Challenges of Ageing in Portugal: Data from the EpiDoC Cohort

Abstract

RESUMOIntrodução: A esperança de vida está a aumentar em Portugal, contudo desconhece-se o estado de saúde dos idosos. Pretende-se determinar a prevalência de multimorbilidade, caracterizar estilos de vida e outros fatores relacionados com a saúde dos idosos. Material e Métodos: Efetuou-se uma avaliação transversal a 2393 adultos com 65 ou mais anos de idade, da coorte EpiDoC que é constituída por uma amostra representativa da população portuguesa. Os inquiridos responderam a um questionário estruturado através de uma entrevista telefónica, tendo-se recolhido dados socioeconómicos demográficos, estilo de vida, doenças crónicas e consumo de recursos em saúde. Análise de clusters foi realizada para a identificação de padrões alimentares. Efetuou-se análise descritiva e analítica para estimar a prevalência de multimorbilidade e fatores associados. ABSTRACT Introduction: Portuguese adults have a long lifespan, but it is unclear whether they live a healthy life in their final years. We aimed to determine the prevalence of multimorbidity and characterize lifestyle and other health outcomes among older Portuguese adults. Material and Methods:We performed a cross-sectional evaluation of 2393 adults, aged 65 and older, during the second wave of follow-up of the EpiDoC cohort, a population-based study involving long-term follow-up of a representative sample of the Portuguese population. Subjects completed a structured questionnaire during a telephone interview. Socioeconomic, demographic, lifestyle behaviours, chronic diseases, and health resources consumption were assessed. Cluster analysis was done to identify dietary patterns. Descriptive and analytic analysis was performed to estimate multimorbidity prevalence and its associated factors. Results: Multimorbidity prevalence among older adults was 78.3%, increased with age strata (72.8% for 65 -69 years to 83.4% for ≥ 80 years), and was highest in Azores (84.9%) and Alentejo (83.6%). The most common chronic diseases were hypertension (57.3%), rheumatic disease (51.9%), hypercholesterolemia (49.4%), and diabetes (22.7%). Depression symptoms were frequent (11.8%) and highest in the oldest strata. The mean health-related quality of life (EQ-5D-3L) score was 0.59 ± 0.38. Hospitalization in the previous 12 months was reported by 25.8% of individuals. Overall, 66.6% of older adults were physically inactive. 'Fruit and vegetables dietary pattern' was followed by 85.4% of individuals; however, regional inequalities were found (69% in Azores). Obesity prevalence was 22.3% overall and was highest among Azoreans (33%). Conclusion:The high prevalence of multimorbidity, combined with unhealthy lifestyle behaviours, suggests that the elderly population constitutes a vulnerable group warranting dedicated intervention.

Factors associated with in-hospital mortality from community-acquired pneumonia in Portugal: 2000–2014

“…Our study revealed a mean LOS of 10.6 days and a median of 8 days which was in line with other reports [3,29,34]. Eventual differences between studies and countries are related to the availability of continuing care outside the hospital environment [41].…”

“…Our results showed a sex gap, with men presenting higher numbers of CAP hospitalizations, mortality and a higher risk of death during hospitalization. These results are in accordance with other studies that show a sex inequality in health indicators associated with hospitalizations [3,4,12,29], with men presenting consistently higher hospitalization rates for CAP, which may be related to a great number of risk factors, such as smoking, alcoholism, and exposure to toxic occupational exposure [3,29]. The greater ratio of male to female mortality may also reflect higher rates of smoking in males predisposing to respiratory disease [3,16].…”

“…Actually, this disproportionate increase may reflect not only, the weight of ageing, but also the overall impact of the associated comorbidities in the elderly, as documented in several studies [25][26][27][28]. Furthermore, apart from the known health consequences of the ageing process, it has been observed that the older Portuguese adults, report a low household income and are a vulnerable group in terms of unhealthy lifestyle behaviors and poor socioeconomic conditions [29]. In particular, older people over 75 years of age who live alone represent a group that is subject to great economic and social vulnerability [30].…”

Association Between Depressive Symptoms and Quality of Life in Elderly Adults in Primary Health Care: A Comparative Analysis Between Brazil and Portugal

“…The favourable results found among the Portuguese do not seem to be explained, however, by their pro le, since their demographic and health data are similar to those of Brazilians, with the number of participants incidentally close in relation to diseases. This fact possibly results from the pairing between the groups carried out in the methodological path of our research, which is similar to that of other studies carried out in Portugal, where high rates of comorbidities were observed in addition to frequent depressive symptoms and obesity (31) . However, it is noteworthy that Brazil and Portugal are countries with very different levels of economic development, which can lead to an important comparison bias from an economic and social point of view (15,16) .…”

Active Ageing in Europe: Adding Healthy Life to Years

“…Low Internet usage is due in part to lower education levels of older European citizens in these countries. In Portugal, for example, 77.3% of individuals over 65 years old have 4 or less years of education, and 84.5% have never used computers, videogames, or tablets ( 41 ). The “Blueprint” initiative, which aims to implement prevention programmes among European older adults, will, therefore, take significant time (e.g., 5–10 years) to implement among elderly EU citizens.…”