Population Aging In Brazil Research Articles

Challenges And Strategies In Healthcare Confronting Population Aging In Brazil

The concept of equity in the Unified Health System (SUS) is essential for ensuring a fair distribution of resources and health opportunities, taking into account the specific needs of different population groups. Equity goes beyond universal access to healthcare services, encompassing the adaptation of these services to address socioeconomic, geographic, and cultural inequalities. In SUS, this means providing additional support to vulnerable populations, such as low-income individuals, residents of remote areas, and groups with cultural and linguistic barriers. Key challenges include regional disparities, such as inadequate healthcare infrastructure in rural and peripheral areas, and socioeconomic inequalities that hinder access due to indirect costs and lack of information. To overcome these challenges, SUS should adopt comprehensive strategies, such as increasing funding and resources for underserved areas, implementing public policies that address socioeconomic inequalities, and investing in transportation and health education. Inclusion is equally crucial, requiring the removal of physical and social barriers, the promotion of a culture of respect and cultural competence among healthcare professionals, and the active participation of diverse groups in policy formulation. Furthermore, promoting interinstitutional collaboration, community participation, and the collection and analysis of disaggregated data to guide targeted policies is important. These strategies aim to create a fairer and more inclusive health system, capable of adequately serving the entire Brazilian population

Relationship between aging and the labor market: cooperativism as a strategy for social inclusion of the elderly in the paranaense context

"The aging of the population is a widely observed structural phenomenon in modern societies. With the increase in life expectancy, there has been a significant growth in the number of elderly individuals worldwide. This demographic shift poses significant challenges of a social, political, and economic nature, requiring special attention regarding the active maintenance of older individuals in the labor market. The present study aims to reflect on the current scenario of population aging in Brazil and the contribution of cooperativism to active aging and social inclusion of the elderly. Through a descriptive and exploratory research approach, utilizing bibliographic procedures, the study culminated in identifying cooperativism as a crucial strategy for promoting active aging and constructing a more inclusive society.

Functional limitation on elderly people in the northeast and the feminization of eld in urban and rural areas of Brazil

Population aging in Brazil increases on a large scale due to declining fertility and mortality. This phenomenon can be influenced by several factors (demographic, biological and social), making them determinants for the health conditions of the elderly populations residing in different geographic areas. The present study aims to identify the functional limitation in elderly residents of urban and rural areas of Brazil. This is a descriptive epidemiological study with a quantitative approach. It was evidenced that the functional limitation for activities of daily living and instrumental activities of daily living are concentrated in the northeast region, mainly in the urban area. The following states presented the highest proportions of daily life activity limitation in urban areas: Alagoas (11.60%), Rio Grande do Norte (10.95%), Pernambuco (10.36%) and Paraíba (9.62%). For activities of daily living in the rural area were found in the states of Paraíba (12.19%), Maranhão (8.93%), Piauí (8.85%) and then Pernambuco (7.24%). Data from the functional limitation for instrumental activities of daily living again highlighted the Northeast region, with the states of Rio Grande do Norte (26.01%), Paraíba (25.96%), Maranhão (25.72%) and Alagoas (24.57%). Lastly, it was verified that the elderly woman exhibits greater proportions of functional limitation in relation to the elderly of the masculine sex, standing out again the northeastern region of the country.

INTEGRALITY IN HEALTH CARE FOR THE ELDERLY: A PUBLIC HEALTH ISSUE

Introduction: the demands for goods and services aimed at the health needs of the elderly require a different perspective that considers the human being in all its dimensions: biopsychosocial and spiritual. Objective: to reflect on the assistance strategies that impact comprehensive care for the elderly, based on public health policies. Methodology: reflective essay that contextualizes comprehensive care for the elderly. Results: the content is presented in four sections: "Population aging in Brazil" "Public Health Policies: a brief historical recovery"; "Comprehensiveness in health care: practices and challenges" and, finally, "Training to work in the health of the elderly and communication strategies". Conclusion: it is clear that different care strategies, including verbal and non-verbal communication, contribute to greater comprehensiveness and humanization in the care of the elderly. It also appears that public health policies depend on intersectoral integration to provide care for the elderly in a holistic way.

Factors Related to Functional Capacity and Quality of Life for Elderly People in a Middle-Sized City of São Paulo, Brazil

Introduction: It is a fact that the elderly population has been increasing all around the world and also in Brazil. This has been a challenge for governments and managers in the development of public policies to promote healthy and quality aging. And one of the conditions for healthy aging is to assess the functional capacity and quality of life of elderly people. Objective: The aim of the present study was to evaluate the factors that influence the loss of functional capacity and the worsening of the quality of life of a representative sample of elderly people from a medium-sized city in the inner of Sao Paulo State, Brazil. Methodology: Questionnaires about activities of daily living (ADL), instrumental activities of daily living (IADL), Flanagan quality of life scale (FQOLS), sociodemographic and morbidities aspects were applied to the elderly people. In order to assess associated factors to functional capacity and quality of life, chi-square tests and logistic regression models were fitted including variables: gender, age group, marital status, income, education level, body mass index, abdominal circumference and some morbidities reported by the elderly people. The level of significance adopted for the statistical tests was 5%. Results: Elderly with age over 75 years old and not married had more risk to be dependent on ADL, while elderly with more than 75 years old, not married, income below one minimal wage, cardiovascular disease and be diabetic had more risk to be dependent by IADL. Already, people with excess of weight had smallest risk to be dependent by IADL, paradoxically. The elderly not married and with an income below a minimum wage had the worst quality of life. Conclusions: Population aging in Brazil is an evident factor, so it is hoped that this study will contribute to the greatest diligence on the issues of the elderly and related social problems.

Prevalence, associated factors, and limitations related to chronic back problems in adults and elderly in Brazil.

The objective was to analyze the epidemiological characteristics of chronic back problems in Brazil and study the association between their prevalence and demographic and socioeconomic factors, lifestyle, and health conditions. The study used micro-data from the Brazilian National Health Survey (PNS), 2013. The epidemiological indicators were: prevalence, time with chronic back problems, life cycle (from young adults to the elderly), limitations in activities of daily living, and mean age at onset of symptoms, according to sex and age bracket. In order to analyze inequality in chronic back problems according to socioeconomic characteristics and risk factors, a multivariate logistic regression model was used, based on life cycle stages, with the presence of chronic back problems as the dependent variable and the following independent variables: sex, schooling, area of residence, race/color, self-rated health, types of chronic diseases, body mass index (BMI), and physical activity. Prevalence of chronic back problems in Brazil was 18.5%, and was higher in women than in men (21.1%; 95%CI: 20.2-21.9). Mean age at onset of chronic back problems was 35 years. There was an association between chronic back problems and lower schooling, poor self-rated health, and presence of the majority of the selected chronic diseases. Area of residence, BMI, age, and race/color were weakly associated or not associated with chronic back problems. Prevalence of chronic back problems stabilized at 50 years of age, but the severity of limitations increased at older ages. As in other countries, high prevalence and the impact on living conditions revealed the need for epidemiological studies on chronic back problems in Brazil. The results suggest that health promotion and the prevention of chronic back problems should be intensified, especially before 50 years of age, considering the on-going population aging in Brazil.

Institutionalization Process: what changes in the life of the elder?

Esta é uma reflexão que tem como objetivo compreender as mudanças que o processo de institucionalização provoca na vida da pessoa idosa e identificar o papel da família e do Estado em relação ao cuidado do idoso em contexto de ILPI. O envelhecimento populacional no Brasil está crescendo, e em uma conjuntura de transformações sociais, econômicas, culturais, no sistema de valores e de novos arranjos familiares. A procura por ILPI’s, diante da perspectiva demográfica e social, está aumentando, e representa uma nova alternativa de moradia para a pessoa idosa. Destaca-se que um dos fatores que culminam na institucionalização da pessoa idosa é a redução da rede de apoio social durante o envelhecimento. No cotidiano das pessoas idosas institucionalizadas, as ILPI’s devem desenvolver atividades que possibilitem à pessoa idosa trocas de saberes e experiências.

Multidimensional Assessment Of Institutionalized Elderly: The Reality Of A Brazilian Institution

Background: The population aging in Brazil is characterized by the accumulation of progressive disabilities in their functional activities and daily life. To consider the elderlies in his/her multiple dimensions turns out to be a critical issue to improve their assistance to an institutionalized level, improving their health and quality of life. To perform a mini-overall evaluation of institutionalized elderly person to trace their profile in relation to the socio-demographic, functional capacity, nutritional status and cognition.
 Methods: descriptive, cross-sectional study of quantitative approach conducted in facilities for the aged people in Natal, RN.
 Results: 63.3% of the elderly were female, with ages varying from 61 to 103 years. 60.0% were single; 56.7% were literate. 66.7% had no children and 55% lived with their families before the institutionalization. As for the institutionalization time, 63.3% resided in the institution for four years. As what concerns the aspects of health, 73.3 of the elderly presented hearing difficulties, 90% make use of medicines predominantly to diabetes and hypertension. There is clear evidence that the institutionalization has been harmful to the elderly as with regards basic activities of daily living, nutritional status and cognitive aspects.
 Conclusion: the progressive disability in functional activities of daily life interferes directly in the quality of life, increasing dependency and minimizing the autonomy of these individuals. It is necessary to effective implementation of public policies directed to the institutionalized elderly from the perspective of effective actions for improved attention and assistance.
 Descriptors: Aged, Institutionalization, Aging, Facilities for the Aged.

Inglês

The article seeks to present a public policy model for healthy and active aging, sponsored by the City of Rio de Janeiro,through SEMEARC - Municipal Aging and Care Resilience. Population aging in Brazil has been growing for decades and everydecade the population growth projection over 60 years Veras (2001) confirms this fact by suggesting that the longevity of thepopulation is a world phenomenon, and that Brazil is a clear example of this process is characterized by absolute and relativeincrease. The decrease in fertility and mortality rates has been altering the age structure of the population, leading to a markeddecrease in mortality rates, particularly in the first years of life (ASSIS, 2005). Thus the application of a policy geared to the care ofthe elderly would be the guarantee of productive people and less spending on Sude system, and provide continuity in the positiveand beneficial actions of the population.

Fiscal Challenges of Population Aging in Brazil

In recent decades, population has been aging fast in Brazil while old age pensions and healthrelated spending have increased. As the population ages, the spending trend threaten to reach unsustainable levels absent reforms. Increasing the retirement age is key, but by itself will not provide sufficient savings to close the pension system financing gap, and reforms reducing replacement rates are necessary. In the area of health, there is scope for improving expenditure efficiency by strengthening outpatient care and regional networks, and developing clinical guidelines for cost-effective treatments and drugs. Reforms are urgent, so that they can be gradual.

Fiscal Challenges of Population Aging in Brazil

Fiscal Challenges of Population Aging in Brazil

Population aging in Brazil: current and future social challenges and consequences

Abstract Objective: To analyze the current and future challenges related to the planning of public policies and population aging. Method: A case study was conducted using quantitative and qualitative data from secondary data information systems and interviews with actors of social policy and the country's health. Results: In 2010, there were 39 elderly persons for every 100 young people, while in 2040 there will be an estimated 153 elderly persons for every 100 young people. For those interviewed, Brazil is not prepared for the needs generated by such population aging, due to challenges such as the adequacy of the social security and health system. The growing number of elderly persons and increasing morbidity and mortality profiles worsen the heterogeneous epidemiological situation with disease, disability and sequelae that require the health system to be a continuous and multidisciplinary organization. The present study identified a reduction of beds and hospitalizations, which may reflect the improvement of primary care and quality of life, with a complexification of hospitalizations. Conclusion: With population aging and a lack of necessary support, society must be aware of the price that it must pay and the state must be prepared to provide specific policies to ensure comprehensive care, recognizing the characteristics of aging and preserving quality of life.

The fiscal impact of population aging in Brazil: 2005-2050

In this paper, we estimate the fiscal impact on population aging in Brazil from 2005 through 2050. We focus on three key areas of public spending: education, pensions, and health care. Our projections are based on a simple model in which aggregate public expenditures are driven by changes in the age structure of the population as well as by changes in the average public benefits received per age. We assess the likely increases in public spending over the coming decades, contrasting the divergent trends in public spending on education, pensions, and health care. We also assess the magnitude of these changes in terms of growth in spending relative to GDP annually through 2050 and estimate the present value of the increase in spending. We find that changing population age structure will lead to increasing cost pressures in health care and especially in pensions. Our projections show that beginning around 2015, public spending will begin a sustained and rapid increase lasting several decades rising from 18% of GDP to reach 27% of GDP by 2050. The needs for increased investment in students will compete against those for sustaining pension benefits and facing increasing demands for health care. In particular, our projections show that an ambitious educational reform aimed at reaching the OECD level of investment per youth within a decade would amount to only about one fourth of the projected cost increases in public health and pension programs.

Avaliação construtivista, sob uma abordagem integradora e intersetorial, das ações do Projeto Disque Idoso em Sobral (CE, Brasil)

The population aging in Brazil and in the world is a reason for an epidemic inquietude. So, the violence against senior people has been considered a problem of public health. This study takes as context the health need of seniors that suffer of violence, aiming to evaluate in a constructive way the Disque Idoso Project in Sobral (Ceará, Brazil). We used Furtado's Constructivist Method of Evaluation, which provides practices of participative evaluation. Trying to reach such perspective, we are guided by paths of the integrative approach (inter, multi and transdisciplinary) and intersectoral. We accomplished the focal groups with representatives of the sections of health, social assistance, justice and senior, the benefited by the project as well as others that contribute to its development. When interacting with the professionals that act in the project headquarters we understood that there is a fear in publishing their work, because there is not structure to enlarge the attendance. The group believes that the efficiency of its actions is limited due to the lack of transport and other professionals. For the professionals of the support social networks, the project should look for intersectoral performance, once it intends to reach a complete attendance. For the seniors, the project is quite valid and needs to be consolidated in the district.

Fatores associados à sintomatologia depressiva numa coorte urbana de idosos

OBJETIVO: Analisar a associação, em uma coorte urbana de idosos, entre sintomatologia depressiva e outros indicadores de capacidade funcional com a mortalidade após 15 anos de seguimento. MÉTODOS: Foram estudados os casos de 1.667 idosos (> 65 anos) residentes em Vila Clementino, na cidade de São Paulo, por meio de uma avaliação multidimensional da capacidade funcional e dos atestados de óbito referentes a mortes ocorridas entre 1991 (início do estudo) e abril de 2006. Na análise univariada foram calculadas as razões de chances e sua significância estatística foi avaliada pelo intervalo de confiança (95%). Na análise múltipla foi empregada a regressão logística. RESULTADOS: Entre os idosos estudados, 21,1% eram deprimidos em 1991. Na análise univariada, as maiores proporções de deprimidos foram observadas entre indivíduos do sexo feminino, com mais de 80 anos, analfabetos, viúvos ou solteiros, com alto nível de dependência física e de déficit cognitivo, usuários de mais medicamentos e entre os que morreram no período de seguimento de 15 anos. Na análise múltipla, controlando-se por sexo e idade, a presença de dependência física e o fato de ser usuário de mais medicamentos foram os principais preditores da ocorrência de depressão. CONCLUSÕES: A ocorrência de sintomatologia depressiva parece estar diretamente relacionada aos níveis de incapacidade física observados entre os idosos.

Infeccious diseases as causes of death in autopsied elderly

The population aging in Brazil was associated with the alterations in the morbimortality of the population. The aim of this study was to verify the causes of death and other pathological processes in autopsied elderly. The elderly with 60 years or more in the period from 1976 to 1998 represented 394 cases (24.4%). The age median was 69 years ranged from 60 to 120 years, being higher in the women (70.5 versus 68 yrs;p<0.05). The male gender (67.5%), white color (69.8%), and the cardiovascular (43.7%) and infectious (31%) causes of death were dominate. In the malnourished (76.2%) it had association of pneumonia and cystitis, (p<0.05). Arteriosclerosis (61.9%), and the chagasic (42.1%) and hypertensive cardiopathies (39.1%) were the most frequent processes. Therefore, it was observed an overlapping of chronic-degenerative and infectious causes of death. This study shows the necessity to value of follow up of body mass index and of risk factors for the development of illness in aging patients like pneumonia.

Use of psychoactive drugs and related falls among older people living in a community in Brazil.

Population aging in Brazil has increased the prevalence of neurodegenerative diseases (Parkinson's and Alzheimer's disease) and affective disorders (anxiety, depression), all common in old age. A retrospective study was carried out with the purpose of ascertaining if there is an association between falls and psychoactive medication use among older residents of a community in Brazil. All residents aged 65+ (n=161) of one neighborhood of Campo Belo, Brazil (population of 48,000) were evaluated regarding the use of psychoactive drugs and the occurrence of falls in the 12 months preceding the study. Vision and hearing screenings were also performed. From the study population, 9.3% were taking prolonged half-life benzodiazepines, 4.4% anticonvulsants (mostly barbiturates), 2.5% antidepressants (all cyclics) and 8.1% alpha-methyldopa. No subject reported use of hypnotics, neuroleptics or drugs to treat Alzheimer's or Parkinson's diseases (except biperiden). As a whole, drugs that increase the risk of falls were used by 1/5 of this population. In the 12-month period preceding the study, 27 residents (16.8%) experienced falls and, of those, 4 (14.8%) had fracture(s). There was an independent association between psychoactive drug use and falls when variables such as age, gender, vision and hearing were controlled (p=0.02). Although the population of this neighborhood must be considered young (only 4% are 65 years old or more), there are already problems related to the use of psychoactive drugs among people. Prescribed anxiolytics, anticonvulsants, antidepressants and antihypertensives are not appropriate for this age group and their use is associated with falls.

Dynamics of institutionalization of older adults in Belo Horizonte, Brazil

Epidemiological and social changes related to population aging in Brazil will probably increase the need for nursing homes (NH). The study analyses the dynamics of institutionalization in Belo Horizonte, a 3 million inhabitant city of whom 8.0% are aged 60 or more. Age and length of stay of 1,128 NH residents (92.5% of the estimated population) was registered and occupancy and institutionalization rates were determined. Among women aged 65+ in Belo Horizonte, 0.88% were living in NH; among men, 0.26%. Occupancy rates were 92%. Women (81%) were older than men (76.4 x 70.4 years; two-tailed t test = 6. 4; p=0.00) and lived there for a longer period (5.6 x 4.5 years; two-tailed t test = 2.6; p=0.01). Almost 1/3 of the men were aged < 65. High occupancy rates, long waiting lists and hard criteria for admission (half reject demented or dependent individuals) insinuates that these low institutionalization rates are related to scarcity of beds. The preponderance of women reflects the proportion of those widowed or separated in the community (66% of those aged 65-+, versus 76% of married man). The high frequency of institutionalized men aged <65 suggests lower capacity of maintaining themselves after widowhood. High death rates (24% during a 20 month follow-up of a 263 random sample) determines the small median length of stay (3 years). These data unveil the anachronism of a system which is not directed towards the maintenance of the Brazilian older people among their families and homes.