Health Self-Awareness in Senior Citizens: Focus on Physical, Emotional and Cognitive Health

Abstract

Senior people usually express high levels of satisfaction and quality of life, even though they may be facing comorbidities and disabilities. This is an evidence of how unreliable quantitative measures, taken alone, can be when trying to understand the health levels of this population. Health self-awareness has been widely used in order to assess the health of old people. The present study describes how a sample of Brazilian senior citizens assesses their general health and verifies the relationship between negative health self-awareness and social-demographic factors as well as physical, emotional and cognitive impairment in this population. There were 427 senior subjects in the sample aged 65 or more from both genders. The primary outcome was assessed by the question: “on the whole, how do you assess your health?”. This variable was divided into 2 groups: positive perception (options very good and good) and negative perceptions (options fair, bad and very bad). The independent variables were: social demographic; physical aspects of health; emotional and humour aspects; and cognitive aspects. In our studies, 42.4% of seniors had negative health self-awareness. The logistic regression analyses showed that the social demographic factor could explain negative health self-awareness in 62.4% of the subjects. However, only the association with education was statistically significant (p < 0.001). Diabetes, self-referred depression and instrumental activities were statistically related to the worse health self-awareness (p = 0.01; 0.05; 0.02 and 0.05, respectively). The emotional aspect was responsible for 64.9% of the negative health self-awareness (p < 0.001), while the cognitive aspect (p = 0.052) had a predictive value of 57.6%. From the findings in the present study, it is possible to conclude functional loss and the presence of chronic diseases is not enough to explain negative health self-awareness in old people. It is important to take into account education and the presence of depressive symptoms.