Prevalence of Older Adult Disability and Primary Health Care Responsiveness in Low-Income Communities.

Giovana Montoro Pazzini Watfe,Euler Ribeiro,Lais Fajersztajn,Marcia Scazufca,Paulo Rossi Menezes

doi:10.3390/life10080133

Abstract

In Brazil and in most low- and middle-income countries (LMICs), information about how prepared the health care system is for the rapid aging of the population is scarce. We investigated the prevalence of disability and areas of life affected by disability among elders of the public primary health care in São Paulo and Manaus, Brazil. We investigated whether people with disability visited a primary care professional more frequently, the individual characteristics associated with disability, and differences by city. We randomly selected participants aged ≥60 years (n = 1375). The main outcome was disability, evaluated with the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Exposure variables were consultation with a family physician, sociodemographic characteristics, health status, social support, and lifestyle. The prevalence of global disability was higher in Manaus (66.2% vs. 56.4% in São Paulo). In both cities, participation and mobility were the areas of life most affected by disability. The number of consultations with a family physician was not associated with disability. The high prevalence of disability and associated risk factors indicates that public primary health care is not meeting the needs of elders in both cities. It is warning because most elders in LMICs live in more underserved communities compared to Brazil.

Highlights

Disability is not a natural consequence of aging [1] and should largely be prevented and treated in primary health care settings [2,3]
We investigated the prevalence and factors associated with disabilities and areas of life affected by disability among older adults enrolled at primary care clinics (PCCs) affiliated with the Family Health Strategy (FHS) in two large metropolitan cities in Brazil: São Paulo and Manaus
The results of the present study show that this model of primary health care is not prepared to deal with the rapid aging of the population of Brazil and, with the increased prevalence of disability

Summary

Introduction

Disability is not a natural consequence of aging [1] and should largely be prevented and treated in primary health care settings [2,3]. Part of the prevention effort is effective screening for chronic diseases, which are more prevalent in older adults, and controlling other conditions that can lead to disability [2]. In Brazil, three-quarters of the population over 49 years of age has at least one chronic disease [4], and 23% of the individuals in that age group already have difficulty performing at least one activity of daily living, such as dressing themselves and getting up from a chair [5]. In addition to activities of daily living, disability affects several other areas important to independent life, such as work, leisure, and participation [6,7,8,9,10,11]. The economic impact of disability on health care systems is significant [13]

Methods

Results

Discussion

Conclusion