Costa Caroline Dos Santos, Flores Thaynã Ramos, Wendt Andrea, Neves Rosália Garcia, Tomasi Elaine, Cesar Juraci A, Bertoldi Andrea Dâmaso, Ramires Virgílio Viana, Nunes Bruno Pereira
Universidade Federal de Pelotas, Pelotas, Brasil.
Instituto Federal de Educação, Ciência e Tecnologia Sul-rio-grandense, Camaquã, Brasil.
Cad Saude Publica. 2018 Nov 23;34(11):e00040718. doi: 10.1590/0102-311X00040718.
Lower socioeconomic level is positively related to multimorbidity and it is possible that the clustering of health conditions carries the same association. The aim of this study was to identify prevalence of multimorbidity and clusters of health conditions among elderly, as well the underlying socioeconomic inequalities. This was a cross-sectional population-based study carried out with 60-year-old individuals. Multimorbidity was defined as the presence of 2+, 3+, 4+ or 5+ health conditions in the same individual. Schooling levels and the National Economic Index were used to investigate inequalities in the prevalence of multimorbidities among elderly. Slope and concentration indexes of inequality were used to evaluate absolute and relative differences. A factorial analysis was performed to identify disease clusters. In every ten older adults, about nine, eight, seven and six presented, respectvely, 2+, 3+, 4+ and 5+ health conditions. Three clusters of health conditions were found, involving musculoskeletal/mental/functional disorders, cardiometabolic, and respiratory factors. Higher inequalities were found the higher amount of health conditions (5+), when considering economic level, and for 3+, 4+ and 5+, when considering educational level. These findings show high multimorbidity prevalence among elderly, highlighting the persistence of health inequalities in Southern Brazil. Strategies by the health services need to focus on elderly at lower socioeconomic levels.
社会经济水平较低与多种疾病并存呈正相关，健康状况的聚集可能也存在同样的关联。本研究的目的是确定老年人中多种疾病并存的患病率和健康状况集群，以及潜在的社会经济不平等情况。这是一项针对60岁个体开展的基于人群的横断面研究。多种疾病并存被定义为同一个体存在2种及以上、3种及以上、4种及以上或5种及以上健康状况。受教育程度和国民经济指数被用于调查老年人中多种疾病并存患病率的不平等情况。不平等的斜率和集中指数被用于评估绝对差异和相对差异。进行了因子分析以确定疾病集群。每十位老年人中，分别约有九位、八位、七位和六位存在2种及以上、3种及以上、4种及以上和5种及以上健康状况。发现了三个健康状况集群，涉及肌肉骨骼/精神/功能障碍、心脏代谢和呼吸因素。在考虑经济水平时，健康状况数量越多（5种及以上），不平等程度越高；在考虑教育水平时，对于3种及以上、4种及以上和5种及以上健康状况，不平等程度也越高。这些发现表明老年人中多种疾病并存的患病率很高，突出了巴西南部健康不平等现象的持续存在。卫生服务部门的策略需要关注社会经济水平较低的老年人。
