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Brech GC, da Silva VC, Alonso AC, Machado-Lima A, da Silva DF, Micillo GP, Bastos MF, de Aquino RDC. Quality of life and socio-demographic factors associated with nutritional risk in Brazilian community-dwelling individuals aged 80 and over: cluster analysis and ensemble methods. Front Nutr 2024; 10:1183058. [PMID: 38235441 PMCID: PMC10792032 DOI: 10.3389/fnut.2023.1183058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/26/2023] [Indexed: 01/19/2024] Open
Abstract
Introduction The aim of the present study was to use cluster analysis and ensemble methods to evaluate the association between quality of life, socio-demographic factors to predict nutritional risk in community-dwelling Brazilians aged 80 and over. Methods This cross-sectional study included 104 individuals, both sexes, from different community locations. Firstly, the participants answered the sociodemographic questionnaire, and were sampled for anthropometric data. Subsequently, the Mini-Mental State Examination (MMSE) was applied, and Mini Nutritional Assessment Questionnaire (MAN) was used to evaluate their nutritional status. Finally, quality of life (QoL) was assessed by a brief version of World Health Organizations' Quality of Life (WHOQOL-BREF) questionnaire and its older adults' version (WHOQOL-OLD). Results The K-means algorithm was used to identify clusters of individuals regarding quality-of-life characteristics. In addition, Random Forest (RF) and eXtreme Gradient Boosting (XGBoost) algorithms were used to predict nutritional risk. Four major clusters were derived. Although there was a higher proportion of individuals aged 80 and over with nutritional risk in cluster 2 and a lower proportion in cluster 3, there was no statistically significant association. Cluster 1 showed the highest scores for psychological, social, and environmental domains, while cluster 4 exhibited the worst scores for the social and environmental domains of WHOQOL-BREF and for autonomy, past, present, and future activities, and intimacy of WHOQOL-OLD. Conclusion Handgrip, household income, and MMSE were the most important predictors of nutritional. On the other hand, sex, self-reported health, and number of teeth showed the lowest levels of influence in the construction of models to evaluate nutritional risk. Taken together, there was no association between clusters based on quality-of-life domains and nutritional risk, however, predictive models can be used as a complementary tool to evaluate nutritional risk in individuals aged 80 and over.
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Affiliation(s)
- Guilherme Carlos Brech
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Vanderlei Carneiro da Silva
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Angelica Castilho Alonso
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Adriana Machado-Lima
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | - Daiane Fuga da Silva
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
| | | | - Marta Ferreira Bastos
- Postgraduate Program in Aging Sciences, Universidade São Judas Tadeu, São Paulo, Brazil
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Silva ECGE, Schmitt ACB, de Godoy CG, de Oliveira DB, Tanaka C, Toufen C, de Carvalho CRR, Carvalho CRF, Fu C, Hill KD, Pompeu JE. Risk Factors for the Impairment of Ambulation in Older People Hospitalized with COVID-19: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7057. [PMID: 37998288 PMCID: PMC10671138 DOI: 10.3390/ijerph20227057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Some older people hospitalized with COVID-19 have experienced reduced ambulation capacity. However, the prevalence of the impairment of ambulation capacity still needs to be established. Objective: To estimate the prevalence of, and identify the risk factors associated with, the impairment of ambulation capacity at the point of hospital discharge for older people with COVID-19. (2) Methods: A retrospective cohort study. Included are those with an age > 60 years, of either sex, hospitalized due to COVID-19. Clinical data was collected from patients' medical records. Ambulation capacity prior to COVID-19 infection was assessed through the patients' reports from their relatives. Multiple logistic regressions were performed to identify the risk factors associated with the impairment of ambulation at hospital discharge. (3) Results: Data for 429 older people hospitalized with COVID-19 were randomly collected from the medical records. Among the 56.4% who were discharged, 57.9% had reduced ambulation capacity. Factors associated with reduced ambulation capacity at discharge were a hospital stay longer than 20 days (Odds Ratio (OR): 3.5) and dependent ambulation capacity prior to COVID-19 (Odds Ratio (OR): 11.3). (4) Conclusion: More than half of the older people who survived following hospitalization due to COVID-19 had reduced ambulation capacity at hospital discharge. Impaired ambulation prior to the infection and a longer hospital stay were risks factors for reduced ambulation capacity.
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Affiliation(s)
- Erika Christina Gouveia e Silva
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Ana Carolina Basso Schmitt
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Caroline Gil de Godoy
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Danielle Brancolini de Oliveira
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Clarice Tanaka
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Carlos Toufen
- Division of Pulmonology, Heart Institute (InCor), School of Medicine—University of Sao Paulo, Brazil. Av. Dr. Eneas Carvalho de Aguiar, 44-Cerqueira Cesar, São Paulo 05403-900, Brazil (C.R.R.d.C.)
| | - Carlos Roberto Ribeiro de Carvalho
- Division of Pulmonology, Heart Institute (InCor), School of Medicine—University of Sao Paulo, Brazil. Av. Dr. Eneas Carvalho de Aguiar, 44-Cerqueira Cesar, São Paulo 05403-900, Brazil (C.R.R.d.C.)
| | - Celso R. F. Carvalho
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Carolina Fu
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
| | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, VIC 3199, Australia;
| | - José Eduardo Pompeu
- Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine—University of Sao Paulo, Brazil. R. Cipotanea, 51-Vila Butanta, São Paulo 05360-160, Brazil; (A.C.B.S.); (C.G.d.G.); (D.B.d.O.); (C.T.); (C.R.F.C.); (C.F.); (J.E.P.)
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Silva VC, Dias AS, Greve JMD, Davis CL, Soares ALDS, Brech GC, Ayama S, Jacob-Filho W, Busse AL, de Biase MEM, Canonica AC, Alonso AC. Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4212. [PMID: 36901230 PMCID: PMC10002325 DOI: 10.3390/ijerph20054212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.
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Affiliation(s)
- Vanderlei Carneiro Silva
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Aluane Silva Dias
- Graduate Program in Aging Science, São Judas Tadeu University (USJT), São Paulo 03166-000, Brazil
| | - Julia Maria D’Andréa Greve
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Catherine L. Davis
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30901, USA
| | - André Luiz de Seixas Soares
- Graduate Program in Aging Science, São Judas Tadeu University (USJT), São Paulo 03166-000, Brazil
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30901, USA
| | - Guilherme Carlos Brech
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
- Graduate Program in Aging Science, São Judas Tadeu University (USJT), São Paulo 03166-000, Brazil
| | - Sérgio Ayama
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Wilson Jacob-Filho
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Alexandre Leopold Busse
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Maria Eugênia Mayr de Biase
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Alexandra Carolina Canonica
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
| | - Angelica Castilho Alonso
- Laboratory for the Study of Movement, Department of Orthopedics and Traumatology, School of Medicine, University of São Paulo, São Paulo 05403-010, Brazil
- Graduate Program in Aging Science, São Judas Tadeu University (USJT), São Paulo 03166-000, Brazil
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Silva ECGE, Schmitt ACB, Godoy CGD, Gambeta AC, Carvalho CRFD, Fu C, Tanaka C, Junior CT, Carvalho CRRD, Pompeu JE. Ambulation capacity, age, immunosuppression, and mechanical ventilation are risk factors of in-hospital death in severe COVID-19: a cohort study. Clinics (Sao Paulo) 2022; 77:100075. [PMID: 35863104 PMCID: PMC9250925 DOI: 10.1016/j.clinsp.2022.100075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/22/2022] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Despite ambulation capacity being associated with a decreased level of physical activity and survival may be influenced by the functional capacity, studies have not addressed the association between ambulation capacity and death in patients hospitalized by COVID-19. OBJECTIVE To verify the functional, clinical, and sociodemographic risk factors associated with in-hospital death in individuals with severe COVID-19. METHODS It is a cohort retrospective study performed at a large tertiary hospital. Patients 18 years of age or more, of both sexes, hospitalized due to severe COVID-19 were included. Cases with dubious medical records and/or missing essential data were excluded. Patients were classified according to their ambulation capacity before the COVID-19 infection. Information regarding sociodemographic characteristics, in-hospital death, total hospital stays, Intensive Care Unit (ICU) stays, and the necessity of Mechanical Ventilation (MV) were collected from medical records and registered in a RedCap database. Multiple logistic regression analysis was used to identify possible factors associated with the in-hospital death rate. RESULTS Data from 1110 participants were included in the statistical analysis. The median age of the patients was 57 (46‒66) years, 58.42% (n = 590) were male, and 61.73% (n = 602) were brown or black. The case fatality rate during hospitalization was 36.0% (n = 363). In-hospital death was associated with ambulation capacity; dependent ambulators (OR = 2.3; CI 95% = 1.2-4.4) and non-functional ambulation (OR = 1.9; CI 95% = 1.1-3.3), age [older adults (OR = 3.0; CI 95% = 1.9‒4.), ICU stays (OR = 1.4; CI 95% = 1.2‒1.4), immunosuppression (OR = 5.5 CI 95% = 2.3‒13.5) and mechanical ventilation (OR = 27.5; CI 95% = 12.0-62.9). CONCLUSION AND RELEVANCE Decreased ambulation capacity, age, length of ICU stay, immunosuppression, and mechanical ventilation was associated with a high risk of in-hospital death due to COVID-19.
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Affiliation(s)
- Erika Christina Gouveia E Silva
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
| | - Ana Carolina Basso Schmitt
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Caroline Gil de Godoy
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Amislaine Cristina Gambeta
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | | | - Carolina Fu
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Clarice Tanaka
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - Carlos Toufen Junior
- Divisão de Pneumologia, Instituto do Coração (InCor), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, Brazil
| | | | - José Eduardo Pompeu
- Department of Physical Therapy, Speech Therapy, and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
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Busatto GF, Silva CA, Pereira AJR, Bonfá E, de Barros-Filho TEP. Scientific legacy of COVID-19 at the FMUSP-HC academic health system: current status and implications for the future. Clinics (Sao Paulo) 2021; 76:e3630. [PMID: 34909915 PMCID: PMC8612300 DOI: 10.6061/clinics/2021/e3630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Geraldo Filho Busatto
- Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, BR
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