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Journal article

The socio-economic determinants of older people's health in Brazil: the importance of marital status and income

Authors:
BOS Antonio, BOS Angelo J.
Journal article citation:
Ageing and Society, 27(3), May 2007, pp.385-405.
Publisher:
Cambridge University Press

Studies in various countries have reported that older people who are married have better health than older widows. This paper reports a replication of these analyses with Brazilian data. The main objective was to explore the relationships between marital status, individual and household income, and the health of men and women using ordered logistic regression with self-assessed health as the dependent variable. The explanatory variables of interest were gender, marital status, and individual and family income. The data are from a survey of 7,920 non-institutionalised older people resident in the southern state of Rio Grande do Sul in 1995. The survey used a structured, multi-disciplinary questionnaire, which collected information on demographic attributes, household composition, social relations, occupation, income and health status. The results show that widows were 20 per cent more likely to report better health than married women. The women without individual income had worse health than those who did, even after controlling for family income. For men, there were no significant differences in health by marital status. The main recommendation is that the health status and economic circumstances of married elderly women should be given more attention in both research and policy, certainly in Brazil and probably in other Latin American countries. Programmes of income support to the poorest households should include specific transfers to these elderly women. Brazil's Family Health and Older People's Health public programmes should place more emphasis on the health of elderly home-makers.

Journal article

Ageing in Brazil

Author:
RAMOS Luiz R.
Journal article citation:
Ageing International, 25(4), Spring 2000, pp.58-64.
Publisher:
Springer
Place of publication:
New York

Brazil is experiencing a rapid and intense demographic transition. The industrialisation that started in the 1940's brought on fast urbanisation. The country is characterised by considerable socioeconomic inequalities and significant regional variations in the demographics of ageing. The pre-eminent role of the family as caregiver is in jeopardy even as more people are living to older ages seeking family care. Health and social services are grossly inadequate. The Ministry of Health launched the first National Health Policy for the elderly with functional capacity as a keyword. Manpower training in the area of gerontology is very little. All these necessitate an urgent focus on the needs of the fast growing elderly population.

Journal article

Clinical and sociodemographic factors in a sample of older subjects experiencing depressive symptoms

Authors:
BARCELOS-FERREIRA Ricardo, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 27(9), September 2012, pp.923-930.
Publisher:
Wiley-Blackwell

Clinically significant depressive symptoms (CSDS) decrease quality of life and are associated with excess morbidity and mortality in older adults. The aim of this study was to determine the frequency of CSDS in a community sample of older Brazilians and to examine their relationship with sociodemographic factors, cognitive and functional impairment (CFI), and medical illness. The participants were 1145 individuals aged 60 years or older living in the City of Ribeirao Preto, Brazil. The participants completed the following instruments: a 10-item scale for screening of depressive symptoms in older people, the mini mental state examination, the Fuld Object Memory Evaluation, the Informant Questionnaire on Cognitive Decline in the Elderly, the Bayer Activities of Daily Living Scale, and a sociodemographic and clinical questionnaire. The findings showed that the prevalence of CSDS in this community-based sample was 15.7%. Logistic regression analysis indicated that being previously depressed, having CFI, having lower level of education, using psychotropics, and not engaging in physical exercise were related to CSDS. On the other hand, being a woman, older, medically ill, employed, or married was not associated with CSDS.

Journal article

Intergenerational interaction through reminiscence processes: a theoretical framework to explain attitude changes

Author:
DESOUZA Elza
Journal article citation:
Journal of Intergenerational Relationships, 5(1), 2007, pp.39-56.
Publisher:
Routledge
Place of publication:
Philadelphia

An intergenerational intervention is described that was delivered in a Brazilian city with a very small (4%) proportion of the population over the age of 60. It involved 111 students and 32 older people who shared their life stories in the classroom. A focus group technique was used to evaluate the programme, and a theoretical framework was developed to explain the mechanism of changes in the attitudes of adolescents towards older people, and vice versa. The results show that stereotyped attitudes exist in both age groups. While the older people expressed pleasure at being valued and respected, the men did not generally change their attitudes. Boys felt they had learned a lot, girls valued the chance to socialise, and both appreciated learning how to respect older people. Both parties complained that the project (which ran from July to December 2002) was too short. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street,  Binghamton, NY 13904-1580).

Journal article

Interest in working with the elderly: a cross-national study of graduating social work students

Author:
WEISS Idit
Journal article citation:
Journal of Social Work Education, 41(3), 2005, pp.379-391.
Publisher:
Council on Social Work Education

This article presents a cross-national study of social work students' interest in working with the elderly, based on a sample of 679 graduating BSW students from 7 countries: Australia, Brazil, England, Germany, Hungary, Israel, and the United States. The findings among all the national cohorts show that the motivation to work with the elderly was lower than motivation to work with any other age group, and that it was equally low in most of the countries. The findings support the growing concern that the social work profession may not be able to meet its obligations to the aging society.

Journal article

Mortality from dementia in a community-dwelling Brazilian population

Authors:
NITRINI Ricardo, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 20(3), March 2005, pp.247-253.
Publisher:
Wiley-Blackwell

The influence of dementia on mortality has not yet been reported for a Latin American country. The aim was to evaluate the influence of dementia on mortality of a community-dwelling elderly population in Brazil, and to verify the extent to which the diagnosis of dementia is reported on death certificates. A cohort of 1,656 individuals, aged 65 and over, was screened for dementia at their domiciles, in 1997. The same population was re-evaluated in 2000, and information on deaths was obtained from relatives and from the municipal obituary service. Kaplan-Meier curves were used for the survival analysis, and the mortality risk ratio (MMR) was calculated using Cox proportional hazards models. We obtained data from 1,393 subjects, corresponding to 84.1% of the target population. The number of deaths was 58 (51.3%) among the patients with dementia and 163 (12.7%) among those without dementia in 1997 (p < 0.0001). Dementia and Alzheimer's disease (AD) decreased survival, with hazards ratios of 5.16 [95% Confidence Interval (CI): 3.74-7.12] for dementia and 4.76 (95% CI: 3.16-7.18) for AD. The Cox proportional hazards model identified dementia (MMR = 3.92, 95% CI: 2.80-5.48) as the most significant predictor of death, followed by age, history of stroke, complaints of visual impairment and heart failure and by severe arterial hypertension in the baseline evaluation. Dementia and/or AD were mentioned in only 12.5% of the death certificates of individuals with dementia. Dementia causes a significant decrease in survival, and the diagnosis of dementia is rarely reported on death certificates in Brazil.

Journal article

Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people

Authors:
BLAY Sergio Luis, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 22(9), September 2007, pp.903-908.
Publisher:
Wiley-Blackwell

Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. The aim was to study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. The overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain, joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 51.1%. In logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. The odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. The association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population.

Book Full text available online for free

Ageing societies: challenges and opportunities: evidence from the BUPA health pulse 2010 international healthcare survey

Authors:
FERNANDEZ Jose-Luis, FORDER Julien
Publisher:
Bupa
Publication year:
2010
Pagination:
27p., bibliog.
Place of publication:
London

This report presents the findings of the Bupa Health Pulse 2010 international healthcare survey around the theme of 'ageing societies'. It summarises some of the most important evidence about the ageing process across the world, and discusses some of the key policy challenges that ageing presents, looking particularly at the capacity for societies to provide high quality support for their older people in the future. The study surveyed 12,262 people across 12 countries (Australia, Brazil, China, France, Germany, India, Italy, Mexico, Russia, Spain, UK, USA), but the patterns described are common to a much larger number of countries. The report is structured around 3 parts. The first examines the question of the ageing process in different societies and what it means in terms of: increases in the older population; changes in the balance between young and old; and increases in the number of people with health problems and in the level of demand for care services. The second part examines the support system required to look after older people in need of care including: the sharing of caring and funding responsibilities between the state and private individuals; the need to ensure that resources are in place to look after the growing number of older people; and the levels of support provided to older people in need. The last section summarises the key policy implications.

Journal article

Psychological distress in Brazilian caregivers of relatives with dementia

Authors:
BANDEIRA D. R., et al
Journal article citation:
Aging and Mental Health, 11(1), January 2007, pp.14-19.
Publisher:
Taylor and Francis

The authors evaluated stress, anxiety, depression, and feelings of hopelessness in caregivers of relatives with dementia. One hundred and twenty-nine caregivers and 145 non-caregivers who lived in metropolitan Porto Alegre, Brazil completed Lipp's Inventory of Stress Symptoms for Adults, (ISSL), and Beck's Anxiety (BAI), Depression (BDI), and Hopelessness (BHS) scales. Caregivers showed higher levels of anxiety, depression, hopelessness, resistance/pre-exhaustion stress than controls. This study indicates that constant caregiving may significantly increase the risk of physical and mental health problems for caregivers in Brazil.

Journal article

A population based study on the intra and inter-rater reliability of the clock drawing test in Brazil: the Bambuí Health and Ageing Study

Authors:
FUZIKAWA Cintia, et al
Journal article citation:
International Journal of Geriatric Psychiatry, 18(5), May 2003, pp.450-456.
Publisher:
Wiley-Blackwell

Reliability should be considered when selecting a scoring system since it influences validity. CDT reliability has rarely been assessed in population based studies and in developing countries. The aim of the present study was to determine intra and inter-rater reliabilities of the CDT scored by the Shulman method, in elderly with very low formal educational level from Brazil. CDTs performed by a random sample of 202 subjects of a population-based cohort of elderly were scored on two occasions by the same rater and by two independent raters. Reliability was measured using the kappa statistic, weighted kappa and the intraclass correlation coefficient. Data were stratified according to gender, age and schooling level. Intra and inter-rater reliabilities were excellent when CDTs were classified as normal (scores 4 or 5) or abnormal (scores 0 to 3) (kappa = 0.99 and 0.94, respectively) and were in the good to excellent range when scored from 0 to 5 (kappa = 0.88 and 0.74, respectively). Difficulties in distinguishing between scores 4 and 5, and a low proportion of score 1 tests were found. The CDT scored by the Shulman method appears to have good to excellent reliability in an elderly population with very low formal educational level. However, difficulties in distinguishing between scores 4 and 5, and a low proportion of score 1 tests suggest these scores may not be totally adequate for this population. Further studies are necessary to determine the consistency of our results in similar populations.

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