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Stroke in older people in Brazil: prevalence, associated factors, limitations and care practices. A cross-sectional
Priscila Maria Stolses Bergamo Francisco1, Athos Paixão Silva Santos2, Daniela de Assumpção3
1Department of Collective Health, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
Insights
Stroke affects 5.6% of older Brazilians, with higher prevalence in men, older adults, and those with lower income or chronic conditions. Many experience activity limitations, highlighting a need for expanded multidisciplinary care.
Area of Science:
- Epidemiology
- Public Health
- Geriatrics
Background:
- Cardiovascular diseases, including stroke, are leading causes of mortality in the elderly population.
- Stroke significantly impacts health outcomes and healthcare utilization in older adults.
Purpose of the Study:
- To determine the prevalence of stroke among older adults in Brazil.
- To investigate associations between stroke and sociodemographic factors, health behaviors, chronic diseases, BMI, and self-rated health.
- To assess limitations and care practices related to stroke in this population.
Main Methods:
- A cross-sectional study utilizing data from the 2019 Brazilian National Health Survey.
- Inclusion of 22,728 individuals aged 60 years and older who reported a stroke diagnosis.
- Logistic regression analysis to estimate adjusted odds ratios for stroke prevalence.
Main Results:
- The prevalence of stroke was 5.6% in older Brazilians.
- Higher stroke prevalence was observed in men, individuals aged 70+, those with lower income, without health insurance, ex-smokers, physically inactive, overweight/obese, and those with chronic conditions (hypertension, diabetes, etc.).
- Common care practices included healthcare provider follow-ups (60.8%), medication (59.3%), and diet (47.2%), with only 17.0% receiving physiotherapy and 53.7% reporting activity limitations.
Conclusions:
- Stroke disproportionately affects older individuals, those with lower socioeconomic status, ex-smokers, and those with comorbidities.
- The low rate of physiotherapy underscores the need for enhanced multidisciplinary care within the Brazilian health system.
Background:
Cardiovascular diseases, especially ischemic heart disease and stroke, are the main causes of mortality in older people.
Objectives:
To estimate the prevalence of stroke in older people in Brazil, we investigated its associations with sociodemographic factors, health-related behaviors, chronic diseases, body mass index and self-rated health and determined the frequency of limitations related to disease and care practices.
Design And Setting:
This population-based, cross-sectional study used data from the 2019 Brazilian National Health Survey.
Methods:
This study included older people aged ≥ 60 years (n = 22,728) who answered the question, "Has any doctor ever given you a diagnosis of stroke?" Adjusted odds ratios were estimated using logistic regression.
Results:
The prevalence of stroke was 5.6% (95% confidence interval = 5.1-6.1) and was higher in men, individuals aged ≥ 70 years, those with a lower income, those without health insurance, ex-smokers, physically inactive individuals, those with excess weight/obesity, those who rated their own health as fair/poor/very poor and those who reported hypertension, diabetes, kidney failure, depression and heart disease. The most adopted care practices were follow-ups by a healthcare provider (60.8%), medication use (59.3%) and diet (47.2%). Only 17.0% of patients underwent physiotherapy, and 53.7% reported limitations in habitual activities.
Conclusions:
Subgroups of people more affected by stroke were identified, which included older individuals, those with lower socioeconomic status, ex-smokers and those with neuroendocrine and cardiovascular comorbidities. Less than 20% of patients underwent physiotherapy, which underscores the need to expand multidisciplinary care in the health network.
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