Physical activity as an indicator of predictive functional disability in elderly

Cut-off points for isometric handgrip and low limb explosive strength in relation to indicators of overweight/obesity in people with intellectual disabilities: analysis by age groups

BACKGROUND

The prevalence of overweight/obesity has been increasing globally and in people with Intellectual Disabilities (IDs), this problem is exacerbated even more, which added to a low physical condition that contributes to the deterioration of functionality and increases the risk of developing chronic diseases in the course of life. Therefore, the aim of this study was to establish cut-off points for levels of isometric handgrip and low limb explosive strength in children, adolescents and adults, which identify overweight/obesity in people with IDs and their respective associations.

METHODS

The sample was made up of 131 individuals with IDs, belonging to four special and community educational centres in the city of Santiago, Chile. Body mass index (BMI) and waist-to-height ratio (WHR) were used as indicators of overweight/obesity. Handgrip strength was used as a measure of isometric strength, and countermovement jump was used as a measure of low limb explosive strength. For the comparison of variables by age group, the analysis of Ancova, Kruskal-Wallis and chi-square tests were used. The total area under the receiver operating characteristic curve of isometric handgrip and low limb explosive strength was identified as an indicator of overweight/obesity according to age groups. A logistic regression model was used to quantify the effect that strength categories below the cut-off point have on the risk of overweight and obesity.

RESULTS

Significant differences were observed between the age groups for body weight, height, BMI and WHR, as well as in the levels of absolute handgrip strength and vertical jump with countermovement (P ≤ 0.05). Children showed the lowest cut-off points for absolute and relative strength. The adolescent group showed the highest cut-off points for relative strength and countermovement jump and adults showed the highest value for absolute strength as indicators of overweight/obesity. Different associations between cut-off points with BMI and WHR were found.

CONCLUSIONS

Adolescents showed the highest cut-off point for relative strength and countermovement jump, and adults showed the highest value for absolute strength, according to overweight/obesity indicators (BMI and WHR). It is suggested to adjust resistance training programmes according to age categories for the prevention of overweight/obesity in people with IDs.

Assessing the psychosocial dimensions of frailty among older adults in Singapore: a community-based cross-sectional study

OBJECTIVE

To examine how multiple dimensions of mental and social health, in addition to physical health, were associated with frailty among older adults.

DESIGN

A door-to-door sampling household community-based survey.

SETTING

Thirty-two public housing blocks within a residential town in Singapore's central region.

PARTICIPANTS

497 residents aged 60 years or older from the public housing town.

OUTCOME MEASURES

Physical frailty was assessed using the FRAIL Scale, which stands for fatigue, resistance, ambulation, illnesses and loss of weight. Physical health was assessed by multimorbidity, physical activity and functional ability; mental illness was assessed by the General Health Questionnaire (GHQ); and social domains were assessed by the Lubben Social Network Scale, Community Integration Measure and UCLA (University of California, Los Angeles) Loneliness Scale.

RESULTS

Compared with robust (59.5%) and prefrail (32.6%) older adults, frail adults (7.9%) reported higher morbidity, lower functional ability and physical activity, higher scores on GHQ, and lower scores on all three social health scales. In multiple regression models, frailty was significantly associated with age 81-90 years (adjusted OR=2.22, 95% CI 1.23 to 3.99), having 2-3 (adjusted OR=1.56, 95% CI 1.02 to 2.38) or >3 (adjusted OR=1.83, 95% CI 1.05 to 3.18) chronic diseases, reduced ability to perform daily tasks without assistance (adjusted OR=0.41, 95% CI 0.23 to 0.73), having fallen in the past 6 months (adjusted OR=2.18, 95% CI 1.18 to 4.06), social dysfunction in GHQ (adjusted OR=1.24, 95% CI 1.08 to 1.43) and loneliness (adjusted OR=1.26, 95% CI 1.06 to 1.50). Physical activity did not remain significantly associated with frailty when mental and social health-related factors were entered in the regression.

CONCLUSION

Community intervention for frailty prevention and management needs to include mental health promotion and social engagement to increase its impact on older adults.

Physical activity, sedentary behavior and functionality in older adults: A cross-sectional path analysis

Disability is negatively associated with the health of older adults, and it can be mediated by healthy lifestyles and behaviors throughout one's life. In this context, understanding the interrelationships between sedentary behavior, physical activity and functionality may assist in the implementation of effective public health actions. Thus, the aim of the present study was to investigate the relationships between both physical activity and sedentary behavior and functionality in older adults and the possible mediators. The variables analyzed were selected according to the content analysis of International Classification of Functioning, Disability and Health model, and included activity, participation, health conditions, body functions and structures, environmental factors and personal factors. 419 individuals participated in the study. Physical activity was directly associated with disability in instrumental activities of daily living (IADL), and the association was mediated by self-esteem, aerobic endurance, and agility/balance. Sedentary behavior was indirectly associated with IADL disability, and the association was mediated by aerobic resistance, nutritional status, and agility/balance. Regarding the basic activities of daily living (BADL), physical activity showed an indirect association mediated by aerobic resistance and IADL. The association of sedentary behavior with BADL was mediated by aerobic resistance and lower limb flexibility. These results reinforce the idea that functionality is multidimensional, and the mediating factors must be considered when strategies for promoting physical activity and reducing sedentary behavior are designed.

Telephonic nursing intervention for laparoscopic cholecystectomy and hernia repair: A randomized controlled study

Background

Patient undergoing surgery may be afraid and concerned about the diagnosis, the treatment, the procedure, the postoperative care, and the surgical recovery. Good communication between staff and patients can minimize or prevent this situation. This study aimed to evaluate the effectiveness of a Telecare nursing intervention, “Telephone consultation”, in reducing the “Delayed surgical recovery” nursing diagnosis in patients undergoing laparoscopic cholecystectomy and hernia repair.

Methods

This study was performed in two different institutions located in Rio de Janeiro, Brazil. A total of 43 patients were enrolled. The experimental group consisted of 22 patients who had access to the telephone follow-up intervention, and the control group consisted of 21 patients who received conventional treatment without telephone follow-up. This was a randomized controlled study with patients who were 60 years or older and awaiting operative procedures of hernia repair and laparoscopic cholecystectomy who had a mobile or landline phone and were available for telephone contact.

Results

There was a reduction in “loss of appetite with nausea” (p = 0.013); “need help to complete self-care” (p = 0.041); “pain” (p = 0.041); and “postoperative sensation” (p = 0.023). The experimental group showed a significantly larger decrease in factors related to the “Delayed surgical recovery” diagnosis, suggesting a positive effect of the intervention compared to the effect in control group.\.

Conclusion

Telephone consultation identified factors that increased the risk of complications after surgery, recognized potential patients for delayed surgical recovery and helped perioperative nurses provide accurate interventions to prevent or mitigate delayed recovery.

This study was registered in the platform Brazilian Registry of Clinical Trials (ReBEC) - link: http://www.ensaiosclinicos.gov.br under registration number RBR-4C249M, retrospectively registered on April 13, 2020.

Association between frailty and the combination of physical activity level and sedentary behavior in older adults

Background

The combined association of physical activity and sedentary behavior with adverse health factors is not yet clear in the literature. A combined analysis of physical activity level and sedentary behavior may provide evidence of the interrelation between these behavioral variables and the frailty syndrome. Thus, the aim of this study was to examine the relationship between physical activity level, sedentary behavior and frailty in older adults.

Methods

In this study, we evaluated 457 older adults (age range = 60 to 96 years old) from the Longitudinal Study of the Elderly Health of Alcobaça, Bahia. The frailty condition was defined by the presence of three or more of the following criteria: unintentional weight loss, slow walking speed measured over a 4.57 m test, a reduction of manual grip strength and exhaustion. Based upon these criteria, participants were classified as non-frail or frail. Physical activity level and time spent in sedentary behavior were assessed with the International Questionnaire of Physical Activity. Descriptive statistics were used to characterize the sample. To examine the combined association of physical activity and sedentary behavior with frailty, chi-square and Poisson regression tests were used. Statistical significance was defined as p ≤ 0.05.

Results

The prevalence of frailty was 8.8% (n = 40), with higher prevalence observed with increasing age. Low physical activity level combined with excessive time spent in sedentary behavior (physical activity level < 150 min/wk. and sedentary behavior ≥540 min/day) was associated with frailty, resulting in a prevalence ratio of 2.83 (95% CI, 1.23 to 6.52).

Conclusion

Frailty is more prevalent among older adults who exhibit insufficient levels of physical activity combined with a great amount of time spent in sedentary behavior, even when adjusted for sociodemographic factors.

Combining perceptual regulation and exergaming for exercise prescription in low-active adults with and without cognitive impairment

BACKGROUND

Exercise adherence in already low-active older adults with and without mild cognitive impairment (MCI) remains low. Perceptual regulation and exergaming may facilitate future exercise behaviour by improving the affective experience, however evidence that this population can perceptually regulate is lacking. To explore this, we investigated 1) perceptual regulation of exercise intensity during either exergaming or regular ergometer cycling and 2) explored affective responses.

METHODS

Thirty-two low active older adults (73.9 ± 7.3 years, n = 16, 8 females) with or without MCI (70.9 ± 5.5 years, n = 16, 11 females) participated in a sub-maximal fitness assessment to determine ventilatory threshold (VT) and two experimental sessions (counterbalanced: exergaming or regular ergometer cycling). Experimental sessions consisted 21-min of continuous cycling with 7-min at each: RPE 9, 11 and 13. Oxygen consumption (VO2), heart rate (HR), and affect (Feeling Scale) were obtained throughout the exercise.

RESULTS

VO2 (p < 0.01) and HR (p < 0.01) increased linearly with RPE, but were not significantly different between exercise modes or cognitive groups. At RPE 13, participants worked above VT in both modes (exergaming: 115.7 ± 27.3; non-exergaming 114.1 ± 24.3 VO2 (%VT)). Regardless of cognitive group, affect declined significantly as RPE increased (p < 0.01). However on average, affect remained pleasant throughout and did not differ between exercise modes or cognitive groups.

CONCLUSIONS

These results suggest low-active older adults can perceptually regulate exercise intensity, regardless of cognition or mode. At RPE 13, participants regulated above VT, at an intensity that improves cardiorespiratory fitness long-term, and affect remained positive in the majority of participants, which may support long-term physical activity adherence.

Fatores sociodemográficos e ocupacionais associados aos ganhos e perdas percebidos por trabalhadores de uma universidade pública frente à proximidade da aposentadoria

Resumo: Objetivou-se analisar os fatores sociodemográficos e ocupacionais associados aos ganhos e às perdas percebidos por trabalhadores de uma universidade pública frente à proximidade da aposentadoria. Pesquisa exploratória, transversal e quantitativa, realizada em uma universidade pública do norte do Estado do Paraná, Brasil, com 164 trabalhadores pré-aposentados, que responderam às escalas de importância de ganhos e de perdas da aposentadoria. Os dados foram analisados por regressão linear simples e múltipla a partir das dimensões das escalas, e foram usadas, como preditores, as variáveis sociodemográficas e ocupacionais. Os trabalhadores atribuíram maior importância aos ganhos do que às perdas da aposentadoria. O aumento da idade associou-se à menor valorização dos ganhos totais e do tempo para relacionamentos. O maior tempo de atuação contribuiu para a valorização das perdas totais e dos aspectos tangíveis do trabalho. Faz-se necessário criar espaços de reflexão nas instituições de trabalho que proporcionem a escuta das necessidades dos trabalhadores, sobretudo, daqueles com maior idade e tempo de serviço.

Prevalence of disability and associated factors in the elderly

The aim of this study was to estimate the prevalence and factors associated with functional disability in the elderly. The cross-sectional design was used with a sample of 624 individuals, between 60 and 96 years of age. In the assessment of the elderly interviews and physical performance tests were used. In the inferential data analysis, the Poisson regression was used, p≤0.05. The prevalence of disability was 17.6% for Basic Activities of Daily Living and 46.3% for Instrumental Activities of Daily Living. Functional disability for Basic Activities of Daily Living was associated with increasing age, alcohol consumption, depressive symptoms and frailty; the Instrumental Activities of Daily Living were associated with increasing age, illiteracy, multigenerational family arrangement, hospitalization and fragility. The variables that remained in the explanatory model for the decline of functional capacity should be emphasized in proposals for public policies to promote the health of the elderly.

Quality of life of elderly practitioners of physical activity in the context of the family health strategy

Cross-sectional, descriptive and correlational study with 107 elderly enrolled in two basic health units in Minas Gerais, in order to describe the sociodemographic profile and evaluate the interdependence of quality of life of the elderly and physical activity, in the face of possible factors. Initially we performed a descriptive analysis of the socioeconomic profile of the sample and the tests applied to the elderly. We sought to explore joint relationships between quality of life, physical activity and exploratory variables through principal component analysis. Three distinct profiles were identified in two dimensions that explained the relationship between quality of life and physical activity. We concluded that the quality of life for the elderly is good and is influenced by regular physical activity, absence of depression, greater cognitive ability and good family functioning.

Old age and elderly people: social representations of adolescent students

OBJECTIVE

to know the main elements of social representations about elderly people and old age among adolescents at a public high school.

METHOD

172 adolescents between 14 and 19 years of age participated. The free evocation of words technique was applied through the terms elderly and old age.

RESULTS

The main elements of the representations significantly designed for elderly people were: respect and disrespect, 78; experience, 49; care, 32; wisdom, 23; fragility, 19. For old age: disease, 51; retirement, 27; experience, 27; wisdom, 19; wrinkles, 17. The social representations of adolescents are strongly marked by physical, psychological and social aspects, with positive and negative aspects about old age.

CONCLUSION

Participatory health education activities are needed to make adolescents critically reflect on and the condition of elderly people in contemporary society.

Nurses and care delivery to elderly women: a social phenomenological approach

OBJECTIVE: To understand how nurses see care delivery to elderly women. METHODS: In this phenomenological study, ten nurses working at Primary Health Care Units were interviewed between September 2010 and January 2011. RESULTS: In care delivery, nurses consider the elderly women's knowledge background and biographical situation, and also value the family's participation as a care mediator. These professionals have the acuity to capture these women's specific demands, but face difficulties to deliver care to these clients. Nurses expect to deliver qualified care to these women. CONCLUSION: The theoretical and methodological approach of social phenomenology permitted revealing that the nurse designs qualified care to elderly women, considering the possibilities in the context. This includes the participation of different social actors and health sectors, assuming collective efforts in action strategies and professional training, in line with the particularities and care needs of elderly women nurses identify.