Significance and management of disability among urban elderly residents in Brazil

Brazil's population is aging very rapidly, and the care for the elderly is an emerging priority. The results of a multidimensional functional assessment of elderly residents in Sao Paulo showed extreme poverty and massive cohabitation in multigenerational households. The health profile showed a high prevalence of chronic illnesses, mental disorders, and disability. Using a Guttman scale, a set of activities of daily living was validated as an indicator of dependency. Attention was given to the dependency associated factors, and in particular to the association between chronic illness and loss of independence among the aged. Fortunately, for the existing health care system in Brazil, cultural values are still keeping the family in the front line of caregiving, but this situation is not likely to withstand the increasing burden of a growing elderly population with an ever higher rate of disability.

[Profile of the elderly in a metropolitan area of southeastern Brazil: results of a domiciliary survey]

A multicentre study concerned with the health needs of the elderly population living in urban areas and coordinated by the Panamerican Health Organization was undertaken in 6 Latin-American countries. In Brazil, 1,602 elderly residents (of 60 years of age and over) in the District of S. Paulo, constituting a multistage random sample stratified by socioeconomic status, participated in a household survey using a multidemensional functional assessment questionnaire. The results showed a highly deprived population (70% had a per capita income of less than US $ 100 per month), living mostly in multigenerational households (59% were living with children and/or grandchildren), with a high prevalence of chronic physical illnesses (only 14% referred no illness) and psychiatric disorders (27% were considered psychiatric cases), a high proportion of them showing a loss of autonomy (47% needed help in performing at least one of the activities of daily living). The results are put into perspective concerning future needs in terms of specialized health services and social support for the growing population of elderly people in Brazil.