Prevalência de doenças crônicas não transmissíveis, fatores de risco e a prática de atividade física, em uma população de idosos residentes em Recife
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Data
2013
Autores
Munk, Márcia [UNIFESP]
Orientadores
Ramos, Luiz Roberto [UNIFESP]
Tipo
Tese de doutorado
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Introdução. O aumento da populacao de 60 anos ou mais foi acompanhado do aumento das doencas cronicas nao transmissiveis (DCNT). As associacoes entre fatores de risco, DCNT e a percepcao do estado de Saúde (PES), serao analisadas neste estudo de base populacional realizado em Recife. Objetivos: Os objetivos deste estudo realizado com a populacao de Recife, estratificada em jovens (16 a 59 anos) e idosos (≥ 60 anos), foram estimar as prevalencias de quatro doencas cronicas nao transmissiveis (DCNT) - Diabetes Mellitus (DM), Hipertensao Arterial (HA), Doenca Cardiovascular (DCV), Osteoporose (OP); o estado de Saúde percebido (PES), fatores socio-demograficos e fatores de risco primarios para DCNT - tabagismo, consumo de alcool, inatividade fisica e obesidade. Analisar o risco associado entre as caracteristicas socio-demograficas, DCNT e PES; risco associado entre fatores de risco primario, DCNT e PES desta populacao. Metodologia: A amostra foi aleatoria e estratificada composta pela populacao de residentes em Recife nao institucionalizada, ≥ 16 anos. Foram selecionados 2400 domicilios distribuidos em 12 conglomerados com 200 numeros de telefones fixos cada. Dentre os 3632 potencialmente elegiveis para responderem a pesquisa, foram entrevistados 2.045 adultos, sendo uma amostra representativa da populacao de Recife. Resultados: Do total de 2045 entrevistados 78,97% eram do grupo jovem - de 16 anos a 59 anos e 21.02% do grupo de idosos - de 60 anos e mais; onde 62.83% sao mulheres e 38,17% de homens,a proporcao de mulheres aumenta com a idade, sendo 70.93% no grupo de idosos. Existem diferencas entre os grupos referentes a educacao e estado civil, no grupo jovem a maior parte tem o ≥ 2o grau (75.48%), enquanto no grupo de idosos 55.90% tem < 2o grau. No referente ao estado civil, ha uma diferenca significativa, enquanto quase a metade do grupo jovem (43.72%) e de solteiros, no grupo de idosos 86.51% sao casados, viuvos ou separados. As DCNT referidas apresentaram uma distribuicao de prevalencia de DM (7.1%), sendo jovens (3.35%) e idosos (21.16%); HA (30.41%) - jovens (23.45%) e nos idosos (56.74%); DCV (3.5%) - jovens (1.49%) e idosos (11.19%); OP (7.28%) - jovens (3.05%) e idosos (23.42%); o diagnostico referido de pelo menos uma DCNT (43.42%) - jovens (35.44%) e idosos (75.81%); mais prevalentes entre as mulheres e aumentando com a idade. A PES como ruim/ regular (37.84%) - jovens (34.61%) e idosos (50%), mais prevalente entre as mulheres. As prevalencias aos fatores de risco primarios sao: sobrepeso/obesidade (37.01%), maior entre os jovens (40.50%) e idosos (32.39%); tabagismo e maior entre idosos (40.70%) e jovens (34.30%); ja o consumo de alcool e maior entre jovens (39.81%) e idosos (20%). A maioria da populacao desta amostra e insuficientemente ativa tanto no lazer (78,29%) quanto no transporte (74,82%). As associacoes entre fatores socio-demograficos e DCNT, foram: ser homem aumenta o risco para DCV (3.52) e e fator de protecao para OP (0.59) entre idosos; ser branco entre os idosos e fator de protecao para HA (0.54) e diagnostico de DCNT (0.44), ja entre os jovens aumenta o risco de OP (4.0); ter ≥ 2o grau entre os jovens aumenta o risco de HA (2.46), DCV (15.18) e OP (11.56), ja entre os idosos aumenta o risco para DM (2.43), HA (1.79) e nao ser solteiro entre os jovens aumenta o risco de DM (5.14), DCV (4.02), OP (5.06) e diagnostico de DCNT (1.82). As associacoes entre fatores socio- demograficos e PES, foram: ser homem e fator de protecao em relacao a PES (ruim 0.43) entre jovens; ter ≥ 2o grau aumenta o risco de PES ruim em ambos os grupos- jovens (1.47) e idosos (1.81). As associacoes entre fatores de risco e DCNT, foram: IMC normal nos jovens e fator de protecao HA (0.28), DM (0.29), diagnostico de DCNT (0.23); fumar nao mostrou associacoes em ambos os grupos, mas beber tem influencia, pois nao beber entre idosos aumenta o risco de DM (2.55) e entre os jovens de DCV (2.53); ser suficientemente ativo no lazer entre idosos e fator de protecao de DCV (0.21); ser suficientemente ativo no transporte entre os jovens e fator de protecao de HA (0.56) e diagnostico de DCNT (0.65). As associacoes entre fatores de risco e PES, foram: IMC normal nos jovens e fator de protecao em relacao a PES ruim (0.43); fumar nao mostrou associacoes em ambos os grupos e beber tem influencia, pois nao beber aumenta o risco de PES ruim em ambos os grupos, jovem (1.75) e idosos (2.61); ser suficientemente ativo no lazer e no transporte e fator de protecao em relacao a PES ruim entre idosos, 0.24 e 0.40, respectivamente. Conclusao: Este estudo de base populacional com dados referidos, mostrou similaridades com outros estudos populacionais no relativo as caracteristicas de genero no envelhecimento e na menor escolaridade entre os idosos do que entre os jovens. Entretanto, diferentemente da maioria dos estudos populacionais que avaliam as relacoes de associacao entre DCNT, fatores de risco e mortalidade, neste sao mostradas as associacoes entre DCNT, PES, fatores de risco e morbidade. O IMC normal se mostrou como um importante fator de protecao para os jovens diminuindo em 80% o risco de HA , DM e ao diagnostico de DCNT. A atividade fisica (AF) tanto no lazer ou no transporte, se mostrou associada de forma positiva a Saúde em ambos os grupos. Entre os jovens, como fator de protecao para HA e ao diagnostico de pelo menos uma DCNT e, entre os idosos, como fator de protecao para DCV. O fato da AF estar fortemente associada com uma melhor PES para o grupo de idosos; sugere a existencia de um o impacto da AF em ambos os grupos, maior para a faixa etaria de 60 anos e mais.
Backgroud. The increase in the population aged 60+ was accompanied by the increase of noncommunicable diseases (NCDs). The NCDs, self-perceived health status (SPHS) and its associations with risk factors will be analyzed in this population-based study conducted in Recife. Objectives: The study´s aims with the Recife´s population, which was stratified into two groups: youth (16-59 years) and elderly (60+ years); were to estimate the prevalence of 4 noncommunicable diseases (NCDs) - Diabetes Mellitus (DM), Hypertension (HA), Cardiovascular Disease (CVD), Osteoporosis (OP), self-perceived health status (SPHS), socio-demographic factors and primary risk factors - smoking, alcohol consumption, physical inactivity and obesity. Analyze associated risk with socio-demographic factors, NCDs and SPHS; associated risk with primary factors risks NCDs and SPHS in this population. Methods: A random sample of residents Recife´s population, non institutionalized ≥ 16 years was stratified. In the final result, were selected 2400 households distributed in 12 clusters with 200 telephone numbers each. Among the 3632 potentially eligible to survey, 2045 adults were interviewed in a representative sample of Recife´s population. Results: In a total of 2045 respondents the youth group was 78.97% and elderly group 21.02%, showed women (62.83%) and men (38.17%); the women´s proportion increases with age to 70.93%. The groups are different regarding education and marital status, showed the youth group with ≥ high school (75.48%), while the elderly group with < high school (55.90%). Regarding marital status, there is a significant difference, while almost half of the youth (43.72%) are single, the elderly 86.51% are married, widowed or divorced. The NCDs showed a prevalence distribution of DM (7.1%), youth (3.35%) and elderly (21.16%), HA (30.41%) - youth (23:45%) and elderly (56.74%); CVD (3.5 %) - young (1.49%) and elderly (11.19%); OP (7.28%) - young (3.05%) and elderly (23:42%); reported at least one NCD (43.42%) - youth (35.44% ) and elderly (75.81%); most prevalent among women and increasing with age. The SPHS as poor/fair (37.84%) - youth (34.61%) and elderly (50%) were more prevalent among women. The primary risk factors prevalence were: overweight/obesity (37.01%), higher among youth group (40.50%) while elderly group (32.39%); tobacco use is higher among the elderly (40.70%) while youth group (34.30%), whereas alcohol consumption is highest among youth (39.81%) while elderly (20%). In this sample population the majority is insufficiently active in both leisure time (78.29%) and transport (74.82%). Socio-demographic factors and NCDs associations showed: being male increases the CVD risk (3.52) and is a protective factor to OP (0.59) among elderly group; being white among the elderly is a protective factor to HA (0.54) and diagnosis of at least one NCDs (0.44), whereas among youth group increases the OP risk (4.0); ≥ high school among youth group increases risk to HA (2.46), CVD (15.18) and OP (11.56); while among the elderly increases the risk to DM (2.43), HA (1.79); not being single among youth group increases the risk to DM (5.14), CVD (4.02), OP (5.06) and diagnosis of at least one NCD (1.82). Socio-demographic factors and SPHS associations showed: being male is a protective factor to SPHS as poor/fair among youth group (0.43); ≥ high school increases risk to SPHS as poor/fair in both group- youth (1.47) and elderly (1.81). The primary risk factors and NCDs associations showed: normal BMI in youth group is a protective factor to HA (0.28), DM (0.29), diagnosis of at least one NCD (0.23); smoke did not showed any associations, however drink has influence whereas not drinking among the elderly increases DM risk (2.55) and among the youth CVD risk (2.53); be sufficiently active in leisure among the elderly is a protective factor to CVD (0.21) and be sufficiently active in transport among youth is a protective factor to HA (0.56) and diagnosis of at least one NCDs (0.65). The primary risk factors and SPHS associations showed: normal BMI in youth group is a protective factor to SPHS as poor/fair (0.43); drink showed an association whereas not drinking increases risk to SPHS as poor/fair in both groups - youth (1.75) and elderly (2.61) and be sufficiently active in leisure and transport among the elderly group is a protective factor to SPHS as poor/fair - 0.24 e 0.40. Conclusion: This population-based study with referred data - NCD, SPHS and risk factors, showed similarities with other population studies regard genre´s characteristics in aging and lower education among the elderly than among the youth. However, unlike most population-based studies which assess the association between NCDs, risk factors and mortality, the current showed associations between NCDs, PES and risk factors and morbidity. The BMI normal is showed as an important protection factor among the youth group, decreasing in 80% the risk of HA, DM and diagnosis for DCNT. Also the physical activity (PA) - leisure time and transport, is shown positively associated with health among both groups in this study, among young group as a protective factor associated with HA and at least one diagnosis of NCDs and, among the elderly group, as a protective factor for CVD. The fact that PA is strongly associated with better SPHS for the elderly group, suggests the existence of a PA´s impact in both groups, stronger to 60 years and older group.
Backgroud. The increase in the population aged 60+ was accompanied by the increase of noncommunicable diseases (NCDs). The NCDs, self-perceived health status (SPHS) and its associations with risk factors will be analyzed in this population-based study conducted in Recife. Objectives: The study´s aims with the Recife´s population, which was stratified into two groups: youth (16-59 years) and elderly (60+ years); were to estimate the prevalence of 4 noncommunicable diseases (NCDs) - Diabetes Mellitus (DM), Hypertension (HA), Cardiovascular Disease (CVD), Osteoporosis (OP), self-perceived health status (SPHS), socio-demographic factors and primary risk factors - smoking, alcohol consumption, physical inactivity and obesity. Analyze associated risk with socio-demographic factors, NCDs and SPHS; associated risk with primary factors risks NCDs and SPHS in this population. Methods: A random sample of residents Recife´s population, non institutionalized ≥ 16 years was stratified. In the final result, were selected 2400 households distributed in 12 clusters with 200 telephone numbers each. Among the 3632 potentially eligible to survey, 2045 adults were interviewed in a representative sample of Recife´s population. Results: In a total of 2045 respondents the youth group was 78.97% and elderly group 21.02%, showed women (62.83%) and men (38.17%); the women´s proportion increases with age to 70.93%. The groups are different regarding education and marital status, showed the youth group with ≥ high school (75.48%), while the elderly group with < high school (55.90%). Regarding marital status, there is a significant difference, while almost half of the youth (43.72%) are single, the elderly 86.51% are married, widowed or divorced. The NCDs showed a prevalence distribution of DM (7.1%), youth (3.35%) and elderly (21.16%), HA (30.41%) - youth (23:45%) and elderly (56.74%); CVD (3.5 %) - young (1.49%) and elderly (11.19%); OP (7.28%) - young (3.05%) and elderly (23:42%); reported at least one NCD (43.42%) - youth (35.44% ) and elderly (75.81%); most prevalent among women and increasing with age. The SPHS as poor/fair (37.84%) - youth (34.61%) and elderly (50%) were more prevalent among women. The primary risk factors prevalence were: overweight/obesity (37.01%), higher among youth group (40.50%) while elderly group (32.39%); tobacco use is higher among the elderly (40.70%) while youth group (34.30%), whereas alcohol consumption is highest among youth (39.81%) while elderly (20%). In this sample population the majority is insufficiently active in both leisure time (78.29%) and transport (74.82%). Socio-demographic factors and NCDs associations showed: being male increases the CVD risk (3.52) and is a protective factor to OP (0.59) among elderly group; being white among the elderly is a protective factor to HA (0.54) and diagnosis of at least one NCDs (0.44), whereas among youth group increases the OP risk (4.0); ≥ high school among youth group increases risk to HA (2.46), CVD (15.18) and OP (11.56); while among the elderly increases the risk to DM (2.43), HA (1.79); not being single among youth group increases the risk to DM (5.14), CVD (4.02), OP (5.06) and diagnosis of at least one NCD (1.82). Socio-demographic factors and SPHS associations showed: being male is a protective factor to SPHS as poor/fair among youth group (0.43); ≥ high school increases risk to SPHS as poor/fair in both group- youth (1.47) and elderly (1.81). The primary risk factors and NCDs associations showed: normal BMI in youth group is a protective factor to HA (0.28), DM (0.29), diagnosis of at least one NCD (0.23); smoke did not showed any associations, however drink has influence whereas not drinking among the elderly increases DM risk (2.55) and among the youth CVD risk (2.53); be sufficiently active in leisure among the elderly is a protective factor to CVD (0.21) and be sufficiently active in transport among youth is a protective factor to HA (0.56) and diagnosis of at least one NCDs (0.65). The primary risk factors and SPHS associations showed: normal BMI in youth group is a protective factor to SPHS as poor/fair (0.43); drink showed an association whereas not drinking increases risk to SPHS as poor/fair in both groups - youth (1.75) and elderly (2.61) and be sufficiently active in leisure and transport among the elderly group is a protective factor to SPHS as poor/fair - 0.24 e 0.40. Conclusion: This population-based study with referred data - NCD, SPHS and risk factors, showed similarities with other population studies regard genre´s characteristics in aging and lower education among the elderly than among the youth. However, unlike most population-based studies which assess the association between NCDs, risk factors and mortality, the current showed associations between NCDs, PES and risk factors and morbidity. The BMI normal is showed as an important protection factor among the youth group, decreasing in 80% the risk of HA, DM and diagnosis for DCNT. Also the physical activity (PA) - leisure time and transport, is shown positively associated with health among both groups in this study, among young group as a protective factor associated with HA and at least one diagnosis of NCDs and, among the elderly group, as a protective factor for CVD. The fact that PA is strongly associated with better SPHS for the elderly group, suggests the existence of a PA´s impact in both groups, stronger to 60 years and older group.
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Citação
MUNK, Márcia. Prevalência de doenças crônicas não transmissíveis, fatores de risco e a prática de atividade física, em uma população de idosos residentes em Recife. 2012. 139 f. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.