Dataset Information

The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design.

ABSTRACT: Brazil is experiencing among the world's fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years or older, residing in 70 municipalities across the 5 Brazilian regions. ELSI-Brazil allows investigations of the aging process, its health, psychosocial and economic determinants, and societal consequences. The baseline examination (2015-2016) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, and timed walk and balance tests). Blood tests and sample storage were performed in a subsample of study participants. Subsequent waves are planned for every 3 years. The study adopts a conceptual framework common to other large-scale longitudinal studies of aging in the world, such as the Health and Retirement Study, allowing cross-national comparisons. The goal of ELSI-Brazil is not only to build an understanding of aging in a large, Western, middle-income country in a rapid demographic transition but also to provide scientific data to support and study policy changes that may affect older adults. We describe the methodology of the study and some descriptive results of the baseline survey.

SUBMITTER: Lima-Costa MF

PROVIDER: S-EPMC6031009 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Objectives Vaccine hesitancy may represent a barrier to effective COVID-19 immunisation campaigns. This study assesses individual, disease-specific and contextual factors associated with COVID-19 vaccine acceptance among a nationally representative sample of older Brazilian adults. Design Cross-sectional analysis of data from household interviews and a supplementary telephone survey. Setting Brazil and its five geographic regions. Participants Data are derived from 6584 individuals aged 50 years and over who participated in the second wave of the Brazilian Longitudinal Study of Aging. Primary and secondary outcome measures Survey-weighted multinomial logistic regression assesses factors associated with intending, not intending or being uncertain about one’s intention to vaccinate against COVID-19. Findings Seventy-one per cent of study participants intend to receive a COVID-19 vaccine once available, while 17% (representative of nearly 9 million people) have no intention to vaccinate, and 12% are still undecided. Besides age, demographic and health-related factors related to COVID-19 severity and complications were not associated with intention to vaccinate. Those who most trusted social media or friends and family for COVID-19 information and those who did not trust any information source were 68% and 78% more likely to refuse vaccination, respectively, as compared with those who trusted official information sources. People who inconsistently used face masks when outside were 3.4 times more likely than consistent face mask users to intend to refuse vaccination. Higher municipal COVID-19 fatality rates were negatively associated with vaccine refusal. Conclusions Most national COVID-19 immunisation strategies identify older individuals as among those prioritised for early vaccination, given their increased risk of more severe symptoms and complications of the disease. Because individual, disease-specific, and contextual factors were associated with vaccine acceptance, there is a clear need for multilevel and multichannel information and outreach campaigns to increase COVID-19 vaccine acceptance among vulnerable older populations.

Project description:OBJECTIVE:To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS:Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS:The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2-4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60-79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS:Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse.

Project description:BACKGROUND:Research on discrimination and health focused on older adults has been scarce, comparatively with younger and middle-aged adults. Considering where people live matters, accurate measures of perceived discrimination might consider how the place of residence interferes on discriminatory experiences. This study aimed to assess the association between perceived discrimination and urban/rural place of residence among a representative sample of older adults in Brazil. METHODS:Data came from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015/2016, with individuals aged 50 years and older. Perceived Discrimination was measured by means of the following question: "In the past 12 months have you felt a victim of any type of discrimination" with five possible answers: (1)"when you sought medical services or health care?", (2)"in social gatherings?", (3)"in the work place?", (4)"within the family?", (5)"due to where you live?". Participants who answered yes for any of the five domains were coded as having reported an experience of discrimination. The main exposure variable was the urban-rural classification of the households, carried out according to the methods employed by the Brazilian Institute of Geography and Statistics during the 2010 Population Census. Other covariates included: age, sex, skin color, household wealth and education. Multiple Poisson regression was used to estimate prevalence ratios and their respective 95% confidence interval for the association between discrimination and independent variables. RESULTS:Prevalence of any perceived discrimination among Brazilian older adults was 16.8%. Regardless the place of residence (either urban or rural), participants reported health care settings as the most common domain where discriminatory experiences occurred and the work place as the least common. According to the adjusted model, perceived discrimination was significantly higher among urban dwellers when compared to their rural counterparts, independent of sociodemographic characteristics, health status and neighborhood social environment. The outcome was significant associated with skin color, education and health status. CONCLUSIONS:Urban environment plays a core role in perceived discrimination and health care settings constitute the most common domain where discriminatory experiences occurred. Our findings may contribute to fulfill the knowledge gap on discrimination among older adults living in developing countries.

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The Brazilian Longitudinal Study of Aging (ELSI-Brazil): Objectives and Design.

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