Chagas' disease and ageing: the coexistence of other chronic diseases with Chagas' disease in elderly patients

Abstract

This study aimed to identify the main comorbidities in elderly chagasic patients treated in a reference service and identify possible associations between the clinical form of Chagas' disease and chronic diseases. Ninety patients aged 60 years-old or over were interviewed and their clinical diagnoses recorded. The study population profile was: women (55.6%); median age (67 years); married (51.1%); retired (73.3%); up to four years' education (64.4%); and earning less than two minimum wages (67.8%). The predominant forms of Chagas' disease were the cardiac (46.7%) and mixed forms (30%). There was a greater proportion of mild cardiac dysfunction (84.1%), frequently in association with megaesophagus. The mean number of concurrent diseases was 2.856 +/- 1.845, and 33% of the patients had four or more comorbidities. The most frequent were systemic arterial hypertension (56.7%), osteoporosis (23.3%), osteoarthritis (21.2%) and dyslipidemia (20%). Positive correlations were verified between sex and comorbidities and between age group and comorbidities.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…A pattern of aging and an expansion of ages at highest age ranges for the population affected by Chagas disease has been verified, not only by previous studies of mortality, but also by other population-based studies based on cases of cohorts followed through long periods of time (63) (64) .…”

Multiple causes of death related to Chagas' disease in Brazil, 1999 to 2007

“…In fact, the predominance of cardiovascular causes observed in the study is linked to coexistence of chronic Chagas' disease 9 with the aging process of the population, since cardiovascular diseases are the leading causes of morbidity and mortality among the elderly 26 . In addition, the frequent association of chronic disease causes significant demand for health services and medications that predispose to numerous risks, whereas the association between Chagas' disease and other chronic diseases may increase mortality and worsen the quality of life of those who find themselves in this unfavorable condition 26 .…”

“…In this study, the increase of hypertensive diseases associated with diabetes mellitus can be attributed to increasing mortality at more advanced ages 3 . In fact, the prevalence of cardiovascular causes observed in the study is partially related to the coexistence of chronic Chagas' disease with the aging process of the population 9 , since cardiovascular diseases are the leading causes of morbidity and mortality among the elderly 26 . In this study, most deaths from Chagas' disease concerned the elderly and patients with chronic cardiac form of the disease.…”

“…In addition, the frequent association of chronic disease causes significant demand for health services and medications that predispose to numerous risks, whereas the association between Chagas' disease and other chronic diseases may increase mortality and worsen the quality of life of those who find themselves in this unfavorable condition 26 .…”

“…A current challenge is to provide assistance, taking into account the harmful effects of a combination of Chagas' disease and other chronic degenerative diseases 9,26 . The elderly chagasic patients should receive priority attention of health services and social assistance, deserving attention of public managers and health professionals, in order to minimize morbidity and mortality by Chagas' disease.…”