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Contributo para o estudo dos efeitos da passagem à situação (e idade) de reforma na frequência das principais doenças crónicas em Portugal
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| 3.92 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
[PT] Introdução: A transição para a reforma é um acontecimento que pode
acarretar alterações suscetíveis de afetar o estado de saúde. Vários estudos
têm investigado os efeitos da reforma no estado de saúde, embora poucos o
tenham investigado, especificamente, nas doenças crónicas. As recentes
políticas de aumento da idade de reforma, assim como a ausência de consenso
sobre os efeitos da reforma na saúde, atribuem-lhe ainda maior importância.
Constituem objetivos do presente estudo quantificar a associação entre a
Passagem à situação de reforma (e idade de reforma) e a frequência de cada
uma das principais doenças crónicas, no sentido dos efeitos da reforma nestes
indicadores de saúde (doença respiratória crónica, diabetes, doença
cardiovascular, AVC, depressão e cancro).
Material e Métodos: Desenvolveu-se um estudo transversal, no qual foram
analisados os dados provenientes das amostras representativas da população
portuguesa SHARE 2011 e ECOS 2013. As associações foram quantificadas
através do cálculo do Odds ratio por Regressão Logística Binária com
avaliação do confundimento e modificação de efeito. As variáveis de doença
crónica foram medidas por auto-reporte. Foram considerados os reformados
que se encontrassem em processo de reforma (ou seja, reformados há 5 anos
ou menos) e que não se tivessem reformado por doença.
Resultados: A reforma não se encontrou significativamente associada a
nenhuma das doenças crónicas consideradas, excetuando-se: i) o cancro (na
amostra ECOS), para o qual foi fator protetor; ii) e a doença cardiovascular (na
amostra SHARE), para a qual teve um efeito prejudicial, mas apenas em não
hipertensos. A reforma em idade antecipada pareceu encontrar-se associada a
um pior estado de saúde, relativamente à reforma em idade legal (ou após). Tal
observou-se no Cancro (nas amostras ECOS e SHARE), na Diabetes (na
amostra SHARE), e no AVC em pessoas sem Doença Cardiovascular (na
amostra SHARE). Pelo contrário, em pessoas com Doença Cardiovascular a
reforma antecipada pareceu constituir um fator protetor.
Discussão e conclusões: As diferenças observadas nos resultados entre
amostras poderão, entre outros, atribuir-se às diferentes populações em
estudo, dimensões amostrais e desenhos de amostragem. Os resultados
obtidos não são muito diferentes dos que têm sido descritos na bibliografia,
ainda que haja um número reduzido de estudos sobre esta matéria. Indicam
que, eventualmente, as recentes alterações de aumento da idade de reforma
poderão expandir o grupo de pessoas que se reformam antecipadamente,
podendo resultar, eventualmente, num aumento da prevalência de doenças
crónicas na população portuguesa. Os mecanismos através dos quais a
reforma poderá influenciar a ocorrência de doenças crónicas permanecem por
explicar, embora os seus principais fatores de risco pareçam representar
importantes modificadores de efeito.
[ENG] Introduction: Retirement transition is an event which may cause changes affecting health. Several studies have investigated the effects of retirement on health, though few have investigated specifically these effects on chronic diseases. The recent policies of increasing the retirement age, as well as the lack of consensus on the effects of retirement on health, result in even greater importance. The present study aims to quantify the association between retirement (and retirement age) and the frequency of each of the major chronic diseases, in the sense of the effects of retirement on these health status indicators (chronic respiratory disease, diabetes, cardiovascular disease, stroke, depression and cancer). Material and Methods: We planed and developed a cross-sectional study, in which data from two representative samples of the Portuguese population were analyzed (SHARE 2011 and ECOS 2013). The associations were quantified by calculating the odds ratio in Binary Logistic Regression with assessment for confounding and effect modification. The chronic disease variables were selfreported. Pensioners who were in retirement process (retired for 5 years or less) and that hadn’t been retired because of disease were considered. Results: The retirement was not found to be significantly associated with any of the chronic diseases considered, except for: i) cancer (in the ECOS sample), to which was a protective factor; ii) and cardiovascular disease (in the SHARE sample), to which was a risk factor, but only in non-hypertensive individuals. Early retirees seemed to find themselves associated with a worse health state, compared to retirees at legal age (or after). This was observed for cancer (in ECOS and SHARE samples), diabetes (in SHARE sample), and stroke but only in people without cardiovascular disease (in SHARE sample). On the contrary, in people with cardiovascular disease early retirement seemed to be a protective factor. Discussion and conclusions: The differences in results between samples may be assigned to the different study populations, sample sizes and sample design. The results are not very different from what have been described in the literature, although there are a small number of studies on this subject. They suggest that, possibly, the retirement age changes may expand the group of early retirees which can result in an increased prevalence of chronic diseases in the Portuguese population. The mechanisms through which retirement could influence the occurrence of chronic diseases remain unexplained, although the main risk factors for chronic diseases appear to represent important effect modifiers.
[ENG] Introduction: Retirement transition is an event which may cause changes affecting health. Several studies have investigated the effects of retirement on health, though few have investigated specifically these effects on chronic diseases. The recent policies of increasing the retirement age, as well as the lack of consensus on the effects of retirement on health, result in even greater importance. The present study aims to quantify the association between retirement (and retirement age) and the frequency of each of the major chronic diseases, in the sense of the effects of retirement on these health status indicators (chronic respiratory disease, diabetes, cardiovascular disease, stroke, depression and cancer). Material and Methods: We planed and developed a cross-sectional study, in which data from two representative samples of the Portuguese population were analyzed (SHARE 2011 and ECOS 2013). The associations were quantified by calculating the odds ratio in Binary Logistic Regression with assessment for confounding and effect modification. The chronic disease variables were selfreported. Pensioners who were in retirement process (retired for 5 years or less) and that hadn’t been retired because of disease were considered. Results: The retirement was not found to be significantly associated with any of the chronic diseases considered, except for: i) cancer (in the ECOS sample), to which was a protective factor; ii) and cardiovascular disease (in the SHARE sample), to which was a risk factor, but only in non-hypertensive individuals. Early retirees seemed to find themselves associated with a worse health state, compared to retirees at legal age (or after). This was observed for cancer (in ECOS and SHARE samples), diabetes (in SHARE sample), and stroke but only in people without cardiovascular disease (in SHARE sample). On the contrary, in people with cardiovascular disease early retirement seemed to be a protective factor. Discussion and conclusions: The differences in results between samples may be assigned to the different study populations, sample sizes and sample design. The results are not very different from what have been described in the literature, although there are a small number of studies on this subject. They suggest that, possibly, the retirement age changes may expand the group of early retirees which can result in an increased prevalence of chronic diseases in the Portuguese population. The mechanisms through which retirement could influence the occurrence of chronic diseases remain unexplained, although the main risk factors for chronic diseases appear to represent important effect modifiers.
Description
Keywords
Reforma Doenças Crónicas Idade de Reforma AVC Doença Cardiovascular Depressão Doença Respiratória Crónica Diabetes Cancro Estados de Saúde e de Doença Portugal Chronic Diseases Retirement Retirement Age Stroke Cardiovascular Disease Cancer Depression Chronic Pumonary Disease