de Almeida Marina Gabriela Nascimento, Nascimento-Souza Mary Anne, Lima-Costa Maria Fernanda, Peixoto Sérgio Viana
Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, MG Brazil.
Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, MG Brazil.
Eur J Ageing. 2020 Feb 14;17(4):521-529. doi: 10.1007/s10433-020-00560-z. eCollection 2020 Dec.
The objective of the study was to evaluate the association between unhealthy lifestyle factors (individual and combined) and multimorbidity stratified by sex, in a national sample representative of Brazilians aged 50 years or older. Data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline, conducted in 2015-2016, were used. Multimorbidity was defined by the existence of two or more of the 19 chronic diseases. Four unhealthy lifestyle factors were considered: (1) at-risk alcohol consumption, (2) current or past smoking, (3) insufficient physical activity and (4) below-recommended consumption of fruits and vegetables. The association between unhealthy lifestyle factors, individual and combined, was assessed by logistic regression. Among the 7918 study participants, the prevalence of multimorbidity was 75.8% (95% CI 73.7-77.7) among women and 58.7% (95% CI 56.0-61.3) among men. Among women, none of the analyzed behaviors presented an independent and statistically significant association ( < 0.05) with multimorbidity. Among men, at-risk alcohol consumption was associated with lower odds of multimorbidity. On the other hand, current or past smoking and insufficient physical activity were associated with greater odds of this condition. In addition, the presence of three or four unhealthy lifestyle factors was associated with greater odds of multimorbidity among men. The results reinforce the need for interventions to promote healthy behaviors among older men with two or more chronic diseases. In addition, it is evident that the health services need to act in an attempt to modify unhealthy behaviors after medical diagnosis of chronic diseases to reduce the risk of future complications.
本研究的目的是在一个代表50岁及以上巴西人的全国性样本中，评估不健康生活方式因素（个体因素及综合因素）与按性别分层的多种疾病并存之间的关联。研究使用了2015 - 2016年进行的巴西衰老纵向研究（ELSI - Brazil）基线数据。多种疾病并存定义为存在19种慢性病中的两种或更多种。考虑了四个不健康生活方式因素：（1）危险饮酒；（2）当前或过去吸烟；（3）体育活动不足；（4）水果和蔬菜摄入量低于推荐量。通过逻辑回归评估不健康生活方式因素（个体因素及综合因素）之间的关联。在7918名研究参与者中，女性多种疾病并存的患病率为75.8%（95%置信区间73.7 - 77.7），男性为58.7%（95%置信区间56.0 - 61.3）。在女性中，所分析的行为均未呈现出与多种疾病并存的独立且具有统计学意义的关联（<0.05）。在男性中，危险饮酒与多种疾病并存的较低几率相关。另一方面，当前或过去吸烟以及体育活动不足与这种情况的较高几率相关。此外，存在三种或四种不健康生活方式因素与男性多种疾病并存的较高几率相关。结果强化了对患有两种或更多种慢性病的老年男性进行促进健康行为干预的必要性。此外，很明显，卫生服务机构需要在慢性病医学诊断后采取行动，试图改变不健康行为，以降低未来并发症的风险。
