68MULTIMORBIDITY IN ELDERLY FROM A MIDDLE-INCOME COUNTRY: PREVALENCE, CLUSTERS OF DISEASES AND ASSOCIATED FACTORS

Abstract

Background: Multimorbidity (MM) is an important challenge to health systems around the world, mainly in deprived areas. However, little evidence is available about the topic in low and middle-income countries, mainly in Brazil. This study evaluate the occurrence, patterns and factors associated with multi-morbidity among Brazilians aged 60 years and over. Methods: A national-based cross-sectional study was carried out in 2013 with 11,177 Brazilian older people. MM was evaluated by a list of 16 physical and mental morbidities (based on self-reported medical diagnosis, Patient Health Questionnaire-9 for depression and obesity by WHO criteria) and analysed taking ≥2 (MM2), ≥3 (MM3) and physicalmental (MMpm) morbidities as cut-off points. Frequencies of MM and of pairs/triads of morbidities were analysed. Factor analysis (FA) was used to identify disease patterns and multilevel models were used to test association with individual and contextual variables. Results: The occurrence of MM2, MM3 and MMpm was 58.6% (95%CI: 57.1-60.2), 36.4% (95%CI: 34.8-38.1) and 12.2% (95%CI: 11.2-13.4), respectively. Hypertension (50.6%) was the most frequent morbidity followed by a back problems, high cholesterol and obesity. The most frequent combination was HBP and high cholesterol (16.9%). HBP was present in 12 of these combinations. In the adjusted analysis, female sex and live in South region had a statistically significant association with all outcomes. Conclusion: Prevalence of MM in Brazilian elderly was high. The Brazilian National Health System should prioritise improving the care of patients with MM. The effects of MM in Brazilian population, mainly in older people, need to be studied.