David Melzer1, Maria Isabel Parahyba. 1. Department of Public Health and Primary Care, University of Cambridge, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK. dm214@medschl.ac.uk
Abstract
INTRODUCTION: Socio-economic differences in mobility disability prevalence in old age have been reported from the US and Europe. Brazil is characterised by gross socio-economic inequalities, but there have been no previous national data on disability prevalence. AIM: This study aimed to estimate disability rates and explore associations identifying the most significant socio-economic markers associated with mobility disability prevalence in old age in Brazil. SUBJECTS AND METHODS: A nationally representative sample of 28,943 people aged 60 years or over was interviewed, in the 1998 National Household Survey (PNAD), conducted by the Brazilian Institute of Geography and Statistics. RESULTS: The prevalence rates of markers of mild, moderate and severe disability were higher in women than men, and increased with age. Prevalence rates of difficulty with personal care and medium distance walking were broadly similar to England, but far more Brazilians reported difficulty climbing stairs. In logistic regression analyses, the strongest markers associated with increased mobility disability prevalence were age, gender, lack of education and low income. Rural residence was also associated with reduced prevalence. Limited differences by region were present, and there were mixed effects for self-reported racial group for women. CONCLUSIONS: Disability in the older population of Brazil shows familiar prevalence patterns by age and gender. Disparity in income and educational attainment in Brazil are the most important markers associated with group differences in mobility disability prevalence in old age.
INTRODUCTION: Socio-economic differences in mobility disability prevalence in old age have been reported from the US and Europe. Brazil is characterised by gross socio-economic inequalities, but there have been no previous national data on disability prevalence. AIM: This study aimed to estimate disability rates and explore associations identifying the most significant socio-economic markers associated with mobility disability prevalence in old age in Brazil. SUBJECTS AND METHODS: A nationally representative sample of 28,943 people aged 60 years or over was interviewed, in the 1998 National Household Survey (PNAD), conducted by the Brazilian Institute of Geography and Statistics. RESULTS: The prevalence rates of markers of mild, moderate and severe disability were higher in women than men, and increased with age. Prevalence rates of difficulty with personal care and medium distance walking were broadly similar to England, but far more Brazilians reported difficulty climbing stairs. In logistic regression analyses, the strongest markers associated with increased mobility disability prevalence were age, gender, lack of education and low income. Rural residence was also associated with reduced prevalence. Limited differences by region were present, and there were mixed effects for self-reported racial group for women. CONCLUSIONS: Disability in the older population of Brazil shows familiar prevalence patterns by age and gender. Disparity in income and educational attainment in Brazil are the most important markers associated with group differences in mobility disability prevalence in old age.
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