Sociodemographic, general health and oral health factors associated with difficulty in eating among elderly people: a cross-sectional study, Brazil, 2019

Soares, Laís Naara de Sousa; Cabral, Ana Estefanny Alves; Luz, Sabrina Barth de Andrade; Lourenço, Mariella Agostinho Gonçalves; Pazinatto, Rafael Barroso; Santos, Bianca Souto de Medeiros; Melo, Laércio Almeida de

doi:10.1590/S2237-96222025v34e20240678.en

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 34 • 2025 • https://doi.org/10.1590/S2237-96222025v34e20240678.en linkcopy

This document is related to:

10.1590/S2237-96222025v34e20240678.a

This document is related to:

10.1590/S2237-96222025v34e20240678.b

Sociodemographic, general health and oral health factors associated with difficulty in eating among elderly people: a cross-sectional study, Brazil, 2019

Factores sociodemográficos, de salud general y bucal asociados a la dificultad para alimentarse en ancianos: un estudio transversal, Brasil, 2019

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To identify sociodemographic, general health, and oral health factors associated with difficulty in eating among elderly people in Brazil.

Methods This is a cross-sectional, population-based study that used data from the 2019 National Health Survey with elderly people (60+ years). Crude analysis was performed using the chi-square test to verify associations between variables and difficulty in eating. After investigating multicollinearity, adjusted prevalence ratios (PR) were calculated using Poisson multiple regression. Cramer’s V was used to measure effect size.

Results The sample consisted of 21,048 elderly individuals. Prevalence of severe or very severe difficulty in eating was 4.1% (95% confidence interval [95%CI] 3.7; 4.5). Multivariate analysis revealed that this condition was higher for females (PR 1.00; 95%CI 1.00; 1.01), older age (PR 1.01; 95%CI 1.00; 1.03), being illiterate (PR 1.01; 95%CI 1.00; 1.01), smoking (PR 1.01; 95%CI 1.00; 1.02), not having health insurance (PR 1.01; 95%CI 1.00; 1.01), multimorbidity (PR 1.01; 95%CI 1.01; 1.02), not brushing teeth daily (PR 1.07; 95%CI 1.03; 1.12) and not using dentures (PR 1.02; 95%CI 1.01; 1.02). Cramer’s V indicated that associations that were significant had a weak effect.

Conclusion Eating difficulties among the elderly were greater in those with unfavorable socioeconomic conditions, smokers, those with multimorbidity, those with inadequate oral hygiene and those who did not use dentures. The associations found suggest a weak relationship, indicating that other factors may also influence eating difficulties.

Keywords
Elderly; Diet; Prevalence; Oral Health; Cross-Sectional Studies

Variable	Severe or very severe difficulty (n=871)	None or slight difficulty (n=20,177)
Variable	n (%)	n (%)	PR (95%CI)	p-value	Cramer’s V
Sex^a
Female	511 (4.4)	11,131 (95.6)	1.40 (1.14; 1.71)	<0.001	0.014
Male	360 (3.8)	9,046 (96.2)
Age (years)^a
60-69	400 (3.4)	11,360 (96.6)	1.00	0.002	0.054
70-79	291 (4.4)	6,312 (95.6)	1.01 (1.00; 1.02)
≥80	180 (6.7)	2,505 (93.3)	1.02 (1.01; 1.04)
Race/skin color^a
White	294 (3.2)	8,997 (96.8)	1.00	<0.001	0.047
Mixed race	439 (4.8)	8,741 (95.2)	1.02 (1.01; 1.02)
Black	128 (5.7)	2,109 (94.3)	1.05 (1.03; 1.07)
Other	10 (3.0)	328 (97.0)	0.99 (0.97; 1.02)
Marital status^a
Single	198 (5.1)	3,652 (94.9)	1.00	0.003	0.039
Married	321 (3.5)	8,979 (96.5)	0.98 (0.97; 0.99)
Divorced	80 (3.4)	2,248 (96.6)	0.99 (0.97; 1.00)
Widowed	272 (4.9)	5,298 (95.1)	1.00 (0.98; 1.01)
Schooling^a
Illiterate	346 (7.2)	4,455 (92.8)	2.34 (1.89; 2.88)	<0.001	0.084
Literate	525 (3.2)	15,722 (96.8)
Alcoholic beverage^a
Yes	83 (2.3)	3,484 (97.7)	0.59 (0.44; 0.80)	<0.001	0.047
No	737 (4.7)	14,990 (95.3)
Tobacco smoking^a
Yes	154 (6.3)	2,274 (93.7)	1.42 (1.09; 1.83)	0.011	0.040
No	717 (3.9)	17,903 (96.1)
Health insurance^a
No	766 (4.9)	14,713 (95.1)	2.74 (2.05; 3.68)	<0.001	0.068
Yes	105 (1.9)	5,464 (98.1)
Multimorbidity^a
Yes	601 (5.2)	10,954 (94.8)	2.39 (1.88; 3.05)	<0.001	0.069
No	212 (2.5)	8,377 (97.5)
Dental insurance^a
No	836 (4.3)	18,505 (95.7)	2.27 (1.44; 3.57)	<0.001	0.031
Yes	35 (2.1)	1,672 (97.9)
Brushing frequency^a
Does not brush every day	19 (17.3)	91 (82.7)	6.60 (3.91; 11.11)	<0.001	0.056
At least once a day	676 (3.4)	19,386 (96.6)
Complete edentulism^a
Yes	370 (5.7)	6,168 (94.3)	1.76 (1.43; 2.17)	<0.001	0.051
No	501 (3.5)	14,009 (96.5)
Use of some kind of prosthesis^a
No	419 (8.1)	4,752 (91.9)	2.15 (1.77; 2.60)	<0.001	0.110
Yes	448 (3.0)	14,535 (97.0)

Variable	Severe or very severe difficulty (n=871)	None or slight difficulty (n=20,177)
Variable	n (%)	n (%)	Adjusted PR (Adjusted 95%CI)	p-value	Cramer’s V
Sex^a
Female	511 (4.4)	11,131 (95.6)	1.00 (1.00; 1.01)	0.010	0.014
Male	360 (3.8)	9,046 (96.2)
Age (years)^a
60-69	400 (3.4)	11,360 (96.6)	1.00	<0.001	0.054
70-79	291 (4.4)	6,312 (95.6)	1.00 (1.00; 1.01)
≥80	180 (6.7)	2,505 (93.3)	1.01 (1.00; 1.03)
Schooling^a
Illiterate	346 (7.2)	4,455 (92.8)	1.01 (1.00; 1.01)	<0.001	0.084
Literate	525 (3.2)	15,722 (96.8)
Tobacco smoking^a
Yes	154 (6.3)	2,274 (93.7)	1.01 (1.01 1.02)	<0.001	0.040
No	717 (3.9)	17,903 (96.1)
Health insurance^a
No	766 (4.9)	14,713 (95.3)	1.01 (1.00; 1.01)	<0.001	0.068
Yes	105 (1.9)	5,464 (98.3)
Multimorbidity^a
Yes	601 (5.2)	10,954 (94.8)	1.01 (1.01; 1.02)	<0.001	0.069
No	212 (2.5)	8,377 (97.5)
Dental insurance^a
No	836 (4.3)	18,505 (95.7)	1.00 (0.99; 1.00)	0.773	0.031
Yes	35 (2.1)	1,672 (97.9)
Brushing frequency^a
Does not brush every day	19 (17.3)	91 (82.7)	1.07 (1.03; 1.12)	0.002	0.056
At least once a day	676 (3.4)	19,386 (96.6)
Complete edentulism^a
Yes	370 (5.7)	6,168 (94.3)	1.00 (1.00; 1.01)	0.251	0.051
No	501 (3.5)	14,009 (96.5)
Use of some kind of prosthesis^a
No	419 (8.1)	4,752 (91.9)	1.02 (1.01 1.02)	<0.001	0.110
Yes	448 (3.0)	14,535 (97.0)

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Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 (61) 3315-3464 - Brasília - DF - Brazil
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[fnte1] ^aThe difference in relation to the total number of cases (100.0%) corresponds to the number of cases recorded as unknown, left blank or missing on the National Health Survey database.