¿Cuántos adultos mayores necesitarán atención a la dependencia en América Latina?

  1. Mauricio Matus-López 1
  2. Alexander Chaverri-Carvajal 1
  1. 1 Universidad Pablo de Olavide
    info

    Universidad Pablo de Olavide

    Sevilla, España

    ROR https://ror.org/02z749649

Revista:
Actas de coordinación sociosanitaria

ISSN: 2529-8240

Ano de publicación: 2022

Número: 31

Páxinas: 74-94

Tipo: Artigo

DOI: 10.48225/ACS_31_74 DIALNET GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: Actas de coordinación sociosanitaria

Resumo

Many studies agree that Latin America is aging rapidly but very few studies have evaluated, from a comparative perspective, the proportion of adults with long-term care needs. This study aims to conduct a systematic review of estimates of older adults who suffer limitations to activities of daily living and/or need help to perform them, in Latin American countries. PubMed, Web of Science, Scopus and Scielo databases were electronically searched until May 31, 2020. We searched for articles published in English, Spanish and Portuguese. Terms included was related to “long-term care”, “older adults” and “activities of daily living” for Latin America as a region or its 18 countries. National-representative estimates were selected. In addition, the snowball sampling methodology was used to include research that could meet the same criteria. In total, 22 papers were identified for seven countries. The results allow us to conclude at least three things. First, that there is a gap in studies with a regional perspective. Second, that there is no consensus on how to measure and what activities to consider for valuations. Third, that, despite the methodological differences, the authors of the studies agree that the percentages of the elderly population, who suffer limitations for the activities of their daily life and / or need help for it, are high, mainly in Uruguay, Costa Rica, Brazil, Chile, Colombia and Argentina. In conclusion, the concern of governments is certain, and it is necessary to make decisive progress in Latin American social protection systems to include systems of care for dependency, while increasing efforts to promote healthy aging.

Referencias bibliográficas

  • Albala, C., Lebrao, M. L., Léon Díaz, E. M., Ham-Chande, R., Hennis, A. J., Palloni, A., … Pratts, O. (2005). Encuesta salud, bienestar y envejecimiento (SABE): Metodología de la encuesta y perfil de la población estudiada. Pan American Journal of Public Health, 17(5–6). 307–322. https://doi.org/10.1590/s1020-49892005000500003
  • Andrade, T. B., & Andrade, F. B. (2018). Unmet need for assistance with activities of daily life among older adults in Brazil. Rev Saude Publica, 52, 75. https://doi.org/10.11606/ s1518-8787.2018052000463
  • Aranco, N. y Soto, R. (2020). Panorama de Envejecimiento y Atención a la Dependencia en Uruguay. Serie Aprendizajes en cohesión social, 1. BID /EUROsociAL. Disponible en: https://eurosocial.eu/biblioteca/doc/panorama-de-envejecimiento-y-atencion-a-ladependencia-en-uruguay/
  • Arce, P., Cerón, G., González, F., Guerrero, M., y Pinto, S. (2017). Caracterización de la dependencia en las personas en situación de discapacidad a partir del II Estudio Nacional de la Discapacidad. Santiago: SENADIS. Disponible en: https://www.senadis.gob.cl/descarga/i/5058
  • Banaszak-Holl, J., Fendrick, N. L. Foster, A. M., Herzog, A. R., Kabeto, M. U., Kent, D. M., Straus, W. L. y Langa. K. M. (2004). Predicting nursing home admission: estimates from a 7-year follow-up of a nationally representative sample of older Americans, Alzheheimer Disease and Associated Disorders, 18(2): 83-89.
  • Barrantes-Monge, M., Garcia-Mayo, E. J., Gutierrez-Robledo, L. M., & Miguel-Jaimes, A. (2007). Dependencia funcional y enfermedades crónicas en ancianos mexicanos. Salud Publica Mex, 49 Suppl 4, S459-66. https://doi.org/10.1590/s0036-36342007001000004
  • Barrientos, J. G., Velosa, L. D., y Cardona, F. A. (2016). What are the long-term care received by the beneficiaries of the social welfare secretary Medellin (Colombia)? a descriptive study. Archivos de Medicina, 16(1). 22–31.
  • Batthyány, K., Berriel, F., Carbajal, M., Genta, N., Paredes, M., Pérez, R., y Perrotta, V. (2014). Las personas mayores ante el cuidado. Aportes de Inmayores para la construcción de un Sistema Nacional de Cuidados. Montevideo: MIDES. Disponible en: http://dspace.mides.gub.uy:8080/xmlui/handle/123456789/451
  • Becker, U., y Reinhard, H.-J. (2018). Long-Term Care in Europe: a Juridical Approach. Cham: Springer. https://doi.org/10.1007/978-3-319-70081-6
  • Bloeck, M. C., Galiani, S., y Ibarraran, P. (2019). Long-Term Care in Latin America and the Caribbean: Theory and Policy Considerations. Economia-Journal of the Latin American and Caribbean Economic Association, 20(1). 1–32.
  • BPS, Banco de Previsión Social (2020). Memoria Anual. Disponible en: https://www.bps.gub.uy/bps/file/18331/1/memoria-2020.pdf
  • CDC, Centers of Disease Control and Prevention (2020). Impairments, Activity Limitations, and Participation Restrictions. Disponible en: https://www.cdc.gov/ncbddd/ disabilityandhealth/disability.html
  • CEPAL, Comisión Económica para América Latina y el Caribe. (2021). Indicadores demográficos. Estimaciones y proyecciones anuales. Disponible en: https://www.cepal.org/es/ indicadores-demograficos-interactivos
  • Colombo, F., Nozal-Llena, A., Mercier, J., y Tjadens, F. (2011). Help wanted? Providing and Paying for Long-Term Care. Paris: OECD Publishing. https://doi.org/10.1080/08832323.1956.9958922
  • Cotlear, D. (2011). Population aging: is Latin America ready?. Washington D.C.: World Bank.
  • Da Roit, B. y Le Bihan, B. (2010). Similar and Yet So Different: Cash-for-Care in Six European Countries’ Long-Term Care Policies. The Milbank Quarterly, 88(3), 286–309. https://doi.org/10.1111/j.1468-0009.2010.00601.x
  • De la Maisonneuve, C., y Oliveira, J. (2013). A Projection Method for Public Health and Long-Term Care Expenditures, OECD Working Papers, 1048. https://doi.org/10.1787/5k44v53w5w47-en
  • De Meijer, C., Koopmanschap, M., d’Uva, T. B., y van Doorslaer, E. (2011). Determinants of long-term care spending: Age, time to death or disability? Journal of Health Economics, 30(2). 425–438. https://doi.org/10.1016/j.jhealeco.2010.12.010
  • Dorantes-Mendoza, G., Ávila-Fuñes, J. A., Mejía-Arango, S., y Gutiérrez-Robledo, L. M. (2007). Factors associated with functional dependence in older adults: A secondary analysis of the National Study on Health and Aging, Mexico, 2001. An American Journal of Public Health, 22(1), 1–11. https://doi.org/10.1590/S1020-49892007000600001
  • EC, European Commission. (2012). The 2012 Ageing Report: Economic and budgetary projections for the 27 EU Member States (2010-2060). European Economy, 2.
  • Foley, D. J., Ostfeld, A. M., Branch, L. G., Wallace, R. B., McGloin, J. y Cornoni-Huntley J. C.. (1992). The risk of nursing home admission in three communities, Journal of Aging and Health 4(2): 155-173
  • Fu, L., Sun, Z., He, L., Liu, F., y Jing, X. (2019). Global Long-Term Care Research: A Scientometric Review. International Journal of Environmental Research and Public Health, 16(12). 2077. https://doi.org/10.3390/ijerph16122077
  • Dorantes-Mendoza, G., Ávila-Fuñes, J. A., Mejía-Arango, S., y Gutiérrez-Robledo, L. M. (2007). Factors associated with functional dependence in older adults: A secondary analysis of the National Study on Health and Aging, Mexico, 2001. An American Journal of Public Health, 22(1), 1–11. https://doi.org/10.1590/S1020-49892007000600001
  • Giacomin, K. C., Duarte, Y. A. O., Camarano, A. A., Nunes, D. P., y Fernandes, D. (2018). Care and functional disabilities in daily activities - ELSI-Brazil. Revista de Saude Publica, 52. https://doi.org/10.11606/S1518-8787.2018052000650
  • González, F., Massad, C., y Lavanderos, F. (2010). Estudio Nacional de la Dependencia en las Personas Mayores. https://doi.org/10.1017/CBO9781107415324.004
  • Gragnolati, M., Jorgensen, O. H., Rocha, R., y Fruttero, A. (2011). Health Care and Long-Term Care. In M. Gragnolati, O. et al. (Eds.), Growing Old in an Older Brazil. (pp. 121–165). Washington: World Bank. https://doi.org/10.1596/9780821388020_ch04
  • Greene, V. L., Lovely, M. E., Miller, M. D. y Ondrich, J. I. (1995). Reducing nursing home use through community long-term care: an optimization analysis, The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 50(4): S259-S268.
  • IMAS, Instituto Mixto de Ayuda Social. (2021). Política Nacional de Cuidados 2021-2031. Disponible en: https://www.imas.go.cr/sites/default/files/custom/Politica%20 Nacional%20de%20Cuidados%202021-2031_0.pdf
  • Jara-Maleš, P., Matus-López, M., y Chaverri-Carvajal, A. (2020). Tendencias y desafíos para conformar un sistema de cuidados de larga duración en Costa Rica. BID Nota Técnica, IDB_TN, 1878. https://doi.org/10.18235/0002214
  • Jotheeswaran, A. T., Bryce, R., Prina, M., Acosta, D., Ferri, C. P., Guerra, M., … Prince, M. (2015). Frailty and the prediction of dependence and mortality in low- and middle-income countries: A 10/66 population-based cohort study. BMC Medicine, 13(1). https://doi.org/10.1186/s12916-015-0378-4
  • Laferrère, A., y Bosch, K. Van den. (2015). Unmet need for long-term care and social exclusion. In A. Börsch-Supan, T. Kneip, H. Litwin, M. Myck, y G. Weber (Eds.). Ageing in Europe -Supporting Policies for an Inclusive Society (pp. 331–342). Berlin, Boston: De Gruyter. https://doi.org/https://doi.org/10.1515/9783110444414-032
  • Lima-Costa, M. F., de Andrade, F. B., Souza, P. R. B. de, Neri, A. L., Duarte, Y. A. de O., CastroCosta, E., y de Oliveira, C. (2018). The Brazilian Longitudinal Study of Aging (ELSIBrazil): Objectives and Design. American Journal of Epidemiology, 187(7), 1345–1353. https://doi.org/10.1093/aje/kwx387
  • Lloyd-Sherlock, P. (2014). Beyond Neglect: Long-term Care Research in Low and Middle Income Countries. International Journal of Gerontology, 8(2). 66–69. https://doi. org/10.1016/j.ijge.2013.05.005
  • Lloyd-Sherlock, P., y Redondo, N. (2009). Institutional Care for Older People in Developing Countries: The Case of Buenos Aires, Argentina. Journal of Population Ageing, 2(1–2). 41–56. https://doi.org/10.1007/s12062-010-9017-1
  • Lozano Keymolen, D., Montoya Arce, B. J., Gaxiola Robles Linares, S. C., y Román Sánchez, Y. G. (2018). Dependencia funcional y su relación con la mortalidad general en adultos mayores. México: 2001-2015. Población y Salud en Mesoamérica, 15(2), 38–68. https://doi.org/10.15517/psm.v15i2.28660
  • Manrique-Espinoza, B., Salinas-Rodriguez, A., Moreno-Tamayo, K. M., Acosta-Castillo, I., SosaOrtiz, A. L., Gutierrez-Robledo, L. M., y Tellez-Rojo, M. M. (2013). Health conditions and functional status of older adults in Mexico. Salud Publica Mex, 55 Suppl 2, S323-31.
  • Matus- López, M. y Terra, F. (2018). The long-term care system in Uruguay. Social Policy Country Briefs, 6. Universitat de Bremen. https://doi.org/10.26092/elib/639
  • Matus-López, M, y Cid, C. (2020). Fiscal Space for Health in Latin America and the Caribbean. Washington D.C.: CEPAL. https://doi.org/10.37774/9789275120002
  • Matus-López, M, y Cid, C. (2014). Costo de un sistema de atención de adultos mayores dependientes en Chile, 2012 – 2020. Pan American Journal of Public Health, 36(1). 31–36.
  • Matus-López, M, y Cid, C. (2016). New Long-Term Care Policies in Latin America: The National System of Care in Uruguay. Journal of the American Medical Directors Association, 17(7). 663–665. https://doi.org/10.1016/j.jamda.2016.04.001
  • Matus-López, M. (2015a). Thinking about long-term care policies for Latin America Salud Colectiva, 11(4). 485–496. https://doi.org/10.18294/sc.2015.785
  • Matus-López, M. (2015b). Tendencias en las políticas de atención a la dependencia de ancianos y sus reformas. Cadernos de Saude Publica, 31(12). 2475–2481. https://doi. org/10.1590/0102-311X00039315
  • Matus-López, M. (2021). Diferencia entre cuidados a la dependencia y cuidados de larga duración o long-term care, MPRA Paper 107959. Disponible en: https://ideas.repec. org/p/pra/mprapa/107959.html
  • Matus-López, M. y Chaverri, A. (2022). Progress Toward Long-Term Care Protection in Latin America: A National Long-Term Care System in Costa Rica. Journal of the American Medical Directors Association, 23(2): 266-271. https://doi.org/10.1016/j.jamda.2021.06.021
  • Matus-López, M. y Vega, M. (2016). Los cuidados para la atención a la dependencia. En Gálvez, L.: La economía de los cuidados. Sevilla: Deculturas. p.136-186.
  • Matus-López, M., Chaverri-Carvajal, A. y Jara-Males, P. (2022). The challenge of ageing in Latin America: long-term care in Costa Rica. Saúde e Sociedade, 31(1): e201078. https://doi.org/10.1590/S0104-12902022201078
  • Matus-López, M., y Rodríguez, P. (2014). Presiones de oferta y demanda sobre políticas formales de cuidados en Latinoamérica. Revista del Clad Reforma y Democracia, (60). 103-130.
  • Mayston, R., Guerra, M., Huang, Y., Sosa, A. L., Uwakwe, R., Acosta, I., … Prince, M. J. (2014). Exploring the economic and social effects of care dependence in later life: Protocol for the 10/66 research group INDEP study. SpringerPlus, 3(1). 1–13. https://doi.org/10.1186/2193-1801-3-379
  • MDS, Ministerio de Desarrollo Social. (2017). Adultos mayores. Síntesis de resultados. CASEN 2017. Disponible en: http://observatorio.ministeriodesarrollosocial.gob.cl/storage/ docs/casen/2017/Resultados_Adulto_Mayores_casen_2017.pdf
  • Medellín, N., Ibarrarán, P., Matus, M., y Stampini, M. (2018). Cuatro elementos para diseñar un sistema de cuidados. BID Nota Técnica, IDB_TN, 1438. https://doi.org/10.18235/0001129
  • Medellín, N., Jara-Males, P. y Matus-López, M (2019). Panorama de Envejecimiento y Atención a la Dependencia en Costa Rica. Serie Aprendizajes en Cohesión Social, 3. BID /EUROsociAL. Disponible en: https://eurosocial.eu/biblioteca/doc/panorama-de-envejecimiento-yatencion-a-la-dependencia-en-costa-rica/
  • Monteverde, M, Noronha, K., Palloni, A., y Angeletti, K. (2008). Costos Individuales Esperados de Cuidados de Larga Duración en Buenos Aires, México y Puerto Rico. In E. Peláez (Ed.). Sociedad y Adulto Mayor en América Latina. Estudios sobre envejecimiento en la región. Córdoba: ALAP.
  • Monteverde, M., Tomas, S., Acosta, L., y Garay, S. (2016). Envejecimiento poblacional y magnitud de la dependencia en Argentina y México: perspectiva comparada con España. Revista Latinoamericana de Población, 18(10). 135–154.
  • Morales-Martínez, F. (2017). Is Geriatric Medicine Possible in a Middle-Income Country? The Case of Costa Rica. Journal of the American Geriatrics Society, 65(8). 1870–1875. https://doi.org/10.1111/jgs.14919
  • MSPS, Ministerio de Salud y Protección Social. (2016). Salud, Bienestar y Envejecimiento en Colombia. Bogotá: COLCIENCIAS. Universidad del Valle y Universidad de Caldas (2016).MINSALUD/COLCIENCIAS.
  • Nam, S., Kuo, Y. F., Markides, K. S., y Al Snih, S. (2012). Waist circumference (WC). body mass index (BMI). and disability among older adults in Latin American and the Caribbean (LAC).Archives of Gerontology and Geriatrics, 55(2). e40–e47. https://doi.org/10.1016/j.archger.2012.04.006
  • Nihtilä, y Martikainen, P. (2007). Household income and other socio-economic determinants of long-term institutional care among older adults in Finland. Population Studies, 61(3), 299–314. https://doi.org/10.1080/00324720701524193
  • Norori, M. L. (2018). Addressing the “Tsunami” of Long-Term Care Needs in Latin America: Is Preparation Feasible? Journal of the American Medical Directors Association, 19(9). 731- 732. https://doi.org/10.1016/j.jamda.2018.07.013
  • OECD, Organization for Economic Co-operation and Development. (2021) Health at a glance 2021. https://doi.org/10.1787/ae3016b9-en OECD, Organization for Economic Co-operation and Development. (2013) Health at a glance 2013. https://doi.org/10.1787/health_glance-2013-en
  • PAHO/WHO. (2019). 57th Directing Council 71st Session of the Regional Committee of WHO for the Americas Plan of Action on the Health of Older Persons. Final report. Washington, D.C.Palloni, A., Pinto-Aguirre, G., y Pelaez, M. (2002). Demographic and health conditions of ageing in Latin America and the Caribbean. International Journal of Epidemiology, 31(4). 762–771.
  • Palloni, A., y McEniry, M. (2007). Aging and health status of elderly in Latin America and the Caribbean: Preliminary findings. Journal of Cross-Cultural Gerontology, 22(3). 263–285. https://doi.org/10.1007/s10823-006-9001-7
  • Prina, A. M., Mayston, R., Wu, Y. T., y Prince, M. (2019). A review of the 10/66 dementia research group. Social Psychiatry and Psychiatric Epidemiology, 54(1). 1–10. https://doi. org/10.1007/s00127-018-1626-7
  • Pugliese, L., & Sosa, S. (2015). Adultos Mayores Dependientes. Insumos de la ELPS para el Sistema Nacional de Cuidados. Comentarios de Seguridad Social, 48, 61–80.
  • Reyes-Ortiz, C. A., Ostir, G. V., Pelaez, M., y Ottenbacher, K. J. (2006). Cross-national comparison of disability in Latin American and Caribbean persons aged 75 and older. Archives of Gerontology and Geriatrics, 42(1). 21–33. https://doi.org/10.1016/j.archger.2005.06.006
  • Silva, H. S., Duarte, Y. A., Andrade, F. B., Cerqueira, A. T., Santos, J. L., y Lebrao, M. L. (2014). Correlates of above-average cognitive performance among older adults: the SABE study. Cadernos de Saude Publica, 30(9). 1977–1986. https://doi.org/10.1590/0102-311x00131913
  • SNC, Secretaría Nacional de Cuidados. (2018). Aproximación a la población dependiente mediante encuestas. Montevideo: MIDES. Disponible en: https://www.gub.uy/sistemacuidados/sites/sistema-cuidados/files/documentos/publicaciones/aproximaciones-ala-poblacion-dependiente-mediante-encuestas.pdf
  • Sousa, R. M., Ferri, C. P., Acosta, D., Guerra, M., Huang, Y., Jacob, K., … Prince, M., (2010). The contribution of chronic diseases to the prevalence of dependence among older people in Latin America, China and India: A 10/66 Dementia Research Group population-based survey. BMC Geriatrics, 10(1). 53. https://doi.org/10.1186/1471-2318-10-53
  • UN, United Nations. (2008). Guide to the National Implementation of the Madrid International Plan of Action on Ageing. New York; UN.
  • UN, United Nations. (2019). World Population Prospects. Retrieved June 10, 2021, from https://population.un.org/wpp
  • Villalobos, P. (2018). Is aging a problem? Dependency, long-term care, and public policies in Chile. Pan American Journal of Public Health, 42, e168. https://doi.org/10.26633/ RPSP.2018.168
  • WHO, World Health Organization. (2001). International Classification of Functioning, Disability and Health. Geneva. Disponible en: https://icd.who.int/dev11/l-icf/en
  • WHO, World Health Organization. (2004). A glossary of terms for community health care and services for older persons. Disponible en: https://apps.who.int/iris/handle/10665/68896
  • WHO, World Health Organization. (2020). Global Health Expenditure Database. Disponible en: https://apps.who.int/nha/database/ViewData/Indicators/en
  • Wong, R., Pelaez, M., y Palloni, A. (2005). Self-reported general health in older adults in Latin America and the Caribbean: usefulness of the indicator Pan American Journal of Public Health, 17(5–6). 323–332. https://doi.org/10.1590/s1020-49892005000500004
  • Wu, C. Y., Hu, H. Y., Huang, N., Fang, Y. T., Chou, Y. J., y Li, C. P. (2014). Determinants of longterm care services among the elderly: A population-based study in Taiwan. PLoS ONE, 9(2). https://doi.org/10.1371/journal.pone.0089213