Impacto da pandemia da Covid-19 na ocorrência de insegurança alimentar e na percepção de qualidade de vida de pessoas idosas: estudo Brazuca Natal pós-Covid

Abstract

The COVID-19 pandemic has led to an increase in the prevalence of food insecurity (FI) worldwide, defined as lack of access to adequate food in terms of quantity and quality. Among older people, FI is associated with poorer health outcomes and contributes to poorer perceived quality of life (QoL). This is a study with two designs: cross-sectional, which aims to analyze the socioeconomic conditions and food insecurity that affect the perception of QoL of older people in the municipality of NatalRN, and cohort, which aims to analyze the impact of the COVID-19 pandemic on the occurrence of food insecurity and the perception of QoL of older people in the Brazuca Natal Study. In both studies, FI was assessed using the Brazilian Food Insecurity Scale (EBIA) and QoL was assessed using the WHOQOL-BREF and WHOQOL-OLD questionnaires. We also analyzed socioeconomic and demographic information. Data were collected using an electronic questionnaire (Epicollect5). In the cohort study, selfreported COVID-19 was collected in addition to the above variables. Statistical analysis of the cross-sectional study included absolute and percentage frequencies with 95% confidence intervals and Poisson regression with robust variance. In the cohort study, we tested whether there was a statistical difference between the scores on the QoL and FI questionnaires before and after the pandemic. The Wilcoxon test was used for continuous variables and the McNemar test for categorical variables. Values of p < 0.05 were considered significant. The results of the cross-sectional study showed that FI was associated with poorer perception of QoL by the older people. The WHOQOLBREF questionnaire showed that the presence of FI increased the probability of having a worse perception of QoL in psychological (PR=1.47; 95%CI: 1.10-1.66), environmental (PR=1.70; 95%CI: 1.21-2.41), and total QoL (PR:1.57: 95%CI 1.15- 2.16) domains. In the WHOQoL-OLD questionnaire, FI was also associated with worse perceived QoL in the domains of sensory functioning (PR:1.46: 95%CI 1.06-2.00), autonomy (PR:1.57: 95%CI 1.13-2. 18), past, present and future activities (PR:1.75: 95%CI 1.23-2.49), social participation (PR:1.34: 95%CI 1.01-1.79), death, dying (PR:1.90: 95%CI 1.34-2.68) and also in the total score (PR:2.28: 95%CI 1.62-3.20). The post-pandemic results did not show a significant increase in FI in the population (p=1.000). Concerning the perception of QoL in the post-pandemic period, there was a significant decrease in the scores of the domains "sensory functioning" (p<0.0001), "social participation" (p=0.018), "death and dying" (p<0.0001) and "total score" (p<0.0001) of the WHOQoL-OLD questionnaire. Our main findings from the crosssectional study showed that not having a partner, being female, and having FI at home may have a negative impact on the perception of QoL among older people. With regard to the post-pandemic findings, it can be concluded that the COVID-19 pandemic had a negative impact on older people's perception of QoL. These findings underscore the need for greater attention to this population in public health interventions against hunger.