Determinants socioeconomic factors for quality of life and depressive symptoms in community-dwelling older people: a cross-sectional study in Brazil and Portugal

The study aimed to analyze the association between the socioeconomic profile and the Quality of Life (QoL) of elderly people with depressive symptoms assisted in Primary Health Care (PHC) in Brazil and Portugal. This is a comparative cross-sectional study with a non-probabilistic sample of elderly people from PHC in Brazil and Portugal, carried out between 2018 and 2018. To assess the variables of interest, a form containing socioeconomic data, the Geriatric Depression Scale (GDS- 15) and the Medical Outcomes Short-Form Health Survey (SF-36). We performed descriptive and multivariate analyzes to test the study hypothesis. The sample consisted of n=150 participants (Brazil n=100 and Portugal n=50). There was similarity in some variables of the socioeconomic profile of both groups, with predominance in the total sample of females (76.0% / p = 0.224) and of individuals aged between 65 and 80 years (88.0% - p = 0.594 ). However, in Brazil, less education (79.0%/ p = 0.001) and participants who did not live alone (86.0%/ p = 0.001) stood out. In Portugal, all participants had an income lower than the minimum wage (100.0% / p <0.001). There is also a predominance of symptoms in the group from Brazil (59.0%) (p=0.015 / OR= 1.81 - 95%CI= 1.12 – 2.81). When performing the multivariate association analysis between socioeconomic variables, presence of depressive symptoms and QoL, we selected and presented the most relevant results in Table 5. It is noted that the Mental Health domain was the domain that was most associated with socioeconomic variables. Among them, the female gender (p= 0.027), age group 65-80 years (p=0.042), marital status “without a partner” (p=0.029), education of up to 5 years (p=0.011) and income of up to 1 minimum wage (p=0.037). In all these variables, higher scores were observed in the group from Brazil. With higher scores in Portugal, the General Health Status domain was associated with female gender (p= 0.042) and education of up to 5 years (p=0.045). In addition, the physical aspect domain was associated with income of up to 1 minimum wage. The results revealed the existence of an association between the socioeconomic profile and the QoL in the presence of depressive symptoms. This association was observed mainly among females, low education and low income with aspects of QoL related to mental, physical and social health and self-perception of health. The group from Brazil had higher QoL scores compared to Portugal.

本研究旨在分析巴西和葡萄牙初级卫生保健（PHC）中具有抑郁症状的老年人的社会经济状况与生活质量（QoL）之间的关联。该研究为一项比较性横断面研究，样本为来自巴西和葡萄牙PHC的非概率性老年人群，研究时间跨度为2018年至2018年。为评估感兴趣的自变量，研究者使用包含社会经济数据、老年抑郁量表（GDS-15）以及医学结果简明健康调查表（SF-36）的问卷。研究者进行了描述性和多元分析以验证研究假设。样本包括n=150名参与者（巴西n=100，葡萄牙n=50）。两组社会经济状况的某些变量存在相似性，总体样本中女性占比最高（76.0% / p = 0.224），65至80岁年龄段的个体占比也最高（88.0% - p = 0.594）。然而，在巴西，受教育程度较低（79.0%/ p = 0.001）以及非独居的参与者（86.0%/ p = 0.001）较为突出。在葡萄牙，所有参与者的收入均低于最低工资（100.0% / p <0.001）。巴西组的症状也较为普遍（59.0%）(p=0.015 / OR= 1.81 - 95%CI= 1.12 – 2.81)。在执行社会经济变量、抑郁症状存在与否以及生活质量之间的多元关联分析时，研究者选取并展示了表5中最相关的结果。值得注意的是，心理健康领域与社会经济变量的关联最为显著。其中，女性性别（p= 0.027）、65-80岁年龄段（p=0.042）、婚姻状况“无伴侣”（p=0.029）、受教育年限不超过5年（p=0.011）以及收入不超过1倍最低工资（p=0.037）等变量，在巴西组中均观察到更高的得分。而在葡萄牙，与女性性别（p= 0.042）和受教育年限不超过5年（p=0.045）相关的总体健康状况领域得分较高。此外，身体外观领域与收入不超过1倍最低工资相关。研究结果表明，在社会经济状况与抑郁症状伴随的生活质量之间存在关联。这种关联主要存在于女性、受教育程度低和收入低的群体中，与心理健康、身体健康、社会健康以及自我健康感知相关的QoL方面。与葡萄牙相比，巴西组的QoL得分较高。