Social determinants of functional mobility and falls in elderly residents of São Paulo, Brazil: a multilevel analysis

Author(s)

Carla Ferreira do Nascimento

• Document type: Master's Dissertation
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública
• Defense date: 06 maio 2016

Examining board members

Alexandre Dias Porto Chiavegatto Filho; Jose Leopoldo Ferreira Antunes; Monica Rodrigues Perracini

• Advisor: Alexandre Dias Porto Chiavegatto Filho

Abstract

Introduction: Recent studies show that falls are the most important external cause of death in elders, leading to hospitalization, injuries, dependency, and to increased costs of health and social care services. Functional mobility impairment is a risk factor for falling, but social, environmental and behavioral aspects may also affect this event. Objective: To identify the socioeconomics and contextual aspects associated with functional mobility and falls in elderly residents of the Municipality of São Paulo, Brazil. Methods: We used data from Health, Wellbeing and Aging (SABE) Study, a representative study of individuals aged 60 and older of the Municipality of São Paulo in 2010. The dependent variables of interest were the occurrence of any fall in the last year and functional mobility impairment, assessed by the Timed Up and Go (TUG) test. Individual (marital status, race, years of schooling and perception of income sufficiency) and contextual (Gini coefficient, green areas per capita, and homicide rate) factors were analyzed by multilevel logistic models. Results: From the sample of 1,190 elderly individuals, 29 per cent reported a fall in the last year and 46 per cent had mobility impairment. The socioeconomic individual factors were not significantly associated with falling, but having eight or more years of schooling was a protective factor for mobility impairment for every model (OR: 0.56). Living in a neighborhood with a moderate homicide rate was associated with higher odds of falling (OR: 1.51, 95 per cent CI: 1.09-2.07). Neighborhoods with moderate greens spaces were associated with higher odds of falling for individuals 80 years old and older (OR: 2.63, 95 per cent CI: 1.23-5.60). Conclusion: Our findings support the concern that neighborhood characteristics are associated with falls and mobility impairment for the elderly. Strategies to prevent falls and mobility impairment in developing countries should consider public environment and social aspects. (AU)

• FAPESP's process: 14/06721-4 - Social determinants of functional mobility and falls on elderly residents from the municipality of São Paulo: a multilevel analysis
• Grantee: Carla Ferreira Do Nascimento
• Support type: Scholarships in Brazil - Master