O uso e acesso aos serviços de saúde entre idosos com indicativo de depressão residentes em um município mineiro

Abstract

Populational aging is a worldwide reality. Brazil is going through a fast demographic transition and, consequently, the epidemiological profile of the country is constantly changing. Considering that, there is an increase in the demands for health services due to a higher requirement by elder individuals. Mental diseases are among the chronic non-transmissible diseases that most directly cause disabilities and worsen the quality of life, also impacting the family of the individuals. Depression is the most frequent mood disorder among elders. In this perspective, this study is justified due to the lack of investigations that can relate the access and the use of health services among elders to depression indexes, as it can advance discussions on the theme, thus obtaining pertinent information on the aforementioned context. This research aimed at assessing the association of the depression indexes to the use and access of health services among elders who live in a city at the state of Minas Gerais. This is a quantitative approach, an analytical, cross-sectional and observational domiciliary inquiry, carried out with 580 elders in the urban area of the city of Uberaba, Minas Gerais. The following instruments were used: Mini-Mental State Examination (MMSE), sociodemographic data characterization, access and use of health services, Depression indexes, use of alcohol, frequency, type of drink ingested and dependency, polypharmacy and morbidities mentioned by the patient. Two groups were formed: elders with depression indexes and elders without them. Data were analyzed according to descriptive statistics and a bivariate analysis was conducted using association measures in contingency tables (chi-square, prevalence ratios and prevalence chance ratios) to the categoric variables. An adjusted analysis included a multiple binomial logistic regression, considering a Confidence Interval (CI) of 95% and a significance level of 5%. This project was approved by the Committee of Ethics in Researches with Humans at UFTM, under protocol n. 2.295.596. The prevalence of depression indexes (DI) was 25.5%. Most elders were female in both groups, 70.9% with DI and 67.4% without. The ratio of elders with probable alcohol abuse was 7.24%. The percentage of those with 5 or more morbidities stood out (62.24%) as did that ofelders who use from 1 to 4 different medications (55.86%). Among the variables of the preliminary bivariate analysis, those which were associated to the use and access to health services were access to health services and use of alcohol (p=0.04). Considering the other indexes of use and access of health services, regarding depression indexes, no variable was statistically significant in the regression model. The results of this research may support the implementation of strategies focused on depression, targeted at the health of the elders who live in the community.