Vanessa de Souza Santos Machado

Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: A population-based study.

To evaluate the prevalence and associated risk factors for urinary incontinence, as well as its association with multimorbidity among Brazilian women aged 50 or over.

Morbidity and associated factors in climacteric women: a population based study in women with 11 or more years of formal education

PURPOSE To evaluate factors associated with morbidities among Brazilian women aged 40-65 years and with 11 or more years of schooling. METHODS A secondary analysis of a cross-sectional population-based study was conducted, using an anonymous self-report questionnaire completed by 377 women. Were evaluated, with this instrument, some morbidities (hypertension, diabetes, insomnia and depression) and sociodemographic, behavioral, clinical and reproductive factors. The association between morbidities and independent variables was evaluated by the χ² test. Multiple logistic regression analysis with stepwise selection criteria was used to select the major factors associated with morbid conditions. RESULTS In the multiple regression analysis, insomnia was associated with bad/fair self-perception of health (OR=2.3) and nervousness (OR=5.1). Depression was associated with bad/fair self-perception of health (OR=3.7) and bad/poor leisure (OR=2.8). Hypertension was associated with obesity (OR=3.1) and being in postmenopausal (OR=2.6). Diabetes was associated with age above 50 years (OR=3.9) and obesity (OR=12.5). CONCLUSIONS The prevalence of morbidities was high and a worse self-perception of health and obesity were the main factors associated with morbidity.

Cancer in Women over 50 Years of Age: A Focus on Smoking

The increase in life expectancy worldwide has resulted in a greater prevalence of chronic non-communicable diseases. This study aims to evaluate the prevalence and factors associated with the occurrence of cancer among Brazilian women over the age of 50. A cross-sectional study with 622 women over the age of 50 was performed using a population survey. The outcome variable was the occurrence of a malignant tumor in any location. The independent variables were sociodemographic characteristics, self-perception of health, health-related habits and morbidities. Statistical analysis was carried out using the chi-square test and Poisson regression. The mean age of the women was 64.1 years. The prevalence of cancer was 6.8%. The main sites of occurrence of malignant tumors were the breast (31.9%), colorectal (12.7%) and skin (12.7%). In the final statistical model, the only factor associated with cancer was smoking > 15 cigarettes/day either currently or in the past: PR 2.03 (95% CI 1.06–3.89). The results have improved understanding of the prevalence and factors associated with cancer in Brazilian women aged 50 years or more. They should be encouraged to maintain a healthy lifestyle and pay particular attention to modifiable risk factors such as smoking.

Self-perception of sexual life and associated factors: a population study conducted in women aged 50 or more years

PURPOSE To evaluate the prevalence of women aged 50 years or more who are sexually active and their self-perception with respect to their sexual lives. Associated factors were also assessed. METHODS A cross-sectional, population-based, self-reported household survey involving 622 Brazilian women aged 50 years or more. Sociodemographic, clinical, and behavioral factors were evaluated. The sexual life self-perception was classified as very good, good, fair, poor, or very poor. Data were analyzed using the χ² test, Fishers exact test, and Poisson multiple regression analysis. Prevalence ratios and their 95% confidence intervals were also calculated. RESULTS Of the women in this sample, 228 (36.7%) reported having a sexual life and, of these, 53.5% classified it as very good or good, while 46.5% considered it fair, poor, or very poor. The bivariate analysis indicated that being postmenopausal (p=0.025) and using natural remedies to treat the menopause (p=0.035) were factors associated with the woman classifying their sexual lives as fair, poor, or very poor. Multiple regression analysis showed that more women who had used or were currently using natural remedies for the menopause scored their sexual lives as fair, poor, or very poor. CONCLUSIONS More than half the women aged 50 years or more in this study were not sexually active. A poorer sexual life self-perception was associated with the use of natural remedies to treat menopausal symptoms. This may indicate a need to improve the way in which these women are evaluated and treated. Womens assessment of their own sexual lives may prove a useful tool in clinical practice.

Factors associated with fragility fractures in women over 50 years of age: a population-based household survey

PURPOSE To analyze the prevalence of and factors associated with fragility fractures in Brazilian women aged 50 years and older. METHODS This cross-sectional population survey, conducted between May 10 and October 31, 2011, included 622 women aged >50 years living in a city in southeastern Brazil. A questionnaire was administered to each woman by a trained interviewer. The associations between the occurrence of a fragility fracture after age 50 years and sociodemographic data, health-related habits and problems, self-perception of health and evaluation of functional capacity were determined by the χ2 test and Poisson regression using the backward selection criteria. RESULTS The mean age of the 622 women was 64.1 years. The prevalence of fragility fractures was 10.8%, with 1.8% reporting hip fracture. In the final statistical model, a longer time since menopause (PR 1.03; 95%CI 1.01-1.05; p<0.01) and osteoporosis (PR 1.97; 95%CI 1.27-3.08; p<0.01) were associated with a higher prevalence of fractures. CONCLUSIONS These findings may provide a better understanding of the risk factors associated with fragility fractures in Brazilian women and emphasize the importance of performing bone densitometry.

Treatment for menopausal symptoms and having health insurance were associated with a lower prevalence of falls among Brazilian women

OBJECTIVES Brazil has an aging population. This study aims to raise awareness of the prevalence and factors associated with falls among Brazilian women. STUDY DESIGN Cross-sectional study with 622 women over 50 years of age was conducted between 05/10/11 and 10/31/11 in the city of Campinas/São Paulo/Brazil in the form of a population survey. MAIN OUTCOME MEASURES The dependent variable was the occurrence of falls in the past 12 months. The independent variables were sociodemographic data, health-related habits and problems, self-perception of health and evaluation of functional capacity. Statistical analysis was carried out by Chi-square test and Poisson regression using the backward selection criteria. RESULTS The mean age of the women was 64.1 years. The prevalence of falls in the past 12 months was 24.6%. Having trouble keeping balance when walking: PR 1.87 (95% CI 1.33-2.63, P<0.001); alcohol consumption: PR 1.69 (95% CI 1.25-2.28, P<0.002); having been admitted to a hospital in the last 12 months: PR 1.46 (95% CI 1.09-1.96, P=0.012); and having cataract: PR 1.40 (95% CI 1.05-1.87, P=0.021) were associated with a higher prevalence of falls. Having health insurance: PR 0.67 (95% CI 0.50-0.89, P=0.007) and using some form of medication to treat menopausal symptoms: PR 0.42 (95% CI 0.19-0.92, P=0.031) were associated with a lower prevalence of falls. CONCLUSION Having health insurance and using some form of medication to treat menopausal symptoms were associated with a lower prevalence of falls among Brazilian women.

Disability and multimorbidity in women older than 50 years: a population-based household survey

ObjectiveThis study aims to evaluate the prevalence of disability and associated factors in Brazilian women older than 50 years. MethodsWe conducted a cross-sectional study (in the form of a population survey) of 622 women older than 50 years and residing in Campinas, Brazil. Disability was assessed through a questionnaire with seven items and defined as “being completely unable to perform any of them.” Independent variables included self-perception of health, sociodemographic data, health-related habits, and morbidities. Statistical analysis was carried out by &khgr;2 test and Poisson regression. ResultsThe mean age of women was 64.1 years, and the prevalence of disability was 43.4%. Age (prevalence ratio [PR], 1.02; 95% CI, 1.01-1.03), fear of falling (PR, 1.59; 95% CI, 1.17-2.16), higher body mass index (PR, 1.03; 95% CI, 1.01-1.05), personal history of myocardial infarction (PR, 1.36; 95% CI, 1.06-1.76), smoking more than 15 cigarettes per day (PR, 1.34; 95% CI, 1.04-1.72), hospitalization in the past year (PR, 1.29; 95% CI, 1.03-1.62), multimorbidity (PR, 1.43; 95% CI, 1.02-2.02), and use of any medication prescribed by a doctor (PR, 1.57; 95% CI, 1.02-2.41) were associated with a higher prevalence of disability. Self-perception of health as good/very good (PR, 0.67; 95% CI, 0.52-0.86), use of alternative medications (PR, 0.54; 95% CI, 0.33-0.90), and more years of schooling (PR, 0.65; 95% CI, 0.45-0.93) were associated with a lower prevalence of disability. ConclusionsThe results improve our understanding of the factors associated with disability in Brazilian women and may help identify those who need multidisciplinary support to reduce effects on quality of life.

Factors associated with the onset of hypertension in women of 50 years of age or more in a city in Southeastern Brazil

PURPOSE To evaluate factors associated with hypertension in Brazilian women of 50 years of age or more. METHODS A cross-sectional population based study using self-reports. A total of 622 women were included. The association between sociodemographic, clinical and behavioral factors and the womans age at the onset of hypertension was evaluated. Data were analyzed according to cumulative continuation rates without hypertension, using the life-table method and considering annual intervals. Next, a Cox multiple regression analysis model was adjusted to analyze the occurrence rates of hypertension according to various predictor variables. Significance level was pre-established at 5% (95% confidence level) and the sampling plan (primary sampling unit) was taken into consideration. RESULTS Median age at onset of hypertension was 64.3 years. Cumulative continuation rate without hypertension at 90 years was 20%. Higher body mass index (BMI) at 20-30 years of age was associated with a higher cumulative occurrence rate of hypertension over time (coefficient=0.078; p<0.001). Being white was associated with a lower cumulative occurrence rate of hypertension over time (coefficient= -0.439; p=0.003), while smoking >15 cigarettes/day was associated with a higher rate over time (coefficient=0.485; p=0.004). CONCLUSION The results of the present study highlight the importance of weight control in young adulthood and of avoiding smoking in preventing hypertension in women aged ≥50 years.

Factors associated with the age of the onset of diabetes in women aged 50 years or more: a population-based study

Objective Investigate factors associated with the onset of diabetes in women aged more than 49 years. Design and methods Cross-sectional, population-based study using self-reports with 622 women. The dependent variable was the age of occurrence of diabetes using the life table method. Cox multiple regression models were adjusted to analyse the onset of diabetes according to predictor variables. Sociodemographic, clinical and behavioural factors were evaluated. Results Of the 622 women interviewed, 22.7% had diabetes. The mean age at onset was 56 years. The factors associated with the age of occurrence of diabetes were self-rated health (very good, good) (coefficient=−0.792; SE of the coefficient=0.215; p=0.0001), more than two individuals living in the household (coefficient=0.656, SE of the coefficient=0.223; p=0.003), and body mass index (BMI) (kg/m2) at 20–30 years of age (coefficient= 0.056, SE of the coefficient=0.023; p=0.014). Conclusions Self-rated health considered good or very good was associated with a higher rate of survival without diabetes. Sharing a home with two or more other people and a weight increase at 20–30 years of age was associated with the onset of type 2 diabetes.