This is a cross-sectional observational study carried out at two primary referral centers for elderly care, Eldorado and Piraporinha. Both clinics are in the city of Diadema, which along with other cities, belongs to the conurbation of São Paulo. The Eldorado clinic is located in the outskirts of the city and the Piraporinha clinic is located in a more privileged area, in the city center, conferring different geographic contexts to the clinics.

This study included 373 participants with clinical data being collected between November 2012 and April 2013. All pre-elderly and elderly male and female individuals (50 years or older) of the two clinics were invited to participate in the study. Subjects who did not live in Diadema and individuals who refused to participate in the study were excluded from the study, as were those who were unable to answer the questions due to deafness, blindness, or with difficulties to understand. A simple random sampling method was used. In order to calculate the sample size, the elderly population of Diadema was considered to be approximately 4% of the total population,5 thus using a 95% confidence level and 5% sampling error, the minimum sample size required was 280 subjects.7 All the individuals who participated in the study provided informed written consent. The Ethics Committee of the Universidade Federal de São Paulo (Unifesp) approved the study protocol (#142.778).

Diagnoses of anemia, high blood pressure and diabetes mellitus were based on clinical charts, whenever available. The diagnoses for anemia and diabetes were based on the results from automated hematology and biochemistry analyzers, respectively. Anemia was defined according to World Health Organization criteria8 as a hemoglobin level <13g/dL in men or <12g/dL in women. The diagnosis of diabetes was defined based on the current American Diabetes Association (ADA) guidelines, which include a fasting plasma glucose level of ≥7.0mmol/L (126mg/dL).9 Hypertension was defined as a consistent (three or more readings by the physician during a medical appointment) systolic blood pressure (SBP) ≥140mmHg or a diastolic blood pressure (DBP) ≥90mmHg.10

One hundred and seven subjects agreed to complete the Brazilian Older Americans Resources And Services Multidimensional Functional Assessment Questionnaire (BOMFAQ)7,8 and the Self-Reporting Questionnaire (SRQ-20)9,10; both interviews were carried out in person by trained students. Demographic data regarding the number of years of schooling and income were also obtained. The BOMFAQ consists of 15 questions about activities of daily living (ADL), divided into two sub-scales; eight physical ADL (PADL), and seven instrumental ADL (IADL). The PADL included getting into and out of bed, eating, combing the hair, walking on flat surfaces, having a bath/shower, getting dressed, getting to the toilet in time and cutting toenails. The IADL included climbing stairs (one flight), taking medicines on time, walking close to home, shopping, preparing meals, getting off buses and cleaning the house.11 The subjects’ responses to the BOMFAQ were analyzed according to two criteria: with or without difficulty to complete the task.

All statistical data analyses were performed using the Statistical Package for the Social Sciences (SPSS, version 21.0; IBM Corp., 2012). The Student's t-test, the chi-square test, and the Pearson correlation coefficient with a level of significance of 5% and a 95% confidence interval (95% CI) were used for data analysis. A two-tailed p-value <0.05 was considered statistically significant.

This report is based on 373 participants; 40% were pre-elderly subjects (50–59 years old) and 60% were women. There were no statistically significant differences in the clinical data (including age and gender) between the health care clinics (Table 1).

The prevalence of anemia in the studied population was approximately 11% for men and women in both health care clinics with hemoglobin <10g/dL being found in approximately 2% of the subjects (Table 2).

Approximately 52% of the subjects had diabetes in the Eldorado health care clinic which was a significantly higher frequency when compared to Piraporinha, where nearly 30% of the subjects were diabetic (p-value=0.0241; Table 2).

The frequencies of hypertension were similar in both clinics (70% in Eldorado and 81% in Piraporinha) with no statistically significant difference between genders (Table 2).

The Pearson correlation coefficient demonstrated that hemoglobin levels were inversely associated with age (Figure 1). In addition, hemoglobin values were significantly lower in the elderly when compared with the pre-elderly group (Figure 2).

Figure 1.

Correlation of hemoglobin values (g/dL) with age (years).

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Figure 2.

Distribution of hemoglobin values (g/dL) in pre-elderly and elderly groups (horizontal lines indicate medians).

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One hundred and seven subjects were assessed using both the BOMFAQ and the SRQ-20 instruments to evaluate the degree of disability and common mental disorders, respectively. Table 3 shows the sociodemographic data of the sample.

When the subjects were evaluated according to their level of independence, the subjects from the Eldorado health care clinic generally reported having more difficulties in two PADL and two IADL; walking on flat surfaces (44.1%), getting dressed (14.2%), getting off buses (40%) and cleaning the house (50%) (Table 4). Subjects from Eldorado also presented with more physical symptoms and emotional disorders when compared with Piraporinha subjects (Table 5).