Simultaneidade de fatores de risco para doenças crônicas não transmissíveis em relação à mortalidade de idosos não institucionalizados do sul do Brasil

Abstract

This study is part of the cohort study called “COMO VAI?” carried out with non- institutionalized elderly. The objective of this study was to evaluate the association of simultaneity of risk factors for chronic non-communicable diseases (NCDs) with the evolution of mortality in elderly community residents living in the urban area of the municipality of Pelotas, RS, Brazil over a period of approximately three years. The outcome of the study was mortality from all causes, assessed by double checking through telephone / home contact and also verification by the Epidemiological Surveillance sector of the Municipal Health Department of the municipality of Pelotas. The main exposure was assessed by the presence or absence of four FRC investigated in 2014: physical inactivity, poor diet quality, alcohol consumption and smoking. Subsequently, this information comprised a score with a score between 0 (minimum) and 4 (maximum). In addition to the simultaneity of FRC for NCDs, other characteristics of the elderly that could influence the results as socioeconomic and demographic factors were considered. Associations were assessed using Cox regression analysis (proportional risk regression) and Wald test or linear trend, with a 5% significance level. In 2014, 1,451 elderly people were interviewed, where 91.3% had at least one of the risk factors studied. 145 deaths were identified by April 2017 (10%). The risk of death was 2.36 (95% CI: 1.12–4.83) times higher among inactive individuals compared to those who practiced physical activity and 2.08 higher among elderly people who smoked (95% CI: 1.24 –3.48) in relation to the elderly who did not smoke. The combinations of CRF that conferred the highest risk of death were those of physical inactivity and smoking (RR = 5.10; 95% CI: 1.91-13.03), low quality of diet and physical inactivity (RR = 3.60; 95% CI: 1.27–10.25). The presence of three or more CRF was associated with a risk of death almost six times greater (RR = 5.71; 95% CI: 1.33-24.57) than that observed among the elderly with no CRF. There was a greater decrease in survival over time among those elderly people who had three or more FRC accumulated in 2014 (<80% at the end of the period). Higher mortality in a period of up to three years of follow-up was observed in those elderly people with simultaneous presence of at least three CRF for CNCD. Some factors seem to have a greater impact on life expectancy than others, although the cumulative amount of factors is of great importance. This volume includes: the research project, fieldwork report, changes made to the research project, original article and the rules of the Public Health Nutrition magazine, to which the article that makes up this Dissertation will be submitted.