Influência de fatores comportamentais e atitudinais na saúde mental de idosos atendidos na estratégia de saúde da família em São João del-Rei, Brasil: estudo longitudinal

Abstract

The prevalence of depression, stress and anxiety in older people is increasing in Brazil, and considered a major public health problem. Previous studies have correlated anxiety, depression and chronic stress with health problems and increased mortality in older adults. Despite this relationship, few investigations have explored the influence of behavioral and attitudinal factors on physical and mental health outcomes, particularly longitudinal studies. Therefore, the objective of the present study was to evaluate the influence of behavioral and attitudinal factors on the physical and mental health of older patients seen by Family Health Strategy (ESF) teams in the city of São João del-Rei, Minas Gerais, Brazil. A population-based longitudinal study with 1-year follow-up was conducted between 2017 and 2019. The sample was selected using the stratified proportional sampling technique with randomization (probabilistic sample), and included a total of 534 individuals in the first stage. Instruments were applied to assess cognition, physical activity, sleep, quality of life, social support, religiousness, spirituality, satisfaction with life, resilience, altruism, volunteerism, loneliness, meaning in life, successful aging, previous illnesses, medication use and mental health (depression, anxiety and stress). Analyses were carried out using linear and logistic regression models. A total of 490 older adults (91.8% of individuals assessed at baseline) were included in the second stage. A reduction in levels of depression, stress and anxiety was found at 1- year follow-up in this population of older adults. Traditional factors such as gender, sleep problems, ethnicity, alcohol use, as well as positive behavioral factors including loneliness, resilience and well-being at baseline, were associated with mental health at 1-year follow-up. Similarly, changes in scores for quality of life, loneliness, religiousness, feeling at peace, sleep problems and altruism were associated with changes in mental health scores. The results show that positive behavioral factors influenced the mental health of the older adults in the same way as traditional factors and should therefore be considered by health professionals and medical managers.