How do demographic transitions and public health policies affect patients with Parkinson’s disease in Brazil?

Abstract

Abstract:Brazil is currently experiencing a significant demographic transition characterized by a decrease in fertility rates and an exponential increase in the number of elderly citizens, which presents a special challenge for the health care professionals. More than other portions of the population, the elderly are most commonly affected by chronic diseases such as Parkinson's disease. Policymakers contend that Brazil is reasonably well-prepared regarding elderly health care, with policies that aim to ensure the quality of life and the well-being of this portion of the population. However, what happens in practice falls short of what the Brazilian Constitution sets forth. Specifically, there is a clear contradiction between what the law recognizes as being a citizen's rights and the implementation of guidelines. Because health financing in Brazil remains relatively low, the civil society tries to fill in the gaps as much as possible in the treatment of elderly patients suffering from chronic diseases such as Parkinson's disease. In this review, we outline the current legislation in Brazil regarding the elderly and in particular, patients with Parkinson's disease, in the context of a rapidly aging population.

Average annual cost of Parkinson’s disease in São Paulo, Brazil, with a focus on disease-related motor symptoms

“…Although in Brazil there are laws 35 providing such forms of assistance to individuals with certain diseases or disabilities, these are not adequately enforced, which means that many patients end up privately paying for such resources. 36 …”

Avaliação da qualidade de vida em idosos de um centro de convivência

“…A transição demográfica brasileira vem ocorrendo de forma crescente e acentuada, relacionada, principalmente, com a queda na taxa de fertilidade e aumento da expectativa de vida, sendo um desafio para as equipes de saúde. Aspecto que reforça a necessidade de compreender a sua qualidade de vida (QV), permitindo um melhor planejamento dos serviços de saúde para com esses idosos 1 .…”

Effects of a power strength training using elastic resistance exercises on the motor and non-motor symptoms in patients with Parkinson’s disease H&Y 1–3: study protocol for a randomised controlled trial (PARK-BAND Study)

“…No inferential analysis will be carried on for baseline characteristics (ie, table 1) and 95% CIs will be provided whenever possible. Two analyses will be carried out 1 : an ITT analysis; including all randomised individuals, and 2 one PP, including all subjects who completed the study (concluding) with adherence to at least 85% of intervention sessions (≥20 sessions for participants allocated in the exercise programme and ≥10 sessions for participants allocated to the educational programme). We will qualitatively document reasons and details of withdrawals for each case.…”

“…Parkinson's disease (PD) is the second most common neurodegenerative condition in Brazil, occurring in approximately 1% of individuals older than 65 years. 1 Considering the projected increase in PD prevalence, 2 interventions to minimise morbidity and improve quality of life are crucial. Currently, there is no proven pharmacological therapy to modify or slow the disease progression.…”

“…We are committed to disseminating the methods and conclusions of the PARK-BAND Study to the interested research groups. Therefore, our disclosure plan after completion of the study covers the following 1 : scientific meeting with residents, students, assistant doctors and researchers of HUWC in which the present study design, results and interpretation will be presented 2 ; provide written communications to journalists and address the general public 3 ; provide a plain summary report of results to the participants and 4 prepare manuscripts. For the manuscripts, criteria authored by the PARK-BAND Study will follow the recommendations of the International Medical Journal Editors’ Committee and those defined by the destination journals.…”