Differences in determinants of active aging between older Brazilian and English adults: ELSI-Brazil and ELSA

• Published in: Cadernos de saúde pública 2023-01, Vol.39 (9), p.e00076823-e00076823
• Main Authors: Silva, Janderson Diego Pimenta da, Martins, Isadora Viegas, Braga, Luciana Helena Reis, Oliveira, Cesar Messias de, Lima-Costa, Maria Fernanda, Braga, Luciana de Souza, Torres, Juliana Lustosa
• Format: Article
• Language: English
• Subjects: Aging; Health of the Elderly; Health Promotion; Healthy Aging; Population Dynamics; PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
• ISSN: 0102-311X; 1678-4464; 1678-4464
• DOI: 10.1590/0102-311xen076823

This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval - 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies. Resumo: Este estudo transversal objetivou investigar as diferenças nos determinantes do envelhecimento ativo entre idosos brasileiros e ingleses, e verificar a associação de determinantes comportamentais, pessoais e sociais com a saúde física. A pesquisa baseou-se nas coortes ELSI-Brasil (2015-2016) e ELSA (2016-2017). Os determinantes do envelhecimento ativo incluíram os determinantes comportamentais (tabagismo, sedentarismo e má qualidade do sono), pessoais (função cognitiva e satisfação com a vida) e sociais (educação, solidão e voluntariado), de acordo com a Organização Mundial da Saúde. A saúde física incluiu limitação de atividades e multimorbidade. Prevalências ajustadas por idade e sexo foram calculadas para cada indicador e escores médios, utilizando-se a regressão binomial negativa para a análise estatís