Concordância para comportamentos de Saúde entre cônjuges de casais idosos: fatores relacionados, morbidade física e mortalidade

• Autor(a) principal: Machado, Mayra Pires Alves [UNIFESP]
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=1333699; http://repositorio.unifesp.br/handle/11600/46190
• topic: aging; spouses; health behavior; chronic disease; concordance; envelhecimento; cônjuges; comportamentos saudáveis; doença crônica; concordância

Background: The rate of population aging is increasing, especially in low and middle income countries. Chronic disease is one of the main causes of disability and mortality in older adults and is influenced by health behavior, making it important to understand the correlates of health behavior concordance among old couples and their association with cardiovascular disease (CVD), depression and mortality. Objectives: To estimate health behavior concordance and its correlates among old couples and their association with cardiovascular disease (CVD), depression and mortality. Methods This is a secondary analysis of the 10/66 Dementia Research Group population-based study, using data regarding alcohol consumption, smoking, physical activity, cardiovascular disease, depression and mortality (after 4 years of follow-up) collected from couples aged 65 and over from 5 low and middle income countries. Logistic regression models were used to estimate the factors associated with health behavior concordance and the association between concordance and chronic conditions. Cox regression models were used to estimate the association between concordance and mortality. Results: There was a high concordance in regard to alcohol (71.4%) and tobacco (83.2%) abstinence, and a smaller concordance for physical activity (46.9%). Increased age was associated with concordance among couples in respect of physical inactivity, alcohol and tobacco abstinence; being part of a wide social network was more common among physically active couples and having a narrow social network more common among alcohol abstinent couples. Physically inactive participants were more likely to have depression, independent of their spouse’s physical activity, but this association was stronger when they were married to an inactive spouse. Active participants married to inactive spouses had lower rates of CVD than those married to also active spouses (OR=0.70 ; 95%IC 0.52-0.94 for men and OR=0.61 ; 95%IC 0.45-0.81 for women). Inactive couples had higher rates of female mortality in comparison to active couples (HR=2.13 ; 95%CI 1.20-3.77); and there were lower rates of mortality in alcohol abstinent women married to at risk drinking husbands than for women from alcohol abstinent couples (HR=0.28 ; 95%CI 0.10-0.80). Conclusion: Older couples often share health behaviors which impact on their wellbeing but beyond this, spousal behavior can have distinct and sometimes unexpected health consequences, particularly for women. Interventions promoting changes in older people’s health behavior may be more effective if both spouses’ health behaviors and how they mutually affect each other’s health are considered.