SABE Study Research Articles

Oral health‐related quality of life of older people from three South American cities

To describe subjective oral health status and its association with overall health conditions and socioeconomic factors in the elderly (60 years and older) living in the capital cities with the oldest average populations in South America. Oral diseases are a public health problem, frequently neglected in older adults. In recent years, the subjective assessment of psychological and social consequences of the problems related to oral health has been valued. One of the instruments used to estimate the Oral Health-Quality of Life is the Geriatric Oral Health Assessment (GOHAI). Representative samples from SABE study (1999-2000) of Santiago (n = 1301), Buenos Aires (n = 1043), and Montevideo (n = 1450) aged 60 and over community-dwelling people. We assessed OH-QoL (GOHAI), self-reported missing teeth, denture use, and self-rated-health, among other indicators. Logistic regression models(GOHAI < 58) for each city, adjusted by sex and age, were applied. GOHAI average scores were higher in Montevideo (54.8 ± 6.1) than in Buenos Aires (53.1 ± 7.4) and Santiago (49.9 ± 8.6). A pronounced gradient of the oral condition and GOHAI scores were observed within the three-cities. Denture use -less prevalent in Santiago and more common among women- is a protective factor against a poor OH-QoL. Socioeconomic inequalities in oral health status and OH-QoL are observed in the three cities. The increasing life expectancy emphasizes the need to integrate prevention and treatment efforts, as a way to improve OH-QoL over the course of a lifetime.

Massa muscular de idosos do município de São Paulo – Estudo SABE: Saúde, Bem-estar e Envelhecimento. DOI: 10.5007/1980-0037.2012v14n1p1

The analysis of skeletal muscle mass (SM), either total (TSM) or appendicular (ASM) mass, in the elderly, is important, in order to monitor this component along aging, and these values are more associated with disability when adjusted for height, thus enabling the analysis of total (TSMI) and appendicular muscle mass indexes (ASMI). The purpose of this study was to present standard mean and percentile values of TSM, ASM, TSMI and ASMI, from elderly of São Paulo city, according to gender and age groups. The sample consisted of 1203 elderly, men and women, from the 2006 cohort of the SABE Study: Health, Well-being and Aging, held in São Paulo, Brazil. Variables TSM and ASM were identified by predictive equations, while the respective indexes, by the ratio between the values of SM and height to the squared (in kg.m-2). The mean values and standard deviation of TSM, of women and men, younger and older than 80 years old, were, in kg, 17.7±3.6, 14.4±3.2, 26.9±3.8 and 24.1±2.9, respectively, while the values for ASM were 14.4±2.1, 13.0±2.0, 21.0±2.8 and 19.4±2.3, respectively. When adjusted by height to the square, the values of TSMI were, in kg.m-2, 7.6±1.4, 6.3±1.2, 9.8±1.1 and 8.9±0.9, and the values of ASMI were 6.1±0.7, 5.7±0.7, 7.6±0.8 and 7.2±0.7, respectively. All the variables were correlated among themselves (r&gt;0,84). Men and younger elderly presented higher values, with statistical significance, in relation to their peers, and the differences between age groups were higher among women.

Survival analysis and iniquities in older Brazilians: a six year follow up survey in São Paulo, Brazil

Methods Data comes from a longitudinal survey – SABE Study (Health, Well Being and Aging) that began in 2000 with a sample of population aged 60+ living in Sao Paulo/Brazil (n=2,143 from a multi stage clustered sampling). A procedure with probability proportional to the size was carried out using census tracts with replacement. To achieve the desired oversampling for respondents aged 75+, additional households close to the selected census tracts were sampled. The second wave was done in 2006 when 1115 elders were re-interviewed. Descriptive statistics included tests for association using Rao Scott procedure with correction for sample-design. Multi variable analysis was done by adjusting Cox regressions with robust estimation, stratified by age and sex. Kaplan-Meier Survival Analysis was used to compare survival curves by social demographic conditions (sex, schooling, income, early conditions) and health (depression, comorbidities, disability, self-perceived health and falls).

Weight estimation in Mexican elderly outpatients from antropometric measures from the SABE Study

The weight is an anthropometric parameter routinely used in ambulatory and hospital settings, and takes its importance, because often there are clinical conditions that impede it´s taking in a traditional scale. There are equations to estimate weight. However, they have not been designed for Mexican ambulatory patients. To develop an equation to estimate weight in Mexican ambulatory patients from the Study of Health, Well Being and Aging, corresponding to Mexico city an surrounded area. The database of the Study of Health, Well Being and Aging of Mexico City was used, and adults of 60 years and older, who completed the anthropometric measures were included. Two groups of datasets were crated though random numbers, one for the design and the other for the validation of the equation. The equation was obtained from the first database and cross-validated in the second. The equations obtained were: (0.67)* (Knee height)+(0.46)* (Mid-arm circumference)+(0.60)* (waist circumference)+(0.38)* (hip circumference)+(0.53)* (calf circumference)-(0.17)* (Age in years)-80.01 and (0.69)* (Knee height)+(0.61)* (Mid-arm circumference)+(0.17)* (waist circumference)+(0.45)* (hip circumference)+(0.58)* (calf circumference)-(0.24)* (Age in years)-55.9 in men and women respectively. The correlation coefficients were 0.94 y 0.92 (p<0.001 for both). The differences between the real and estimated values were not significant. The equations developed in our analysis were confident and can be employed to estimate weight in ambulatory elderly. It is needed to test its validity in clinical scenarios were it is not possible to weight patients directly in the rest of the Mexican republic and adjust to specific populations.

P2-468 Inequities in the early conditions of life: effects on the mortality of elders. Results from the SABE Study - SÃo Paulo - Brasil: 2000–2006

IntroductionStudies indicate connections between childhood conditions and health in old ages. Early conditions of life may be related to individual factors of development. Thus, rural areas can harbour states of...

P1-71 Incidence and determinants of disability in instrumental activities of daily living (IADL) in elderly

IntroductionKnowing the incidence of disability in IADL in elderly is very important for planning health services.ObjectiveTo analyse the incidence rate and determinants of disability in IADL in elderly people.MethodsData comes...

O2-3.5 The short form health survey as an instrument for the screening of depressive symptoms in the elderly population

<h3>Introduction</h3> There is a large volume of scientific works concerning the utility of the 12-item Short-Form Health Survey (SF-12) and its mental health component (MCS-12) for diagnosing depression and anxiety disorders in samples of a general population. Because of the existence of a great number of studies using SF-12 data, it is convenient to estimate depressive symptoms from measurements of MCS-12 in more susceptible populations <i>such as the elderly</i>. In this paper we studied the validity of this scale as a screening measure of severe depressive symptoms in epidemiological research. <h3>Objectives</h3> To elect a cut-off point in the MCS-12 scale leading to proper discrimination of severe cases of depressive symptoms as measured by the GDS scale, with good sensibility and specificity. <h3>Methods</h3> Data come from part of the SABE study—a longitudinal research in the city of São Paulo, 2000/2006/2010. N=1155 people aged 65 and plus were interviewed in the 2006 round. ROC analysis was used to select a cut-off point in the MCS-12. <h3>Results</h3> 905 persons reported answers to both scales. General prevalence of severe depression was 2.6% (1.6 males, 3.2 females). A cut-off point of 43 in MCS-12 leaded to 88% area under ROC curve. Accuracy was 89.3 (86.5 females, 93.5 males), sensibility 0.73 (0.72 females, 0.75 males) and specificity 0.90 (0.87 females, 0.94 males). <h3>Conclusions</h3> The validation parameters found in this research indicate that the MCS-12 is a valid measure of depressive symptoms in epidemiologic studies of elders, and a screening tool for depression in clinical practice.

P1-121 Weight change and incidence of disability in activities of daily living in elderly women

IntroductionWeight change in elderly is known as associated with risk of diseases and mortality.ObjectiveTo examine the association between 2-year weight change and incidence of activities of daily living (ADL) disability...

P2-460 Proposed method for evaluation of frailty

IntroductionThe evaluation of frailty requires some measurable components. In our environment, it is known that the use of these measures on a large scale will not easily operationalise. Given this,...

P1-139 Frailty impact on older Brazilian survival: 3 years follow-up survey

ObjectiveIn this study we will analyse the survival curve of older Brazilians (≥75 years) according frailty categories (not frail, intermediate, frail) in a large, well-defined sample of older Brazilian in...

Association between urinary incontinence in elderly patients and caregiver burden in the city of Sao Paulo/Brazil: Health, Wellbeing, and Ageing Study

Some elderly patients with incontinence require the care of third parties, known as caregivers. Such care can occur on a daily basis leaving little opportunity for the caregiver to take care of himself/herself. The aims are to assess the association between urinary incontinence in elderly patients and caregiver burden and identify independent factors for caregiver's burden in the city of Sao Paulo, Brazil. The Pan-American Health Organization and World Health Organization coordinated a multicenter study named Health, Wellbeing and Aging (SABE Study) in elderly people living in seven countries of Latin America and the Caribbean. In Brazil, the study population carried out in São Paulo in the year 2000 and reassessed in 2006 (COHORT A). Urinary incontinence was assessed by ICIQ-SF and caregiver burden by means of Zarit Burden Scale. A total of 327 patients with caregivers were included in the study. The general prevalence of urinary incontinence was 25.8%, higher among the women. There was a significant positive association between caregiver burden and incontinent patients, demonstrating that urinary incontinence in elderly patients produced greater caregiver burden. In the present study, the variables with significant correlations were assessed using the multivariate logistic regression model. Category 2 of the ICIQ-SF (incontinent patients) increased the chances of caregiver burden 1.96-fold in comparison to Category 1 (continent patients). Likewise, the category of impaired cognition increased the chances of caregiver burden 2.34-fold. Urinary incontinence and cognitive impairment in elderly patients were associated to an increase in caregiver burden.

Nocturia is not associated with falls among the elderly: a population study in the city of São Paulo

IntroductionThe present study aims to evaluate the association between nocturia and falls in a group of community-living elderly men in the city of São Paulo (Brazil). Material and methodsUnder the coordination of the Pan American Health Organization and World Health Organization, a multicenter study named Health, Welfare and Aging (SABE Study) is being conducted to evaluate the living and health conditions of older people in Latin America and Caribbean. In Brazil, this study is evaluating the elderly population (60 years or more) in São Paulo since 2000. The presence of nocturia was taken as the response “yes” to the question “ you need to void three times or more at night?”. The presence of falls was also taken as the response “yes” to the question “Did you have any fall during the last 12 months?” The intergroup analysis used was the logistic regression. ResultsTotal of 865 men was interviewed, mean age 68 years. It was observed high prevalence of nocturia and falls in all groups, with higher prevalence of both in the eldest group (p<0.001), however, the association of nocturia and falls was not statistically significant in any of the groups (p=0.45). ConclusionThis is one of the pioneering studies that assess only the male population, showing that nocturia was not significantly associated with falls. Nocturia and falls are highly prevalent conditions in the elderly, but no association was found between both, so that these variables may be correlated to age and other clinical conditions.

La nicturia no se asocia con las caídas del anciano: un estudio de población en la ciudad de São Paulo

Introduction the present study aims to evaluate the association between nocturia and falls in a group of community-living elderly men in the city of São Paulo (Brazil). Material and methods under the coordination of the Pan American Health Organization and World Health Organization, a multicenter study named Health, Welfare and Aging (SABE Study) is being conducted to evaluate the living and health conditions of older people in Latin America and Caribbean. In Brazil, this study is evaluating the elderly population (60 years or more) in São Paulo since 2000. The presence of nocturia was taken as the response “yes” to the question “Do you need to void three times or more at night?” .The presence of falls was also taken as the response “yes” to the question “Did you have any fall during the last 12 months?” The intergroup analysis used was the logistic regression. Results total of 865 men was interviewed, mean age 68 years. It was observed high prevalence of nocturia and falls in all groups, with higher prevalence of both in the eldest group (p < 0.001), however, the association of nocturia and falls was not statistically significant in any of the groups (p = 0.45). Conclusion this is one of the pioneering studies that assess only the male population, showing that nocturia was not significantly associated with falls. Nocturia and falls are highly prevalent conditions in the elderly, but no association was found between both, so that these variables may be correlated to age and other clinical conditions.

Prevalence of Urinary Incontinence in Men: Results From the National Health and Nutrition Examination Survey

We estimated the prevalence of urinary incontinence in the United States adult male population and identified associated factors. Data were analyzed for 5,297 men 20 years old or older who participated in the 2005 to 2006 and 2007 to 2008 cycles of the National Health and Nutrition Examination Survey, a cross-sectional, nationally representative survey of the United States noninstitutionalized population. Urinary incontinence (score of 3 or greater on a validated incontinence severity index, indicating moderate to severe leakage) was assessed. Potential associated factors included age, race/ethnicity, education, self-reported health status, prior diagnosis of prostate cancer and/or enlarged prostate (men 40 years old or older), chronic diseases and depression status. Prevalence ORs were estimated from a multivariable logistic regression analysis using appropriate sampling weights. The prevalence of moderate/severe urinary incontinence was 4.5% (95% CI 3.8, 5.4). Prevalence increased with age from 0.7% (95% CI 0.4, 1.6) in men 20 to 34 years old, to 16.0% (95% CI 13.0, 19.4) in men 75 years old or older (p <0.001). We found no difference in prevalence by racial/ethnic group (p = 0.38). Factors significantly associated (p <0.05) with urinary incontinence were age (per 10-year increase, OR 1.8; 95% CI 1.6, 2.0), major depression (OR 2.7; 95% CI 1.6, 4.0) and hypertension (OR 1.3; 95% CI 1.1, 1.5). Age and race adjusted prevalence estimates for urinary incontinence in men are consistent with other estimates using a similar definition. To our knowledge this is the first study that identifies factors associated with moderate to severe urinary incontinence in men.

Analysis of the prevalence of and factors associated with urinary incontinence among elderly people in the Municipality of São Paulo, Brazil: SABE Study (Health, Wellbeing and Aging)

To investigate the prevalence of urinary incontinence among elderly people living in São Paulo, Brazil and their associated risk factors. The Pan-American Health Organization and World Health Organization coordinated a multicenter study named Health, Wellbeing and Aging (SABE Study) in elderly people (over 60 years old) living in seven countries in Latin America and the Caribbean. In Brazil, the study was carried out in São Paulo in the year 2000. The total Brazilian sample included 2,143 people. The prevalence of self reported urinary incontinence was 11.8% among men and 26.2% for women. It was verified that among those reporting urinary incontinence, 37% also reported stroke and 34% depression. It was found that the greater the dependence that the elderly people presented, the greater the prevalence of urinary incontinence. The associated factors found were depression (odds ratio = 2.49), female (2.42), advanced age (2.35), important functional limitation (2.01). Urinary incontinence is a highly prevalent symptom among the elderly population of the municipality of São Paulo, especially among women. The adoption of preventive measures can reduce the negative effects of urinary incontinence.

Functional performance of the elderly in instrumental activities of daily living: an analysis in the municipality of São Paulo, Brazil

The changes that occur during aging are accompanied by limitations in functional performance that impair elderly people's social participation and consequently harm their quality of life. In the SABE Study (São Paulo, Brazil), the results indicated relationships between life expectancy without disabilities and demographic and social variables. This article sought to evaluate these and other variables together as explanatory factors for the presence or absence of difficulties in instrumental activities of daily living (IADL), directly related to the possibility of more efficient community participation. Five of the eight questions relating to IADL that were applied to the sample of 2,143 elderly individuals in the municipality of São Paulo in 2000 were considered. Odds ratios were calculated using logistic regression. All the socio-demographic variables analyzed (age, income, ethnicity, schooling, and gender) were significant, with the exception of "sufficient money". All the variables in the "health" group (one or two or more diseases reported, and depression) were also significant. The two other variables that entered the model were physical activity and alcohol consumption.

Fatores de risco para mortalidade em idosos

The risk factors for diseases and premature deaths are important in drawing up preventive measures. This study had the aim of analyzing the risk factors for death among elderly people. This study was carried out among participants in the SABE (Health, Wellbeing and Aging) study, in the city of São Paulo in 2000. Interviews were conducted with 2,143 elderly people (60 years old or over), using a standardized questionnaire for the SABE study. The sample was obtained from census tracts, in two stages, with replacements and with probability proportional to the population, and with supplementation of the sample of people aged 75 years or over. The final data were weighted so that they could be expanded. Between the two data collection times, there were 38 deaths which comprised study sample. Logistic regression was utilized for the data analysis, with a significance level of 5%. The risk factors found were: locomotion difficulty, advanced age, male gender, self-assessment of health as "bad" and difficulty in going to the bathroom, OR=3.15; 2.93; 2.90; 2.69 and 2.51, respectively. The results may contribute towards the adoption of preventive measures for elderly people, with the aim of diminishing the expected number of fatal outcomes.

Encuesta Salud, Bienestar y Envejecimiento (SABE): metodología de la encuesta y perfil de la población estudiada

This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.