	0.84 (0.76-0.93)		0.94 (0.82-1.07)
Currently working		0.003
No	1.00		1.00
Yes	1.24 (1.08-1.42)		1.04 (0.90-1.20)
Schooling (years)		< 0.001
No formal schooling	1.00		1.00
0-4	1.12 (0.84-1.50)		1.05 (0.80-1.39)
5-8	1.40 (1.13-1.73)		1.26 (1.03-1.55)
9-11	1.76 (1.40-2.21)		1.53 (1.21-1.95)
≥ 12	2.07 (1.62-2.64)		1.68 (1.32-2.13)
Per capita income (BRL)		< 0.001
1^st quartile (lowest)	1.00		1.00
2^nd quartile	0.90 (0.73-1.09)		0.87 (0.71-1.06)
3^rd quartile	1.23 (1.02-1.47)		1.08 (0.90-1.28)
4^th quartile (highest)	1.48 (1.28-1.71)		1.12 (0.96-1.31)
Block 2: Lifestyle				< 0.001
Alcohol consumption		< 0.001
None	1.00		1.00
Moderate	1.53 (1.34-1.75)		1.33 (1.18-1.51)
High	1.66 (1.45-1.91)		1.37 (1.18-1.57)
Smoking		0.001
Never smoked	1.00		1.00
Former smoker	1.14 (1.02-1.28)		1.04 (0.93-1.15)
Current smoker	1.29 (1.11-1.48)		1.16 (0.99-1.36)
Leisure-time physical activity		< 0.001
Insufficiently active	1.00		1.00
Active	1.36 (1.25-1.48)		1.20 (1.12-1.30)
Block 3: Internet use				< 0.001
Internet use		< 0.001
No	1.00		1.00
Yes	1.67 (1.53-1.83)		1.21 (1.07-1.36)
Block 4: Health conditions				< 0.001
Number of diseases		< 0.001
≥ 3	1.00		1.00
1-2	1.91 (1.69-2.16)		1.45 (1.29-1.64)
None	2.14 (1.79-2.56)		1.52 (1.27-1.82)
Cognitive status		0.028
Cognitive deficit	1.00		1.00
Normal	1.16 (1.02-1.34)		1.05 (0.94-1.18)
Dependence in ADL		< 0.001
Moderate/Severe	1.00		1.00
Mild	2.72 (2.19-3.40)		2.20 (1.74-2.76)
Absence of dependence	3.53 (2.89-4.31)		2.67 (2.10-3.39)
Fall in previous year		< 0.001
Yes	1.00		1.00
No	1.48 (1.22-1.79)		1.19 (1.05-1.36)
Block 5: Use of medicines and healthcare services				< 0.001
Health plan		< 0.001
No	1.00		1.00
Yes	1.27 (1.12-1.43)		1.10 (0.99-1.22)
Hospitalization in previous 6 months		0.019
No	1.00		1.00
Yes	1.47(1.07-2.02)		1.04 (0.78-1.41)
Polypharmacy		< 0.001
Yes	1.00		1.00
No	1.47 (1.07-2.02)		1.27 (1.14-1.41)

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[1] Correspondence:I. J. C. Schneider. Programa de Pós-graduação em Saúde Coletiva, Universidade Federal de Santa Catarina. Campus Universitário Reitor João David Ferreira Lima, Florianópolis, SC. 88040-970, Brasil. ione.jayce@gmail.com