Analfabetismo e relação com a saúde de pessoas idosas brasileiras: um estudo de base nacional.

Abstract

In elderly individuals, illiteracy can significantly impair the understanding of health information, adherence to medical instructions, interpretation of prescriptions and medication labels, adversely affecting their health. This limitation also restricts access to crucial preventive healthcare information and treatments. Understanding how illiteracy affects the health of this age group, in different regions of Brazil, is crucial for guiding intervention strategies and public policies. This study aimed to analyze, based on the 2019 PNS (National Health Survey), the magnitude of illiteracy's influence on the health of the elderly population residing in Brazil's five macro-regions. The observational, cross-sectional, quantitative, and exploratory study used secondary data from the 2019 PNS, involving 43,554 elderly individuals in households across the country. The 'Literacy' variable was determined by the question: "Can you read and write?" Independent variables were selected from modules on residents' general characteristics, chronic diseases, and elderly health. Descriptive analyses with absolute and relative frequencies, prevalence ratio, and statistical tests such as chi-square and binary logistic regression (at a significance level of 95%) were performed. Among the elderly, 23.8% were illiterate, with 38.9% in the Northeast macro-region, followed by 27% in the North and 16.5% in the Midwest. Difficulty in performing Instrumental Activities of Daily Living (IADL) was 39.2%, higher in the Northeast (45.1%) and lower in the South (33.5%). For Basic Activities of Daily Living (BADL), the prevalence was 21.2%, higher in the Northeast (23.1%) and lower in the South (19.3%). The presence of Non-Communicable Chronic Diseases (NCDs) was 82.6%, more prevalent in the Southern (85.2%) and Southeastern (84.9%) macro-regions. The national prevalence of multimorbidity was 68.7%, higher in the Southern (71.7%) and Southeastern (70.5%) macro-regions. The IADLs with the most difficulties were going to the doctor (27.6%) and using transportation alone (27.4%). In BADL, the greatest difficulties were lying down (13.2%), dressing (12.9%), and sitting alone (12.8%). Comparing illiterate and literate elderly individuals, the prevalence of difficulties in all ADLs was significantly higher in illiterates (p<0.05). They had 2.84 times morem chances of difficulties in IADL and 1.75 times in BADL than the literate. IADLs most influenced by illiteracy were managing money (OR=1.67), using transportation (OR=1.62), and going to the doctor alone (OR=1.45). For BADL, the most impacted difficulties were walking (OR=1.32), eating (OR=1.29), bathing (OR=1.21), and dressing (OR=1.21) alone. Diseases with higher prevalence among elderly individuals are hypertension (55.1%), chronic back problems (29.3%), high cholesterol (26.0%), and Diabetes Mellitus (19.1%). Illiterate elderly individuals have a higher probability of having hypertension, Diabetes Mellitus, Stroke, and chronic back problems. However, high cholesterol, heart diseases, asthma, arthritis/rheumatism, depression, cancer, and chronic kidney disease are more common among literate elderly individuals. In conclusion, illiteracy influences the health of elderly individuals in Brazil's five regions, affecting the understanding of health information and the ability to make informed decisions, thereby impacting quality of life. The diversified aging in these regions underscores the need for tailored policies addressing health, education, and healthy aging.