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巴西老年人功能障碍相关因素:一项多层次分析。

Factors associated with functional disability of elderly in Brazil: a multilevel analysis.

机构信息

Centro de Saúde Escola Germano Sinval Faria, Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil.

出版信息

Rev Saude Publica. 2010 Jun;44(3):468-78. doi: 10.1590/s0034-89102010005000009. Epub 2010 May 7.

Abstract

OBJECTIVE

To analyze the influence of demographic, socioeconomic, health, and contextual factors of the Brazilian federation units on the functional disability of the elderly.

METHODS

Cross-sectional study based on data from the 2003 PNAD (Brazilian National Household Survey), of IBGE (Brazilian Institute of Geography and Statistics) and Ipea (Institute of Applied Economic Research). The sample was composed of 33,515 individuals aged 60 years and older. The dependent variable was functional disability, measured by difficulty in climbing slopes or stairs. The independent variables were divided into two levels: individual (demographic, socioeconomic and health-related characteristics) and contextual (Gini Index and Gross Domestic Product per capita by Brazilian state in 2000). A multinomial and multilevel logistic regression model was utilized in order to estimate the effect of the independent variables on the functional disability of the elderly.

RESULTS

Functional disability was associated with demographic, socioeconomic and health factors. At the individual level, sex, level of schooling, income, occupation, self-perception of health and chronic diseases were the factors that were most strongly related to functional disability. At the contextual level, income inequality proved to exert an important influence.

CONCLUSIONS

Self-perception of health is the factor that is most strongly related to the functional disability of the elderly in Brazil, followed by chronic diseases. Sex, occupation, level of schooling and income are also highly associated with it. Actions that approach the main factors associated with functional disability can contribute significantly to the well-being and quality of life of the elderly.

摘要

目的

分析巴西联邦单位的人口统计学、社会经济、健康和环境因素对老年人功能障碍的影响。

方法

本研究基于 2003 年 PNAD(巴西全国住户抽样调查)、IBGE(巴西地理与统计研究所)和 Ipea(应用经济研究所)的数据进行了一项横断面研究。该样本由 33515 名年龄在 60 岁及以上的个体组成。因变量为功能障碍,通过攀爬斜坡或楼梯的难度来衡量。自变量分为两个层次:个体(人口统计学、社会经济和健康相关特征)和环境(2000 年巴西各州的基尼指数和人均国内生产总值)。采用多项和多层次逻辑回归模型来估计自变量对老年人功能障碍的影响。

结果

功能障碍与人口统计学、社会经济和健康因素有关。在个体水平上,性别、受教育程度、收入、职业、自我健康感知和慢性病是与功能障碍最密切相关的因素。在环境水平上,收入不平等证明具有重要影响。

结论

自我健康感知是巴西老年人功能障碍最密切相关的因素,其次是慢性病。性别、职业、受教育程度和收入也与之高度相关。接近与功能障碍相关的主要因素的行动可以极大地促进老年人的福祉和生活质量。

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