Sintomas depressivos e qualidade de vida em idosos na atenção primária

Abstract

Brazilian population aging is a challenge for public policies, with an estimated 65 million elderly people by 2050. Primary Care, the main access to the Unified Health System, is responsible for incorporating actions that meet the demand of the elderly population at the municipal level . Depression presents as a relevant and growing public health problem, being the main psychopathology in the elderly, with important repercussions such as reduction of quality of life, functional decline, increase in the use of health services and high mortality due to comorbidities and suicide. The general objective of this dissertation was to evaluate the quality of life and depressive symptoms in the elderly in primary care. It is composed of two exploratory, descriptive, quantitative and cross-sectional studies carried out with 248 elderly people enrolled in the Basic Health Units, in the city of Uberaba-MG. The instruments used were: a questionnaire with socio-demographic data, life habits and health conditions, the Mini-Mental State Examination - MMSE, the Geriatric Depression Scale (GDS-15), WHOQOL-Bref and WHOQOL- Old. For the analysis of the data was used Software Statistical Package for Social Science (SPSS) version 20.0 and level of significance for all inferential procedures was 1% (p≤0.01). This project was approved by the Municipal Health Secretariat and was approved by the Research Ethics Committee of the Federal University of Triângulo Mineiro. The first study aimed to determine the depressive symptomatology and associated factors, as well as to investigate the diagnosis of depression prior to the research and the use of antidepressant medication according to the intensity of depression. Depressive symptoms were observed in 32.7% of the elderly, 25.4% with indicative of mild depression and 7.3% with indicative of severe depression. Factors associated with the presence of depressive symptoms were physical activity and comorbidities. The diagnosis of depression prior to the research was observed in 22.2% of the elderly and 17% used antidepressant medication (44.4% of the elderly with indicative of severe depression, 22.2% of those with indicative of mild depression and 12% of the elderly with no depression). The second study aimed to evaluate the perception of quality of life (QoL) and its relation with socioeconomic variables and depressive symptoms. The elderly had a global score of 62.6 in WHOQOL-Bref, with the highest score in the psychological domain and the lowest in the environmental domain and the a global score in WHOQOL-Old of 64.9, with a better score in facet intimacy and a worse score for facet Social participation. Variables, sex, age, schooling income, occupation, religion and possess a companion affected WHOQOL-Bref domains and WHOQOL-Old facets. There was a significant relationship between the depressive symptoms and the psychological and social domains of the WHOQOL-Bref and the facet past, present and future activities of the WHOQOL-Old. Depressive symptoms were strong predictors of worse QoL perception by the two instruments, and lower educational level affected the psychological domain and did not have a companion influenced the social domain and facet intimacy. The results found in these two studies can guide programs, strategies and interventions to reduce depressive symptoms with a reduction in the negative impact on the QoL perception of this population.