Community determinants of mortality in middle-aged and older adults: evidence from the pandemic and post-pandemic periods
DOI:
https://doi.org/10.11606/issn.1679-9836.v105i2e-234700Keywords:
Aged, COVID-19, Mortality, Middle AgedAbstract
Introduction: The older population faces a higher risk of complications and death due to health conditions and social isolation. The COVID-19 pandemic has aggravated these factors and increased mortality. Objective: To identify the community determinants of mortality among middle-aged and older adults during and after the pandemic. Material and methods: This is a longitudinal and quantitative study with 300 participants aged 45 years or older, registered in Family Health Units in Três Lagoas, Mato Grosso do Sul. Participants were evaluated at three time points: before (2018/2019), during (2021) and after (2023) the pandemic. Sociodemographic data and health conditions were collected. The deaths were recorded in 2021 and 2023. Binomial logistic regression was used to analyze the factors associated with mortality. Results: The majority of the sample in the baseline was female (65.7%), married (56.0%), with a mean age of 60.9 years and 5.7 years of education. The mean daily use was 2.3 medications; 10.3% reported recent hospitalization; 29.0% suffered a fall; 56.7% had hypertension; 25.7% had diabetes mellitus; 46.6% were obese; 18.7% smoked; 60.3% were physically inactive and 56.7% had depressive symptoms. The mortality rate was 4.7% during and 1.8% after the pandemic, totaling 6.3%. Recent hospitalizations increased the risk of death (OR=5.49 in the pandemic and OR=4.50 overall), as did smoking (OR=4.24 in the pandemic and OR=3.86 overall). Conclusion: Recent hospitalization and smoking were associated with higher mortality, indicating that follow-up after hospital discharge and actions to quit smoking can reduce morbidity and mortality risks and promote a better quality of life for an aging population.
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