TITLE:
Activity Limitation in the Elderly People and Inequalities in Brazil
AUTHORS:
André Luiz Barbosa de Lima, Kenio Costa de Lima
KEYWORDS:
Multilevel Analysis, Aged, Activities of Daily Living
JOURNAL NAME:
Open Access Library Journal,
Vol.1 No.4,
July
28,
2014
ABSTRACT: Functional status decline in elderly individuals can compromise home life and lead to social isolation. Therefore, we aimed to determine the influence of income inequality on the limitation of activities among elderly people in Brazil. The present study included 18,484 individuals aged 60 years old or more from data of the Health Supplement of the National Household Sample Survey (PNAD), conducted in 2008. Random effects ordinal regression was proposed for multilevel analysis of the Global Activity Limitation Index (GALI), and its association among independent variables on two levels. With regards to socio-demographic status, the factors most commonly associated with activity limitation were as follows: 75 years old or more; female; living with others; living in urban areas; earning less than two minimum wages and having completed three or less years of study. With regards to health status: poor or very poor self-perceived health, hospitalization in the last 12 months, continued use of medication and depression. On a contextual level, income inequality exerted a major influence on activity limitations in elderly individuals. Analysis of these results should also consider the limitations of the data. The rural sample is not complete, because the rural north was excluded due the logistical complexity required to conduct a survey in this area. In addition, it was not possible to use any measures of cognitive disability or mental health. We concluded that the limitations in activities among elderly individuals are reflected widely in the worsening self-rated health and condition of depression. Chronic diseases should be associated with increased activity limitations, especially chronic kidney disease, arthritis, tendinitis and cancer. The effective preventive and rehabilitation strategies for reducing the activity limitations in the elderly population should be implemented, considering the social determinants and the determinants of disability.