Medication use and lifestyle behaviors among older adults in an urban population: implications for equitable and sustainable health systems
1
Departamento de Medicina Preventiva da Faculdade de Medicina, Universidade de São Paulo, São Paulo / São Paulo, Brazil
2
Departamento de Epidemiologia da Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo / São Paulo, Brazil
3
Departamento de Pesquisa, Hospital Sírio Libanês, São Paulo / São Paulo, Brazil
4
Faculdade de Farmácia, Universidade de São Paulo, São Paulo/São Paulo, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A102
ABSTRACT
BACKGROUND:
Medication use is highly prevalent among older adults and is a central component of chronic disease management, with important implications for the sustainability of health systems. Understanding how sociodemographic factors, health conditions, and lifestyle behaviors jointly influence medication use is essential to support integrated and equitable public health strategies. This study aimed to estimate the prevalence of medication use and examine its associated factors among older adults living in São Paulo, Brazil, using a hierarchical analytical approach.
METHODS:
This population-based cross-sectional study analyzed data from the ISA-Capital 2015 survey, including adults aged 60 years or older (n = 1,019), representative of the urban population of São Paulo. Self-reported information on medication use in the previous 15 days, sociodemographic characteristics, multimorbidity, self-rated health, sedentary behavior, physical activity, smoking, and alcohol consumption was collected. Prevalence estimates, 95% Confidence Intervals (95% CI), and associations were estimated as Prevalence Ratios (PR) using Poisson regression with robust variance, within a hierarchical model that included distal (sociodemographic), intermediate (health conditions), and proximal (lifestyle behaviors) determinants.
RESULTS:
The prevalence of medication use was 84.1%. In the final hierarchical model, higher medication use was observed with increasing age and among women. Multimorbidity was associated with medication use (PR = 1.41; 95%CI: 1.29–1.55), as was negative self-rated health (PR=1.14; 95%CI 1.09–1.20). Regarding lifestyle behaviors, spending ≥4 hours/day in sedentary behavior (PR=1.06; 95%CI: 1.01–1.12), engaging in ≥150 minutes/week of physical activity (PR=1.06; 95%CI 1.00–1.13), and alcohol consumption (PR=1.08; 95%CI 1.01–1.15) were independently associated with higher medication use.
CONCLUSIONS:
Medication use among older adults is influenced by a complex interplay of sociodemographic factors, health conditions, and lifestyle behaviors. These findings highlight the need for integrated public health strategies that combine pharmacological care with lifestyle interventions to support rational medication use and sustainable ageing in urban populations.
Medication use is highly prevalent among older adults and is a central component of chronic disease management, with important implications for the sustainability of health systems. Understanding how sociodemographic factors, health conditions, and lifestyle behaviors jointly influence medication use is essential to support integrated and equitable public health strategies. This study aimed to estimate the prevalence of medication use and examine its associated factors among older adults living in São Paulo, Brazil, using a hierarchical analytical approach.
METHODS:
This population-based cross-sectional study analyzed data from the ISA-Capital 2015 survey, including adults aged 60 years or older (n = 1,019), representative of the urban population of São Paulo. Self-reported information on medication use in the previous 15 days, sociodemographic characteristics, multimorbidity, self-rated health, sedentary behavior, physical activity, smoking, and alcohol consumption was collected. Prevalence estimates, 95% Confidence Intervals (95% CI), and associations were estimated as Prevalence Ratios (PR) using Poisson regression with robust variance, within a hierarchical model that included distal (sociodemographic), intermediate (health conditions), and proximal (lifestyle behaviors) determinants.
RESULTS:
The prevalence of medication use was 84.1%. In the final hierarchical model, higher medication use was observed with increasing age and among women. Multimorbidity was associated with medication use (PR = 1.41; 95%CI: 1.29–1.55), as was negative self-rated health (PR=1.14; 95%CI 1.09–1.20). Regarding lifestyle behaviors, spending ≥4 hours/day in sedentary behavior (PR=1.06; 95%CI: 1.01–1.12), engaging in ≥150 minutes/week of physical activity (PR=1.06; 95%CI 1.00–1.13), and alcohol consumption (PR=1.08; 95%CI 1.01–1.15) were independently associated with higher medication use.
CONCLUSIONS:
Medication use among older adults is influenced by a complex interplay of sociodemographic factors, health conditions, and lifestyle behaviors. These findings highlight the need for integrated public health strategies that combine pharmacological care with lifestyle interventions to support rational medication use and sustainable ageing in urban populations.
| eISSN: | 2654-1459 |
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