Fabíola Bof de Andrade

Relationship Between Oral Health–Related Quality of Life, Oral Health, Socioeconomic, and General Health Factors in Elderly Brazilians

To assess the impact of oral health on quality of life in elderly Brazilians and to evaluate its association with clinical oral health measures and socioeconomic and general health factors.

Relationship between oral health and frailty in community-dwelling elderly individuals in Brazil.

To test the hypothesis that clinical oral health conditions are associated with frailty independent of socioeconomic and general health status.

Fatores associados à utilização dos serviços odontológicos por idosos brasileiros

OBJETIVO: Avaliar a associacao entre a utilizacao recente de servicos odontologicos, fatores socioeconomicos e condicoes de saude bucal entre idosos no Brasil. METODOS: A amostra foi composta pelos individuos de 65-74 anos (n = 6.702) que participaram da Pesquisa Nacional de Saude Bucal em 2010 (SBBrasil 2010). A variavel dependente foi a utilizacao recente de servicos odontologicos (ultima consulta ha dois anos ou menos). As variaveis independentes foram: fatores sociodemograficos, medidas clinicas de saude bucal e medida subjetiva de saude bucal. A analise estatistica foi feita por meio da descricao das medidas de frequencia, analise bivariada e multipla utilizando-se regressao de Poisson. RESULTADOS: Observou-se que 46,5% dos idosos foram ao dentista ha dois anos ou menos. A partir da analise multipla observou-se que a escolaridade, a renda e a macrorregiao foram independentemente associadas ao desfecho. Individuos com zero a 20 dentes e necessidade de protese apresentaram menor prevalencia de consulta odontologica recente. Maiores prevalencias de consulta recente foram observadas entre os individuos com necessidade de tratamento odontologico e usuarios de protese. CONCLUSOES: A utilizacao recente de servicos odontologicos foi associada a fatores socioeconomicos (escolaridade, renda e macrorregiao do Pais) e a medidas clinicas de saude bucal (numero de dentes, uso e necessidade de protese e necessidade de tratamento).

Factors associated to vaccination against influenza among elderly in a large Brazilian metropolis.

Background This study aimed to estimate coverage and identify factors associated to vaccination against influenza in the elderly population. Methods The study design was cross-sectional and population based. Data was collected in 2010 by the Health, Well-Being and Aging Study. Sample consisted of 1,341 community-dwelling elderly, in São Paulo, Brazil. Association between vaccination and covariates was evaluated by means of prevalence ratios estimated by Poisson regression models. Results Self-reported vaccination coverage was 74.2% (95% confidence interval: 71.3–76.9). Remaining physically active and having had recent interaction with health services, mainly with public units of healthcare, were the main incentives to increase vaccination coverage among the elderly; whereas lower age, living alone and absent interaction with health services were the main constraints to influenza vaccination at the community level. These covariates had already been reported to influence influenza vaccination of elders in previous years. Conclusion Previous knowledge already available on the main constraints to influenza vaccination has not allowed to remove them. Influenza campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination. Instructing healthcare providers to recommend vaccine uptake is an important piece of this puzzle.

Atividades avançadas de vida diária e incidência de declínio cognitivo em idosos: Estudo SABE

O objetivo deste trabalho foi avaliar o impacto das atividades avancadas de vida diaria (AAVD) na incidencia de declinio cognitivo. A amostra foi composta por idosos participantes do estudo longitudinal Saude, Bem-estar e Envelhecimento (SABE). O declinio cognitivo foi avaliado por meio do Mini - Exame do Estado Mental abreviado. As AAVD compreenderam 12 atividades sociais, produtivas, fisicas e de lazer que envolvem funcoes cognitivas superiores. Foram considerados grupos de covariaveis do estudo: fatores sociodemograficos, saude geral, estilo de vida e funcionalidade. A associacao entre a incidencia de declinio cognitivo e as variaveis independentes foi avaliada usando-se o modelo de regressao de Poisson multiplo. A incidencia de declinio foi de 7,9%. A media de desempenho de AAVD em 2006 foi significativamente maior entre os idosos que nao desenvolveram o declinio. Apos analise multivariada os resultados mostraram que quanto maior o numero de AAVD realizadas menor a chance de declinio cognitivo no periodo estudado.The objective of this study was to evaluate the association between advanced activities of daily living (AADL) and incidence of cognitive decline. The sample consisted of non-institutionalized older adults who participated in the second (2006) and third (2010) waves of the Health, Wellbeing, and Aging (SABE) cohort study in São Paulo, Brazil. Cognitive decline was measured using a modified Mini-Mental State Examination. Advanced activities of daily living covered 12 social, productive, physical, and leisure-time activities that involve higher cognitive functions. Other covariates included socio-demographic conditions, overall health, lifestyle, and functional disability. The association between the independent variables and incidence of cognitive decline was assessed by multiple Poisson regression. Incidence of cognitive decline was 7.9%. Mean number of AADL in 2006 was significantly higher among elders who had not developed cognitive decline. Multivariate analysis showed that the number of AADL performed was a significant inverse predictor of cognitive decline.

Factors associated with the use of dental services by elderly Brazilians

OBJETIVO: Avaliar a associacao entre a utilizacao recente de servicos odontologicos, fatores socioeconomicos e condicoes de saude bucal entre idosos no Brasil. METODOS: A amostra foi composta pelos individuos de 65-74 anos (n = 6.702) que participaram da Pesquisa Nacional de Saude Bucal em 2010 (SBBrasil 2010). A variavel dependente foi a utilizacao recente de servicos odontologicos (ultima consulta ha dois anos ou menos). As variaveis independentes foram: fatores sociodemograficos, medidas clinicas de saude bucal e medida subjetiva de saude bucal. A analise estatistica foi feita por meio da descricao das medidas de frequencia, analise bivariada e multipla utilizando-se regressao de Poisson. RESULTADOS: Observou-se que 46,5% dos idosos foram ao dentista ha dois anos ou menos. A partir da analise multipla observou-se que a escolaridade, a renda e a macrorregiao foram independentemente associadas ao desfecho. Individuos com zero a 20 dentes e necessidade de protese apresentaram menor prevalencia de consulta odontologica recente. Maiores prevalencias de consulta recente foram observadas entre os individuos com necessidade de tratamento odontologico e usuarios de protese. CONCLUSOES: A utilizacao recente de servicos odontologicos foi associada a fatores socioeconomicos (escolaridade, renda e macrorregiao do Pais) e a medidas clinicas de saude bucal (numero de dentes, uso e necessidade de protese e necessidade de tratamento).

Factors associated with adherence to influenza vaccination among non-institutionalized elderly in São Paulo, Brazil

The objectives of this study were to estimate influenza vaccination coverage in the elderly and identify factors associated with vaccination uptake. A cross-sectional population-based study was conducted with data collected in 2006 by the Health, Well-Being, and Aging study. The sample consisted of 1,399 elderly in the city of São Paulo, Brazil. The association between vaccine uptake and independent variables was assessed with prevalence ratios, estimated by Poisson regression. Self-reported vaccination was 73.8%. In the final explanatory model, influenza vaccination was associated with older age, presence of chronic diseases, and use of health care in the previous year. A negative association was observed with hospitalization during the previous year. The study concludes that it is necessary to encourage vaccination of elderly less than 70 years of age and those without chronic diseases, as well as to orient health professionals to expand coverage in groups with lower uptake during vaccination campaigns.The objectives of this study were to estimate influenza vaccination coverage in the elderly and identify factors associated with vaccination uptake. A cross-sectional population-based study was conducted with data collected in 2006 by the Health, Well-Being, and Aging study. The sample consisted of 1,399 elderly in the city of Sao Paulo, Brazil. The association between vaccine uptake and independent variables was assessed with prevalence ratios, estimated by Poisson regression. Self-reported vaccination was 73.8%. In the final explanatory model, influenza vaccination was associated with older age, presence of chronic diseases, and use of health care in the previous year. A negative association was observed with hospitalization during the previous year. The study concludes that it is necessary to encourage vaccination of elderly less than 70 years of age and those without chronic diseases, as well as to orient health professionals to expand coverage in groups with lower uptake during vaccination campaigns.

Advanced activities of daily living and incidence of cognitive decline in the elderly: the SABE Study.

O objetivo deste trabalho foi avaliar o impacto das atividades avancadas de vida diaria (AAVD) na incidencia de declinio cognitivo. A amostra foi composta por idosos participantes do estudo longitudinal Saude, Bem-estar e Envelhecimento (SABE). O declinio cognitivo foi avaliado por meio do Mini - Exame do Estado Mental abreviado. As AAVD compreenderam 12 atividades sociais, produtivas, fisicas e de lazer que envolvem funcoes cognitivas superiores. Foram considerados grupos de covariaveis do estudo: fatores sociodemograficos, saude geral, estilo de vida e funcionalidade. A associacao entre a incidencia de declinio cognitivo e as variaveis independentes foi avaliada usando-se o modelo de regressao de Poisson multiplo. A incidencia de declinio foi de 7,9%. A media de desempenho de AAVD em 2006 foi significativamente maior entre os idosos que nao desenvolveram o declinio. Apos analise multivariada os resultados mostraram que quanto maior o numero de AAVD realizadas menor a chance de declinio cognitivo no periodo estudado.The objective of this study was to evaluate the association between advanced activities of daily living (AADL) and incidence of cognitive decline. The sample consisted of non-institutionalized older adults who participated in the second (2006) and third (2010) waves of the Health, Wellbeing, and Aging (SABE) cohort study in São Paulo, Brazil. Cognitive decline was measured using a modified Mini-Mental State Examination. Advanced activities of daily living covered 12 social, productive, physical, and leisure-time activities that involve higher cognitive functions. Other covariates included socio-demographic conditions, overall health, lifestyle, and functional disability. The association between the independent variables and incidence of cognitive decline was assessed by multiple Poisson regression. Incidence of cognitive decline was 7.9%. Mean number of AADL in 2006 was significantly higher among elders who had not developed cognitive decline. Multivariate analysis showed that the number of AADL performed was a significant inverse predictor of cognitive decline.

The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design

Abstract Brazil is experiencing among the world’s fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years or older, residing in 70 municipalities across the 5 Brazilian regions. ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination (2015–2016) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, and timed walk and balance tests). Blood tests and sample storage were performed in a subsample of study participants. Subsequent waves are planned for every 3 years. The study adopts a conceptual framework common to other large-scale longitudinal studies of aging in the world, such as the Health and Retirement Study, allowing cross-national comparisons. The goal of ELSI-Brazil is not only to build an understanding of aging in a large, Western, middle-income country in a rapid demographic transition but also to provide scientific data to support and study policy changes that may affect older adults. We describe the methodology of the study and some descriptive results of the baseline survey.

Measuring socioeconomic inequalities in the use of dental care services among older adults in Brazil

OBJECTIVES The primary objectives are to assess socioeconomic inequality in the use of dental care among older Brazilian adults and to analyse the extent to which certain determinants contribute to that inequality. METHODS A cross-sectional study using data from the National Oral Health Survey conducted in 2010. All individuals answered a structured questionnaire containing questions on their use of dental care and socioeconomic conditions and underwent a clinical oral examination by a dentist. Concentration indices were decomposed to determine the contribution of socioeconomic factors to inequalities. RESULTS Being in the fifth wealth, quintile was associated with higher odds of having recently visited a dentist (reference: 1st quintile, odds-ratio (OR) 2.26, 95% confidence interval (CI) 1.51-3.38). In addition, being in the top two quintiles of wealth was negatively associated with the use of public dental services. Having eight or more years of schooling was associated with higher odds of both having a recent dental visit and receiving preventive care (relative to having 0-3 years of education), and negatively associated with using public dental services. Results indicate pro-rich inequalities in recent dental visits and preventive dental care. Further, there was a pro-poor inequality in the use of public dental care services. CONCLUSIONS The recent use of dental care and the use of preventive care are disproportionately concentrated among wealthier older adults, whereas the use of public services is more common among poorer individuals. Wealth inequalities in dental care use were mainly explained by socioeconomic factors, such as wealth and education, rather than oral health factors, such as needing treatment or a dental prosthesis.