Consumo de álcool na população idosa brasileira: da prevalência à intervenção
Data
2021-06-15
Autores
Paula, Tassiane Cristine Santos de [UNIFESP]
Orientadores
Ferri, Cleusa Pinheiro
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O envelhecimento da população está ocorrendo rapidamente. Com o aumento da expectativa de vida, comportamentos que costumavam ser uma preocupação em pessoas mais jovens, como consumo de álcool, estão se tornando mais comuns entre os idosos. É fundamental entender essa problemática para propor estratégias para redução do consumo de álcool entre os idosos. Objetivos: Estimar os padrões de consumo de álcool da população idosa no país e na atenção primária, e propor uma intervenção custo-efetiva para reduzir o consumo de álcool. Método: Para estimar a prevalência dos padrões de consumo de álcool da população geral idosa foi realizada uma análise secundária dos dados da linha de base do Estudo Longitudinal de Saúde dos Idosos Brasileiros - ELSI Brasil com uma amostra de 5.432 participantes representativa dos brasileiros acima de 60 anos. Para estimar a prevalência dos padrões de consumo de álcool em idosos da atenção primária foram utilizados dados da triagem inicial do ensaio clínico realizado em sete Unidades Básicas de Saúde com 503 participantes. Em ambas as amostras foi utilizada a regressão de Poisson para identificar fatores sociodemográficos, comportamentos de saúde e condições de saúde associados aos diferentes padrões de consumo de álcool. Por fim, foi desenvolvida uma proposta de Intervenção Breve para Idosos (IBI) e elaborado um protocolo para testar a efetividade desta intervenção em idosos na atenção primária que foi iniciada e suspensa devido à pandemia. Resultados: Na população brasileira acima de 60 anos (n=5.432) foi encontrado que 23,7% faziam consumo de álcool, 3,8% consumo de risco e 6,7% binge, todos os padrões de consumo foram mais comuns na região Sudeste (25,1%, 4,2% e 7%) independente do sexo, idade e escolaridade. Enquanto na atenção primária foi encontrado 33,6% consumo de álcool, 4% consumo de risco e 12,5% binge. Nas duas amostras, os homens eram os mais prováveis de fazer consumo de risco e binge, bem como os mais jovens e com maior escolaridade. Enquanto os fumantes eram os mais prováveis de fazer consumo de risco e binge apenas na população geral. Foi desenvolvida uma Intervenção Breve para Idosos (IBI) registrada na plataforma REBEC que se mostrou factível e aceitável para o contexto da atenção primária administrada por agentes comunitários de saúde, com apenas 6,2% de 80 participantes elegíveis convidados se recusando a participar. Discussão/Conclusão: Foi encontrado que tanto na
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população geral quanto na atenção primária há uma proporção alta dos idosos que consomem álcool em quantidades que podem trazer danos a sua saúde. Considerando que se trata de uma população que geralmente apresenta problemas de saúde e faz uso de medicação, esta faixa-etária merece atenção. A administração inicial da intervenção nas unidades básicas de saúde parece ser factível e bem aceita pelos participantes, mas necessita ser testada de forma completa em um ensaio clinico para avaliar a sua efetividade assim como a sua relação custo efetividade no futuro.
Background: Population aging is occurring rapidly. With the increase in life expectancy, behaviors that used to be a concern in younger people, such as alcohol consumption, are becoming more common among older adults. It is essential to understand this problem in order to propose strategies to reduce alcohol consumption among older adults. Objectives: To estimate the drinking patterns of older population in the country and in primary care, and to propose a cost-effective intervention to reduce alcohol consumption. Method: In order to estimate the prevalence of drinking patterns in the general older population, a secondary analysis of the baseline data from the Longitudinal Study of Health of the Elderly Brazilians - ELSI Brazil was performed with a sample of 5.432 participants representing Brazilians over 60 years. To estimate the prevalence of drinking patterns among older adults in primary care, data from the initial screening of the clinical trial conducted in seven Basic Health Units with 503 participants were used. In both samples, Poisson regression was used to identify sociodemographic factors, health behaviors and health conditions associated with different drinking patterns. Finally, a Brief Intervention for Older adults (BIO) proposal was developed and a protocol was elaborated to test the effectiveness of this intervention among older adults in primary care that was initiated and suspended due to the pandemic. Results: In the Brazilian population over 60 years (n = 5,432) it was found that 23.7% used alcohol, 3.8% at-risk drinking and 6.7% binge, all drinking patterns were more common in the Southeast region (25.1%, 4.2% and 7%) regardless of gender, age and education. While in primary care, 33.6% alcohol consumption, 4% at-risk drinking and 12.5% binge were found. In both samples, males were the most likely to at-risk and binge drinkers, as well as the youngest and high education. While smokers were the most likely to at-risk and binge drinkers only in the general population. A Brief Intervention for the Older adults (BIO) registered on the REBEC platform was developed and proved to be feasible and acceptable for the context of primary care administered by community health workers, with only 6.2% of 80 eligible participants invited refusing to participate. Discussion/Conclusion: It was found that both in the general population and in primary care there is a high proportion of older adults who consume alcohol in quantities that can harm their health. Considering that it is a population that generally presents health problems and uses medication, this age group deserves attention. The initial administration of the intervention in the basic health units seems to be feasible and well accepted by the participants, but it needs to be thoroughly tested in a clinical trial to evaluate its effectiveness as well as its costeffectiveness in the future.
Background: Population aging is occurring rapidly. With the increase in life expectancy, behaviors that used to be a concern in younger people, such as alcohol consumption, are becoming more common among older adults. It is essential to understand this problem in order to propose strategies to reduce alcohol consumption among older adults. Objectives: To estimate the drinking patterns of older population in the country and in primary care, and to propose a cost-effective intervention to reduce alcohol consumption. Method: In order to estimate the prevalence of drinking patterns in the general older population, a secondary analysis of the baseline data from the Longitudinal Study of Health of the Elderly Brazilians - ELSI Brazil was performed with a sample of 5.432 participants representing Brazilians over 60 years. To estimate the prevalence of drinking patterns among older adults in primary care, data from the initial screening of the clinical trial conducted in seven Basic Health Units with 503 participants were used. In both samples, Poisson regression was used to identify sociodemographic factors, health behaviors and health conditions associated with different drinking patterns. Finally, a Brief Intervention for Older adults (BIO) proposal was developed and a protocol was elaborated to test the effectiveness of this intervention among older adults in primary care that was initiated and suspended due to the pandemic. Results: In the Brazilian population over 60 years (n = 5,432) it was found that 23.7% used alcohol, 3.8% at-risk drinking and 6.7% binge, all drinking patterns were more common in the Southeast region (25.1%, 4.2% and 7%) regardless of gender, age and education. While in primary care, 33.6% alcohol consumption, 4% at-risk drinking and 12.5% binge were found. In both samples, males were the most likely to at-risk and binge drinkers, as well as the youngest and high education. While smokers were the most likely to at-risk and binge drinkers only in the general population. A Brief Intervention for the Older adults (BIO) registered on the REBEC platform was developed and proved to be feasible and acceptable for the context of primary care administered by community health workers, with only 6.2% of 80 eligible participants invited refusing to participate. Discussion/Conclusion: It was found that both in the general population and in primary care there is a high proportion of older adults who consume alcohol in quantities that can harm their health. Considering that it is a population that generally presents health problems and uses medication, this age group deserves attention. The initial administration of the intervention in the basic health units seems to be feasible and well accepted by the participants, but it needs to be thoroughly tested in a clinical trial to evaluate its effectiveness as well as its costeffectiveness in the future.
Descrição
Citação
PAULA, Tassiane Cristine Santos de. Consumo de álcool na população idosa brasileira: da prevalência à intervenção. São Paulo, 2021. 143 p. Tese (Doutorado em Psicobiologia) - Universidade Federal de São Paulo (UNIFESP), São Paulo, 2021.