Original articleGender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in São Paulo, Brazil
Section snippets
Methods
We analyzed data from the two waves (2000 and 2006) of SABE São Paulo, Brazil. The SABE is a multicenter survey with respondents in seven capital/major cities throughout the countries of Latin America and the Caribbean that has been investigating the health and well-being of older adults (age ≥60 years). The Pan American Health Organization, the Center for Demography and Ecology at the University of Wisconsin—Madison, and the National Institute on Aging provided funding and support for the
Results
Table 1 presents the prevalence estimates of ADL disability and assistance by age group and gender in São Paulo, Brazil for 2000. Weighted estimates indicate that 19.2% of individuals aged 60 years and over in São Paulo reported having difficulty in performing at least one ADL. The most prevalent types of ADL disabilities were difficulties in dressing and getting out of bed. The prevalence of ADL disability was higher among women (22.3%) than among men (14.9%; p < .01). In analyses controlling
Discussion
The current paper had three goals. The first was to examine the impact of gender on the TLE, the DFLE, and the DLE, while taking health transitions into account. Women in Brazil were more likely than men to have difficulty getting in and out of bed and walking across the room. Difficulties performing these activities could be lessened with the use of assistive devices such as a walkers or grab bars. There were no differences between men and women in other ADL disability measures more closely
Conclusion
Using longitudinal data from São Paulo, Brazil, this study confirmed previous studies that found that older women faced a greater disability burden than men. Given the greater prevalence of disability and longer periods of DLE compared with older men, older women face more social and economic marginalization tied to the stigma associated with disability (Filmer, 2008, Robb et al., 2008). The findings have important implications for policy makers in São Paulo, Brazil and other developing
Acknowledgments
The authors thank the editor and the anonymous reviewers for their insightful comments. The author thanks the following individuals for comments during the 2010 REVES meeting in Cuba: Sandra L. Reynolds, Yasuhiko Saito and Zachary Zimmer. The authors also acknowledge the help of Fernão Dias de Lima in the careful database management.
Flavia Cristina Drumond Andrade, PhD, is an Assistant Professor at the Kinesiology and Community Health Department at the University of Illinois, Urbana-Champaign. Her primary research interest focuses on the determinants of population health, particularly in Latin America and in the Caribbean.
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2018, Archives of Gerontology and GeriatricsCitation Excerpt :On the other hand, similar effect in both sexes was observed for BADL and mobility among elderly from Netherlands (Majer et al., 2011) and in the elderly’s cohort older than 90 years old living in Denmark, for disability in BADL (Nybo et al., 2003). Usually women experience higher rates of disability, despite living longer than men (Camargos, Perpetuo, & Machado, 2005; Drumond Andrade et al., 2011; Dunlop, Hughes, & Manheim, 1997; Hardy, Allore, Guo, & Gill, 2008; van Houwelingen et al., 2014). This high frequency of disability among older women can be due to the high incidence and long duration of the limitation in performance BADL, resulting in low rates of recovery and mortality, compared to men (Dunlop et al., 1997; Hardy et al., 2008).
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2020, Archives of Gerontology and GeriatricsCitation Excerpt :Research in developing countries is limited and several papers report recovery as an indirect result of their main objectives. While calculating disability-free life expectancy, researchers report that Mexicans aged 65+ have a higher probability of recovering from an ADL limitation than Puerto Ricans (Payne, 2018); others find no gender differences in the probability of recovering from an ADL limitation in São Paulo, Brazil (Andrade, Guevara, Lebrão, de Oliveira-Duarte, & Ferreira-Santos, 2011); additional research finds that around 34 % of a national sample of older Mexican Americans recovered within two years, with factors like fewer depressive symptoms, higher BMI, and younger age being associated with their recovery (Al Snih, Markides, Ostir, Ray, & Goodwin, 2003). Finally, in China, older women have a lower probability than older men of recovering after reporting an ADL limitation (Gu & Zeng, 2004).
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Flavia Cristina Drumond Andrade, PhD, is an Assistant Professor at the Kinesiology and Community Health Department at the University of Illinois, Urbana-Champaign. Her primary research interest focuses on the determinants of population health, particularly in Latin America and in the Caribbean.
Pilar Egüez Guevara is a PhD candidate in Anthropology at the University of Illinois, Urbana-Champaign. She has experience in the field of women's health, gender responsive budgeting and human rights in Ecuador. Her current research focuses on women's sexuality in Cuba.
Maria Lúcia Lebrão, PhD, is Professor at the School of Public Health, Universidade de São Paulo, located in Pinheiros, São Paulo, Brazil. She is one of the principal investigators of the SABE study in São Paulo.
Yeda Aparecida de Oliveira Duarte, PhD, is a Professor at the School of Nursing at Universidade de São Paulo.
Jair Lício Ferreira Santos, PhD, is Professor of Demography at the School of Public Health, where he also served as Director, and at the School of Medicine of Ribeirão Preto at the University Universidade de São Paulo.
Supported by FAPESP/Brazil, the Brazilian Ministry of Health and the Lemann Institute for Brazilian Studies at the University of Illinois at Urbana-Champaign.