Sociodemographic, behavioral, and health factors associated with positive self-perceived health of long-lived elderly residents in Florianópolis, Santa Catarina, Brazil

Krug, Rodrigo de Rosso; Schneider, Ione Jayce Ceola; Giehl, Maruí Weber Corseuil; Antes, Danielle Ledur; Confortin, Susana Cararo; Mazo, Giovana Zarpellon; Xavier, André Junqueira; d’Orsi, Eleonora

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ORIGINAL ARTICLE • Rev. bras. epidemiol. 21 • 2018 • https://doi.org/10.1590/1980-549720180004 copy

Sociodemographic, behavioral, and health factors associated with positive self-perceived health of long-lived elderly residents in Florianópolis, Santa Catarina, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

The objective of this study was to identify the factors associated with positive self-perceived health of long-lived elderly (80+) individuals. This cross-sectional study was conducted in the city of Florianópolis, Santa Catarina, Brazil, and included 239 elderly participants from the EpiFloripa Ageing Project. We used collection instruments to verify sociodemographic and economic data, self-reported health status, falls, and lifestyle. Then, we identified factors associated with positive self-perceived health using a Poisson regression adjusted for sex. We found that a positive self-reported health status was more prevalent among the long-lived elderly who were not depressed (PR = 0.49), and among those who consumed alcohol (PR = 1.99). Understanding which variables may interfere in the self-perceived health of the long-lived elderly can result in better health options for this population, mainly, new methods to prevent depression. Additionally, this information can help reduce costs associated with hospitalizations, medications and health treatments, all of which are very common among the long-lived elderly.

Keywords:
Elderly people aged 80 and older; Self-assessment; Health; Comorbidity; Life style; Treatment

Variables	n = 239
Variables	n	% (95%CI)
Self-perceived health
Positive	100	41.4 (34.6 - 48.5)
Negative	139	58.6 (51.5 - 65.4)
Sociodemographics
Sex
Feminine	159	66.0 (58.5 - 72.7)
Masculine	80	34.0 (27.3 - 41.4)
Marital status
Married/together	91	35.7 (28.7 - 43.4)
Single	9	3.3 (1.6 - 6.6)
Divorced/separated	9	3.9 (2.0 - 7.5)
Widowed	130	57.1 (49.5 - 64.3)
Housing
Alone	45	20.8 (15.2 - 27.6)
Accompanied	194	79.2 (72.3 - 84.7)
Care-giver
No	167	71.1 (60.8 - 81.3)
Yes	72	28.9 (18.7 - 39.17)
Schooling
Illiterate	44	16.6 (11.0 - 24.2)
Incomplete elementary school	104	41.8 (32.8 - 51.4)
Elementary school	28	14.7 (8.3 - 24.7)
High school	43	19.4 (12.7 - 28.4)
Higher education	20	7.5 (3.9 - 13.6)
Skin color
White	211	87.8 (80.6 - 92.5)
Black/black with light skin/yellow	28	12.2 (7.5 - 19.3)
Work
No work	232	97.3 (94.0 - 98.8)
Works	7	2.7 (1.2 - 6.0)
Income (minimum wages)
< 1	128	49.7 (39.8 - 59.6)
1 to 3	74	31.8 (26.6 - 37.4)
4 to 6	13	6.0 (3.3 - 10.6)
> 6	24	12.4 (6.9 - 21.4)
Health
Cognitive deficit
No deficit	124	56.5 (46.8 - 66.2)
Probable deficit	112	43.5 (33.8 - 53.2)
Spine disease
No	132	52.1 (44.5 - 59.7)
Yes	107	47.9 (40.3 - 55.5)
Arthritis/rheumatism
No	147	65.9 (57.0 - 74.8)
Yes	92	34.1 (25.2 - 43.0)
Diabetes
No	188	76.1 (68.4 - 82.3)
Yes	5	23.9 (17.6 - 31.5)
Bronchitis/asthma
No	199	83.5 (77.1 - 90.0)
Yes	40	16.4 (10.0 - 22.9)
Systemic arterial hypertension
No	89	37.1 (28.1 - 47.1)
Yes	150	62.9 (52.9 - 71.8)
Cardiovascular diseases
No	15	60.7 (52.0 - 68.8)
Yes	88	39.2 (31.2 - 48.0)
Depression
No	180	75.9 (70.6 - 80.5)
Yes	59	24.1 (19.4 - 29.4)
Stroke
No	206	87.7 (82.5 - 92.9)
Yes	33	12.3 (7.1 - 17.5)
Stomach ulcer
No	212	89.0 (84.4 - 93.6)
Yes	27	11.0 (6.3 - 15.6)
Urinary incontinence
No	132	62.7 (54.3 - 71.2)
Yes	107	37.2 (28.8 - 45.7)
Medication usage
No	13	5.8 (3.1 - 10.6)
Yes	226	94.2 (89.4 - 96.8)
Behavioral
Tobacco use
No	156	64.5 (57.4 - 70.9)
Smoke and stopped	75	32.3 (26.3 - 39.0)
Currently smoked	8	3.2 (1.5 - 6.5)
Alcohol use
No	195	82.3 (76.3 - 87.0)
Yes	44	17.7 (13.0 - 23.7)
Participation in social groups
No	75	33.4 (25.2 - 42.6)
Yes	164	66.6 (57.3 - 74.8)
Level of physical activity during leisure times (minutes per week)
< 150	200	83.1 (76.5 - 88.1)
≥ 150	39	16.9 (11.9 - 23.5)
Others
Falls in the past year
No	178	75.0 (68.8 - 80.2)
Yes	61	25.0 (19.7 - 31.1)

Variables	Positive self-perceived health % (95%CI)	Brute analysis		Adjusted analysis
Variables	Positive self-perceived health % (95%CI)	PR (95%CI)	p-value	PR (95%CI)	p-value
Sociodemographic
Age	-	1.01 (0.97 - 1.05)	0.657	-
Sex
Feminine	38.9 (30.4 - 48.1)	1	0.341	1	0.616
Masculine	46.2 (34.5 - 58.3)	1.19 (0.83 - 1.70)	0.341	0.91 (0.63 - 1.31)	0.616
Marital status
Married/together	47.3 (35.4 - 59.6)	1	0.146	-
Single	50.8 (19.7 - 81.3)	1.07 (0.53 - 2.17)
Divorced/separated	83.0 (47.8 - 96.3)	1.75 (1.18 - 2.61)
Widowed	34.3 (24.4 - 45.7)	0.72 (0.47 - 1.12)
Housing
Alone	41.8 (27.7 - 57.5)	1	0.955	-
Accompanied	41.3 (32.6 - 50.5)	0.99 (0.61 - 1.59)	0.955	-
Care-giver
No	45.5 (0.37 - 0.54)	1	0.127
Yes	31.2 (0.55 - 0.83)	0.68 (0.42 - 1.12)	0.127
Schooling
Illiterate	24.6 (13.3 - 41.0)	1	0.068	-
Incomplete elementary school	38.2 (28.4 - 48.6)	1.55 (0.82 - 2.95)
Elementary school	42.6 (29.0 - 57.5)	1.73 (0.90 - 3.34)
High school	57.5 (28.9 - 81.9)	2.34 (1.07 - 5.09)
Higher education	51.9 (28.4 - 74.6)	2.11 (1.04 - 4.27)
Skin color
White	43.6 (36.8 - 50.7)	1	0.171	-
Black/black with light skin/yello	25.2 (10.5 - 49.0)	0.58 (0.26 - 1.27)	0.171	-
Work
No work	41.3 (34.5 - 48.5)	1	0.964	-
Works	42.3 (12.3 - 79.2)	1.02 (0.39 - 2.66)	0.964	-
Variables	Positive self-perceived health % (95%CI)	Brute analysis		Adjusted analysis
Variables	Positive self-perceived health % (95%CI)	PR (95%CI)	p-value	PR (95%CI)	p-value
Income (minimum wages)
< 1	37.6 (29.2 - 46.9)	1	0.219	-
1 to 3	39.7 (25.6 - 55.7)	1.06 (0.68 - 1.84)
4 to 6	23.4 (7.6 - 53.3)	0.62 (0.22 - 1.75)
> 6	69.4 (49.8 - 83.8)	1.85 (1.29 - 2.64)
Health
Cognitive deficit
No deficit	44.4 (36.3 - 52.6)	1	0.455
Probable deficit	38.7 (26.5 - 50.9)	0.87 (0.60 - 1.26)	0.455
Spine disease
No	43.7 (33.1 - 54.3)	1	0.495	-
Yes	38.8 (29.5 - 48.2)	0.89 (0.63 - 1.25)	0.495	-
Arthritis/rheumatism
No	45.6 (35.3 - 55.8)	1	0.187	-
Yes	33.3 (20.7 - 45.8)	0.73 (0.46 - 1.17)	0.187	-
Cancer
No	39.8 (31.3 - 48.2)	1	0.182	-
Yes	52.8 (35.8 - 69.8)	1.33 (0.87 - 2.02)	0.182	-
Diabetes
No	45.9 (37.4 - 54.7)	1	0.058	-
Yes	26.8 (15.3 - 42.6)	0.58 (0.33 - 1.02)	0.058	-
Bronchitis/asthma
No	40.7 (33.3 - 48.2)	1	0.656	-
Yes	44.7 (27.5 - 62.0)	1.10 (0.72 - 1.67)	0.656	-
Systemic arterial hypertension
No	44.1 (31.7 - 57.3)	1	0.583	-
Yes	39.8 (31.8 - 48.3)	0.90 (0.62 - 1.31)	0.583	-
Cardiovascular diseases
No	46.8 (38.6 - 55.1)	1	0.079	-
Yes	33.0 (22.8 - 45.2)	0.71 (0.48 - 1.04)	0.079	-
Depression
No	47.9 (39.2 - 56.7)	1	0.004*	1	0.013*
Yes	20.8 (12.0 - 33.5)	0.43 (0.25 - 0.76)	0.004*	0.49 (0.28 - 0.85)	0.013*
Variables	Positive self-perceived health % (95%CI)	Brute analysis		Adjusted analysis
Variables	Positive self-perceived health % (95%CI)	PR (95%CI)	p-value	PR (95%CI)	p-value
Stroke
No	43.6 (36.1 - 51.1)	1	0.132	-
Yes	25.4 (7.8 - 43.1)	0.58 (0.29 - 1.18)	0.132	-
Stomach ulcer
No	41.8 (34.3 - 49.2)	1	0.778	-
Yes	38.1 (14.4 - 61.8)	0.91 (0.47 - 1.75)	0.778	-
Urinary incontinence
No	41.4 (33.3 - 49.5)	1	0.994	-
Yes	41.3 (29.1 - 53.6)	1.00 (0.71 - 1.41)	0.994	-
Medication usage
No	69.6 (37.0 - 90.0)	1	0.024*	1	0.058
Yes	39.6 (32.1 - 47.6)	0.57 (0.35 - 0.93)	0.024*	0.62 (0.37 - 1.02)	0.058
Behavioral
Tobacco use
No	41.2 (30.8 - 52.4)	1	0.639	-
Smoke and stopped	40.0 (29.0 - 52.2)	0.97 (0.61 - 1.53)
Currently smoked	58.1 (21.6 - 87.4)	1.41 (0.66 - 2.98)
Alcohol use
No	34.5 (28.4 - 41.1)	1	> 0.001*	1	> 0,001*
Yes	73.2 (56.0 - 85.5)	2.21 (1.64 - 2.25)	> 0.001*	1.99 (1.54 - 2.56)	> 0,001*
Participation in social groups
No	47.7 (33.2 - 62.6)	1	0.265	-
Yes	38.2 (30.5 - 46.5)	0.80 (0.54 - 1.19)	0.265	-
Level of physical activity during leisure times (minutes per week)
< 150	38.1 (31.1 - 45.7)	1	0.010*	1	0.150
≥ 150	57.3 (42.1 - 71.3)	1.50 (1.11 - 2.05)	0.010*	1.22 (0.93 - 1.60)	0.150
Others
Falls
No	39.9 (33.3 - 47.0)	1	0.454	-
Yes	45.8 (31.0 - 61.3)	1.15 (0.80 - 1.65)	0.454	-

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[1] Corresponding author: Rodrigo de Rosso Krug. Programa de Pós-Graduação em Ciências Médicas, Centro de Ciências da Saúde. Rua Delfino Conti, s/n, bloco A, sala 126, Campus Universitário, Trindade, CEP: 88040-410, Florianópolis, SC, Brasil. E-mail: rodkrug@bol.com.br