Functioning and associated factors in older adult users of primary health care

Figueiredo, Chris Evert Moura Tabosa de; Castro, Shamyr Sulyvan de; Ferreira, Marcelo José Monteiro

doi:10.1590/1809-2950/e23017524en

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ORIGINAL RESEARCH • Fisioter. Pesqui. 32 • 2025 • https://doi.org/10.1590/1809-2950/e23017524en linkcopy

Functioning and associated factors in older adult users of primary health care

Factores personales y clínicos asociados a la alteración de la funcionalidad en personas mayores usuarias de atención primaria de salud

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Population aging is a major challenge for public health, society, and policymakers worldwide. This challenge becomes increasingly complex in developing countries. Our research evaluated the functioning and factors associated with clinical and sociodemographic aspects of older adult users of Primary Health Care in Fortaleza city. A cross-sectional analytical study was conducted using the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to measure functioning. Mann-Whitney and Kruskall-Wallis tests were employed for bivariate analyses, along with negative binomial regression for multivariate analysis. Age was associated with the loss of functioning across all WHODAS 2.0 domains (p<0.01). Respondents who presented clinical decompensation related to any comorbidity performed worse in the self-care (p<0.05), school and work activities (p<0.05), life activities (p<0.05), participation (p<0.05), and total domains (p<0.01). Our findings reinforce the key role of Primary Health Care as a strategic space to preserve functioning in the older adult population.

Keywords
Health of the elderly; Aging; Disability studies; Primary health care; Health promotion

Characteristic	N (170)	%
Gender
Man	56	32.94
Woman	114	67.06
Age
60 – 70	95	55.88
71 – 80	57	33.53
>80	18	10.59
Skin-color
White	48	28.24
Mixed-race	110	64.71
Black	12	7.06
Schooling
Illiterate	24	14.12
Complete primary education	87	51.18
Complete secondary education	37	21.76
Tertiary education	22	12.94
Marital status
Single/Divorced	64	37.65
Married/Stable union	73	42.94
Widow/Widower	33	19.41
Household type
Alone	24	14.12
Living with spouse	33	19.41
Living with family members	113	66.47
Religion	165	97.06
Monthly income
Up to 1 MW	91	53.53
1 to 3 MW	57	33.53
More than 3 MW	32	12.94
Beneficiary of the Bolsa Família Program	5	2.94
Employment status
Employed	6	3.53
Self-employed	11	6.47
Retiree/Pensioner	140	82.35
Unemployed	13	7.65

Characteristic
Characteristic	N (170)	%
Clinical decompensation related to any comorbidity	87	51.18
Number of comorbidities ^*
1	41	28.28
2	54	37.24
3	32	22.07
≥ 4	18	12.41
Number of medications used
None	24	14.12
From 1 to 4	102	60.00
≥5	44	25.88
Lifestyle habits
Regular physical activity	62	36.47
Smoking habit	21	12.35
Frequent alcohol consumption	22	12.94

WHODAS 2.0 domains	N	Median	IQR
Cognition	170	10	20
Mobility	170	18.75	37.5
Self-care	170	0	10
Getting along	170	0	16.6
Domestic activities	170	10	40
School and work activities	170	14.28	25
Life activities	170	12.5	29.17
Participation	170	18.75	29.17
Total	170	14.15	16.09

Characteristic	Cognition	Mobility	Self-care	Getting along	Domestic activities	School and work activities	Life activities	Participation	Total
Gender	<0.05	<0.05	0.34	0.78	<0.05	0.75	0.07	<0.05	<0.05
Woman	15 (330.94)	25 (533.43)	0 (168.60)	0 (254.79)	20 (715.48)	10.71 (472.10)	16.66 (481.05)	25 (389.79)	17.45 (244.43)
Man	75 (196.10)	12.5 (411.12)	0 (195.55)	0 (160.15)	0 (431.68)	14.28 (375.56)	8.33 (340.54)	12.5 (354.61)	10.37 (183.30)
Age	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01	<0.01
60 – 70	10 (242.01)	6.25 (498.73)	0 (164.88)	0 (127.06)	0 (496.30)	7.14 (284.49)	8.33 (297.53)	16.66 (392.23)	12.26 (192.96)
71 – 80	10 (300.25)	18.75 (408.93)	0 (186.27)	0 (181.05)	10 (525)	14.28 (373.44)	12.5 (325.48)	16.66 (333.78)	16.98 (168.34)
>80	25 (470.99)	32.37 (533.08)	15 (188.23)	8.33 (735.29)	45 (1236.92)	28.57 (967.88)	35.41 (1004.67)	33.33 (402.82)	26.41 (407.91)
Schooling	<0.01	-	-	-	-	<0.01	<0.01	-	<0.01
Illiterate	15 (436.54)	15.65 (602.85)	0 (179.71)	0 (489)	20 (851.99)	14.28 (786.65)	14.58 (737.72)	22.91 (428.61)	17.92 (372.63)
Complete primary education	10 (294.83)	18.75 (450.49)	0 (188.63)	8.33 (170.70)	10 (525.20)	21.46 (315.26)	16.66 (302.99)	25 (384.65)	17.45 (183.25)
Complete secondary education	10 (248.53)	12.5 (677.37)	0 (201.20)	0 (167.87)	10 (865.76)	7.14 (440.41)	8.33 (549.42)	16.66 (357.49)	12.26 (253.07)
Tertiary education	0 (148.53)	6.25 (272.67)	0 (109.95)	0 (246.66)	0 (541.99)	0 (518.59)	4.16 (448.98)	12.5 (332.82)	8.01 (179.09)
Monthly income	-	-	-	-	-	-	-	<0.01	-
Up to 1 MW	10 (337.42)	1.75 (544.58)	0 (189.03)	8.33 (254.00)	10 (670.03)	14.28 (461.77)	12.5 (462.66)	25 (378.40)	16.98 (250.19)
1 to 3 MW	15 (228.14)	18.75 (477.21)	0 (169.61)	0 (123.22)	10 (566.04)	14.28 (366.54)	12.5 (362.70)	12.5 (365.67)	14.15 (173.82)
More than 3 MW	5 (291.17)	9.37 (380.14)	0 (163.63)	8.33 (348.27)	10 (852.16)	7.14 (552.16)	8.33 (579.19)	12.5 (341.81)	7.54 (273.26)
Retiree/Pensioner	10 (301.04)	18.75 (476.65)	0 (163.30)	4.16 (242.14)	10 (654.45)	14.28 (457.12)	12.5 (447.04)	18.75 (372.10)	15.56 (217.86)
Unemployed	25 (397.75)	12.5 (948.01)	0 (466.66)	8.33 (214,56)	10 (826.92)	14.28 (457.12)	12.5 (490.11)	20.83 (689.10)	14.15 (416.57)
Smoker	<0.05	<0.05	<0.05	0.82	0.17	0.17	0.13	0.39	<0.05
Yes	15 (281.10)	18.75 (507.35)	0 (195.35)	0 (238.99)	10 (678.35)	7.14 (299.07)	12.5 (464.14)	20.83 (384.59)	16.98 (231.28)
No	5 (401.19)	6.25 (396.94)	0 (9.04)	8.33 (114.41)	0 (424.76)	14.28 (456.22)	8.33 (245.86)	16.66 (388.88)	7.54 (195.07)
Frequent alcohol consumption	<0.05	<0.05	0.54	0.60	0.09	0.52	0.26	0.76	0.12
Yes	15 (260.73)	18.75 (511.44)	0 (183.42)	0 (227.66)	10 (670.69)	10.71 (325.11)	12.5 (458.43)	20.83 (380.82)	16.50 (228.96)
No	0 (544.58)	0 (366.95)	0 (140.25)	0 (198.41)	0 (491.99)	14.28 (456.12)	8.33 (310.43)	16.66 (426.02)	10.37 (225.68)
Regular physical activity	0.15	<0.05	0.18	0.91	<0.05	<0.05	<0.05	<0.01	<0.01
Yes	10 (167.58)	6.25 (360.18)	0 (67.37)	0 (187.80)	10 (513.51)	7.14 (337.81)	8.33 (334.93)	12.5 (260.98)	12.26 (140.25)
No	15 (363.05)	25 (550.56)	0 (234.50)	0 (245.01)	10 (710.34)	14.28 (466.33)	16.66 (47.44)	25 (409.72)	17.92 (260.37)
Number of comorbidities	-	-	-	<0.01	-	-	-	<0.01	<0.01
1	10 (208.47)	12.5 (417.77)	0 (104.87)	0 (164.97)	20 (454.75)	14.28 (309.79)	12.5 (287.98)	16.66 (286.64)	15.09 (165.37)
2	10 (313.20)	18.75 (453.13)	0 (197.65)	0 (207.50)	10 (727.74)	14.28 (418.36)	12.5 (472.76)	16.66 (458.20)	12.73 (219.08)
3	15 (327.01)	31.25 (514.38)	0 (277.01)	8.33 (160.17)	20 (696.67)	21.42 (503.15)	25 (434.51)	29.16 (323.54)	19.81 (215.57)
≥ 4	10 (471.97)	21.87 (466.32)	0 (158.49)	8.33 (655.63)	25 (967.64)	21.42 (783.64)	27.08 (797.53)	29.16 (355.90)	17.92 (386.80)
Number of medications used	<0.01	<0.01	-	-	<0.01	<0.01	<0.01	<0.01	<0.01
None	10 (162.99)	0 (386.94)	0 (60.14)	0 (117.62)	0 (317.21)	3.57 (176.63)	8.33 (123.66)	12.5 (193.23)	8.01 (69.70)
1-4	10 (245.87)	12.5 (484.25)	0 (169.29)	0 (165.15)	10 (581.55)	7.14 (400.99)	12.5 (415.42)	18.75 (384.92)	12.73 (217.10)
≥5	20 (447.04)	31.25 (472.61)	0 (255.60)	8.33 (400,81)	20 (854.96)	21.42 (554.29)	29.16 (542.00)	29.16 (396.06)	21.68 (269.01)
Clinical decompensation related to any comorbidity	0.29	0.21	<0.05	0.15	0.37	<0.05	<0.05	<0.05	<0.01
Yes	10 (333.62)	18.75 (548.60)	0 (234.96)	8.33 (289.97)	10 (814.78)	21.42 (548.67)	16.66 (572.65)	25 (401.74)	17.92 (277.70)
No	10 (255.96)	12.5 (451.34)	0 (110.66)	0 (146.99)	10 (470.14)	7.14 (272.92)	8.33 (269.81)	12.5 (322.29)	12.26 (160.93)

Domains and variables	Crude IRR	CI		p-value	Adjusted IRR	CI		p-value
Domains and variables	Crude IRR	Lower Limit	Upper Limit	p-value	Adjusted IRR	Lower Limit	Upper Limit	p-value
COGNITION
Gender
Woman	1				1
Man	0.61	0.40	0.94	0.02	0.56	0.37	0.87	0.01
Skin-color
White	1				1
Mixed-race	1.53	0.65	3.56	0.32	-	-	-	-
Black	1.27	0.80	2.00	0.30	-	-	-	-
Age
60 – 70	1				1
71 – 80	1.15	0.74	1.78	0.52	-	-	-	-
>80	1.91	0.98	3.71	0.05	2.21	1.15	4.24	0.01
Marital status
Married/Stable union	1				1
Widow/Widower	1.12	0.63	1.98	0.68	-	-	-	-
Single/Divorced	1.09	0.63	1.91	0.74	-	-	-	-
Household type
Living with family members	1				1
Living with spouse	1.18	0.65	2.14	0.56	-	-	-	-
Alone	3.21	2.19	4.21	0.01	2.32	1.32	4.07	<0.05
Number of medications used
None	1				1	-	-	-
1-4	1.13	0.62	2.04	0.68	-	-	-	-
≥5	1.75	0.9	3.39	0.09	2.10	1.09	4.05	<0.05
Monthly income
More than 3 MW	1				1
1 to 3 MW	1.63	0.87	3.05	0.12	-	-	-	-
Up to 1 MW	1.52	0.78	2.96	0.21	-	-	-	-
Schooling
Tertiary education	1				1
Complete secondary education	2.75	1.27	5.92	0.01	2.18	1.09	4.37	0.02
Complete primary education	2.00	1.07	3.73	0.02	2.25	1.23	4.14	<0.01
Illiterate	1.75	0.86	3.53	0.11	3.65	1.67	7.98	<0.01
Clinical Decompensation
No	1				1
Yes	1.20	0.80	1.80	0.36	-	-	-	-
Smoking habit
No	1				1
Yes	1.40	0.76	2.61	0.27	-	-	-	-
Frequent alcohol consumption
No	1				1
Yes	1.31	0.71	2.39	0.37	-	-	-	-
Beneficiary of the Bolsa Familia Program
No	1				1
Yes	0.92	0.27	3.07	0.89	-	-	-	-
Regular physical activity
No	1				1
Yes	0.72	0.47	1.09	0.12	-	-	-	-
Number of comorbidities
1	1				1
2	1.20	0.70	2.06	0.48	-	-	-	-
3	1.49	0.81	2.74	0.19	-	-	-	-
More than 3	1.06	0.51	2.21	0.85	-	-	-	-
Employment status
Employed	1.00
Self-employed	1.22	0.26	3.83	0.99	1
Retiree	1.47	0.49	4.41	0.48	-	-	-	-
Unemployed	2.34	1.64	4.41	0.01	3.23	1.12	10.45	0.05
GETTING ALONG
Gender
Woman	1
Man	0.85	0.41	1.75	0.66
Skin-color
White	1
Mixed-race	0.63	0.15	2.63	0.52
Black	1.02	0.47	2.19	0.94
Age
60 – 70	1
71 – 80	0.99	0.48	2.06	1.00
>80	2.66	0.87	8.08	0.08
Marital status
Married/Stable union	1
Widow/Widower	1.41	0.59	3.63	0.47
Single/Divorced	1.22	0.48	3.09	0.66
Household type
Living with family members	1
Living with spouse	0.35	0.13	0.95	0.04
Living alone	0.65	0.27	1.53	0.32
Number of medications used
None	1
1-4	1.53
≥5	2.31
Monthly income
More than 3 MW	1
1 to 3 MW	0.78	0.27	2.22	0.65
Up to 1 MW	0.56	0.18	1.69	0.30
Schooling
Tertiary education	1
Complete secondary education	1.35	0.37	4.95	0.64
Complete primary education	1.08	0.37	3.08	0.88
Illiterate	0.73	0.22	2.40	0.61
Clinical Decompensation
No	1
Yes	1.52	0.77	2.98	0.22
Smoking habit
No	1
Yes	1.14	0.40	3.19	0.80
Frequent alcohol consumption
No	1
Yes	1.20	0.43	3.30	0.72
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.67	0.09	5.03	0.70
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.67	0.09	5.03	0.70
Physical Activity
No	1
Yes	0.93	0.46	1.89	0.85
Number of comorbidities
1	1
2	1.61	0.69	3.76	0.26
3	2.08	0.79	5.45	0.13
More than 3	2.77	0.87	8.77	0.08
Employment status
Employed	1
Self-employed	-	-	-
Retiree	-	-	-
Unemployed	-	-	-
DOMESTIC ACTIVITIES
Gender
Woman	1
Man	0.51	0.27	0.95	<0.05	0.35	0.18	0.70	<0.05
Skin-color
White	1				1
Mixed-race	1.18	0.34	4.12	0.78	2.70	0.69	10.53	0.15
Black	1.14	0.58	2.23	0.68	2.25	1.06	4.80	<0.05
Age
60 – 70	1				1
71 – 80	1.18	0.62	2.24	0.59	-	-	-	-
>80	2.73	1.03	7.24	<0.05	3.7	1.31	10.46	<0.01
Marital status
Married/Stable union	1
Widow/Widower	0.94	0.41	2.16	0.89
Single/Divorced	0.76	0.33	1.70	0.50
Household type
Living with family members	1
Living with spouse	1.40	0.59	3.33	0.44
Living alone	1.16	0.54	2.49	0.69
Number of medications used
None	1				1
1-4	1.84	0.77	4.38	0.16	2.54	1.02	6.35	<0.05
≥5	2.96	1.12	7.80	<0.05	3.23	1.20	8.67	<0.05
Monthly income
More than 3 MW	1
1 to 3 MW	1.13	0.45	2.83	0.79
Up to 1 MW	1.01	0.38	2.67	0.97
Schooling
Tertiary education	1				1
Complete secondary education	2.32	0.74	7.24	0.14	6.01	1.59	22.64	<0.01
Complete primary education	2.01	0.80	5.04	0.13	4.22	1.33	13.33	<0.01
Illiterate	2.00	0.71	5.65	0.18	3.84	1.22	12.02	<0.01
Clinical Decompensation
No	1
Yes	1.33	0.73	2.40	0.32
Smoking habit
No	1
Yes	1.59	0.64	3.92	0.31
Frequent alcohol consumption
No	1
Yes	1.56	0.64	3.77	0.32
Beneficiary of the Bolsa Familia Program
No	1				1
Yes	0.37	0.06	2.18	0.27	0.10	0.13	0.85	<0.05
Regular Physical Activity
No	1
Yes	0.64	0.35	1.19	0.16
Number of comorbidities
1	1
2	0.94	0.44	2.00	0.83
3	1.23	0.52	2.92	0.63
More than 3	1.54	0.55	4.33	0.40
Employment status
Employed	1
Self-employed	1.18	0.25	12.96	0.55
Retiree	2.12	0.42	10.72	0.36
Unemployed	2.53	0.37	17.14	0.33
SCHOOL AND WORK ACTIVITIES
Gender
	1
Woman	0.91	0.53	1.54	0.72
Skin-color
White	1
Mixed-race	1.65	0.58	4.66	0.33
Black	1.26	0.72	2.20	0.40
Age
60 – 70	1				1
71 – 80	1.35	0.80	2.29	0.25	-	-	-	-
>80	2.88	1.29	6.43	0.01	2.55	1.17	5.54	<0.01
Marital status
Married/Stable union	1
Widow/Widower	1.27	0.63	2.53	0.49
Single/Divorced	1.23	0.62	2.42	0.54
Household type
Living with family members	1
Living with spouse	0.97	0.47	2.00	0.93
Living alone	0.98	0.51	1.85	0.95
Number of medications used
None	1				1
1-4	1.61	0.78	3.32	0.19	-	-	-	-
≥5	2.76	1.23	6.16	0.01	3.89	1.77	8.51	<0.01
Monthly income
More than 3 MW	1
1 to 3 MW	1.24	0.57	2.67	0.57
Up to 1 MW	1.06	0.47	2.38	0.88
Schooling
Tertiary education	1
Complete secondary education	2.02	0.78	5.20	0.14
Complete primary education	1.79	0.83	3.85	0.13
Illiterate	1.34	0.56	3.19	0.50
Clinical Decompensation
No	1				1
Yes	1.81	1.11	2.95	0.01	1.98	1.23	3.18	<0.01
Smoking habit
No	1				1
Yes	1.44	0.67	3.06	0.34	2.22	1.07	4.61	<0.05
Frequent alcohol consumption
No	1
Yes	1.23	0.58	2.57	0.58
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.54	0.12	2.40	0.42
Regular Physical Activity
No	1				1
Yes	0.55	0.33	0.91	<0.05	0.43	0.27	0.71	<0.01
Number of comorbidities
1	1
2	1.02	0.56	1.86	0.94
3	1.47	0.74	2.91	0.26
More than 3	1.63	0.71	3.69	0.24
Employment status
Employed	1				1
Self-employed	2.99	0.57	15.66	0.19	-	-	-	-
Retiree	3.91	0.99	15.36	0.61	4.55	1.20	17.17	<0.05
Unemployed	4.15	0.83	20.72	0.08	5.57	1.23	25.12	<0.05
LIFE ACTIVITIES
Gender
Man	1
Woman	0.71	0.46	1.09	0.12
Skin-color
White	1				1
Mixed-race	1.43	0.61	3.33	0.40	-	-	-	-
Black	1.20	0.76	1.90	0.41	1.61	1.03	2.53	<0.05
Age
60 – 70	1				1
71 – 80	1.27	0.83	1.95	0.26	-	-	-	-
>80	2.81	1.47	5.38	<0.01	3.08	1.66	5.74	<0.00
Marital status
Married/Stable union	1
Widow/Widower	1.09	0.62	1.92	0.74
Single/Divorced	0.98	0.56	1.70	0.94
Household type
Living with family members	1				1
Living with spouse	1.15	0.64	2.09	0.62	-	-	-	-
Living alone	1.05	0.62	1.78	0.82	1.66	1.03	2.68	<0.05
Number of medications used
None	1				1
1-4	1.71	0.95	3.08	0.07	1.94	1.10	3.42	<0.01
≥5	2.84	1.48	5.46	0.01	3.26	1.76	6.04	<0.00
Monthly income
More than 3 MW	1
1 to 3 MW	1.19	0.63	2.22	0.58
Up to 1 MW	1.03	0.53	2.01	0.9
Schooling
Tertiary education	1
Complete secondary education	2.14	0.99	4.64	0.06
Complete primary education	1.68	1.00	3.51	<0.05
Illiterate	1.61	0.80	3.27	0.18
Clinical Decompensation
No	1
Yes	1.57	1.05	2.34	<0.05
Smoking habit
No	1
Yes	1.50	0.81	2.78	0.19
Frequent alcohol consumption
No	1
Yes	1.36	0.74	2.49	0.31
Beneficiary of the Bolsa Familia Program
No	1				1
Yes	0.46	0.14	1.57	0.22	0.21	0.67	0.71	<0.01
Physical Activity
No	1				1
Yes	0.59	0.39	0.9	<0.01	0.53	0.35	0.79	<0.05
Number of comorbidities
1	1
2	0.98	0.59	1.62	0.95
3	1.35	0.76	2.40	0.29
More than 3	1.59	0.80	3.14	0.18
Employment status
Employed	1				1
Self-employed	2.29	0.59	8.81	0.22	-	-	-	-
Retiree	2.84	0.93	8.65	0.08	-	-	-	-
Unemployed	3.18	0.85	11.79	0.08	3.78	1.15	12.42	<0.05
SELF-CARE
Gender
Man	1
Woman	1.32	0.43	4.10	0.62
Skin-color
White	1
Mixed-race	1.75	0.18	16.20	0.62
Black	0.99	0.30	3.28	0.99
Age
60 – 70	1
71 – 80	1.16	0.36	3.67	0.80
>80	2.26	0.38	13.19	0.36
Marital status
Married/Stable union	1
Widow/Widower	1.14	0.26	5.04	0.85
Single/Divorced	1.53	0.35	6.52	0.56
Household type
Living with family members	1
Living with spouse	0.86	0.18	4.08	0.85
Living alone	0.91	0.23	3.61	0.9
Number of medications used
None	1
1-4	1.57	0.32	7.55	0.56
≥5	2.29	0.39	13.18	0.35
Monthly income
More than 3 MW	1
1 to 3 MW	0.99	0.19	5.16	0.99
Up to 1 MW	0.89	0.15	5.07	0.89
Schooling
Tertiary education	1
Complete secondary education	1.30	0.16	10.09
Complete primary education	1.10	0.21	5.74
Illiterate	1.01	0.15	6.57
Clinical Decompensation
No	1
Yes	1.81	0.63	5.20	0.26
Smoking habit
No	1
Yes	8.24	1.62	41.71	0.01
Frequent alcohol consumption
No	1
Yes	1.32	0.27	6.45	0.72
Beneficiary of the Bolsa Familia Program
No	1
Yes	1.43	-	-	-
Regular Physical Activity
No	1
Yes	0.48	0.16	1.45	0.19
Number of comorbidities
1	1				-	-	-	-
2	1.92	0.48	7.60	0.35	5.25	1.16	23.76	<0.05
3	2.26	0.47	10.82	0.30	6.17	1.15	33.06	<0.05
More than 3	2.27	0.34	14.85	0.39	6.10	0.84	44.08	0.07
Employment status
Employed	1
Self-employed	-	-	-	-
Retiree	-	-	-	-
Unemployed	-	-	-	-
PARTICIPATION
Gender
Man	1				1
Woman	0.76	0.55	1.06	0.10	0.64	0.47	0.88	<0.01
Skin-color
White	1				1
Mixed-race	1.59	0.84	3.01	0.15	1.88	1.01	3.48	<0.05
Black	1.12	0.79	1.59	0.49
Age
60 – 70	1
71 – 80	0.96	0.69	1.34	0.84
>80	1.53	0.92	2.53	0.09
Marital status
Married/Stable union	1				1
Widow/Widower	1.58	1.03	2.41	<0.05	1.60	1.06	2.40	<0.05
Single/Divorced	1.41	0.93	2.15	0.09	1.58	1.04	2.38	<0.05
Household type
Living with family members	1
Living with spouse	1.03	0.66	1.62	0.86
Living alone	1.03	0.99	1.54	0.85
Number of medications used
None	1
1-4	1.58	1.01	2.47	<0.05
≥5	2.14	1.30	3.53	<0.05
Monthly income
More than 3 MW	1
1 to 3 MW	1.51	0.94	2.41	0.08
Up to 1 MW	1.05	0.64	1.73	0.82
Schooling
Tertiary education	1
Complete secondary education	1.70	0.94	3.05	0.07
Complete primary education	1.61	1.00	2.59	<0.05
Illiterate	1.36	0.79	2.32	0.25
Clinical Decompensation
No	1
Yes	1.50	1.11	2.03	<0.01
Smoking habit
No	1
Yes	1.17	0.73	1.87	0.50
Frequent alcohol consumption
No	1
Yes	1.03	0.65	1.63	0.88
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.47	0.19	1.20	0.11
Regular Physical Activity
No	1				1
Yes	0.59	0.43	0.80	0.01	0.53	0.39	0.71	<0.01
Number of comorbidities
1	1				1
2	1.21	0.83	1.77	0.30	-	-	-	-
3	1.54	1.00	2.36	<0.05	1.58	1.06	2.35	<0.05
More than 3	1.56	0.93	2.61	0.9	-	-	-	-
Employment status
Employed	1
Self-employed	1.84	0.66	5.12	0.23
Retiree	1.92	0.82	4.45	0.12
Unemployed	2.41	0.89	6.48	0.08
SCHOOL ACTIVITIES
Beneficiary of the Bolsa Familia Program
No	1
Yes	1.81	0.41	7.93	0.42	-	-	-	-
Smoking habit
No	1
Yes	1.44	0.67	3.06	0.34	-	-	-	-
MOBILITY
Gender
Man	1
Woman	0.69	0.43	1.13	0.14
Skin-color
White	1
Mixed-race	1.12	0.43	2.93	0.81
Black	0.86	0.51	1.44	0.57
Age
60 – 70	1
71 – 80	1.23	0.75	2.02	0.40
>80	2.04	0.96	4.35	0.06
Marital status
Married/Stable union	1
Widow/Widower	0.76	0.40	1.44	0.41
Single/Divorced	0.80	0.43	1.49	0.49
Household type
Living with family members	1
Living with spouse	1.16	0.59	2.27
Living alone	0.92	0.50	1.66
Number of medications used
None	1
1-4	1.62	0.83	3.16	0.15
≥5	2.52	1.19	5.31	0.01
Monthly income
More than 3 MW	1
1 to 3 MW	1.48	0.73	3.01	0.27
Up to 1 MW	1.26	0.59	2.67	0.53
Schooling
Tertiary education	1				-	-	-	-
Complete secondary education	1.85	0.77	4.45	0.16
Complete primary education	1.85	0.9	3.76	0.08
Illiterate	1.77	0.16	3.94	0.16
Clinical Decompensation
No	1
Yes	1.22	0.77	1.93	0.38
Smoking habit
No	1				-	-	-	-
Yes	1.77	0.88	3.55	0.10	2.31	1.16	4.59	0.01
Frequent alcohol consumption
No	1
Yes	1.78	0.9	3.53	0.09
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.97	0.25	3.78	0.97
Regular Physical Activity
No	1				-	-	-	-
Yes	0.61	0.38	0.98	0.04	0.54	0.35	0.83	<0.01
Number of comorbidities
1	1
2	1.21	0.71	2.06	0.47
3	1.62	0.89	2.97	0.11
More than 3	1.24	0.60	2.56	0.55
Employment status
Employed	1
Self-employed	2.49	0.54	11.42	0.23	2.93	0.69	12.33	0.14
Retiree	3.23	0.92	11.38	0.06	2.46	0.76	7.97	0.13
Unemployed	3.82	0.87	16.78	0.07	4.83	1.16	20.02	<0.05
TOTAL
Gender
Man	1				1
Woman	0.73	0.56	0.96	<0.05	0.71	0.55	0.92	<0.01
Skin-color
White	1
Mixed-race	1.38	0.80	2.36	0.23
Black	1.09	0.81	1.46	0.53
Age
60 – 70	1				1
71 – 80	1.12	0.85	1.47		-	-	-	-
>80	2.06	1.36	3.11	<0.01	1.97	1.39	2.79	<0.01
Marital status
Married/Stable union	1
Widow/Widower	1.14	0.80	1.64	0.44
Single/Divorced	1.08	0.76	1.54	0.63
Household type
Living with family members	1				1
Living with spouse	1.05	0.72	1.54	0.77	-	-	-	-
Living alone	1.00	0.72	1.40	0.95	1.39	1.03	1.86	<0.05
Number of medications used
None	1				1
1-4	1.51	1.04	2.20	<0.05	-	-	-	-
≥5	2.28	1.51	3.46	<0.01	2.01	1.10	3.67	<0.05
Monthly income
More than 3 MW	1
1 to 3 MW	1.34	0.9	1.99	0.14
Up to 1 MW	1.09	0.71	1.67	0.67
Schooling
Tertiary education	1
Complete secondary education	1.91	1.17	3.13	<0.01
Complete primary education	1.69	1.13	2.52	<0.01
Illiterate	1.46	0.93	2.30	0.09
Clinical Decompensation
No	1
Yes	1.41	1.10	1.82	<0.01
Smoking habit
No	1				1
Yes	1.43	0.96	2.12	0.07	1.48	1.01	2.17	<0.05
Frequent alcohol consumption
No	1
Yes	1.28	0.87	1.88	0.20
Beneficiary of the Bolsa Familia Program
No	1
Yes	0.63	0.29	1.39	0.26
Regular Physical Activity
No	1				1
Yes	0.63	0.48	0.82	<0.01	0.65	0.51	0.82	0.00
Number of comorbidities
1	1				1
2	1.19	0.86	1.64	0.22	-	-	-	-
3	1.54	1.07	2.22	<0.05	1.48	1.07	2.05	<0.01
More than 3	1.50	0.96	2.32	0.06	1.52	1.02	2.26	<0.01
Employment status
Employed	1
Self-employed	1.96	0.82	4.69	0.12	2.21	1.00	4.84	<0.05
Retiree	2.42	1.17	5.00	<0.01	1.93	1.01	3.7	<0.05
Unemployed	3.08	1.32	7.17	<0.01	4.32	1.98	9.41	0.00

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Universidade de São Paulo Rua Ovídio Pires de Campos, 225 2° andar. , 05403-010 São Paulo SP / Brasil, Tel: 55 11 2661-7703, Fax 55 11 3743-7462 - São Paulo - SP - Brazil
E-mail: revfisio@usp.br

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[1] Note: MW – minimum wage.