User's Manual for the SABE Databases

User’s Manual for the SABE Databases

Washington, D.C. September 2004

The user’s manual for the SABE survey databases was prepared by the SABE regional coordination team of the Pan American Health Organization, Washington, DC, August 2004.

International teams responsible for the survey in each of the seven cities provided technical support for the preparation and review of this document.

Comments, questions, or requests for information can be directed to Martha Peláez at [email protected]

TABLE OF CONTENTS

INTRODUCTION ………………………………………………………………………………….…… 4

PRINCIPAL SABE SURVEY RESEARCHERS………………………………………………..……...…6

DESIGN OF THE SAMPLE….……………………………………………………………...…...7

DIRECT, PROXY, AND ASSISTED INTERVIEWS ………..…………………………………..…...... 15

SECTION A: GENERAL DATA ………………………………………………………………………16. Identification of the Gender of the Interviewee A3 Classification and Code: Birthplace A11a Religion A12 Ethnic Group A13 History of Relationships and Marital Status

SECTION B: COGNITIVE STATUS ……………………………….………………….……………….20 Mini Mental State Examination (MMSE) Pfeffer

SECTION C: HEALTH STATUS.…………………………………………………………..………….21 C6c Organ(s) or Part(s) of the Body where Cancer Began C17 Geriatric Oral Health Assessment Index (GOHAI) (C17-C17K) C21a-o Yesavage Geriatric Depression Scale C22a-y Other Variables: Nutritional Evaluation C24 Smoking C28h Illnesses during Childhood

SECTION D: FUNCTIONAL STATUS ………….………….……………………………………….....28

SECTION E: MEDICINES……………………………………………………………………………..29 E-2 Medicines Codes

SECTION F: USE AND ACCESSIBILITY OF SERVICES ………………………………………...... 35 F1 Type of Health Insurance

SECTION G: FAMILY AND SOCIAL SUPPORT NETWORK………………………………………...…36

SECTION H: WORK HISTORY AND SOURCES OF INCOME ………………………………………...36 H9 / H16 Occupation or Type of Work H10 Most Important Activities or Tasks of Primary Job H11 Type of Activity H17 Reasons for Changing Jobs H20 Work-related Health Problems

SECTIONS K AND L: ANTHROPOMETRY AND TESTS OF FUNCTIONALITY…………………………38

INTER-AMERICAN DEVELOPMENT BANK MODULES………………………………………………..39

SELECTED BIBLIOGRAPHICAL REFERENCES………………………………...... ………...….41

INTRODUCTION

Objectives of the Survey on Health, Welfare, and Aging in Latin America and the Caribbean (SABE)

The protocol of the SABE survey,1 which is included in this CD, should be reviewed in order to understand both the general and particular objectives of the survey as well as the proposed methodology for the design of the sample. The document entitled “Survey on Health and Well-being of Elders: Regional Findings” should also be consulted.2 That document is also included in the information package that accompanies the databases. The SABE survey was designed to produce information that enables researchers to achieve, at a minimum, the following goals:

a) Describe the health conditions of older adults (age 60 and older) with regard to chronic and acute diseases, disability, and physical and mental impairment in seven Latin American cities (Buenos Aires, Santiago, São Paulo, Montevideo, Mexico, Havana, and Bridgetown). It is important to emphasize that the findings represent the prevalence rates of those illnesses as reported by the interviewees, except in the countries where screening tests were carried out. Such was the case for Mexico City, where blood samples were taken after fasting to detect diabetes. b) Evaluate the extent to which older adults use and have access to health care services, including services that are outside the formal system (local healers, traditional medicine), as well as the conditions under which people seek and obtain these services. The countries included in the SABE study differ dramatically with regard to the organization and administration of their health facilities, and their health systems have gone through major changes in recent years. Consequently, it is important for the researchers to familiarize themselves with the health systems of each country by exchanging information with the principal researchers in each locality. c) Evaluate the proportional contribution by principal sources of support—relatives and family networks, public assistance, and private resources (income, assets)—towards meeting the health-related needs of older adults, Given the recent reorganization of pension and social welfare systems, the countries in this survey represent a unique opportunity to study the differences between and within social contexts in terms of the availability of public and private health programs and plans, as well as the extent to which those programs and plans influence the health status of older adults and their access to and use of health care services. Before making any inferences based on SABE data, it is important to have a good understanding of the social context and the supply of services in each locality. d) Evaluate access to health insurance offered by private organizations, governmental institutions, and mixed systems, as well as the extent to which that insurance is actually used. In several countries, such as Barbados and Brazil, there are explicit guarantees to universal access to the health system. In others, the lack of such explicit guarantees to insurance constrains access to services. It is important to underline the need to complement any analysis of the data with information on the types of coverage in each locality during the survey period (1999-2000). e) Analyze the differentials in the self-evaluation of health conditions, access to health care, and sources of support with regard to socioeconomic group, gender, and birth cohort.

1 Alberto Palloni (1998). Protocol of the Multicenter Survey on Health, Welfare and Aging. CD-ROM PAHO/SABE-2000. 2 Peláez, M., and A. Palloni (2004). Survey on Health and Well-being of Elders: Regional Findings. CD-ROM PAHO/SABE-2000.

4 f) Evaluate the relationships between strategic factors—health-related behavior, occupational background, socioeconomic status, gender, and cohort—in health conditions, according to the health evaluation at the time of the survey. g) Carry out comparative analyses in countries that share similar characteristics but that differ with regard to such factors as the role of family support, public assistance, access to health services, and health-related behavior and exposure to risk.

Language The surveys were conducted in the official language of each country:

- Spanish in Buenos Aires (Argentina), Mexico City (Mexico), Havana (Cuba), and Formatted: Spanish Montevideo (Uruguay); (Spain-Traditional Sort) - English in Bridgetown (Barbados); - Portuguese in São Paulo (Brazil).

The original languages were maintained during processing of the databases. However, in order to assist users, databases in the STATA format included (in the field labeled “Notes”) translations of the name of the variable in the three official languages of SABE. As a result, users will have access to the seven databases in the three languages used in the survey.

Dates of the Field Work The Santiago team began field work at the end of 1999 and finished at the start of 2000, while the teams for the remaining countries began in the first quarter of 2000 and finished in the second half of 2000.

How to Cite SABE Data In accordance with international standards, we recommend citing the SABE database as follows: Peláez, Martha; Palloni, Alberto; Albala, Cecilia; Alfonso, Juan C; Ham-Chande, Roberto; Hennis, Anselm; Lebrao, Maria Lucia; León-Diaz, Esther; Pantelides, Edith; Prats, Omar. SABE - Survey on Health, Welfare, and Aging, 2000 [electronic file]: Pan American Health Organization (PAHO/WHO) [producer and distributor], 2004.

5 PRINCIPAL SABE SURVEY RESEARCHERS

The names and electronic addresses of SABE researchers are listed below.

Regional Coordination: Martha Peláez, Ph.D. ([email protected]) Pan American Health Organization

Alberto Palloni, Ph.D. ([email protected]) University of Wisconsin-Madison

Principal Researchers in Each Locality:

Bridgetown, Barbados: Anselm Hennis, MD ([email protected]) - Chronic Disease Research Centre, School of Clinical Medicine and Research - University of the West Indies

Buenos Aires, Argentina: Edith Pantelides, Ph.D. ([email protected]) - Centro de Estudios de Población/CENEP (Center for Population Studies)

Havana, Cuba: Juan Carlos Alfonso, Esther María León Díaz ([email protected]; [email protected]) - Centro de Estudios de Población y Desarrollo (CEPDE), Oficina Nacional de Estadística (Center of Population and Development Studies, National Statistics Office)

DF Mexico, Mexico: Roberto Ham-Chande, Ph.D. ([email protected]) - El Colegio de la Frontera Norte, Tijuana, Baja California and Luis Miguel Gutierrez, MD ([email protected]) - Instituto Nacional de la Nutrición "Salvador Zubirán," (“Salvador Zubirán” National Nutrition Institute), México, D.F., and Yolanda Palma, INSAD en México, DF ([email protected]).

Montevideo, Uruguay: Omar Prats, MD ([email protected]) - Comisión Salud Cardiovascular y Universidad de Uruguay. (Commission on Cardiovascular Health, University of Uruguay)

Santiago, Chile: Cecilia Albala, MD, MPH ([email protected]; [email protected]) - Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile (Institute of Nutrition and Food Technology, University of Chile) and Pedro Paulo Marín, MD ([email protected]) - Pontificia Universidad Católica de Chile.

São Paulo, Brazil: Maria Lucia Lebrao, MD ([email protected]), Ruy Laurenti - Faculdade de Saúde Pública, Universidade de São Paulo (Public Health Faculty, University of São Paulo).

6 DESIGN OF THE SAMPLE The variables relative to the sample are called STRATUM and CLUSTER, except for the survey of Buenos Aires. For Buenos Aires, the information on the sample is included in the variable “Folio,” which has the following structure: one number—two letters—two numbers—two numbers. The stratum corresponds to the first two groups of the variable (one number—two letters). The cluster corresponds to the third group of the folio variable (two numbers).

Study Sample The sample for the study corresponded to the population over 60 years of age that resides in private households in each of the selected urban areas.

Sampling Framework In five of the seven cities—Buenos Aires, Havana, Mexico, Montevideo, and São Paulo—the samples were obtained from national employment surveys and from other household surveys that, in general, provide up-to-date sampling frameworks. For Santiago, the sampling framework was from the 1992 census, and in Barbados it was based on the national electoral registry, which is periodically updated.

General Characteristics of the Sampling Design The samples were generated through a multistage process by conglomerates, with stratification of the units at the highest levels of aggregation. Three selection stages were used in all cities except for Bridgetown and São Paulo, for which only two stages were used. The scheme that was followed was quite similar in all the countries. The Primary Stage Unit (PSU) was a conglomerate of independent households within the predetermined geographical areas. Each conglomerate was selected with a probability proportional to the distribution of the households within each stratum. The primary stage units are grouped within the geographical or socioeconomic strata. The primary stage units were, in turn, divided into secondary stage units (SSU), each made up of a conglomerate of households. The secondary stage units then were divided into third stage units (TSU) . In Mexico City and São Paulo, the third stage units were made up of all people age 60 and older who live in a household, while in the other cities the units included selected people age 60 and older in the household. Consequently, the household or the individuals selected constitute the last selection stage in the sample. In all cases, the stages of this design make it possible for the researcher to calculate the selection probability for each selected individual. Together with ex post knowledge of the nonresponse rates by primary stage unit, this provides information sufficient to estimate weighing factors that convert the sample into units equivalent to the population. These sampling weights are calculated within the variable called “ponder.”

Specific Characteristics of the Sampling Design There are several differences between the cities participating in the SABE study in terms of the design of the sample. The first difference is in the stratification of the conglomerates. In some cities, the stratification was based only on geography, while in others the strata were defined by socioeconomic as well as geographic and global indicators.

7 The second difference involves oversampling of the target population. Some cities ensured the oversampling of individuals age 80 or older, while in most cities the probabilities of individual selection are proportional to the distribution of ages in the population. The third difference has to do with the last stage of the selection. In three cities, (Buenos Aires, Santiago and Montevideo), only one individual was selected per household. In two cities (Havana and Bridgetown), in addition to the selected individual, the companion of the selected person was interviewed when available. In these cases, a second database was created with interviews of companions or spouses. In Mexico City and São Paulo, all eligible individuals found in the home were interviewed. In Mexico City, there was an additional sample of women from 50-59 years old. In Santiago, only one individual was selected for the interview, and a second interview also was carried out of any person age 80 or over residing in the household, if that person had not been previously selected. The table that follows shows the characteristics of the sampling process in each of the cities included in the study.

Table 1. CLASSIFICATION OF CITIES ACCORDING TO DIMENSIONS OF SAMPLING PLAN

BUENOS AIRES Population aged 60+ in Buenos Aires and suburbs (Greater Target Population Buenos Aires) Sampling Frame Household Survey 1998 Sampling Technique Three-stage cluster stratified probability sampling PSU: Census radius (300 households) Sampling Units SSU: Households

TSU: One individual 60+ per household Geographic and Socioeconomic: two main geographic Stratification regions (City of Buenos Aires and Grand Buenos Aires); six

socioeconomic strata Sampling Allocation Proportional allocation among strata Oversampling None PSU: Census radius, chosen with probability proportional to the number of households; Method of selection SSU: Households selected systematically with equal probability of selection TSU: One individual 60+ per household was selected with equal probability Selection Older Person Randomly select one person 60+ per household Spouse Interview None

BRIDGETOWN Target Population Population 60+ in Greater Bridgetown Household voting registry last updated 1997; households Sampling Frame with individuals aged 60 and older were selected Sampling Technique Two-state stratified sampling PSU, Households with a persons 60+ Sampling Units SSU: One individual 60+ per household

TSU: None Demographic: 4 strata (households with a person 80 years Stratification old or older or not; households with only 1 person 60 years old or older; households with 2 or more persons 60 years old or older). Allocation of the sample Proportional allocation among strata Oversampling None PSU:Households (with individuals 60+) were selected systematically with equal probability from voting Method of selection registry SSU: One person 60+ selected per household with equal probability TSU: None Selection Older Person Randomly select one person aged 60+ per household Spouse Interviewed Selected if target selected had a spouse.

SAO PAULO

Target Population Population 60+ in urban area of the Municipality of Household Survey on Health and Nutrition of Children Sampling Frame under 5 years old. Based on 1996 Census master sampling frame Sampling Techniques Two-stage stratified sampling PSU: Census sector (about 300 households ) Sampling Units SSU: Households

TSU: None Stratification Socioeconomic: ranking of PSU according to proportion of heads of households who are illiterate Sampling Allocation Proportional allocation among strata Persons aged 75+ were selected with equal probability in Oversampling an additional sample PSU: Households (with individuals 60+) selected with probability proportional to the number of households Method of selection SSU: households selected systematically with equal

probability TSU: None Selection Older Person All persons 60+ living in a household Spouse Interviewed If spouse resided in household

SANTIAGO Target Population Population 60+ in Greater Santiago 1992 Master Sampling Frame of the National Institute of Sampling Frame Statistics (INE) Probability Sampling Three-stage stratified sampling Techniques PSU: Census sector (blocks of about 8 households Sampling Units SSU: Households

TSU: One individual 60+ in each household Geographical: 284 districts Stratification Socioeconomic a posteriori: “comunas” (parishes) were ranked according to their index of human development and poverty level to create three socioeconomic strata Sampling Allocation Proportional allocation among strata Oversampling Persons 80+, selected after the target was drawn randomly. PSU: selected with probability proportional to the number of households Method of selection SSU: households selected systematically with equal probability TSU: one individual 60+ per household was selected with equal probability Selection Older Person Randomly select one person 60+ per household Spouse Interviewed None HAVANA Target Population Population 60+ in Havana Sampling Frame Census master sampling frame (1999) Probability Sampling Three-stage stratified sampling Techniques PSU: Basic Geostatistical Area (AGEB) (about 180 Sampling Units households) SSU: Sections (about 5 households) TSU: One person 60+ living in each household Stratification Geographic; 15 municipalities

Sampling Allocation Proportional allocation among strata One individual 80+ in household was always selected; if no Oversampling person 80+ was available, a persons 60+ was selected with equal probability PSU: Selected with probability proportional to the number of households Method of selection SSU: Sections were selected with equal probability

TSU: One person 60+ per household was selected with equal probability (persons 80+ were always selected Randomly select one person 60+ living in household Selection Older Person (persons 80+ were always selected) If target selected had a spouse, the spouse was Spouse Interviewed interviewed with a reduced questionnaire.

MEXICO CITY Persons 60+ in Mexico City Metropolitan Area and an Target Population additional sample of women 50+ Sampling Frame Household survey sampling frame (1999) Probability Sampling Three-stage stratified sampling Techniques PSU: Basic AGEB (about 480 households) Sampling Units SSU: Blocks

TSU: Households Stratification Geographic: Metropolitan Area, Federal District and State of Mexico Sampling Allocation Proportional allocation among strata Oversampling None PSU: AGEB selected with probability proportional to Method of selection number of households SSU: blocks TSU: households were selected with equal probabilities All persons 60+ residing in household were selected in Selection Older Person addition women 50+ were selected Since all persons 60+ residing in a household were Spouse Interviewed interviewed; it is possible to have couples included in the sample.

MONTEVIDEO

Target Population Population 60+ in Montevideo Sampling Frame Population census of 1997 Probability Sampling Three-stage stratified sampling Techniques PSU: Segments Sampling Units SSU: Households

TSU: Target Person Stratification Socio-economic. Three strata formed by segments according to education and access to potable water. Sampling Allocation Proportional allocation among strata One person 80+ in household was always selected; Oversampling otherwise a person 60+ was selected with equal probability PSU: Selected with probability proportional to the number of households within strata Method of selection SSU: Households were selected systematically with equal probability TSU: One individual 60+ was selected with equal probability (persons 80+ were always selected) Randomly select one person 60+ living in a household Selection Older Person (persons 80+ were always selected) Spouse Interviewed No spouse interviewed

11 Selected Individuals and their Spouses

The original objectives of SABE mention two types of interviews: an extensive interview of the individual who is the subject of the study and another shorter interview of the spouse. From an analytical standpoint, the information concerning the couples (that is, the individuals selected as subjects of the study and their spouses) provides data on health status and the common risk factors associated with each couple. At the same time, however, obtaining the information creates a series of logistical complications, such as extending the time of the interview in the household. For this reason, some cities could only finance the basic interviews of older adults and had to omit the interview with the spouse. In other countries; however, the decision was taken to include all available people age 60 or older in selected households as part of the sample. As a result, there are three groups of cities (Table 2). In the first group (Buenos Aires, Santiago, and Montevideo), one person age 60 or older was selected per household. In the second (Bridgetown and Havana), one individual from all those available in the household was randomly selected to be interviewed. The selected individual’s spouse was also interviewed if available. Both in Bridgetown and Havana, databases were created for interviewed spouses. In the third group of cities (São Paulo and Mexico City), all available members of a household age 60 or older were interviewed, regardless of marital status or family relations. In these two cities, couples can be identified from the raw data. Only the standardized file for São Paulo includes an indicator that identifies spouses who reside in the same household. Because of confidentiality restrictions, data on couples in Mexico were not reconstituted. A sample of independent units differs according to the country group—it is the same as both the overall sample for the cities in group one as well as the sample of people selected in cities in group two. The sample of independent units also is the same as the sample of all individuals in households where one individual was selected and interviewed along with one randomly selected household member age 60 or older, among all households where multiple interviews were carried out.

Table 2: cities by identification of target and spouse

Identification of Target and Others City Target Population Dependencies belonging to same household Buenos Aires Santiago 1 individual 60+ Not needed None Montevideo Bridgetown 1 individual 60+ and Flag variable for Target-spouse Comment: Diferente a version Havana spouse target and ID spouse español Sao Paulo (*) All individuals Flag multiple Multiple Mexico City(**)(***) 60+ members Comment: No sé si es equivalente a versión español (*)Couples recreated from raw data and explicitly identified (**)Couples can be recreated from data but were not explicitly identified Comment: Compare español (***)An additional sample of women 50-59 years of age is included in the database. Comment: Ver version español

12 Nonresponse Rate in the Sample

The nonresponse rate in the sample fluctuates significantly between cities. Table 3 presents in detail the results of the interview process.

13 TABLE 3. RESULTS OF THE INTERVIEW PROCESS BY CITY AND NONRESPONSE RATE

Total Total Total of Total Selected Total number Sample loss Total number Response rate Total in data selected households households Individuals of refusals duse to other of persons base Comment: N City households visited with adults reasons interviewed 60+

Buenos Aires (1) 4192 1800 1736 1662 383 240 1039 62.5 1039

Bridgetown (2) 2994 2951 1878 1878 313 57 1508 80.3 1508

Havana 5000 4816 1998 1998 51 92 1905 95.3 1905

Mexico City (3) 6000 1711 1534 1489 ------1247 83.7 1247

Montevideo 4610 4450 2210 2210 98 668 1444 65.3 1444

Santiago 5440 5248 1755 1563 187 75 1301 83.2 1301

Sao Paulo (4) 6480 ------1852 246 39 1567 84.6 2143 576* (1) In Buenos Aires, the survey was carried out using the sample of a household survey round that identified 1,800 households with people age 60 and older from among the total of 4,192 selected households. (2) The survey in Bridgetown interviewed 345 spouses in addition to the selected sample. (3) In Mexico City, the survey was carried out using the sample of a household survey round that identified 1,742 households with people age 60 and older from among the total of 6,000 selected households. (4) The sample in Sao Paulo was enlarged by adding a sample of 576 people age 75 and older. N/A: Not available.

14 DIRECT, PROXY, AND ASSISTED INTERVIEWS

Most of the interviews were carried out directly with the selected person. All of the people surveyed were given a test on their cognitive status (Section B of the questionnaire). If the test showed that the selected person had some cognitive deterioration, the interview was continued with a proxy (substitute). In some cases, although there was some marginal deterioration, the person was able to answer directly but needed assistance to recall certain things. These were termed assisted interviews. An exception to the above-mentioned procedure occurred if, at the beginning of the interview, the selected individual presented such an obvious cognitive loss that it rendered impossible his or her participation in Section A of the questionnaire. This was confirmed by interviewing a companion or relative of the individual using the Pfeffer Scale (Portable Functional Assessment Questionnaire) in Section B. In cases of cognitive deterioration confirmed by the observations of the interviewer together with the Pfeffer Scale, the interview was carried out with a family member, companion, or other substitute. The following table shows the proportion of interviews that could not be carried out directly with the selected person and were thus carried out with a substitute or proxy.

Table 4. Proportion of interviews carried out with a substitute or proxy

City % Proxies

Buenos Aires 3.8 Bridgetown 4.3 Sao Paulo 12.9 Santiago 9.0 Havana 9.2 Mexico City 5.9 Montevideo 1.1

The interviews with a proxy should have omitted subjective questions. However, this problem was not addressed in uniform fashion. In some cases, the responses of the proxy to subjective questions appear in the categories of “does not know,” “no response” or “does not apply.” In other cases, the interviewee or the proxy answered the questions. The questions that had to be answered only by the subject of the interview and not by the proxy were the following:

- A7c-A10c; G27b, G39b, G47b: Satisfaction with family arrangements - A11b: Importance of religion - C1-C3: Self-assessment of health - C17e, C17f, C17h, C17i, C17j: Satisfaction with dental health - C21a-C21o: Symptoms of depression - C26, C27: Health and well-being during infancy - H30: Satisfaction with economic status - R1 (Related to religion in the case of Barbados)

SECTION A: GENERAL DATA

Identification of the Gender of the Interviewee

Use variable C18

A3 Classification and Code: Birthplace

United Nations country codes were used in five cities—Bridgetown, Mexico City, Havana, Santiago,and São Paulo (see Table 1).

Table 1. United Nations Country Codes used in Bridgetown, Mexico City, Havana, Santiago and Sao Paulo. http://www.loria.fr/~jacquot/enseignement/GPW2.xls

Code Country Code Country Code Country 4 Afghanistan 120 Cameroon 246 Finland 8 Albania 124 Canada 250 France 12 Algeria 132 Cape Verde 254 French Guiana 16 American Samoa 136 Cayman Islands 258 French Polynesia 20 Andorra Central African 140 262 Djibouti 24 Angola Republic 266 Gabon Antigua and 144 Sri Lanka 28 268 Georgia Barbuda 148 Chad 270 Gambia 31 Azerbaijan 152 Chile 276 Germany 32 Argentina 156 China 288 Ghana 36 Australia 170 Colombia 292 Gibraltar 40 Austria 174 Comoros 296 Kiribati 44 Bahamas 178 Congo 300 Greece 48 Bahrain Congo, Dem. 180 304 Greenland 50 Bangladesh Republic 308 Grenada 51 Armenia 184 Cook Islands 312 Guadeloupe 52 Barbados 188 Costa Rica 316 Guam 56 Belgium 191 Croatia 320 Guatemala 60 Bermuda 192 Cuba 324 Guinea 64 Bhutan 196 Cyprus 328 Guyana 68 Bolivia 203 Czech Republic 332 Haiti Bosnia 204 Benin 70 336 Holy See Herzegovina 208 Denmark 340 Honduras 72 Botswana 212 Dominica Hong Kong SAR 76 Brazil Dominican 344 214 (China) 84 Belize Republic 348 Hungary 90 Solomon Islands 218 Ecuador 352 Iceland British Virgin 222 El Salvador 92 356 India Islands 226 Equatorial Guinea 360 Indonesia Brunei 231 Ethiopia Iran (Islamic 96 364 Darussalam 232 Eritrea Republic of) 100 Bulgaria 233 Estonia 368 Iraq 104 Myanmar 234 Faeroe Islands 372 Ireland 108 Burundi Falkland Islands 238 376 Israel 112 Belarus (Malvinas) 380 Italy 116 Cambodia 242 Fiji

16 Code Country Code Country Code Country 384 Côte d'Ivoire 558 Nicaragua 705 Slovenia 388 Jamaica 562 Niger 706 Somalia 392 Japan 566 Nigeria 710 South Africa 398 Kazakstan 570 Niue 716 Zimbabwe 578 Norway 724 Spain 400 Jordan Svalbard 732 Western Sahara 404 Kenya 578 (Norway) 736 Sudan Korea, Dem. 408 Northern Mariana People's Rep. of 580 740 Suriname Islands 410 Korea, Republic of 748 Swaziland Fed. States of 752 Sweden 414 Kuwait 583 Micronesia 756 Switzerland 417 Kyrgyzstan 584 Marshall Islands Syrian Arab Lao People's 760 418 585 Palau Republic Dem. Rep. 586 Pakistan 762 Tajikistan 422 Lebanon 591 Panama 764 Thailand 426 Lesotho Papua New 768 Togo 428 Latvia 598 Guinea 776 Tonga 430 Liberia 600 Paraguay Trinidad and Libyan Arab 780 434 604 Peru Tobago Jamahiriya 608 Philippines United Arab 438 Liechtenstein 784 612 Pitcairn Emirates 440 Lithuania 616 Poland 788 Tunisia 442 Luxembourg 620 Portugal 792 Turkey 446 Macau 624 Guinea-Bissau 795 Turkmenistan 450 Madagascar 626 East Timor Turks and Caicos 454 Malawi 796 630 Puerto Rico Islands 458 Malaysia 634 Qatar 798 Tuvalu 462 Maldives 638 Réunion 800 Uganda 466 Mali 642 Romania 804 Ukraine 470 Malta Russian The former 643 474 Martinique Federation 807 Yugoslav Rep. of 478 Mauritania 646 Rwanda Macedonia 480 Mauritius 654 St. Helena 818 Egypt 492 Monaco Saint Kitts and 826 United Kingdom 659 496 Mongolia Nevis United Rep. of Republic of 834 498 660 Anguilla Tanzania Moldova 662 Saint Lucia United States of 840 500 Montserrat St. Pierre and America 666 504 Morocco Miquelon United States 850 508 Mozambique St. Vincent and Virgin Islands 670 512 Oman the Grenadines 854 Burkina Faso 516 Namibia 674 San Marino 858 Uruguay 520 Nauru Sao Tome and 860 Uzbekistan 678 524 Nepal Principe 862 Venezuela 528 Netherlands 682 Saudi Arabia Wallis and Futuna Netherlands 876 530 686 Senegal Islands Antilles 690 Seychelles 882 Samoa 533 Aruba 694 Sierra Leone 887 Yemen 540 New Caledonia 702 Singapore 891 Yugoslavia 548 Vanuatu 703 Slovakia 894 Zambia 554 New Zealand 704 Viet Nam

17 Country codes used in Buenos Aires

Code Country or group of countries 1 Border countries (Including Peru) 2 Other countries in Latin America Other countries in the Americas (USA, Canada, English 3 speaking Caribbean countries) 4 Italy 5 Spain 6 Other countries in Europe 7 African countries 8 Asian countries 9 Oceania countries

Country codes used in Montevideo

Code Contry 1 Uruguay 2 Argentina 3 Brazil 4 Spain 5 Italy 6 England 7 France 8 Germany 9 United States 10 Other countries

A4b Rural Residence during Childhood In Montevideo and Santiago, the time period that respondents resided in rural areas was not specified. In the other six cities, the reference time is five years.

A11a Religion The codes for this variable were adapted to the situation in each of the countries. A separate option, different than those used for other cities, was used for Bridgetown.

Religion codes by city Buenos Aires Mexico City Havana Bridgetown Montevideo Santiago Sao Paulo Code Religion Code Religion 1 Roman Catholic 1 Roman Catholic 2 Anglican 2 Evangelical 3 Pentecostal 3 Judaic 4 Methodist 4 Other syncretism - - 5 Other 6 Other 6 None 7 Doesn’t have - - Doesn’t know (Except Buenos 8 Doesn’t know 8 Aires) Doesn’t answer (Only Buenos - - 9 Aires)

A12 Ethnic Group

This question was not asked in Buenos Aires (although in the database the variable appears with the value “zero”) or in Mexico City. The codes used were:

Code Etnia (What is the option that describes it better?) –

1 White - Blanco 2 Mestizo – Mestizo 3 Mulatto – Mulato 4 Black – Negro 5 Indigenous - Indígena 6 Asian - Asiático 7 Other* (Sao Paulo) 8 Other* (Bridgetown, Santiago, Havana) - “Doesn’t know” in Sao Paulo 98 Doesn’t know (Bridgetown, Santiago, Montevideo) 88 Doesn’t know (Havana) 99 Doesn’t answer ** (Santiago, Havana, Montevideo) * In Montevideo it was not used the category “Other” ** In Bridgetown, Sao Paulo the category “Doesn’t answer” was not used

A13-A17 History of Relationships and Marital Status The MARITAL variable (current marital situation) was created based on available information on the history of relationships.

A6 Level of Education The YEDUCA variable (years of education) was constructed based on available information on level of education and degree obtained.

SECTION B: COGNITIVE STATUS

Mini Mental State Examination (MMSE)

The evaluation of cognitive deterioration is a complex process made even more difficult by the lack of instruments validated for use with older adults with lower levels of education in different parts of Latin America and the Caribbean. The Folstein “Mini Mental State Examination” (known as the MMSE) was validated in Chile as part of the World Health Organization (WHO) study entitled “Dementia Associated with Age” conducted in Concepción toward the end of the 1990s. The study recommended using the MMSE in combination with the Pfeffer Scale to improve the specificity of the test. Using the WHO database, the research group in Chile directed by Dr. Cecilia Albala carried out a regression analysis to identify the MMSE questions that could best explain cognitive deterioration and, using these questions, determine “cutoff points” for the abbreviated MMSE. The Modified MMSE was developed with nine variables instead of the 19 original MMSE variables. A cutoff point of 12/13 was defined to identify people with cognitive deterioration. It was also decided to use the modified MMSE in conjunction with the Pfeffer Scale for those people who obtained a sum of 12 or less in the MMSE. The Pfeffer Scale was administered to an informant or caretaker accompanying the person with cognitive deterioration. “Module B: Cognitive Evaluation” of the SABE questionnaire contains the set of indicators necessary for this evaluation:

Variables B1 to B9 for application of the modified MMSE Comment: Variables B9A to B11 for use of the Pfeffer Scale. Comment:

Bibliographic References:

Pfeffer, RI, Kurosaki, TT, Harrah, CH, Jr. Chance, JM, Filos, S. Measurement of functional activities in older adults in the community, Journal of Gerontology 1982, 37(3):323- 329.

Folstein Mf, Folstein S, Mchugh Pr. Mini-Mental State: A Practical Method for Grading the Clinician. J Psychiatr Res 1975; 12:189-198.

Icaza M. G. y Albala C. (1999): MInimental State Examinaitons (MMSE) del estudio de la demencia en Chile: Análisis Estadístico – Serie Investigaciones en Salud Pública – Documentos Técnicos. (Coordinación de Investigaciones – División de Salud y Desarrollo Humano – OPS. www.paho.org. SABE CD-Rom.

20 SECTION C: HEALTH STATUS

C6c: Organ(s) or Part(s) of the Body Where Cancer Began

01. Oral (lips, oral cavity, or pharynx) 02. Digestive organs 03. Thorax and respiratory organs 04. Bones and joints 05. Melanoma and other malignant neoplasms of the skin 06. Mesothelial tissue 07. Breasts 08. Feminine genital organs 09. Male genital organs 10. Urinary tract 11. Eye, parts of the brain, and other parts of the central nervous system. 12. Thyroid gland and other endocrine glands 13. Unclearly-defined locations; secondary or nonspecific locations 14. Lymphatic tissue; hematopoietic organs and related tissues

Source: ICD 10 -The International Statistical Classification of Diseases and Related Health Problems, tenth revision (C00-D48) http://www.who.int/whosis/icd10//

C17 Geriatric Oral Health Assessment Index (GOHAI)

The objective of the scale is to quantify the odontological needs of older adults through self- assessment of certain conditions related to oral health. The scale was adapted using the translation and validation by Pinzón-Pulido, SA and Gil- Montoya JA in Grenada, Spain. The reference time was expanded to the last 12 months. The scale is applied using variables C17 to C17k. The maximum score that can be obtained is 60. A score lower than 57 has been regarded as an indicator of unmet needs for oral health services (Quanta Healthcare Solutions, Inc., 2003) http://www.medal.org/adocs/docs_ch9/doc_ch9.14.html#A09.14.01 ) In order to apply the scale: The responses to variables C17, C17a, C17c, C17d, C17e, C17g, C17h, C17ii, C17j, C17k are added in accordance with the following score: Always 1 Frequently 2 Sometimes 3 Rarely 4 Never 5

However, the responses to variables C17b and C17f are added to the score inversely:

Always 5 Frequently 4 Sometimes 3 Rarely 2 Never 1

Bibliographic References:

Atchison, KA. Dolan TA (1990): Development on the Geriatric Oral Health Assessment Index. Journal of Dental Education 1990; .(54) 11:680-6.

Pinzón-Pulido, Sandra Arlette: Gil Montoya J.A. (sin fecha): Validación del Geriatric Oral Health Assessment Index en población geriátrica institucionalizada en Granada (inédito) Quanta Healthcare Solutions, Inc (2003): The Medical Algorithms Project - The Geriatric Oral Health Assessment Index (GOHAI) http://www.medal.org/adocs/docs_ch9/doc_ch9.14.html#A09.14.01

C2101-C2115 Yesavage Geriatric Depression Scale The Yesavage Geriatric Depression Scale (GDS) consists of 15 variables: C2101, C2102, C2103, C2104, C2105, C2106, C2107, C2108, C2109, C2101, C2111 C2112, C2113, C2114, and C2115.

For each one of the questions is added either YES or NO in capital letters in accordance with Table 2. The cutoff point to identify symptoms of depression is considered 5/6 (see Yesavage and Brink, 1983). In the SABE survey, the period of reference was two weeks instead of the one week used in the Yesavage GDS.

Bibliographic References:

Yesavage JA, Brink TL., (1983): Development and Validation of a geriatric screening scale: a preliminary report J Psychiat Res. 1983 17:37:49.

Sheik JI, Yesavage JA Geriatric Depression Scale: recent evidence and development of a shorter version. Clin Gerontol. 1986;5:165-172.

Brink TL., Yesavage JA, Lum O (1982): Screening test for geriatric depression. Clinical Gerontologist 1:37-43.

Table 2 ABREVIATED GERIATRIC DEPRESSION SCALE (Adapted from: Sheik JI, Yesavage JA, 1986) 1. ¿Have you been basically satisfied with your life? yes NO ¿Have you dropped many of your activities and interests? YES no 2. ¿Did you feel that your life is empty? YES no 3. ¿Did you frequently feel bored? YES no 4. ¿Are you in good spirits most of the time? yes NO 5. ¿Are you afraid that something bad was going to happen YES no to you? 6. ¿Do you feel happy most of the time? yes NO 7. ¿Do you often feel helpless? YES no 8. ¿Do you prefer to stay at home instead of going out and YES no doing new things? 9. ¿Do you feel that you have more problems with your YES no memory that other people your age? 10. ¿Do you feel it was wonderful to be alive? yes NO 11. ¿Do you feel useless or worthless in your present YES no situation? 12. ¿Do you feel full of energy? yes NO 13. ¿Do you feel that your present situation was hopeless? YES no 14. ¿Do you feel that most people were better off than you? YES no

C22a Other Variables: Nutritional Evaluation

The “Mini-Nutritional Assessment – MNA” Scale makes it possible to determine the level of risk of malnutrition among the population age 60 and older. The scale has 17 variables. The SABE survey does not have all the necessary data to apply the MNA, and some variables, although similar, do not have the same period of reference. However, we present the MNA with the variables in SABE that could be associated with one another (Table 11). Question C22f on weight reduction has a different period of reference:

- In Montevideo and Santiago, it is three months. - In the other five cities, it is 12 months.

23 Table 3: 3 MINI- NUTRITIONAL ASSESSMENT

A. ANTROPOMETRÍCS

1. Body Mass Index < 19 = 0 - See K05 and K11 19 < 21 = 1

21 < 23 = 2

> 23 = 3

2. Mid-arm circumference (MAC) in cm MAC < 21 = 0 - See K7 MAC 21 to 22 = 0.5

MAC > 22 = 1

3. Calf circumference (CC) in cm - See K12 CC < 31 = 0

CC > 31 = 1

4. Weight loss during the last 3 months > 3 Kg = 0 Does not know = 1 - See C22h 1 to 3 Kg = 2 No weight loss = 3

B. GLOBAL EVALUATION

5. Lives independently at own home - See Section D No = 0 Yes = 1

6. Takes more than 3 prescription drugs per day No = 0 Yes = 1 - See Section E

7. Has suffered psychological stress or acute disease - See F4 No = 0 Yes = 1

8. Mobility Bed or chair bound = 0 - See D11- D12c Able to get out of bed but does not go out = 1 - See D16a – 16c Goes out = 2 - See 20a

9. Neuropsychological problems - Severe dementia or depression = 0 - See B11 - Mild dementia = 1 - See C21a - 21o. - No psychological problems = 2

10. Pressure sores or skin ulcers No = 0 Yes = 1 Not available

C. DIETARY PARÁMETERS

11. ¿Diago many wholesome meals do you eat each

day? - See C22a One meal = 0 Two meals = 1 Three meals = 2 12. Selected consumption makers for protein intake - See C22b-d

- At least one serving of dairy products per day Some of the questions on feeding in SABE have a o Yes No different time of reference from the ones required - Two or more servings of legumes or eggs per week by MNA. o Yes No

3 Reproduced from Guigoz Y, Vellas B, Garry PJ. 1994.

24 - Meat, fish or poultry every day o Yes No

- If 0 or 1 yes = 0 If 2 yes = 0.5 If 3 yes = 1

13. ¿Consumes two or more servings of fruits or vegetables per day? No = 0 Yes = 1 - See C22e

14. ¿Has food intake decline over the past 3 months due to loss of appetite, digestive problems, chewing or swallowing difficulties? - See C22f Severe loss of appetite = 0 - See 17 Moderate loss of appetite = 1 No loss of appetite = 2

15. ¿How much fluid (water, juice, coffee, tea, milk)…is consumed? < 3 cups = 0 - See C22g 3 to 5 cups = 0.5 > 5 cups = 1

16. Mode of feeding: 0 Unable to eat without assistance 1 Self-fed with some difficulty - See D15a-b 2 Self-fed without any problem

D. VALORACIÓN SUBJETIVA

17. Self view of nutricional status 0 View self as being malnourished 1 Is uncertain of nutritional state - See C22i 2 view self as having no nutritional problem

18. In comparison with other people of the same age, how does the patient consider his/her health status? 0 Not as good - See C3 0.5 Does not know 1 As good 2 Better

Bibliographic references:

Guigoz, Y., B. Vellas and P.J. Garry. “Mini Nutritional Assessment: A practical assessment tool for grading the nutritional state of elderly patients.” Facts and Research in Gerontology. 1994; Supplement #2: 15-59.

C24 Smoking

Questions related to the use of tobacco were identified differently in the database of each city. Table 12 provides an example, identifying pipe tobacco consumption variables in each city.

Table 12. Variables related to the use of tobacco in the SABE databases in each city Buenos Sao Mexico Havana Montevideo Santiago Bridgetown Aires Paulo City C24A2 C24A2 C24A2 1. Number of pipes 1. Number of pipes 1. Number of a day. a day pipes a day 2. Number of pipes 2. Number of pipes 2. Number of daily? daily? pipes daily?

C24A3 C24A3 C24A3 C24A3 1. Number of 1. Number of pipes 1. Number of 1. Number of pipes a pipes a day a day pipes a day day 2. Number of 2. Number of pipes 2. Number of 2. Number of pipes pipes daily? daily? pipes daily? daily? Comment: Está bien escrito ésto?

Porque es la misma pregunta twice.

C28h Illnesses during Childhood

The research team in Chile, directed by Dr. Cecilia Albala, prepared and adapted the list of codes for childhood illnesses using codes from the International Classification of Diseases (ICD 10).

CLASSIFICATION OF DISEASES AND CODES PROJECT SABE

Group 1. INFECTIOUS AND PARASITIC DISEASES. (A00-B89 OF ICD 10).

010100 INTESTINAL INFECTIOUS DISEASES (A00-A09 OF THE ICD 10) 010101 Cholera 010102 Typhoid fever, paratyphoid, and other salmonellosis 010103 Other infectious intestinal diseases (amebiasis, isosporiasis, viral diseases, etc.) 010104 OTHER INTESTINAL INFECTIOUS DISEASES

010200 BACTERIAL ZOONOSES (A20-A28 OF THE ICD 10) 010201 Brucellosis 010202 Anthrax, erysipela, leptospirosis 010203 OTHER BACTERIAL ZOONOSES

010300 OTHER INFECTIOUS DISEASES (A30-B83 OF THE ICD 10) 010301 Poliomyelitis 010302 Smallpox, Chickenpox, Mumps, Whooping Cough, Diphtheria, Rubella, Tetanus, Scarlet Fever, Meningitis 010303 Toxoplasmosis 010304 Malaria 010305 Leprosy 010306 Chagas’ disease

26 010307 Other infectious diseases 010309 (*) 010310 (*) 010311 (*) (*) Specific for those interviewed in Havana.4

010400 Parasitic Diseases (B85-B89 of the ICD 10) 010401 Scabies, ticks, pediculosis 010402 Taeniasis, helminthiasis, oxyuriasis, other helminths 010403 Trichinosis 010404 Other parasitic diseases

Group 2 DISEASES OF THE BLOOD, HEMATOPOIETIC ORGANS AND CERTAIN DISORDERS THAT AFFECT THE IMMUNE SYSTEM (D50-D89 of the CIE10) 020100 Anemia 020200 Diseases of the coagulation 020300 Diseases that affect the immune system 020400 OTHER DISEASES OF THE BLOOD

Group 3 ENDOCRINE, NUTRITIONAL AND METABOLIC DISEASES (E00-E90 OF THE ICD 10) 030100 Deficit of vitamin A, Beriberi, Pellagra, Scurvy 030200 Rickets 030300 Disorders of the thyroid gland 030400 Other endocrine, nutritional, and metabolic diseases

Group 4 MENTAL ILLNESSES AND OF THE NERVOUS SYSTEM (F00 - F99 and G00-G99) 040100 Schizophrenia 040200 Epilepsy, convulsions 040300 Other mental illnesses and of the nervous system

Group 5 DISEASES OF THE EAR (H60-H95 of the ICD 10) 050100 OTITIS 050200 Other diseases of the ear

Group 6 DISEASES OF THE RESPIRATORY SYSTEM (J00-J99 of the ICD 10) 060100 PNEUMONIA, BRONCHOPNEUMONIA, PLEURISY 060200 Other respiratory system diseases

Group 7 RESULTS OF EXTERNAL CAUSES (S00--T98 and V01-Y98 of the ICD 10) 070100 Bone fractures 070200 Burns 070300 Craneoencephalic traumatism 070400 Amputations 070500 Other consequences of external causes

Group 8 SURGERIES 080100 Appendectomy 080200 Herniorrhaphy 080300 Cholecystectomy 080400 Surgery of eyes or ears 080500 Surgery of the heart 080600 Orthopedic and bone surgery 080700 Reparative surgery 080800 Other surgeries

Group 9 OTHER DISEASES NOT ADJUSTABLE TO THE PREVIOUS’ GROUPS 090500 090100 Other diseases not adjustable to the previous’ groups. 090000

SECTION D: FUNCTIONAL STATUS

In the databases, two new variables—“cannot do it” or “does not do it”—were added for the following questions related to key activities of daily life.

D18a: Difficulty with preparing cooked food D19a: Difficulty with handling your own money D20a: Difficulty with going places alone, such as the doctor, church, etc. D21a: Difficulty with shopping for groceries D22a: Difficulty with making telephone calls (this variable includes the category “does not have a telephone”) D23a: Difficulty with doing light housework

28 D24a: Difficulty with doing heavy housework D25a: Difficulty with taking your medicines.

Options for all the 1. YES BADL and IADL4 2. NO

Additional options for the adl 3. Is not able to do it (D18a-D25a) 4. Does not do it

SECTION E: MEDICINES

The research team in Chile, led by Dr. Cecilia Albala, prepared and adapted the list of codes for medicines using the Anatomical, Therapeutic and Chemical Classifying System (ATC), 1999.

DRUG CLASSSIFICATION AND CODES SABE

ALIMENTARY TRACT AND METABOLISM 100000 (Group A of ATC System)

ANTACIDS AND ANTIFLATULENTS (A02A & A02D) 010100 Plain antacids and combinations of antacids: 010101 Magnesium hydroxide; Aluminum hydroxide; Alginic Acid - Sodium bicarbonate - Aluminum hydróxide - Magnesium trisilicate ; others Antiflatulents and combinations of antiflatulents: 010102 Simethicone; Dimethyl polysiloxane; Magaldrate-Simethicone; others Antacids in combination with aniflatulents: 010103 Simethicone- Aluminum hydroxide -Magnesium hydroxide; Simethicone- Magnesium carbonate - Magnesium and Aluminum hydroxide; others. Combination of antacids,antiflatulents and tranquilizers: 010104 Metoclopramide-Simethicone-Chlordiazepoxide; others Digestive enzymes: 010105 Pankreatine; others Others 010106 TREATMENT OF PEPTIC ULCER (A02B) 010200 H2-receptor antagonists: 010201 Famotidine; Ranitidine; Cimetidine and others Proton pump inhibitors: 010202 Omeprazole; Pantoprazole; others

4 BADL: basic activities of daily living; IADL: instrumental activities of daily living

29 Others 010203 ANTISPASMODIC AND ANTICHOLINERGIC AGENTS AND 010300 PROPULSIVES (A03) Antispasmodic and anticholinergic agents, plain and in combinations: 010301 Trimebutine; Domperidone; Propinoxate-Metamizole; others Propulsives: 010302 Metoclopramide ; Cisapride; Domperidone; others Others 010303 ANTIEMETICS (A04) 010400 LAXATIVES (A06): 010500 Cáscara sagrada extract; Phenolphtalein; Psyllium hidrophilic mucilloid; Vaseline; others ANTIDIARRHEALS, INTESTINAL ANTIINFLAMMATORY/ANTIINFECTIVE 010600 AGENTS (A07) Loperamide; Sulfasalazine; others DRUGS USED IN DIABETES (A10) 010700 Oral blood glucose lowering drugs: Clorpropamida, Glicazida, Glipizide, 010701 Tolbutamide, Metformin, Glibenclamide, others. Insulins 010702 VITAMINS (A11) 010800 Vitamins, plain 010801 Vitamins with minerals 010802 Other combinations, like Procaine-Vitamins-Minerals 010803 MINERAL SUPPLEMENTS (A12) 010900 Calcium, plain and in combination with other drugs: 010901 Calcium; Phosfate, lactate y calcium chloride; calcium gluconate; Calcium and Vit D, Calcium and other vitamins; others Microminerals: Zinc, Magnesium, others 010902 Other mineral supplements 010903 ANABOLIC AGENTS FOR SYSTEMIC USE (A14): 011000 Nandrolona decanoate and others APPETITE STIMULANTS (A15) 011100

BLOOD AND BLOOD FORMING ORGANS 020000 (Group B of ATC System)

ANTITHROMBOTIC AGENTS: 020100 Dipiridamol, Ticlopidine clorhidrate; acetylsalicilic acid -Cafeine; Acenocumarol; others Acetylsalicylic acid 100 mg or less (or infant) 020101 Others 020102 ANTIANEMIC PREPARATIONS (B03): 020200 Elemental iron; Ferrous fumarate; Ferrous sulfate and others

CARDIOVASCULAR SYSTEM 030000 (Group C of ATC System)

CARDIAC GLYCOSIDES (C01A): 030100 Digitalis glycosides; Digoxine; others ANTIARRHYTHMICS (C01B): 030200 Amiodarone; Propafenone; others VASODILATORS USED IN CARDIAC DISEASES (C01D) 030300 Dialtizem clorhydrate, isosorbide nitrate; Nitroglicerine; others) ANTIHYPERTENSIVE AGENTS (C02) 030400 Beta Blocking Agents (C07): 030401 Celiprolol; Atenolol; Propanolol; others Calcium Channel Blockers (C08): 030402 Amlodipine; Nifedipine; Nitrendipine; others Agents Acting on the Renin-Angiotensin System (C09): 030403 Enalapril; Captopril; Losartan; Enalapril-Hydrochlorotiazide- Losartan; Hydrochlorotiazide; others Others: Clonidine; Methyldopa; Reserpine: asociations with diuretics; others 030404 DIURETICS (C03): 030500 Hidrochlorotiazide; Furosemide; Acetazolamide; others PERIPHERAL VASODILATORS (C04) 030600 Cinarizine; Flunarizine;Ginko biloba; Nimodipine; others VASOPROTECTIVES (C05) 030700 Antihemorrhoidals 030701 Antivaricose: Diosmine and others 030702 AGENTS THAT LOWER SERUM LIPIDS (C10) 030800 Estatinas: 030801 Atorvastatine, Lovastatine, Pravastatine; Simvastatine, Fluvastatine; Others Fibratos: 030802 Gemfibrozile, Bezafibrate; others Others 030803

DERMATOLOGICAL AGENTS 040000 (Group D of ATC System)

ANTIMYCOTICS, ANTIBIOTICS AND CHEMOTHERAPEUTICS FOR 040100 DERMATOLOGICAL USE: Povidone iodine; others EMOLLIENTS, PROTECTIVES, AND CICATRIZANTS: Vitamina A 040200 (cream); Vitamin A-Boric Acid-Zinc oxide; others ANTIPRURITICS 040300 CORTICOSTEROIDS, DERMATOLOGICAL PREPARATIONS 040400 ANTISEPTICS AND DISINFECTANTS 040500 Others 040600

GENITO URINARY SYSTEM AND SEX HORMONES 050000 (Group G of ATC System)

UROLOGICALS (G04) 050100 Urinary antiseptics and antiinfectives: 050101 Others: Finasteride, Sildenafil 050102 SEX HORMONES AND MODULATORS OF THE GENITAL SYSTEM (G03) 050200 Androgens, estrogens, progestogens, androgens in combination with female 050201 sex hormones and progestogens in combination with estrogens: Estradiol valerate; Estrogen conjugates; Ethinyl estradiol; Medroxyprogesterone acetate; others Others 050202

SYSTEMIC HORMONAL PREPARATIONS, EXCLUDING SEX 060000 HORMONES (Group H of ATC System)

HYPOPHYSIARY HORMONES: Bromocriptine; others CORTICOSTEROIDS FOR SYSTEMIC USE: 060200 Methylprednisolone, Prednisone, Betametasone, Dexametasone; others THYROID HORMONES (H03A) 060300 Thyroid preparations: 060301 L- thyroxine (pure), Liothyronine; others Antithyroid preparations (H03B): 060302 Propyl thiouracil; others CALCIUM HOMEOSTASIS (H05): 060400 Calcitonin and others OTHERS 060500

GENERAL ANTIINFECTIVES FOR SYSTEMIC USE 070000 (Group J of ATC System)

ANTIBACTERIALS FOR SYSTEMIC USE: 070100 Amoxicillin; Cefadroxil; Ciprofloxacine; Claritromicine; Erythromycin; Nitrofurantoine; Penicilin; Roxitromicine;Tobramicine; Trimetoprim; Metronidazole; others ANTIMYCOTICS FOR SYSTEMIC USE(J02): 070200 Nistatin; Griseofulvine; others ANTIVIRALS FOR SYSTEMIC USE (J05): 070300 Acyclovir; others OTHERS 070400

ANTINEOPLASTIC AND IMMUNOMODULATING AGENTS 080000 (Group L of ATC System)

MUSCULO-SKELETAL SYSTEM 090000 (Group M of ATC System)

ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS (M01A) 090100 non-steroidal antiinflammatory agents: 090101 Acetylsalicylic acid; Mefenámic acid; Diclofenac; Etofenamate; Phenilbutazone; Ibuprofen; Ketoprofen; Meloxicam; Naproxen; Nimesulide; Piroxicam; antiinflamatory-analgesic combinations; others Antiarthrosics 090102 cartilage soluble extract / bone marrow; Glucosamine and others MUSCLE RELAXANTS (M03) 090200 Cyclobenzaprine; Clormezanone; others ANTIGOUT PREPARATIONS (M04) 090300 Hallopurinol; Colchicine; others OTHERS 090400

NERVOUS SYSTEM 100000 (Group N of ATC System)

ANALGESICS (N02): 100100 lysine Clonixinate de; Flurbiprofen; Ketorolac; Trometamol; Tramadol Chlorhydrate; Metamizole sodium; Paracetamole; lisine acetylsalicylate - Vitamin B12-Glicine; Paracetamole-Acetylsalicylic acid-Cafeine; Paracetamole-Codeine; Acetylsalicylic acid- Cafeine;others ANTIMIGRAINE PREPARATIONS (N02C): 100200 Sumatriptan; Ergotamine; Ergotamine-Cafeine-Diphenhydramine; Ergotamine- Dipirone-Chlorphenaminae Maleate-Cafeine; Cafeine- Metamizole; others ANXIOLYTICS (N05B): 100300 Alprazolam; Bromazepam; Clonazepam; Calcium bromolactobionate; Chlorodiazepoxide; Diazepam; Ketazolam; Lorazepam; pentaerythrol Tetranitrate; Chlormezanone-Dipirone; Diazepam- Chlormezanone; others HYPNOTICS AND SEDATIVES (N05C): 100400 Midazolam; Zolpidem hemitartrate; Zoplicone; others ANTIEPILEPTICS (N03): 100500 Carbamazepine; Clonazepam; Phenitoin; Oscarbazepine; others

33 ANTIDEPRESSANTS (N06A): 100600 Amitriptyline; Fluoxetine; Imipramine;Maprotyline; Mianserine; Mirtazapine; Moclobemide; Paroxetine; Sertraline;Trazodone; Fluphenazine- nortriptiline; others ANTI-PARKINSON DRUGS (N04): 100700 Trihexyphenidyl; Levodopa-Carbidopa; others ANTIPSYCHOTICS (N05A): 100800 Chlorpromazine; Haloperidol; Periciazine; Pipotiazine; Thioridazine; others OTHER PSYCOTROPIC, NOOTROPICS, AND STIMULANTS: 100900 Cyticholine; others OTHERS 101000

RESPIRATORY SYSTEM 110000 (Group R of ATC System)

NASAL PREPARATIONS (R01) 110100 ANTI-ASTHMATICS (R03): 110200 Phenoterol; Teophylline; Salbutamol; Aminophylline; Bunesonide; Beclometasone; Aminophylline; Clenbuterol; Phenoterol hydrobromide – Ipatropium bromide; Salbutamol-Beclomethasone; Phenoterol hydrobromide- Ipatropium bromide; others COUGH AND COLD PREPARATIONS (R05): 110300 Codeine; Clobutinol; Noscapine; Oxolamine; others ANTIHISTAMINES FOR SYSTEMIC USE (R06) 110400 chlorphenamine; Hydroxyzine; Loratadine; others OTHERS 110500

SENSORY ORGANS 120000 (Group S of ATC System)

OPHTHALMOLOGICALS (S01) 120100 Antiinfectives, antiinflammatory agents and combinations of both 120101 Antiglaucoma preparations and miotics; 120102 Betaxolol Clorhydrate; Pilocarpine; Timolol; others Decongestants, antiallergics, nonspecific preparations: 120103 Hidroxypropyl methyl cellulose; Artificial tears; others Others 120104 OTOLOGICALS (S02) 120200 Antiinfectives, antiinflammatory agents and combinations of both 120201 Others 120202 OPHTHALMOLOGICAL AND OTOLOGICAL PREPARATIONS (S03) 120300 Antiinfectives, antiinflammatory agents and combinations of both 120301 Others 120302

34 OTHERS 120400

NUTRITIONAL SUPPLEMENTS: Fish fatty acids; Eicosapentaenoic acids ; Soy Lecithin and others 130000 (not classified by the ATC System)

HERBS AND OTHER NATURAL PREPARATIONS: Valeriana, Passiflora, St. John’s Wort and other 140000 (not classified by the ATC System)

HOMEOPATHIC PREPARATIONS 150000 (not classified by the ATC System)

SECTION F: USE AND ACCESSIBILITY OF SERVICES

F1 Type of Health Insurance Question F1 varies among the different cities in the study, since the supply of either public or private insurance is different between countries. In order to adequately analyze health coverage, researchers in every city should be consulted to gain an understanding of the context of social coverage in health and the supply and availability of services for people age 60 and older in each locality. For example, in the specific case of Barbados, where there is a system of universal health coverage, the question on health insurance was interpreted with reference to insurance complementary to universal health services. As a result, the responses are not comparable with Cuba, where the system of universal health coverage was regarded as health insurance.

F6b Name and Address of Hospital This information was not processed and was used only as auxiliary data.

Health Expenditures (F10, 19, 24, and 29) Health expenditures were obtained using local currency. For international comparison, it is suggested that purchasing power parity (PPP) be used.5 Instructions on currency conversion can be found on the World Bank website at http://www.worldbank.org/data/ppp/index.htm

5 Purchasing power parity (PPP) is a method used to measure the relative purchasing power of currencies of different countries for the same types of goods and services. Given that goods and services can cost more in one country than in another, PPP makes it possible to compare standards of living in different countries. PPP is calculated using comparative prices. For a more precise definition of PPP, consult the website: http://www.worldbank.org/depweb/english/modules/glossary.html#ppp

SECTION G: FAMILY AND SOCIAL SUPPORT NETWORK

G4 Family Relationships

Code 97 identifies the person who is the target of the interview. Although the terminology used for this variable varies between countries, the purpose of the variable is the same. In Bridgetown, the variable is identified as “does not apply.” In Havana, the variable exists but does not have name. For Montevideo, Mexico City, Buenos Aires, Santiago, and São Paulo, the variable is identified as “not applicable.”

SECTION H: WORK HISTORY AND SOURCES OF INCOME

H9 and H16 Occupation or Type of Work

The International Labour Organization’s (ILO) International Standard Classification of Occupations (ISCO) was used: ISCO-88 and the following occupational groups:

Codes: 1. Member of the executive branch and legislative bodies, and civil service and business management 2. Scientific and intellectual professionals 3. Mid-level technical personnel and professionals 4. Office employees 5. Services workers and salesmen involved in trade and commerce 6. Farmers and skilled workers in livestock and fishing 7. Officials, workers, and artisans in the mechanical arts and other types of arts 8. Machine and equipment operators and assemblers 9. Unskilled workers 10. Armed forces

H10 Most Important Activities or Tasks of Primary Job

This question classified tasks in accordance with three principal criteria: Tasks that mainly require physical effort; Tasks that mainly require mental effort; or Tasks that require a mix of the two.

Codes:

1. Work that primarily involves physical effort and manual skills (laborers, masons, carpenters, laundresses, seamstresses, agricultural workers, cooks, machinery workers, drivers, domestic workers, security guards, nursing auxiliaries, artists, dancers, athletes, etc.) 2. Work that primarily involves mental effort and intellectual or creative skills (professionals, executives, teachers, managers, administrative employees and managers, accountants, plastic artists, secretaries, clerks, etc.)

36 3. Work that basically requires skills from both of the previous two categories (sales clerks, traveling and door-to-door salesmen, drug representatives, nurses, laboratory workers, land professionals, etc.) H11 Type of Activity

The type of economic activity is understood as the activity of the establishment where the person works during the period of reference. The data were coded in accordance with the International Standard Industrial Classification of All Economic Activities (ISIC) of 1989.

Codes:

1. Agriculture, livestock, game, and forestry 2. Fishing 3. Mining and quarrying 4. Manufacturing industries 5. Supply of electricity, gas, and water 6. Construction 7. Wholesale and retail trade, and repair of automobiles, motorcycles, engines, personal items, and household appliances 8. Hotels and restaurants 9. Transport, storage, and communications 10. Financial intermediation 11. Real estate, business, and rental activities 12. Civil service and defense; mandatory affiliation social security plans 13. Teaching 14. Social and health services 15. Other community, social, and personal services 16. Private homes with domestic service 17. Nonregional organizations and entities

H17 Reasons for Changing Jobs

The following codes were used to classify the responses to this question:

Codes:

1. Retirement 2. Change of residence (neighborhood, city, country) 3. Closing of the company 4. Dismissal 5. Health problems 6. Wage (low income, offer of better wage) 7. Lack of technical qualification 8. Promotion 9. Other

H20 Work-related Health Problems

100. Occupational injuries and professional illnesses 101. Consequence of occupational injury such as injuries to limbs that hinder walking 102. Neurosis 103. Eye injuries 104. Deafness 105. Pneumoconiosis, including diseases of the lungs due to external agents (J60 to J70 of ICD 10), pneumoconiosis in coal workers, and pneumoconiosis due to

37 asbestos, silica and other causes. The only exclusion is pneumoconiosis associated with tuberculosis (J65). 106. Pneumoconiosis associated with tuberculosis (e.g., silicotuberculosis) 107. Dermatosis 108. Diseases of the joints and bones 109. Synovitis, tendinitis 110. Sciatica 111. Chronic laryngitis 112. Asthma 113. Cellulitis 114. Poisoning 115. Other

200. Symptoms and signs without clear and specific diagnosis

2.1 (or 201) Symptoms and signs related to the eyes 2.2 (or 202) Symptoms and signs related to the ears 2.3 (or 203) Symptoms and signs related to the circulatory system 2.4 (or 204) Symptoms and signs related to the respiratory system 2.5 (or 205) Symptoms and signs related to the digestive system 2.6 (or 206) Symptoms and signs related to the skin and subcutaneous tissue 2.7 (or 207) Symptoms and signs related to the musculoskeletal system 2.8 (or 208) Symptoms and signs related to the genitourinary system 2.9 (or 209) Other symptoms and signs

H26-H27: Income

The income of adults was recorded in local currency. For international comparison, it is suggested that purchasing power parity (PPP) be used.6 Instructions on currency conversion can be found on the World Bank website at http://www.worldbank.org/date/ppp/index.htm

SECTIONS K AND L: ANTHROPOMETRY AND TESTS OF FUNCTIONALITY

Variables K15, K16, and K17 have the following specificities:

City Bridgetown Buenos Aires Variable Mexico City Montevideo Sao Paulo Santiago

Havana Measures of Measures of Measures of strength with the strength with the strength with the Operations had in K15 hands (use of the hands (use of the hands (use of the arms or hands dynamometer) dynamometer) dynamometer)

Questions on blood Measures of strength pressure but without with the hands (use of K16 Blood pressure Blood pressure observations the dynamometer)

K17 Capillary Glucose

6 See footnote 3 on PPP in the section on expenditure on medicines.

38 INTER-AMERICAN DEVELOPMENT BANK MODULES

In Buenos Aires, Montevideo, and Santiago, some questions and a module were added in order to carry out a complementary study sponsored by the Inter-American Development Bank (IDB).

IDB Social Services Module

In Buenos Aires: Starts with variable G58: “Has domestic worker” (Number of observations = 0) Ends with variable G70 (A, B, and C): “Services that respondent knows about in the neighborhood.” In Santiago: Starts with variable G59A: “Would prefer spouse for housekeeping services” (Number of observations = 1,167) Question G58 was not processed. Ends with variable G70: “Knows about services for older persons.” In Montevideo: Starts with variable G58: “Has domestic worker” (Number of observations = 1,422) Ends with variable G70 (A and B): “Services that respondent knows about in the neighborhood.”

IDB Module for Domestic Economy, Consumption of Goods and Services

H31a-H47c

IDB Module for Physical Risks of Household and Its Surroundings; Demands for Goods and Services Adapted to Older Persons

J14-J39

IDB Module for Leisure and Free Time

M01-M06

The following codes were used to classify responses to questions M01-M06:

Codes for Types of Frequent Activities:

(1.) (Code not used.) 2. Home chores 3. Watch tv or listen to radio 4. Social contacts 5. Walk 6. Light exercise 7. Moderate exercise or programs

39 8. Cultural activities 9. Read or write, do crossword puzzles

Codes for Frequency

1. Less than once a month 2. More than once a month 3. At least once a week 4. Several times a week 5. Every day

M13-M14 Reason for Stopping Participation in Activities

The following codes were used to classify responses to these questions:

1. Lack of money 2. Visual or auditory problems or physical disability 3. Illnesses or pain 4. Lack of interest; fear or weariness 5. Lack of companionship 6. Does not answer 7. Other

M15a Reason for not Traveling

The following codes were used to classify the response to this question:

1. Lack of money – does not have enough money 2. Own health problems or family problems with health 3. Does not want to travel, is tired, sad 4. Not accustomed to or not in the habit of traveling 5. The opportunity did not present itself 6. Does not have time 7. Does not have someone to accompany him/her 8. Other

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