Mortality in Brazilian community-dwelling older adults: 7 years of follow up in primary care.

Aim: To describe the main causes and factors associated with mortality in community-dwelling older adults in a county where the public health system covers most of the population.
Methods: We analyzed data from an existing cross-sectional study of 2209 participants (age ≥60 years) in a city in southeast Brazil where 92% of the population is served by a public system of primary care. Over a period of 7 years, 386 participants died and were included in the sample. We assessed the impacts that dependence on others for basic activities of daily living and instrumental activities of daily living, Geriatric Depression Scale scores, and health history have on mortality.
Results: The participants' mean age was 75.2 years (SD 8.2); 51.7% of the participants were women, and 51.3% had depressive symptoms. The main causes of death were circulatory diseases (40.3%), cancer (19.8%) and respiratory diseases (13.5%). Multivariate analysis showed that, taken together, the use of more than four medications per day, smoking, lower income, older age and dependence on others for a greater number of instrumental activities of daily living predicted death in this population.
Conclusions: Understanding the factors that are associated with mortality can facilitate understanding, and aid in developing policies regarding primary care for the elderly. Geriatr Gerontol Int 2016; 16: 804-809.
(© 2015 Japan Geriatrics Society.)