Baixo peso e dependência funcional em idosos institucionalizados de Uberlândia (MG), Brasil

Is body image perception and (dis)satisfaction associated with anthropometric profile of older women attending a senior community center?

The study aimed to assess the association between body image perception and (dis)satisfaction and the anthropometric profile of older women. Data from 60 women attending a senior community center were analyzed. Body image perception and (dis)satisfaction were considered dependent variables and were assessed using a silhouette scale constructed for the Brazilian population. The independent variables were body mass (BM), body mass index (BMI), waist circumference (WC), and calf circumference (CC). The associations were performed by logistic and linear regression models. Half of the participants overestimated their body size and 61.7% were dissatisfied due to excess weight. Overweight older women had 3.6 times higher odds to overestimate body size and 14.4 higher odds to be dissatisfied due to excess weight compared to normal-weight women. The increase in BM, BMI, WC, and CC raised mean difference between perceived and desired BMI and the odds of dissatisfaction due to excess weight. The anthropometric profile was more important to explain (dis)satisfaction than body size perception. The stimulus to changes that provide the adequacy of the anthropometric profile may reduce dissatisfaction due to excess weight among older women.

Agreement between two Meal Quality Indexes adapted to evaluate food consumption of institutionalized elderly

ABSTRACT Objective To assess agreement between two meal quality indexes adapted for elderly people, evidencing their similarities and differences Methods Agreement study with 322 institutionalized elderly individuals. Food consumption data were collected by the method of weighted food record, in two nonconsecutive days. The Meal Quality Index and the Main Meal Quality Index of each older adult were calculated for the lunch meal. Agreement between methods was tested by cross-classification in quartiles and weighted kappa (Kw), and the difference between medians by the Wilcoxon test. Results The Meal Quality Index median was 54.67 points and the Main Meal Quality Index 53.51 points (p=0.723). When the components of each index were assessed, those associated to the consumption of carbohydrates, total fat and saturated fat were similar. The consumption of fruits separated from vegetables in the Main MealQuality Index evidenced low consumption of vegetables by the elderly. Cross-classification by quartiles showed good agreement; the exact one being 48.8% and the disagreement 3.4% (Kw=0,447). The proportion of elderlyindividuals in the same exact or adjacent quartile was greater than 85.0%. Agreement was higher in males (89.4%, Kw=0.475); in the age range of 70 to 79 years (91.1%; Kw=0.562) and in non-profit nursing homes(96.7%; Kw=0.622). Conclusion The two indexes reviewed show a good agreement between them and common characteristics. The number of components is higher in the MMQI and may represent a more detailed assessment of meal quality.

Risk of malnutrition and associated factors in institutionalized elderly persons

Abstract Objective : to evaluate the risk of malnutrition and associated factors in institutionalized elderly persons. Method : a cross-sectional study was carried out with elderly persons living in long-term care facilities in the municipal regions of Passo Fundo (Rio Grande do Sul) and Carazinho (Rio Grande do Sul) in 2017. A standardized, pre-codified questionnaire with sociodemographic variables was used, along with anthropometric data and the Mini Nutritional Assessment. Cognitive decline and non-intentional weight loss were also evaluated. The qualitative variables were presented in terms of univariate frequencies and the quantitative variables were described through measures of central tendency and dispersion. In order to verify the association between the categorical variables, the Pearson’s correlation coefficient, Chi-Squared test and the Fisher Exact test were applied, and in the crude and adjusted analysis the Poisson regression was used with robust variance. The level of significance was 5%. Results : a total of 399 elderly people were included, of whom 69.9% were female, 54.5% were aged 80 years or older and 88.4% were white. Of these elderly people, 61.7% lived in non-profit facilities. In the evaluation of nutritional status, 26.6% of the elderly were found to be malnourished, 48.1% were at risk of malnutrition and 25.3% had normal nutritional status. The highest prevalence ratio of at risk of malnutrition/malnutrition was with cognitive decline and unintentional weight loss (p<0.001). Conclusion : through the results, identifying nutritional status and the characteristics associated with the risk of malnutrition contribute to effective evaluation and nutritional monitoring, assisting in the prevention of diseases related to this condition.

Profile of the body mass index and associated factors in active elderlies

OBJECTIVE

Identifying the profile of Body Mass Index and associated factors in active elderlies.

METHOD

This is an analytical type of research with cross-sectional design and quantitative approach, with sample represented by 105 elderly people. The research instrument consisted of Cognitive assessment, Sociodemographic data, Health conditions and Motor performance evaluation. The data were analyzed by using descriptive analysis and binary logistic regression.

RESULTS

The elderlies without partners have 7.753 times the chance of presenting excess weight when compared to those with partners. Having an income higher than a minimum wage represents 6.014 times the chance of being overweight. Not having health problems amounts to 0.015 times the chance of being overweight. In the motorperformance, not presenting limitation of balance represents 6.785 times the possibility of being affected by excess weight.

[Factors associated with being underweight among elderly community-dwellers from seven Brazilian cities: the FIBRA Study]

The aim of this study was to assess the prevalence of being underweight among the elderly according to demographic and socioeconomic characteristics, health-related behaviors, diseases and health status. This was a cross-sectional multi-center study with 3,478 community-dwelling elders (≥ 65 years). The dependent variable was the prevalence of being underweight, classified by Body Mass Index < 22kg/m2. Adjusted prevalence rate ratios were estimated using multivariable Poisson regression. The mean age was 72.9 years and 12.0% of the elderly were underweight (CI95%:10.9-13.1). Aged elderly ≥ 80 years, former and current smokers, those who reported appetite loss and those classified as pre-frail or frail (PR=1.41; CI95%:1.09-1.82) presented a higher prevalence of being underweight. Individuals who received medical diagnosis of hypertension, diabetes and rheumatism had the lowest underweight prevalence observed. The results highlight the importance of nutritional status assessment and monitoring among the elderly, with emphasis on the most vulnerable subgroups, particularly the frail elderly, taking into account the health consequences of low weight.

[Nutritional status of elderly Brazilians: a multilevel approach]

The objectives of this study were to diagnose the nutritional status of the elderly Brazilian population and to identify associated factors. The study used data from the Brazilian Household Budget Survey (2008/2009) for 20,114 elderly, whose nutritional status was assessed by body mass index (BMI). Associated factors were tested with the Pearson chi-square test and multilevel linear models. The hierarchical analysis showed a significant effect of state of Brazil on BMI variance (p-value = 0.001). The individual level showed a negative association (p-value < 0.001) with Asian-descendant race, male gender, living alone, and older age and a positive association with per capita income. Underweight was more prevalent among elderly in rural areas (26.3%) and in the Northeast (23.7%) and Central regions (20.9%), and obesity was more prevalent in the South (45.1%) and Southeast (38.3%) and in cities (39%). The study suggests the importance of further in-depth research on nutritional status of elderly based on contextual variables.

Factors associated with the institutionalization of the elderly: a case-control study

Abstract Objective: to identify the factors associated with the institutionalization of the elderly. Method: a case-control, population-based study was performed with 387 elderly people. The study considered cases of elderly people (n=191) living in long-term care facilities, and a control group (n=196) who lived in homes in urban areas of the city. Both groups were identified from the records of the Family Health Strategy and were randomly selected. Institutionalization was considered a dependent variable, and sociodemographics, clinical factors, functional status, and cognitive impairment were considered independent variables. Comparison between groups was analyzed using the Chi-squared and Pearson tests and the logistic regression model was used in adjusted analysis, with measurements of effect expressed as odds ratio with a 95% confidence interval. Variables with p≤0.20 were considered for entry in the multiple model. Results: variables that remained associated with institutionalization in multiple analysis were: not having a partner (OR=9.7), not having children (OR=4.0), presenting cognitive impairment (OR=11.4), and depending on others to perform basic activities of daily living (OR=10.9). Conclusion: cognitive impairment and dependency for basic activities of daily living were more strongly associated with institutionalization. Home care strategies and preventive actions for risk factors should be stimulated to delay the referral of elderly people to Long Term Care Facilities for the Elderly, and to develop strategies that allow the elderly to remain socially active.

Quality of Life, Family Support, and Comorbidities in Institutionalized Elders With and Without Symptoms of Depression

The institutionalization of elders can decrease the health status and quality of life in this population. The aim of this study was to analyze the socio-demographic, quality of life, family support, and comorbidities variables in institutionalized elders with and without symptoms of depression. This was a cross-sectional study in institutions for long permanence for the elderly in the State of Rio Grande do Norte, Brazil. Two institutionalized elderly groups were compared (138 elders: 69 with and 69 without depressive symptoms). The instruments used were: mini-mental state examination, geriatric depression scale in the reduced version, socio-demographic questionnaire, quality of life (World Health Organization Quality of Life abbreviated-WHOQOL-bref), and inventory of perception of family support. Elders with depressive symptoms had inferior quality of life than those without depressive symptoms. Other factors that negatively influenced the quality of life in this population include: low economic conditions, occurrence of comorbidities, and deficient family assistance. These results have important implications in the decision making process with regard to strategies for improving the health status of institutionalized elders.