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      Prevalência e fatores associados a multimorbidades em idosos brasileiros Translated title: Prevalence and factors associated with multimorbidities in Brazilian older adults

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          Abstract

          Resumo Objetivou-se identificar a prevalência de multimorbidade em idosos no Brasil e seus fatores associados com variáveis socioeconômicas e referentes ao estilo de vida. Trata-se de um estudo transversal e de base populacional. Para a sua realização, foi utilizada a base de dados da Pesquisa Nacional de Saúde. O idoso foi considerado com multimorbidade quando se tinha um diagnóstico de duas ou mais doenças crônicas. Na análise dos dados, o teste Qui-quadrado foi utilizado e em seguida as razões de prevalência foram estimadas por meio da regressão múltipla de Poisson, ambos com nível de confiança de 95%. Foram avaliados 11.697 idosos e a prevalência de multimorbidade foi de 53,1%. Como resultado na análise multivariada, os idosos do sexo feminino (p < 0,001), os mais envelhecidos (p = 0,002), os que não são solteiros, mais fortemente associados aos viúvos (p = 0,001) e os que possuem plano de saúde no ato da entrevista (p < 0,001) estão associados à multimorbidade. Ademais, comparando com os idosos que possuem duas doenças crônicas, as mulheres estão associadas à presença de três (p = 0,003) e quatro ou mais doenças crônicas (p < 0,001). Conclui-se que a multimorbidade em idosos brasileiros é uma condição bastante comum e que ela tem sido influenciada por fatores socioeconômicos e pouco relacionada ao estilo de vida.

          Translated abstract

          Abstract This study aimed to identify the prevalence of multimorbidity in Brazilian older adults and factors associated with socioeconomic and lifestyle variables. This is a cross-sectional, population-based study carried out with data from the National Health Survey database. Seniors with multimorbidity where the ones with a diagnosis of two or more chronic diseases. The chi-square test was used in data analysis, and then prevalence ratios were estimated through Poisson multiple regression, both with 95% confidence level. In total, 11,697 older adults were evaluated and the multimorbidity prevalence was 53.1%. As a result of the multivariate analysis, female seniors (p < 0.001), the oldest elderly (p = 0.002), those who were not single, more strongly associated with widowers (p = 0.001) and those with a health plan at the interview (p < 0.001) were associated with multimorbidity. Also, in comparison with older adults with two chronic diseases, women are associated with three (p = 0.003) and four or more chronic diseases (p < 0.001). We can conclude that multimorbidity in Brazilian older adults is a widespread condition and that it has been influenced by socioeconomic factors and is poorly related to lifestyle.

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          Most cited references13

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          Multimorbidity in older adults.

          M Salive (2013)
          Multimorbidity, the coexistence of 2 or more chronic conditions, has become prevalent among older adults as mortality rates have declined and the population has aged. We examined population-based administrative claims data indicating specific health service delivery to nearly 31 million Medicare fee-for-service beneficiaries for 15 prevalent chronic conditions. A total of 67% had multimorbidity, which increased with age, from 50% for persons under age 65 years to 62% for those aged 65-74 years and 81.5% for those aged ≥85 years. A systematic review identified 16 other prevalence studies conducted in community samples that included older adults, with median prevalence of 63% and a mode of 67%. Prevalence differences between studies are probably due to methodological biases; no studies were comparable. Key methodological issues arise from elements of the case definition, including type and number of chronic conditions included, ascertainment methods, and source population. Standardized methods for measuring multimorbidity are needed to enable public health surveillance and prevention. Multimorbidity is associated with elevated risk of death, disability, poor functional status, poor quality of life, and adverse drug events. Additional research is needed to develop an understanding of causal pathways and to further develop and test potential clinical and population interventions targeting multimorbidity. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2013.
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            Causes and consequences of comorbidity: a review.

            A literature search was carried out to identify and summarize the existing information on causes and consequences of comorbidity of chronic somatic diseases. A selection of 82 articles met our inclusion criteria. Very little work has been done on the causes of comorbidity. On the other hand, much work has been done on consequences of comorbidity, although comorbidity is seldom the main subject of study. We found comorbidity in general to be associated with mortality, quality of life, and health care. The consequences of specific disease combinations, however, depended on many factors. We recommend more etiological studies on shared risk factors, especially for those comorbidities that occur at a higher rate than expected. New insights in this field can lead to better prevention strategies. Health care workers need to take comorbid diseases into account in monitoring and treating patients. Future studies on consequences of comorbidity should investigate specific disease combinations.
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              Multiple chronic conditions and life expectancy: a life table analysis.

              The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                October 2020
                : 25
                : 10
                : 3869-3877
                Affiliations
                [1] Natal Rio Grande do Norte orgnameUniversidade Federal do Rio Grande do Norte orgdiv1Centro de Ciências da Saúde orgdiv2Departamento de Odontologia Brazil laercio_melo91@ 123456hotmail.com
                Article
                S1413-81232020001103869 S1413-8123(20)02501003869
                10.1590/1413-812320202510.34492018
                32997019
                4e72d9b8-64f7-4659-9d54-be0ab62cc9aa

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 December 2018
                : 26 September 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 9
                Product

                SciELO Public Health

                Categories
                Artigo

                Older adults,Multimorbidade,Associated factors,Multimorbidity,Fatores associados,Idosos

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