Impact of combined hypertension and diabetes on the prevalence of disability in brazilian older people evidence from population studies in 2013 and 2019

Abstract

Disability in basic and instrumental activities of daily living (BADL and IADL) reflects functional decline in older adults and can be associated with chronic conditions like type 2 diabetes (T2DM) and hypertension (SAH). This cross-sectional study utilized data from the 2013 and 2019 Brazilian National Health Surveys to investigate the associations between T2DM, SAH, and disability levels. Exposures were self-reported diagnoses and outcomes were classified as independent, moderate, or severe. Multivariable Poisson regression models, with robust variance estimates, estimated adjusted prevalence ratios (PRa), accounting for sociodemographic variables and the survey design. In 2013, the absence of diabetes and hypertension was associated with a lower prevalence (PRa = 0.70; 95% CI: 0.58–0.85) of moderate disability in BADL when compared with the presence of only one of the conditions. On the other hand, the coexistence of T2DM and SAH was associated with a higher prevalence (PRa = 1.39; 95% CI: 1.01–1.91). A similar result was found in 2019 with the addition that coexistence was also associated with a higher prevalence of severe disability in BADLs (PRa = 1.82; 95% CI: 1.59–2.07). For IADL, the absence of T2DM and SAH was associated with a lower prevalence of severe disability in 2013 and 2019 and a lower prevalence of moderate disability only in 2019. However, coexistence showed a higher prevalence in both degrees of disability and both years of the survey. These findings highlight the impact of T2DM and SAH on disability in older people. Therefore, it is crucial to develop targeted strategies for vulnerable subgroups to enhance functional independence in aging populations.