ABSTRACT
INTRODUCCIÓN. La depresión es uno de los trastornos neuropsiquiátricos más frecuentes en el adulto mayor y no debe ser considerada como parte del envejecimiento normal. La prevalencia varía según la población estudiada, es más frecuente en países de menor desarrollo y se asocia a varios factores considerados de riesgo, muchos de ellos modificables. OBJETIVO. Estimar la prevalencia de depresión e identificar factores asociados en personas mayores de 65 años en la consulta externa de un hospital público. MATERIALES Y MÉTODOS. Estudio descriptivo, transversal. La muestra fue de 365 pacientes adultos mayores y el muestreo no probabilístico, secuencial, realizado durante los primeros cuatro meses del año 2018. Fueron excluidos pacientes con deterioro cognitivo importante, índice de morbilidad de 3 o más personas que se negaron a participar. Se aplicó encuesta elaborada en que constaban datos demográficos, Índice de Katz, Escala sociofamiliar de Gijón y para realizar el diagnóstico se usó la entrevista International Neuropsychiatric Interview. Se calculó proporción de depresión y se estableció asociación con chi2 de homogeneidad y Odds ratio de prevalencia. RESULTADOS. La prevalencia de depresión actual en la muestra estudiada fue 25,80% (94; 365) con un 15,10% (55; 365) de episodio depresivo leve. Un 24,47% (23; 94) de personas deprimidas presentaron episodio recurrente. Se encontró asociación significativa entre depresión y dependencia con OR de 3,107 (1,250 - 7,722), situación de riesgo social con OR de 2,853 (1,746 - 4,659) y malas relaciones sociales con OR de 1,748 (1,064 - 2,872). CONCLUSIÓN. La prevalencia de depresión en la población estudiada es alta y los adultos mayores dependientes y en riesgo social son más proclives a deprimirse.
INTRODUCTION. Depression is one of the most frequent neuropsychiatric disorders in the elderly and should not be considered as part of normal aging. The prevalence varies according to the population studied, is more frequent in less developed countries and is associated with several risk factors, many of them modifiable. OBJECTIVE. Estimate the prevalence of depression and identify associated factors in people over 65 in the outpatient clinic of a public hospital. MATERIALS AND METHODS. Descriptive, cross-sectional study. The sample was 365 elderly patients and the non-probabilistic, sequential sampling, performed during the first four months of 2018. Patients with significant cognitive impairment, morbidity index of 3 or more people who refused to participate were excluded. A survey was carried out, which included demographic data, Katz Index, Gijón socio-family scale and the International Neuropsychiatric Interview interview was used to make the diagnosis. Depression ratio was calculated and association was established with chi2 homogeneity and Odds prevalence ratio. RESULTS. The prevalence of current depression in the sample studied was 25,80% (94; 365) with a 15,10% (55; 365) mild depressive episode. 24,47% (23; 94) of depressed people had recurrent episode. A significant association was found between depression and dependence with OR of 3,107 (1,250 - 7,722), social risk situation with OR of 2,853 (1,746 - 4,659) and poor social relations with OR of 1,748 (1,064 - 2,872). CONCLUSION. The prevalence of depression in the population studied is high and dependent and socially risky older adults are more likely to become depressed.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Office Visits , Aged , Activities of Daily Living , Risk Factors , Socioeconomic Survey , Depression , Referral and Consultation , Aging , Diagnosis , Cognitive Dysfunction , Interpersonal RelationsABSTRACT
INTRODUCCIÓN. La desnutrición y la depresión son problemas frecuentes en adultos mayores y tienen características propias. Varios factores modificables están asociados. OBJETIVO. Determinar la existencia de relación entre desnutrición y depresión en mujeres mayores de 65 años atendidas en la consulta externa del Hospital de Especialidades Carlos Andrade Marín en el año 2017. MATERIALES Y MÉTODOS. Estudio relacional, transversal en mujeres con estado nutricional normal y desnutrido. La muestra fue de 160 mujeres adultas mayores, en dos grupos de 80 pacientes con y sin desnutrición. Se aplicaron las escalas de: Yesavage para depresión, de Katz para dependencia y de Gijón para valoración socio-familiar. La asociación se estableció mediante Chi Cuadrado de homogeneidad, la fuerza de asociación se midió con Razón de prevalencia. RESULTADOS. La proporción de depresión en pacientes con desnutrición fue el doble que en las no desnutridas, p valor de 0,003 y OR de 2,82 (1,42-5,59). Además, se encontró relación estadísticamente significativa entre desnutrición con: viudez, baja instrucción, bajos ingresos, dependencia, poca ayuda social, aislamiento; y, vivienda con barreras arquitectónicas. CONCLUSIÓN. Existió asociación entre desnutrición y depresión. Las pacientes con desnutrición tienen más probabilidades de presentar síntomas depresivos.
INTRODUCTION. Malnutrition and depression are frequent problems in older adults and have their own characteristics. Several modifiable factors are associated. OBJECTIVE. To determine the existence of a relationship between malnutrition and depression in women over 65 years of age treated in the outpatient clinic of the Carlos Andrade Marín Specialty Hospital in 2017. MATERIALS AND METHODS. Relational, cross-sectional study in women with normal and malnourished nutritional status. The sample was 160 older adult women, in two groups of 80 patients with and without malnutrition. The following scales were applied: Yesavage for depression, Katz for dependency and Gijón for socio-family assessment. The association was established by Chi Square of homogeneity, the strength of association was measured with Reason of prevalence. RESULTS. The proportion of depression in patients with malnutrition was double that in the non-malnourished, p value of 0,003 and OR of 2,82 (1,42-5,59). In addition, a statistically significant relationship was found between malnutrition with: widowhood, low education, low income, dependency, little social help, isolation; and, housing with architectural barriers. CONCLUSIONS. There was an association between malnutrition and depression. Patients with malnutrition are more likely to have depressive symptoms.
Subject(s)
Humans , Male , Female , Aged , Aged , Socioeconomic Survey , Malnutrition , Office Visits , Activities of Daily Living , DepressionABSTRACT
Objective: To analyze the prevalence of medical consultations in the last three months among elderly adults and associated factors. Methods: A cross-sectional, population-based study was carried out with 1,705 elderly adults (60+ years of age) in the urban region of Florianópolis, Santa Catarina, Brazil, in 2009 and 2010. The sampling selection was performed in two stages. The sample was complex, with census tracts as primary and households as secondary sampling units. For association analysis, Poisson regression was performed using predisposing factors, enabling factors and need as independent variables, according to Andersen's theoretical model. Results: The response rate was 89.2%. The prevalence of medical appointments by elderly adults was 70.4% (95%CI 67.5 - 73.4). Factors associated with higher prevalence of medical consultations in the crude analysis were female gender, accumulation of chronic diseases, negative self-perception of health, and report of chronic pain. The multivariate analysis showed that having at least one chronic disease and negative self-perception of health was positively associated with the outcome. Conclusion: Only variables from the need dimension were associated with medical consultations, indicating an equal use of this service. .
Objetivo: Analisar a prevalência de consultas médicas nos últimos três meses e os fatores associados entre idosos. Métodos: Estudo transversal de base populacional com 1.705 idosos com 60 anos ou mais, residentes na área urbana do município de Florianópolis, Santa Catarina, em 2009 e 2010. A amostra foi complexa, sendo os setores censitários as unidades primárias de amostragem e os domicílios o segundo estágio. Para análise de associação foi realizada a regressão de Poisson, tendo como variáveis independentes fatores predisponentes, capacitantes e de necessidade, segundo modelo teórico de Andersen. Resultados: A taxa de resposta foi de 89,2%. A prevalência de consultas médicas foi de 70,4% (intervalo de confiança de 95% 67,5 -73,4). Na análise bruta associaram-se com maior prevalência de consultas médicas o sexo feminino, o maior acúmulo de doenças crônicas, a autopercepção negativa de saúde e o relato de dor crônica. A análise multivariável identificou que possuir pelo menos uma doença crônica e ter autopercepção de saúde negativa estiveram associados positivamente ao desfecho. Conclusão: Apenas variáveis da dimensão de necessidade se associaram ao desfecho, apontando para uma igualdade no uso desse serviço. .
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Health Services for the Aged , Brazil , Cross-Sectional StudiesABSTRACT
OBJETIVO: Descrever a prevalência de consultas médicas e os fatores associados na população adulta de um município de médio porte do sul do Brasil. MÉTODOS: Realizou-se estudo transversal de base populacional em Lages, Santa Catarina. A população de referência foram os adultos (20 a 59 anos). O processo de amostragem foi por conglomerados e foram entrevistadas 2.022 pessoas. O desfecho foi a realização de consulta médica nos 12 meses anteriores à pesquisa. Também foram coletadas informações relativas à natureza do serviço utilizado (público/privado) e a avaliação do mesmo. As variáveis independentes foram sexo, raça/cor de pele, estado civil, renda per capita, escolaridade, autopercepção da saúde, estado nutricional, diabetes autorreferido, nível pressórico elevado, tabagismo e problemas com álcool. Foi realizada regressão de Poisson obtendo-se a Razão de Prevalência como medida de efeito. RESULTADOS: A prevalência de consultas médicas nos 12 meses anteriores à entrevista foi de 76 por cento (IC95 por cento 73,6-78,4). As mulheres, os mais ricos, aqueles com diabetes, fumantes, ex-fumantes, com problemas com álcool e que avaliaram negativamente a sua saúde reportaram maior prevalência do desfecho. Também se observou que entre os estratos com menor renda a utilização do Sistema Único de Saúde para a realização das consultas médicas foi mais elevada. CONCLUSÃO: A realização de consultas médicas variou entre estratos da população. As políticas de saúde das três esferas de governo devem considerar tal desigualdade para subsidiar suas ações para o setor a fim de propor políticas equânimes.
OBJECTIVE: describe the prevalence of medical visits and associated factors in an adult population of a midsized town in Southern Brazil. METHODS: a population-based cross-sectional study was carried out in a representative random cluster sampling in Lages, Santa Catarina. The reference population were adults (aged 20 to 59 years) and 2,022 persons were queried. The outcome was medical visits during twelve months prior to the survey. Information related to kind of service (public/private) and evaluation of this service were also collected. The independent variables were gender, race/skin color, marital status, income, educational background, health self-perception, nutritional state, self-reported diabetes, hypertension, smoking and alcohol problems. Poisson regression was carried out and the Prevalence Rate was obtained. RESULTS: the prevalence of medical visits was 76.0 percent (CI95 percent 73.6-78.4). Women, the wealthier, those who have diabetes, smokers, ex-smokers, those with alcohol problems, also those who evaluated their health negatively, reported a greater prevalence of medical visits. It was also observed that among lower income people, medical visits to the Public Health System (Sistema Único de Saúde) were more frequent.. CONCLUSION: Prevalence of medical visits varied according to the population queried. Health policies at the three government levels must acknowledge such inequality to subsidize actions in the sector to propose equanimous policies.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Health Services Accessibility/statistics & numerical data , Referral and Consultation/statistics & numerical data , Brazil , Cross-Sectional Studies , Prevalence , Socioeconomic Factors , Urban PopulationABSTRACT
OBJETIVO: Estimar a prevalência de consultar com médico e analisar fatores a ela associados. MÉTODOS: Estudo transversal de base populacional realizado de dezembro de 1999 a abril de 2000, na cidade de Pelotas (RS). Foram incluídos 1.962 indivíduos de ambos os sexos, de 20 a 69 anos, residentes na zona urbana. Os dados foram coletados por meio de questionários padronizados e pré-codificados. O desfecho "consultar com médico nos 12 meses antes da entrevista" foi analisado com fatores socioeconômicos, demográficos, presença de doenças crônicas e distúrbios psiquiátricos, estado nutricional, tabagismo, consumo de bebidas alcoólicas, e internação no ano anterior à entrevista. Foi realizada regressão de Poisson seguindo modelo hierarquizado, controlada por variáveis de confusão, considerando nível de significância <0,05. RESULTADOS: Entre os entrevistados, 1.395 (70,9 por cento) haviam consultado com médico no período analisado. A análise multivariada entre os homens revelou que os indivíduos que apresentaram maiores prevalências de consultas com médico possuíam renda familiar per capita maior de 10 salários mínimos, mais de 60 anos de idade, diabetes mellitus, índice de massa corporal maior ou igual a 25 kg/m² e que haviam sido hospitalizados. As mulheres com renda familiar per capita acima de seis salários mínimos, com mais de 60 anos, brancas, não fumantes, com hipertensão arterial, com diabetes e as que haviam sido hospitalizadas apresentaram maiores prevalências do desfecho. CONCLUSÕES: Foram identificadas iniqüidades em saúde em relação à cor da pele e renda familiar e alta prevalência de consulta com médicos, principalmente entre os indivíduos mais idosos e com algumas doenças crônicas não transmissíveis.
OBJECTIVE: To estimate the prevalence of visiting doctors and to analyze associated factors. METHODS: Cross-sectional, population-based study performed in the city of Pelotas, Southern Brazil, between December 1999 and April 2000. A total of 1,962 individuals of both sexes, aged between 20 and 69 years and living in the urban area were included in this study. Data were collected with standardized, pre-coded questionnaires. The outcome "visited doctor during the 12 months prior to interview" was analyzed with socioeconomic and demographic factors, presence of chronic diseases and psychiatric disorders, nutritional status, smoking, alcohol consumption, and hospitalizations in the year prior to interview. Poisson regression was used, according to a hierarchical model, controlled by confounding variables, and considering a significance level of <0.05. RESULTS: Among interviewees, 1,395 (70.9 percent) had visited a doctor in the period analyzed. Multivariate analysis among men revealed that individuals who showed higher prevalences of medical visits had a per capita family income higher than 10 minimum wages per month, were over 60 years of age, suffered from diabetes mellitus, had a body mass index equal to or above 25kg/m², and had been hospitalized. Women who had a per capita family income higher than six minimum wages per month, were over 60 years of age, white and non-smokers, suffered from hypertension and diabetes, and had been hospitalized showed higher outcome prevalences. CONCLUSIONS: Health inequalities were identified in relation to ethnicity and family income. In addition, there was high prevalence of medical visits, especially among individuals who were older and suffered from certain chronic, non-communicable diseases.
OBJETIVO: Estimar la prevalencia de consultas con un médico y analizar factores asociados a ella. MÉTODOS: Se realizó estudio transversal de base poblacional de diciembre de 1999 a abril de 2000, en la ciudad de Pelotas (Sur de Brasil). Fueron incluidos 1.962 individuos de ambos sexos, de 20 a 69 años, residentes en la zona urbana. Los datos fueron colectados por medio de cuestionarios estandarizados y pre-codificados. La condición "consultar con médico en los 12 meses antes de la entrevista" fue analizada con factores socioeconómicos, demográficos, presencia de enfermedades crónicas y disturbios psiquiátricos, estado nutricional, tabaquismo, consumo de bebidas alcohólicas e internación en el año anterior a la entrevista. Fue realizada una regresión de Poisson siguiendo el modelo jerarquizado, controlado por variables de confusión, considerando nivel de significancia <0,05. RESULTADOS: Entre los entrevistados, 1.395 (70,9 por ciento) habían consultado con un médico en el período analizado. El análisis multivariado entre los hombres reveló que los individuos que presentaron mayor prevalencia de consultas con médico poseían renta familiar per capita mayor de 10 salarios mínimos, más de 60 años de edad, diabetes mellitas, índice de masa corporal mayor o igual a 25 kg/m2 y que habían sido hospitalizados. Las mujeres con renta familiar per capita por encima de seis salarios mínimos, con mas de 60 años, blancas, no fumadoras, con hipertensión arterial, con diabetes y las que habían sido hospitalizadas presentaron mayor prevalencia de la condición. CONCLUSIONES: Fueron identificadas inequidades en salud con relación al color de la piel y renta familiar y alta prevalencia de consulta con médicos, principalmente entre los individuos de mayor edad y con algunas enfermedades crónicas no transmisibles.