ABSTRACT
BACKGROUND: Few studies have specifically investigated the inverse relationship between reduced quality of life in different domains and elevated C-reactive protein (CRP) serum levels in older adults. Therefore, this study investigates the cross-sectional association between quality of life and inflammation in older Brazilian adults. METHODS: Data were collected from 1255 participants from the third wave (2010) of the Brazilian Health, Well-being and Aging study (SABE), a community-based cohort study of aging. Inflammation was assessed using CRP serum levels and quality of life (QoL) was measured using the 12-item Short-Form Health Survey (SF-12) questionnaire. The covariates included age, sex, education level, financial sufficiency, number of non-communicable diseases, self-reported doctor diagnosed diseases, Activity of Daily Living (ADL) difficulties, Body Mass Index (BMI), and waist circumference. RESULTS: The fully adjusted models showed that older adults with low scores in the physical domain of the SF12 (OR 1.34, 95%CI 1.02;1.77) and high BMI values (> 30) (OR 2.05, 95%CI 1.50;2.81) were more likely to present high CRP serum levels. CONCLUSION: Our findings suggest a significant association of lower scores in the physical domain of quality of life and the presence of obesity with high CRP serum levels.
Subject(s)
Activities of Daily Living , Inflammation/diagnosis , Quality of Life , Aged , Body Mass Index , Brazil , C-Reactive Protein/analysis , Cohort Studies , Comorbidity , Cross-Sectional Studies , Female , Health Surveys , Humans , Inflammation/epidemiology , Male , Middle Aged , Obesity/epidemiology , Surveys and Questionnaires , Waist CircumferenceABSTRACT
BACKGROUND: The age is a variable positively related to healthcare expenditures on diabetes (DM), however other factors could also be associated. Physical activity, normal weight and walking habit could be inversely associated to healthcare expenditures related to DM control. The aim of this study was to describe healthcare diabetic-related expenditures and analyze the associations with Body Mass Index (BMI), Physical Activity Level (PAL), and walking habit among the elderly Brazilians. METHODS: A cross-sectional analysis was carried out on a population-based study (SABE Study) in Brazil. Healthcare expenditures were estimated for the medicine prescriptions, outpatient service and hospitalization. The sample was classified according to BMI, the PAL, and according to weekly frequency of walking habit.The annual healthcare expenditures were estimated, and the multiple logistic regression was used to analyze the associations between variables. RESULTS: The sample included 295 elderly diabetics, with a mean age 70 years. The excess weight group presented significantly higher annual expenditures with medicine prescriptions, hospitalization, and outpatient services. Absence of walking habit was related to higher costs and inversely associated to higher expenditures to medicine prescriptions (OR 2.82, IC95% 1.48 - 5.40) and hospitalizations (OR 5.79, IC95% 1.10 - 10.93), independent of BMI, sex, age and the presence of hypertension. CONCLUSION: BMI and insufficient PAL were associated to higher public expenditures related to DM control in elderly people. Walking habit was inversely associated to healthcare expenditures on behalf of the diabetes control among Brazilian elderly population.
Subject(s)
Body Mass Index , Diabetes Mellitus/economics , Diabetes Mellitus/therapy , Exercise , Health Care Costs , Health Expenditures , Walking , Age Factors , Aged , Ambulatory Care/economics , Brazil , Cost Savings , Cross-Sectional Studies , Diabetes Mellitus/diagnosis , Drug Costs , Female , Habits , Health Behavior , Health Knowledge, Attitudes, Practice , Health Status , Hospital Costs , Humans , Hypoglycemic Agents/economics , Hypoglycemic Agents/therapeutic use , Logistic Models , Male , Odds Ratio , Risk Factors , Risk Reduction BehaviorABSTRACT
BACKGROUND: The literature shows the inverse association between physical activity level (PAL) and chronic diseases that have a significant burden over health care costs. However, in upper-middle income countries and in elderly population this information are scarce. OBJECTIVE: To describe the annual drug expenditures for the hypertensive and diabetic elderly population in Brazil and to analyze the association with PAL and engagement in walking. METHODS: This cross sectional study is part of SABE Survey and comprised 806 hypertensive and/or diabetic elderly (≥60 years old). The annual expenditures of medicine use was estimated for all medications for hypertension and/or diabetes they were taking. The PAL was considered insufficient when moderate physical activity was <150 min/week or vigorous physical activity was < 75 min/week. Engagement in walking was considered by at least 1 day a week. All expenditures were presented through the descriptive values (in American Dollars US$) according PAL and engagement in walking. The association analysis between annual expenditures, PAL and engagement in walking were performed by multiple logistic regression models adjusted for gender, age and body mass index. RESULTS: The average annual cost was higher in diabetic and insufficient physically activity elderly. The 1-year estimated.cost was US$ 73386,09 and 295% higher in insufficiently physically active. Older people who reported not walking had a higher risk to higher annual expenditures of medicine use (OR = 1.57, 95% CI 1.03-2.40). CONCLUSIONS: The annual expenditures of medicine use for controlling hypertension and diabetes of Brazilian elderly were higher and inversely associated with physical activity level and engagement in walking.
