Prevalence of multimorbidity in older adults in São Paulo, Brazil: a study with ISA-Capital
DOI:
https://doi.org/10.11606/s1518-8787.2022056004252Keywords:
Aged, Multimorbidity, Prevalence, Risk Factors, Health SurveysAbstract
OBJECTIVE To estimate the prevalence of multimorbidity in older adults in São Paulo, Brazil. METHODS A cross-sectional study based on the 2015 ISA-Capital population-based survey, with a subsample of 1,019 older adults aged ≥ 60 years old. Multimorbidity was categorized considering two or more chronic diseases, based on a previously defined list. The data were analyzed in univariate and multiple models with Poisson regression. RESULTS The prevalence of multimorbidity was 40% (95%CI: 36.6–43.8), being higher in women (PR a = 1.95 [compared to men]; 95%CI: 1.58–2.40), in individuals aged ≥ 75 years old (PR a = 1.25 [compared to individuals aged ≥ 60 to 64 years old]; 95%CI: 1.01–1.60), in Black people (PR a = 1.28 [compared to White people]; 95%CI: 1.04–1.59), in high-income people (PR a = 1.27 [compared to low income]; 95%CI: 1.09–1.50) and in former smokers (PR a = 1.30 [compared to those who never smoked]; 95%CI: 1.05–1.60), and lower in smokers (PR a = 0.72 [compared to those who never smoked]; 95%CI: 1.09–1.50). CONCLUSION The prevalence of multimorbidity was lower than that reported in most of the reviewed studies, but consistently associated with gender, age, race/skin color, smoking habit and socioeconomic status. The standardization of conceptual and methodological criteria for estimation is a challenge to relieve problems in the planning and management of health care systems for older populations.
References
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
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Kaio Keomma, Aylene Bousquat, Chester Luiz Galvão César
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Funding data
-
Secretaria Municipal da Saúde Cicade de São Paulo
Grant numbers 0.235.936-0/2013