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Lopes Vieira MM, Borges VS, Oliveira EJP, Bof de Andrade F. Functional limitation in the older Brazilian adults: Association with multimorbidity and socioeconomic conditions. PLoS One 2023; 18:e0294935. [PMID: 38032910 PMCID: PMC10688755 DOI: 10.1371/journal.pone.0294935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/11/2023] [Indexed: 12/02/2023] Open
Abstract
The aim of this study was to assess the association between multimorbidity and the presence of functional limitation in basic (BADL) and instrumental activities of daily living (IADL) among Brazilian older adults and to verify whether this association is moderated by socioeconomic conditions. Cross-sectional study with data from the Brazilian National Health Survey (PNS) (2019) for the Brazilian population aged 60 years and over. The dependent variables were functional limitation, based on self-reported difficulty in performing one or more activities of daily living, including six BADL (feeding, bathing, using the toilet, dressing, crossing a room on the same floor and getting out of bed) and four IADL (shopping, managing money, taking medication and using transportation). The independent variables were multimorbidity (presence of two or more self-reported chronic diseases) and socioeconomic measures (per capita household income, asset score, and education level). The association between multimorbidity and outcomes was assessed using adjusted logistic regression models. The moderating effect of socioeconomic conditions on the association between multimorbidity and functional limitations was assessed by including an interaction term. The final sample consisted of 22,725 individuals. The prevalence of functional limitation was 8.5% (95%CI: 7.9-9.2) and 18.6% (95%CI: 17.8-19.5) in BADL and IADL, respectively. Multimorbidity was associated with BADL [OR: 2.30 (95%CI: 1.93-2.74)] and IADL [OR: 2.26 (95%CI: 1.98-2.57)]. The odds of functional limitation were higher among individuals with lower levels of education and income, but there was no interaction between multimorbidity and socioeconomic position measures. Multimorbidity was associated with functional limitation (BADL and IADL) and socioeconomic conditions, and this association was constant across socioeconomic position levels.
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Affiliation(s)
| | | | | | - Fabíola Bof de Andrade
- René Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brasil
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Silva JDPD, Martins IV, Braga LHR, Oliveira CMD, Lima-Costa MF, Braga LDS, Torres JL. Differences in determinants of active aging between older Brazilian and English adults: ELSI-Brazil and ELSA. CAD SAUDE PUBLICA 2023; 39:e00076823. [PMID: 37851723 PMCID: PMC10599105 DOI: 10.1590/0102-311xen076823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 10/20/2023] Open
Abstract
This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval - 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies.
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Affiliation(s)
| | | | | | | | - Maria Fernanda Lima-Costa
- Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brasil
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Jiao D, Li X, Zhu Z, Zhang J, Liu Y, Cui M, Matsumoto M, Banu AA, Sawada Y, Watanabe T, Tanaka E, Anme T. Latent Subtype of Cognitive Frailty among Multimorbidity Older Adults and Their Association with Social Relationships. Healthcare (Basel) 2023; 11:1933. [PMID: 37444767 DOI: 10.3390/healthcare11131933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/18/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to explore all the relevant subtypes of cognitive frailty among Japanese community-dwelling older adults with multimorbidity. Moreover, it examined the associations between these potential subtypes of cognitive frailty and social relationships. This study targeted relevant cross-sectional data regarding community-based older adults with multimorbidity. It employed a person-centered method to perform a latent class analysis and explore the subtypes of cognitive frailty among older adults. Moreover, a multinominal logistic regression analysis was employed to examine the association between potential subtypes of cognitive frailty and social relationships. Data for 396 participants (mean age, 75.8 [SD, 7.3] years; 51.3% females) were analyzed. Three cognitive frailty subtypes were subsequently revealed: the robust group (42.0%), the group with partial cognitive frailty (38.6%), and the group with cognitive frailty (19.4%). People with high levels of social relationships were more likely to be in the robust and the partial cognitive frailty groups. This study identified different subtypes of cognitive frailty among multimorbid older adults and highlighted the significance of social relationships. These findings could serve as a reference for conceptualizing cognitive frailty through the person-centered method. Promoting a high level of social relationships could be useful to prevent the cognitive frailty among older adults with multimorbidity.
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Affiliation(s)
- Dandan Jiao
- Department of Nursing, The First Affiliated Hospital, and College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471003, China
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Xiang Li
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Zhu Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Jinrui Zhang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Yang Liu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Mingyu Cui
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Munenori Matsumoto
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Alpona Afsari Banu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Yuko Sawada
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka 559-0034, Japan
| | - Taeko Watanabe
- Faculty of Nursing, Shukutoku University, Chiba 260-8701, Japan
| | - Emiko Tanaka
- Faculty of Nursing, Musashino University, Tokyo 135-8181, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
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Silva DSMD, Silva MF, Assumpção DD, Francisco PMSB, Neri AL, Yassuda MS, Borim FSA. [Influence of multimorbidity patterns on the activities in the day-to-day lives of the elderly: nine-year follow-up of the Fibra Study]. CIENCIA & SAUDE COLETIVA 2023; 28:2003-2014. [PMID: 37436314 DOI: 10.1590/1413-81232023287.14842022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/03/2023] [Indexed: 07/13/2023] Open
Abstract
The scope of this article was to evaluate the influence of multimorbidity and associated effects on the activities in the day-to-day lives of community-dwelling elderly individuals. It involved a cohort study with data from the FIBRA Study, the baseline (2008-2009) and follow-up (2016-2017). The basic activities in daily living (ADL) were evaluated using Katz's index, and the chronic diseases were classified as: (1) multimorbidity and multimorbidity patterns; (2) cardiopulmonary; (3) vascular-metabolic; and (4) mental-musculoskeletal. The chi-square test and Poisson regression data were used for analysis. A total of 861 older adults with no functional dependency at baseline were analyzed. Elderly individuals with multimorbidity (RR = 1.58; 95%CI: 1.19-2.10) and classified according to cardiopulmonary (RR = 2.43; 95%CI: 1.77-3.33), vascular-metabolic (RR = 1.50; 95%CI: 1.19-1.89) and mental-musculoskeletal (RR = 1.30; 95%CI: 1.03-1.65) had a higher risk of presenting functional decline in ADL in the follow-up compared to those who didn't have the same disease patterns. Multimorbidity and its patterns increased the risk of functional disability in older adults over the nine-year period.
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Affiliation(s)
- Diego Salvador Muniz da Silva
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Marcela Fernandes Silva
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Daniela de Assumpção
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Priscila Maria Stolses Bergamo Francisco
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
| | - Anita Liberalesso Neri
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
- Departamento de Psicologia Médica e Psiquiatria, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas SP Brasil
| | - Mônica Sanches Yassuda
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
- Programa de Pós-Graduação em Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo. São Paulo SP Brasil
| | - Flávia Silva Arbex Borim
- Programa de Pós-Graduação em Gerontologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. R. Tessália Vieira de Camargo 126, Cidade Universitária Zeferino Vaz. 13083-887 Campinas SP Brasil.
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Idalino SCC, Canever JB, Cândido LM, Wagner KJP, de Souza Moreira B, Danielewicz AL, de Avelar NCP. Association between sleep problems and multimorbidity patterns in older adults. BMC Public Health 2023; 23:978. [PMID: 37237275 DOI: 10.1186/s12889-023-15965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/23/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Sleep problems are frequent in older adults and are associated with chronic diseases. However, the association with multimorbidity patterns is still unknown. Considering the negative impacts that multimorbidity patterns can have on older adults' life, knowledge of this association can help in the screening and early identification of older adults with sleep problems. The objective was to verify the association between sleep problems and multimorbidity patterns in older Brazilian adults. METHODS This was a cross-sectional study conducted with data from 22,728 community-dwelling older adults from the 2019 National Health Survey. The exposure variable was self-reported sleep problems (yes/no). The study outcomes were: multimorbidity patterns, analyzed by self-report of the coexistence of two or more chronic diseases with similar clinical characteristics: (1) cardiopulmonary; (2) vascular-metabolic; (3) musculoskeletal; (4) coexisting patterns. RESULTS Older adults with sleep problems had 1.34 (95%CI: 1.21; 1.48), 1.62 (95%CI: 1.15; 2.28), 1.64 (95%CI: 1.39; 1.93), and 1.88 (95%CI: 1.52; 2.33) greater odds of presenting vascular-metabolic, cardiopulmonary, musculoskeletal, and coexisting patterns, respectively. CONCLUSIONS These results suggest that public health programs aimed at preventing sleep problems in older adults are essential to reduce possible adverse health outcomes, including multimorbidity patterns and their negative consequences for older adults' health.
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Affiliation(s)
- Stefany Cristina Claudino Idalino
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
- Post-Graduate Program in Neuroscience, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Letícia Martins Cândido
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Katia Jakovljevic Pudla Wagner
- Federal University of Santa Catarina (UFSC), Campus Curitibanos, Rod. Ulysses Gaboardi, 300, Curitibanos, 89520-000, Santa Catarina, Brazil
| | - Bruno de Souza Moreira
- Center for Studies in Public Health and Aging, Federal University of Minas Gerais (UFMG), Av. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100, Minas Gerais, Brazil
| | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina (UFSC), Campus Araranguá, Rod. Governador Jorge Lacerda, Urussanguinha, Araranguá, 3201, 88906-072, Santa Catarina, Brazil.
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da Rosa PPDS, Marques LP, Corrêa VP, De Oliveira C, Schneider IJC. Is the combination of depression symptoms and multimorbidity associated with the increase of the prevalence of functional disabilities in Brazilian older adults? A cross-sectional study. FRONTIERS IN AGING 2023; 4:1188552. [PMID: 37288071 PMCID: PMC10242069 DOI: 10.3389/fragi.2023.1188552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/02/2023] [Indexed: 06/09/2023]
Abstract
Introduction: Functional disabilities are more prevalent in older adults with multimorbidity and depression. However, few studies have investigated the combination of multimorbidity and depression with functional disability. This study aims to verify whether symptoms of depression and multimorbidity combined increase the prevalence of functional disability in Brazilian older adults. Material and methods: This is a cross-sectional study conducted with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline examination in 2015-2016 in adults aged 50 years and older. The variables included were basic (BADL) and instrumental activities of daily living (IADL), depressive symptoms, multimorbidity (≥2 chronic diseases), sociodemographic variables, and lifestyle. Logistic regression was performed to estimate crude and adjusted odds ratios. Results: A total of 7,842 participants over 50 years of age were included. Of these, 53.5% were women and 50.5% were between 50 and 59 years old, 33.5% reported ≥4 depressive symptoms, 51.4% had multimorbidity, 13.5% reported difficulty in performing at least one BADL, and 45.1% reported difficulty in performing the IADL. In the adjusted analysis, the prevalence of difficulty on BADL was 6.52 (95% CI: 5.14; 8.27) and on IADL was 2.34 (95% CI: 2.15; 2.55), higher for those with depression and multimorbidity combined when compared with those without these conditions. Conclusion: The combination of symptoms of depression and multimorbidity may increase functional impairments in the BADL and IADL of Brazilian older adults, impairing self-efficacy, independence, and autonomy. Early detection of these factors benefits the person, their family, and the healthcare system for health promotion and disease prevention.
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Affiliation(s)
| | | | - Vanessa Pereira Corrêa
- Graduate Program in Collective Health, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Cesar De Oliveira
- Epidemiology and Public Health Department, University College London, London, United Kingdom
| | - Ione Jayce Ceola Schneider
- Graduate Program in Rehabilitation Science, Federal University of Santa Catarina, Araranguá, Brazil
- Graduate Program in Collective Health, Federal University of Santa Catarina, Florianópolis, Brazil
- Epidemiology and Public Health Department, University College London, London, United Kingdom
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Cabral JF, Galvão ND, Andrade ACDS, Silva AMCD. Factors associated with functional disability in older adults with cancer treated at reference outpatient clinics in the state of Mato Grosso, Brazil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220019. [PMID: 35766776 DOI: 10.1590/1980-549720220019.supl.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/01/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze factors associated with functional disability in older adults with cancer treated at reference outpatient clinics in the state of Mato Grosso, Brazil. METHODS This is a cross-sectional study of 463 older adults aged 60 years or older. The outcome variable was functional disability, evaluated by Lawton and Brody's Instrumental Activities of Daily Living (IADL) scale. The independent variables were sociodemographic characteristics, lifestyle, social support, and health aspects. We performed bivariate and multivariate analyses and calculated prevalence ratios (PR) using Poisson regression with robust variance. RESULTS The prevalence of IADL functional disability was 55.3%. The variables associated with this disability in the multivariate analysis were: not working (PR=1.36; 95% confidence interval - 95%CI 1.03-1.78); low (PR=1.49; 95%CI 1.10-2.03) and moderate (PR=1.30; 95%CI 1.04-1.64) perceived affectionate support; depressive symptoms (PR=1.31; 95%CI 1.10-1.56); malnutrition (PR=1.28; 95%CI 1.03-1.59); having two or more comorbidities (PR=1.30; 95%CI 1.03-1.64), and having a companion to health services (PR=1.39; 95%CI 1.05-1.83). CONCLUSION In addition to physical health aspects, comorbidities, and malnutrition, functional disability was associated with emotional, social support, and work issues, reinforcing the importance of comprehensive care and actions to maintain and recover functional capacity, promoting a better quality of life, the independence of older adults with cancer, and a reduced risk of adverse biopsychosocial outcomes.
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Affiliation(s)
- Juliana Fernandes Cabral
- Universidade do Estado de Mato Grosso, School of Agricultural, Biological, Engineering, and Health Sciences - Tangará da Serra (MT), Brazil.,Universidade Federal de Mato Grosso, Institute of Collective Health, Graduate Program in Collective Health - Cuiabá (MT), Brazil
| | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Institute of Collective Health - Cuiabá (MT), Brazil.,Mato Grosso Health Department - Cuiabá (MT), Brazil
| | | | - Ageo Mário Cândido da Silva
- Universidade Federal de Mato Grosso, Institute of Collective Health - Cuiabá (MT), Brazil.,Mato Grosso Health Department - Cuiabá (MT), Brazil
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Franken DL, Olinto MTA, Dias-da-Costa JS, Bairros FSD, Paniz VMV. Lifestyle, high Body Mass Index, and markers of socioeconomic conditions associated with multimorbidity in women. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220007. [PMID: 35475903 DOI: 10.1590/1980-549720220007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 02/17/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study aimed to identify the prevalence of multimorbidity and its associated factors in women in southern Brazil. METHODS We conducted a cross-sectional, population-based study with a sample of 1,128 women (age 20-69 years), living in São Leopoldo, southern Brazil. Multimorbidity was defined as two or more chronic conditions measured using the therapeutic and chemical anatomical classification of continuous use medications prescribed by a physician. Poisson regression model with robust variance was used to assess the association between sociodemographic and lifestyle variables and multimorbidity. RESULTS The prevalence of multimorbidity was 21.7% (95%CI 19.3-24.2), and 26 chronic conditions were identified. A direct linear association was observed with age and income and an inverse association with education. Being unemployed was a risk factor for multimorbidity (PR 1.95; 95%CI 1.51-2.52). Alcohol consumption (moderate or excessive) had a protective effect. Overweight and obese women were 53% (PR 1.53; 95%CI 1.09-2.15) and 76% (PR 1.76; 95%CI 1.27-2.45) more likely to have multimorbidity than eutrophic women. CONCLUSION Over 20% of the adult women had multimorbidity, and its occurrence was strongly associated with socioeconomic characteristics, such as fewer years of schooling, higher income, and not having an occupation. The results regarding alcohol consumption are still insufficient to propose a public policy for the prevention of multimorbidity. Excess weight was an independent risk factor and should be addressed in public health policies for the prevention and management of multimorbidity.
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Affiliation(s)
- Débora Luiza Franken
- Universidade do Vale do Rio dos Sinos, Post-graduate Programme in Collective Health - São Leopoldo (RS), Brazil
| | - Maria Teresa Anselmo Olinto
- Universidade do Vale do Rio dos Sinos, Post-graduate Programme in Collective Health - São Leopoldo (RS), Brazil.,Universidade Federal do Rio Grande do Sul, Department of Nutrition - Porto Alegre (RS), Brazil
| | | | - Fernanda Souza de Bairros
- Universidade Federal do Rio Grande do Sul, Department of Collective Health - Porto Alegre (RS), Brazil
| | - Vera Maria Vieira Paniz
- Universidade do Vale do Rio dos Sinos, Post-graduate Programme in Collective Health - São Leopoldo (RS), Brazil
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Canever JB, de Souza Moreira B, Danielewicz AL, de Avelar NCP. Are multimorbidity patterns associated with fear of falling in community-dwelling older adults? BMC Geriatr 2022; 22:192. [PMID: 35272634 PMCID: PMC8915478 DOI: 10.1186/s12877-022-02889-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/02/2022] [Indexed: 01/09/2023] Open
Abstract
Background Multimorbidity is defined as the co-occurrence of multiple chronic or acute diseases and medical conditions in the same individual and can be grouped into different patterns based on the type of disease. These patterns are associated with poorer quality of life and premature death. It is believed that these patterns entail functional limitations, which may contribute to the fear of falling; however, this association remains unknown. Identifying this possible association is fundamental for developing individual and collective care approaches aimed at preventing the different patterns of chronic diseases in older adults in order to decrease the fear of falling. The objective of this study was to investigate the association between multimorbidity patterns and fear of falling in older adults. Methods This was a cross-sectional study including 308 older adults. The exposure variables were the presence of three multimorbidity patterns (cardiopulmonary, musculoskeletal, and vascular-metabolic) and pattern association assessed by self-report of two or more similar coexisting chronic diseases. The outcome was fear of falling assessed by the Brazilian version of Falls Efficacy Scale-International (cut-off point ≥ 23 points). Multivariable logistic regression was used to analyze the association between variables. Results Older adults with cardiopulmonary, musculoskeletal, vascular-metabolic patterns and pattern association had 3.49 (95%CI 1.13; 10.78), 2.03 (95%CI 1.13; 3.64), 2.14 (95%CI 1.20; 3.82), and 4.84 (95%CI 2.19; 10.68), respectively, greater chances of presenting fear of falling when compared to older adults without the patterns. Conclusions The presence of multimorbidity patterns is associated with higher chances of reporting fear of falling. It is emphasized that the introduction of public health programs aimed at preventing multimorbidity patterns is essential to reduce possible adverse health outcomes, including fear of falling and its negative consequences for older adult health.
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Affiliation(s)
- Jaquelini Betta Canever
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | | | - Ana Lúcia Danielewicz
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil
| | - Núbia Carelli Pereira de Avelar
- Laboratory of Aging, Resources and Rheumatology, Department of Health Sciences, Federal University of Santa Catarina, Campus Araranguá, Rod. Governador Jorge Lacerda, Araranguá, Santa Catarina, Urussanguinha, 320188906-072, Brazil.
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Cândido LM, Niehues JR, Avelar NCPD, Danielewicz AL. Incapacidade, desempenho físico-funcional e ambiente de vizinhança: avaliação de idosos comunitários com base na Classificação Internacional de Funcionalidade, Incapacidade e Saúde. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20030829012022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) ainda é uma ferramenta distante e muitas vezes temida na área da saúde do idoso. Diante disso, o objetivo deste estudo foi descrever a incapacidade nas atividades da vida diária (AVDs), as limitações no desempenho físico-funcional e a percepção do ambiente de vizinhança em idosos comunitários do extremo sul de Santa Catarina, classificando-os segundo os domínios e qualificadores propostos pela CIF. Tratou-se de estudo transversal realizado com idosos de ambos os sexos. As variáveis analisadas foram categorizadas de acordo com os domínios da CIF: (1) funções e estruturas do corpo: testes de desempenho físico-funcional; (2) atividade e participação: instrumento de autoavaliação das AVDs; e (3) fatores ambientais: autopercepção do ambiente de vizinhança. Foram avaliados 308 idosos, sendo a maioria mulheres (57,8%) e com idade entre 60 e 69 anos (54,7%). Considerando os qualificadores da CIF, verificou-se maior dificuldade moderada/grave para o teste de sentar e levantar da cadeira de 5 repetições (TSLC5R) (66,2%) no domínio “função e estrutura do corpo”, enquanto para o domínio “atividade e participação” observou-se a prevalência de incapacidade moderada/grave para a tarefa de cortar as unhas dos pés (21,2%). No domínio “fatores ambientais”, verificou-se o predomínio de ausência de locais para a prática de atividade física no ambiente de vizinhança (72,5%).
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Cabral JF, Galvão ND, Andrade ACDS, Silva AMCD. Fatores associados à incapacidade funcional em idosos com câncer atendidos em ambulatórios de referência no estado de Mato Grosso, Brasil. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220019.supl.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
RESUMO: Objetivo: Analisar os fatores associados à incapacidade funcional em idosos com câncer atendidos em ambulatórios de referência do estado de Mato Grosso, Brasil. Métodos: Estudo transversal, com 463 idosos de 60 anos ou mais. A variável desfecho foi a incapacidade funcional, avaliada por meio da Escala de Atividades Instrumentais de Vida Diária (AIVD) desenvolvida por Lawton e Brody. As variáveis independentes foram características sociodemográficas, estilo de vida, apoio social e condições de saúde. Foram realizadas análises bivariada e múltipla, calculando-se as razões de prevalência (RP), com o uso de regressão de Poisson com variância robusta. Resultados: A prevalência de incapacidade funcional para as AIVD foi de 55,3%. As variáveis que se associaram a essa incapacidade na análise múltipla foram: não trabalhar (RP=1,36, intervalo de confiança — IC95% 1,03–1,78); percepção de apoio afetivo baixo (RP=1,49; IC95% 1,10–2,03) e médio (RP=1,30; IC95% 1,04–1,64); sintomas depressivos (RP=1,31; IC95% 1,10–1,56); desnutrição (RP=1,28; IC95% 1,03–1,59); ter duas ou mais comorbidades (RP=1,30; IC95% 1,03–1,64) e ter acompanhante aos serviços de saúde (RP=1,39; IC95% 1,05–1,83). Conclusão: Além das condições de saúde física, comorbidade e desnutrição, as questões emocionais, de apoio social e trabalho associaram-se à incapacidade funcional, reforçando a importância de uma atenção integral e de ações de manutenção e recuperação da capacidade funcional, promovendo maior qualidade de vida, a independência do idoso com câncer e a redução do risco de desfechos adversos em âmbito biopsicossocial.
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Affiliation(s)
| | - Noemi Dreyer Galvão
- Universidade Federal de Mato Grosso, Brazil; Mato Grosso Health Department, Brazil
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Cândido LM, Niehues JR, Avelar NCPD, Danielewicz AL. Disability, physical-functional performance, and neighborhood environment: evaluation of community-dwelling older adults based on the International Classification of Functioning, Disability, and Health. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/20030829012022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The International Classification of Functioning, Disability, and Health (ICF) is still a distant and often feared tool in the area of older adults health. This study aimed to describe the inabilities to perform activities of daily living (ADLs), limitations in the physical-functional performance, and the perception of the surrounding environment in community-dwelling older adults from the extreme South of Santa Catarina, classifying them according to the domains and qualifiers proposed by the ICF. This is a cross-sectional study, with older adults of both sexes. The analyzed variables were classified and categorized according to the ICF: (1) Body Functions and Structures: physical-functional performance tests; (2) Activity and Participation: ADL self-assessment instrument; and (3) Environmental factors: self-perception of the surrounding environment. A total of 308 older adults were evaluated, most of them were women (57.8%) and aged 60-69 years (54.7%). There were higher prevalence of moderate/severe difficulty in the 5-times sit-to-stand test (5TSTS) (66.2%), of moderate/severe disability in the activity of cutting toenails (21.2%), and no reports of places for the practice of physical activity near the residence (72.5%). As for the ICF qualifiers, there was greater “moderate/severe difficulty” for the 5TSTS in the “Body Function and Structure” categories and in the task of cutting toenails in the “Activity and Participation” categories. In the category “Environmental factors,” there was a higher prevalence of lack of places for physical activity in the neighborhood.
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Cândido LM, Wagner KJP, Costa MED, Pavesi E, Avelar NCPD, Danielewicz AL. Comportamento sedentário e associação com multimorbidade e padrões de multimorbidade em idosos brasileiros: dados da Pesquisa Nacional de Saúde de 2019. CAD SAUDE PUBLICA 2022; 38:e00128221. [DOI: 10.1590/0102-311x00128221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/09/2021] [Indexed: 11/21/2022] Open
Abstract
Resumo: O comportamento sedentário emerge como um importante determinante da saúde da pessoa idosa, no entanto, sua relação com a multimorbidade e seus padrões de acometimento em estudos epidemiológicos têm sido pouco explorados na população brasileira. Tais associações poderão auxiliar na elaboração de políticas públicas visando à modificação desse comportamento. Assim, o objetivo deste estudo foi avaliar a associação entre comportamento sedentário com multimorbidade e seus padrões em idosos brasileiros. Estudo transversal, com 43.554 idosos da Pesquisa Nacional de Saúde de 2019. O comportamento sedentário autorreferido foi categorizado em < 3; 3-6; e > 6 horas por dia. A presença de multimorbidade e seus padrões foram analisados pelo autorrelato da coexistência de duas ou mais doenças crônicas, sendo que os três padrões estabelecidos consideraram as doenças com características clínicas similares: (1) cardiopulmonar; (2) vascular-metabólico; e (3) mental-musculoesquelético. As associações foram realizadas pela regressão logística binária. Os idosos que despendiam 3-6 horas/dia em comportamento sedentário tiveram maiores chances (OR = 1,39; IC95%: 1,29; 1,50) de apresentar multimorbidade, padrão vascular-metabólico (OR = 1,39; IC95%: 1,29; 1,50) e mental-musculoesquelético (OR = 1,11; IC95%: 1,00; 1,24). Quando o comportamento sedentário foi > 6 horas/dia, houve maiores chances de multimorbidade (OR = 1,58; IC95%: 1,43; 1,74) e dos padrões cardiopulmonar (OR = 1,73; IC95%: 1,33; 2,27), vascular-metabólico (OR = 1,49; IC95%: 1,35; 1,64) e mental-musculoesquelético (OR = 1,15; IC95%: 1,01; 1,31), quando comparados àqueles que ficavam até 3 horas/dia. Dessa forma, evidenciou-se que tempos elevados em comportamento sedentário são fatores de risco relevantes para a ocorrência de multimorbidade e seus padrões em idosos.
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