Stroke in older people in Brazil: prevalence, associated factors, limitations and care practices. A cross-sectional study.

Abstract

Background: Cardiovascular diseases, especially ischemic heart disease and stroke, are the main causes of mortality in older people.

Objectives: To estimate the prevalence of stroke in older people in Brazil, we investigated its associations with sociodemographic factors, health-related behaviors, chronic diseases, body mass index and self-rated health and determined the frequency of limitations related to disease and care practices.

Design and setting: This population-based, cross-sectional study used data from the 2019 Brazilian National Health Survey.

Methods: This study included older people aged ≥ 60 years (n = 22,728) who answered the question, "Has any doctor ever given you a diagnosis of stroke?" Adjusted odds ratios were estimated using logistic regression.

Results: The prevalence of stroke was 5.6% (95% confidence interval = 5.1-6.1) and was higher in men, individuals aged ≥ 70 years, those with a lower income, those without health insurance, ex-smokers, physically inactive individuals, those with excess weight/obesity, those who rated their own health as fair/poor/very poor and those who reported hypertension, diabetes, kidney failure, depression and heart disease. The most adopted care practices were follow-ups by a healthcare provider (60.8%), medication use (59.3%) and diet (47.2%). Only 17.0% of patients underwent physiotherapy, and 53.7% reported limitations in habitual activities.

Conclusions: Subgroups of people more affected by stroke were identified, which included older individuals, those with lower socioeconomic status, ex-smokers and those with neuroendocrine and cardiovascular comorbidities. Less than 20% of patients underwent physiotherapy, which underscores the need to expand multidisciplinary care in the health network.