Social determinants of functioning and well-being in older adults: a multidimensional approach
1
Department of Speech, Language and, Hearing Sciences, São Paulo State University, Marília, Brazil
2
Graduate Program in Speech, Language, and Hearing Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
3
Department of Speech, Language, and Hearing Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Several factors accompany the aging process, including physical, cognitive, and social changes that may directly impact individuals’ autonomy in health care and their quality of life1-2. Therefore, this study aimed to analyze the association between functioning, perceived well-being, health literacy, and contextual aspects among older adults.
METHODS:
This was a cross-sectional analytical observational study with a sample of 101 older residents of a small city in Brazilian southeast, approved by the institutional ethics committee. Procedures included the application of the Brazilian Economic Classification Criterion (CCEB), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18), the WHO-5 Well-Being Index, and a clinical-care questionnaire. Descriptive and bivariate analyses, as well as multiple linear regression, were performed. Variables were manually removed from the initial model one by one, considering the highest p- value in each model, until only variables with a p-value <0.05 remained, forming the final model (backward elimination).
RESULTS:
Most participants were female, and the majority belonged to the socioeconomic class with the lowest purchasing power. The mean age was 76.2 years (±8.95), and mean schooling was 4.58 years (±4.00), considered low. In WHODAS 2.0, the mean scores across domains indicated good functional clinical status. In the WHO-5, the mean score was 16.81 points (±6.35), indicating good perceived well-being. In SAHLPA-18, the mean score was 12.38 points (±4.01), which is considered inadequate. In the final regression model for the Cognition domain, significant predictors were age, well-being, and health literacy. In the other domains assessed, the final models identified age and psychological well-being as significant predictors.
CONCLUSIONS:
Higher levels of health literacy and well-being were associated with better cognition and greater autonomy in health-related decision-making, whereas increasing age was associated with reduced functioning.
Several factors accompany the aging process, including physical, cognitive, and social changes that may directly impact individuals’ autonomy in health care and their quality of life1-2. Therefore, this study aimed to analyze the association between functioning, perceived well-being, health literacy, and contextual aspects among older adults.
METHODS:
This was a cross-sectional analytical observational study with a sample of 101 older residents of a small city in Brazilian southeast, approved by the institutional ethics committee. Procedures included the application of the Brazilian Economic Classification Criterion (CCEB), the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the Short Assessment of Health Literacy for Portuguese-Speaking Adults (SAHLPA-18), the WHO-5 Well-Being Index, and a clinical-care questionnaire. Descriptive and bivariate analyses, as well as multiple linear regression, were performed. Variables were manually removed from the initial model one by one, considering the highest p- value in each model, until only variables with a p-value <0.05 remained, forming the final model (backward elimination).
RESULTS:
Most participants were female, and the majority belonged to the socioeconomic class with the lowest purchasing power. The mean age was 76.2 years (±8.95), and mean schooling was 4.58 years (±4.00), considered low. In WHODAS 2.0, the mean scores across domains indicated good functional clinical status. In the WHO-5, the mean score was 16.81 points (±6.35), indicating good perceived well-being. In SAHLPA-18, the mean score was 12.38 points (±4.01), which is considered inadequate. In the final regression model for the Cognition domain, significant predictors were age, well-being, and health literacy. In the other domains assessed, the final models identified age and psychological well-being as significant predictors.
CONCLUSIONS:
Higher levels of health literacy and well-being were associated with better cognition and greater autonomy in health-related decision-making, whereas increasing age was associated with reduced functioning.
| eISSN: | 2654-1459 |
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