The burden of disease among Brazilian older adults and the challenge for health policies: results of the Global Burden of Disease Study 2017

Abstract

Background Brazil is the world’s fifth most populous nation, and is currently experimenting a fast demographic aging process in a context of scarce resources and social inequalities. To understand the health profile of older adults in Brazil is fundamental for planning public policies. Methods The estimates were derived from data obtained through the collaboration between the Brazilian Ministry of Health and the Institute of Health Metrics and Evaluation of the University of Washington. The Brazilian Institute of Geography and Statistics provided the population estimates. Data on causes of death came from the Mortality Information System. To calculate morbidity, population-based studies on the prevalence of diseases in Brazil were comprehensively searched, in addition to information obtained from national databases such as the Hospital Information System, the Outpatient Information System, and the Injury Information System. We presented the Global Burden of Disease (GBD) 2017 estimates among Brazilian older adults (60+ years old) for life expectancy at birth (LE), healthy life expectancy (HALE), cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), from 2000 to 2017. Results LE at birth significantly increased from 71.3 years (95% UI to 70.9-71.8) to 75.2 years (95% UI 74.7-75.7). There was a trend of increasing HALE, from 62.2 years (95% UI 59.54-64.5) to 65.5 years (95% UI 62.6-68.0). The proportion of DALYs among older adults increased from 7.3 to 10.3%. Chronic noncommunicable diseases are the leading cause of death among middle aged and older adults, while Alzheimer’s disease is a leading cause only among older adults. Mood disorders, musculoskeletal pain, and hearing or vision losses are among the leading causes of disability. Conclusions The increase in LE and the decrease of the DALYs rates are probably results of the improvement of social conditions and health policies. However, the smaller increase of HALE than LE means that despite living more, people spend a substantial time of their old age with disability and illness. Preventable or potentially controllable diseases are responsible for most of the burden of disease among Brazilian older adults. Health investments are necessary to obtain longevity with quality of life in Brazil.

Reasons for nonadherence to vaccination for influenza among older people in Brazil

“…However, the impacts of the political and economic crisis and the austerity measures incorporated in Brazil in recent years, including the approval of Constitutional Amendment No. 95 of 2016, which freezes the federal budget for 20 years [ 63 ] (including investments in health), compromises and challenges the Brazilian public health care system and may increase difficulties regarding the development of health promotion and disease prevention/control actions [ 25 , 64 , 65 ].…”

“…The most frequent events are local reactions, such as pain, erythema, swelling. Symptoms similar to those of the flu may also occur, such as malaise, a low fever, respiratory discomfort, cough, and coryza [2,21,[23][24][25][26][27][28][29][30], which can give a false notion that the vaccine causes the flu. According to the study by Santos et al [48], 74% of individuals in a risk group believed that the vaccine produces symptoms similar to those of the flu.…”

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The Health Impact Fund: making the case for engagement with pharmaceutical laboratories in Brazil, Russia, India, and China

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Depressive and subthreshold depressive symptomatology among older adults in a socioeconomically deprived area in Brazil

“…Depression among older adults is a global public health concern and low‐ and middle‐income countries account for a high global burden of depression 1 . Brazil has been experiencing a rapid population ageing and, consequently, an increasing prevalence of age‐related diseases 2 . The current sociodemographic profile of older adults in Brazil shows a higher proportion of women and a high illiteracy rate 3,4 .…”