Trajectories and determinants of ageing in Portugal: insights from EpiDoC, a nationwide population-based cohort

Abstract

Abstract Introduction The population in Portugal is ageing due to increased life expectancy and reduced fertility rates. We aimed to estimate the health trajectories of Portuguese older adults (60 + years old) in a 10-year period and to assess associated sociodemographic, lifestyle factors and multimorbidity status. Methods Using the population-based EpiDoC cohort, we estimated the trajectories of health-related quality of life and physical function of 4135 Portuguese older adults over 10 years using linear mixed models. Factors associated to health-related quality of life and physical function were assessed using linear mixed models and random intercept tobit regression, respectively. Results The physical disability of participants increased by 0.263 (0.240, 0.286), and health-related quality of life declined by 0.074 (-0.084, -0.063), over 10 years. With advancing age, older adults reported a faster reduction in health-related quality of life and faster increase in physical disability. In general, women were in worse health than men at baseline, albeit with a similar rate of change throughout the follow-up. Higher education and regular exercise were associated with better health-related quality of life and physical function while multimorbidity and excess weight were associated with worse reporting of these outcomes. Conclusions These findings, based on longitudinal data with 10 years of follow-up, are essential to effectively plan resource allocation, plan better healthcare and design informed public health policies in Portugal. Brief summary This study characterizes ageing in Portugal showing increased physical disability and decreased health-related quality of life with advancing age older adults, helping to develop public health policies.

Keywords

• Disability
• Health-related quality of life
• Older adults
• Trajectories
• Longitudinal