Prevalência do autorrelato da qualidade auditiva e seu impacto na sobrevivência de idosos ribeirinhos de Maués - AM

Abstract

Human aging is associated to progression of physiological dysfunctions and risk to develop chronic non-transmissible diseases (CNTDs. Among degenerative alterations found in elderly people that can compromise its social interaction and cognition is hearing loss (presbiacusia). This condition is triggered from progressive degeneration of sensorial, neural estrial regions and also of cells that given support to cochlea. Considering that it is a main cause of hearing loss in elderly people, studies about this dysfunction area strongly relevant. Evidence showed that riverine elderly living in Amazonian Raiforest region present lowest prevalence of CNTDs, such as cardiovascular diseases and metabolic syndrome than elderly living in Manaus, a highest urbanized area of Amazonas State. However, studies about impact of hearing loss on quality of life of riverine elderly was not produced yet. Therefore, the main objective of the present investigation was to investigate the hearing quality by auto-report of riverine elderly inserted in the Family Strategy Health Program of Brazilian’s Health Ministry (ES-SUS) of Maués-AM city and its impact on elderly survival followed by 7-years (84 months). Socioeconomic, cultural, health and lifelstyle indicators including health, memory, hearing and vision self-report were obtained from a databank organized in July 2009. From this databank, the elderly the mortality of elderly that participated of this first phase of project was followed by 84 months in order to evaluate the impact of self-report hearing quality on survival. Initially was performed a statistical analysis comparing elderly that report poor, regular or good hearing condition with other health, lifestyle and socioeconomic and cultural variables using Student t test. Survival among these three groups of hearing quality was determined by Kaplan-Meier mortality curve. In both analysis, multivariate logistic regression was performed to evaluate potential intervenient variables in the univariate statistical significant analysis. Results: A total of 540 elderly with previous information collected in July 2009 was included in the study with mean age 72.3 ± 7,8 years old. Most elderly reported hearing well or very well, and younger elderly (60 to 74 years) presented less prevalence of poor hearing self-reported (7.6%) than older elderly ( > 75 years) (15,8%) (p=0.001). From all elderly investigated, 107 (19.5%) died in the period evaluated. As expected age influenced the mortality since just 11.9% of younger elderly died whereas 24.8% of older elderly died in the 7-years follow-up. From elderly that reported poor hearing, 20.6% (n=22) died, whereas just 10.6% (n=46) of elderly that report regular or good hearing died in the same period. Multivariate analysis showed that association between self-report hearing condition and risk of mortality was independent of sex, age and other previous morbidities (p = 0.007). In this way, the results reported here suggested that hearing condition has a strong impact on riparian elderly survival than clinical conditions, probably due high relevance of hearing in social interactions. These results corroborate previous epidemiological that also described negative impact of poor hearing in the elderly survival. An explanation to higher mortality risk associated to poor hearing is the fact that traditional populations, such as riverine the communication is strongly performed by oral transmission than writing and reading-transmission. In fact, most riverine elderly included in this study did not have or have lower formal education, and in the Amazonas rural-riverine area the main mass communication is yet the radio and the “communitarian voices”, and not tv or journal, magazines, book reading, or internet reading. Therefore, results described here reinforce that hearing condition is a sensorial aspect that has large impact on traditional communities living in Amazonian rainforest.