Factors determining the negative perception of the health of Brazilian elderly people

Abstract Objective: To identify factors that determine the negative perception of the health of the Brazilian elderly, considering sociodemographic conditions, functional limitations and illness, patterns of utilization of health services and oral health condition. Method: A cross-sectional study with data from the National Health Survey (2013), involving 23,815 elderly persons was carried out. Once the database was treated, dimensionality reduction was performed using the Waikato Environment for Knowledge Analysis. The variables related to health perception were evaluated through logistic regression to measure the magnitude of the associations. Health perception and 36 independent variables were considered as outcome variables. Results: The variables most strongly related to the negative perception of the health of the elderly were illiteracy (OR=1.48), low educational level, total difficulty in performing instrumental activities of daily living (OR=2.04), impossibility of performing any activity (OR=3.20), presence of a diagnosis of physical or mental illness (OR=2.44), negative self-perception of oral health (OR=1.92), an increased need for health services in recent weeks (OR=1.16), medical visits and hospitalization in the last 12 months (OR=1.40). Conclusion: The use of multidimensional methodologies can identify the influence of determinants of a negative perception of health among Brazilian elderly persons, and can support the formulation of public health policies aimed at the elderly population.

摘要 研究目的：本研究旨在明确影响巴西老年人健康负面感知的相关因素，纳入社会人口学特征、功能受限与疾病状况、医疗服务利用模式以及口腔健康状况等维度开展分析。
研究方法：本研究采用横断面研究设计，使用2013年全国健康调查（National Health Survey）的数据，共纳入23815名老年人。完成数据库预处理后，借助怀卡托知识分析环境（Waikato Environment for Knowledge Analysis）开展降维分析；通过逻辑回归评估各变量与健康感知的关联强度，以健康感知作为结局变量，共纳入36个自变量。
研究结果：与老年人健康负面感知关联性最强的变量依次为：文盲状态（比值比（Odds Ratio, OR）=1.48）、低受教育水平、完全无法完成工具性日常生活活动（OR=2.04）、无法完成任何活动（OR=3.20）、确诊躯体或精神疾病（OR=2.44）、口腔健康自我感知不良（OR=1.92）、近期数周内健康服务需求增加（OR=1.16）以及过去12个月内就诊及住院（OR=1.40）。
研究结论：采用多维度研究方法可明确巴西老年人健康负面感知的影响因素，能够为面向老年人群的公共卫生政策制定提供科学支撑。