Prevalência de multimorbidade em idosos em São Paulo, Brasil: um estudo com o ISA-Capital
DOI:
https://doi.org/10.11606/s1518-8787.2022056004252Palavras-chave:
Idoso, Multimorbidade, Prevalência, Fatores de Risco, Inquéritos EpidemiológicosResumo
OBJETIVO Estimar a prevalência de multimorbidade em idosos em São Paulo, Brasil. MÉTODOS Estudo transversal, aninhado ao inquérito de base populacional ISA-Capital, de 2015, com sub amostra de 1.019 idosos com 60 anos ou mais. A multimorbidade foi categorizada considerando duas ou mais doenças crônicas, a partir de uma lista previamente definida. Os dados foram analisados em modelos univariado e múltiplo com a regressão de Poisson. RESULTADOS A prevalência de multimorbidade foi de 40% (IC95% 36,6–43,8), sendo maior nas mulheres (RP a = 1,95 [comparado com homens]; IC95% 1,58–2,40), nos indivíduos com 75 anos ou mais (RP a = 1,25 [comparado com indivíduos de 60 a 64 anos]; IC95% 1,01–1,60), nos pretos (RP a = 1,28 [comparado com brancos]; IC95% 1,04–1,59), nas pessoas de alta renda (RP a = 1,27 [comparado com baixa renda]; IC95% 1,09–1,50) e nos ex-fumantes (RP a = 1,30 [comparado com quem nunca fumou]; IC95% 1,05–1,60) e menor nos que se declararam fumantes (RP a = 0,72 [comparado com quem nunca fumou]; IC95% 1,09–1,50). CONCLUSÕES A prevalência de multimorbidade foi inferior à reportada na maioria dos estudos revisados, mas há consistência sobre sua associação com sexo, idade, cor da pele, tabagismo e nível socioeconômico. A padronização de critérios conceituais e metodológicos para a sua estimação é um desafio para mitigar problemas no planejamento e gestão de sistemas de saúde para populações cada vez mais envelhecidas.
Referências
Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4):430-9. https://doi.org/10.1016/j.arr.2011.03.003
Johnston MC, Crilly M, Black C, Prescott GJ, Mercer SW. Defining and measuring multimorbidity: a systematic review of systematic reviews. Eur J Public Health. 2019;29(1):182-9. https://doi.org/10.1093/eurpub/cky098
Harrison C, Britt H, Miller G, Henderson J. Examining different measures of multimorbidity, using a large prospective cross-sectional study in Australian general practice. BMJ Open. 2014;4(7):e004694. https://doi.org/10.1136/bmjopen-2013-004694
Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009;7(4):357-63. https://doi.org/10.1370/afm.983
Nunes BP, Batista SRR, Andrade FB, Souza Junior PRB, Lima-Costa MF, Facchini LA. Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil). Rev Saude Publica. 2018;52 Suppl 2:10s. https://doi.org/10.11606/S1518-8787.2018052000637
Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37-43. https://doi.org/10.1016/S0140-6736(12)60240-2
Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, et al. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One. 2014;9(7):e102149. https://doi.org/10.1371/journal.pone.0102149
Nunes BP, Thumé E, Facchini LA. Multimorbidity in older adults: magnitude and challenges for the Brazilian health system. BMC Public Health. 2015;15:1172. https://doi.org/10.1186/s12889-015-2505-8
Kalgotra P, Sharda R, Croff JM. Examining multimorbidity differences across racial groups: a network analysis of electronic medical records. Sci Rep. 2020;10:13538. https://doi.org/10.1038/s41598-020-70470-8
Zaitune MPA, Barros MBA, Lima MG, César CLG, Carandina L, Goldbaum M, et al. Fatores associados ao tabagismo em idosos: Inquérito de Saúde no Estado de São Paulo (ISA-SP). Cad Saude Publica 2012;28(3):583-95. https://doi.org/10.1590/S0102-311X2012000300018
Nunes BP, Flores TR, Mielke GI, Thumé E, Facchini LA. Multimorbidity and mortality in older adults: a systematic review and meta-analysis. Arch Gerontol Geriatr. 2016;67:130-8. https://doi.org/10.1016/j.archger.2016.07.008
Salisbury C. Multimorbidity: redesigning health care for people who use it. Lancet. 2012;380(9836):7–9. https://doi.org/doi:10.1016/S0140-6736(12)60482-6
Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:m606. https://doi.org/10.1136/bmj.m606
Wong SYS, Zhang D, Sit RWS, Yip BHK, Chung RY, Wong CKM, et al. Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care. Br J Gen Pract. 2020;70(700):e817-24. https://doi.org/10.3399/bjgp20X713021
Almeida PF, Medina MG, Fausto MCR, Giovanella L, Bousquat A, Mendonça MHM. Coordenação do cuidado e Atenção Primária à Saúde no Sistema Único de Saúde. Saude Debate. 2018;42 Nº Epec 1:244-60. https://doi.org/10.1590/0103-11042018s116
Almeida MGN, Nascimento-Souza MA, Lima-Costa MF, Peixoto SV. Lifestyle factors and multimorbidity among older adults (ELSI-Brazil). Eur J Ageing. 2020;17(4):521-9. https://doi.org/10.1007/s10433-020-00560-z
Melo LA, Lima KC. Prevalência e fatores associados a multimorbidades em idosos brasileiros. Cienc Saude Colet. 2020;25(10):3869-77. https://doi.org/10.1590/1413-812320202510.34492018
Nunes B, Souza AS, Nogueira J, Andrade F, Thumé E, Teixeira D, et al. Envelhecimento, multimorbidade e risco para COVID-19 grave: ELSI-Brasil. Scielo Preprints. 2020 [postado 6 mar 2020]. https://doi.org/10.1590/SciELOPreprints.703
Leite BC, Oliveira-Figueiredo DST, Rocha FL, Nogueira MF. Multimorbidity due to chronic noncommunicable diseases in older adults: a population-based study. Rev Bras Geriatr Gerontol. 2019;22(6):e190253. http://doi.org/10.1590/1981-22562019022.190253
Alves MCGP, Escuder MML, Goldbaum M, Barros MBA, Fisber RM, César CLG. Plano de amostragem em inquéritos de saúde, município de São Paulo, 2015. Rev Saude Publica. 20218;52:81. https://doi.org/10.11606/S1518-8787.2018052000471
Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorb. 2019;9:2235042X19870934. https://doi.org/10.1177/2235042X19870934
Vollset SE, Goren E, Yuan CW, Cao J, Smith AE, Hsiao T, et al. Fertility, mortality, migration, and population scenarios for 195 countries and territories from 2017 to 2100: a forecasting analysis for the Global Burden of Disease Study. Lancet. 2020;396(10258):1285-306. https://doi.org/10.1016/S0140-6736(20)30677-2
Francisco PMSB, Segri NJ, Borim FSA, Malta DC. Prevalence of concomitant hypertension and diabetes in Brazilian older adults: individual and contextual inequalities. Cienc Saude Colet. 2018;23(11):3829-40. https://doi.org/10.1590/1413-812320182311.29662016
Paynter NP, Chasman DI, Paré G, Buring JE, Cook NR, Miletich JP, et al. Association between a literature-based genetic risk score and cardiovascular events in women. JAMA. 2010;303(7):631-7. https://doi.org/10.1001/jama.2010.119
Vellakkal S, Subramanian SV, Millett C, Basu S, Stuckler D, Ebrahim S. Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures. PLoS One. 2013;8(7):e68219. https://doi.org/10.1371/journal.pone.0068219
Mackenbach JP, Looman CW, Meer JB. Differences in the misreporting of chronic conditions, by level of education: the effect on inequalities in prevalence rates. Am J Public Health. 1996;86(5):706-11. https://doi.org/10.2105/AJPH.86.5.706
Nunes BP, Chiavegatto Filho ADP, Pati S, Teixeira DSC, Flores TR, Camargo-Figuera FA, et al. Contextual and individual inequalities of multimorbidity in Brazilian adults: a cross-sectional national-based study. BMJ Open. 2017;7(6):e015885. https://doi.org/10.1136/bmjopen-2017-015885
Dalstra JAA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005;34(2):316-26. https://doi.org/10.1093/ije/dyh386
Marinho V, Blay SL, Andreoli SB, Gastal F. A prevalence study of current tobacco smoking in later life community and its association with sociodemographic factors, physical health and mental health status. Soc Psychiatry Psychiatr Epidemiol 2008;43(6):490. https://doi.org/10.1007/s00127-008-0338-9
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Copyright (c) 2022 Kaio Keomma, Aylene Bousquat, Chester Luiz Galvão César
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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Secretaria Municipal da Saúde Cicade de São Paulo
Números do Financiamento 0.235.936-0/2013