Condições de Saúde e Envelhecimento bem-sucedido: um estudo com pessoas idosas rurais ribeirinhas de um município amazônico

Abstract

Brazil has experienced population aging and this scenario implies important epidemiological changes, represented by the greater prevalence of chronic non-communicable diseases (NCDs) and the restructuring of health systems. However, more recent evidence, supported by the Lifespan paradigm, has shown that it is possible to achieve successful aging (EBS), with a low burden of these diseases and a good level of biological, psychological and social functionality. The way of life of elderly people in regions with a low Human Development Index (HDI) directly influences health conditions and the aging process. Therefore, it is important to investigate the different regions of the country to better understand their particularities. The rural riverside context, for example, presents distinct sociocultural characteristics and scientific research in this field is fundamental to understanding health in old age and promoting EBS in this context. This work aims to understand the health conditions and EBS of elderly people living in the rural riverside context of the municipality of Cametá, in the state of Pará. For this, two observational, descriptive studies were carried out, with a quantitative approach and cross-sectional collection of data. data. 77 elderly people living on 11 river islands participated and the sociodemographic data questionnaire, the health characteristics questionnaire and the Successful Aging Scale (SAS-B) were used to collect data. Statistical analysis included descriptive treatment of data through frequency distribution, percentage rate, 95% confidence intervals (95% CI), minimum, maximum, mean and standard deviation; in addition to regression models and decision tree analysis. The results of study 1 showed that the majority of the sample were young elderly people (60- 69 years old), female, married, mixed race, low education and income, working active, Catholic, living with their parents. spouses and descendants, were heads of families and owners of their own residence. Regarding health conditions, it was observed that most participants perceived their health as poor, had satisfactory social support, were not smokers or alcohol drinkers and considered their diet to be healthy. Furthermore, the majority were functionally independent, did not present polypathology or polypharmacy, but used institutional health services. In relation to the EBS investigation, the performance of rural riverside elderly people drew positive attention, reaching an average score of 76.40 (±7.28). About the behavior of EBS domains, better performance was observed in “Engagement with Life” with an average of 31.20 points (±3.21), followed by “Healthy Lifestyle” with an average of 24.18 points (±3. 15). In study 2, it was possible to identify, from the multinomial logistic regression analysis, that the categories male sex (p=0.04), non-Catholic religion (p>0.0001), absence of polypharmacy (p=0.05) and use of health services (p> 0.0001) were the most important in the association with EBS. Furthermore, the analysis of the decision tree model highlighted three interesting outcomes to explain EBS in the study sample. In a general assessment of the findings revealed in this dissertation, it is noted that the study participants achieved a high score for identifying EBS in the investigated context, which can be better explained by the modulation between psychosocial and behavioral factors, which can be the target of Primary Health Care services for elderly people, from a perspective of comprehensive and long-term care in the rural riverside context.