Prevalence of non-communicable chronic diseases: arterial hypertension, diabetes mellitus, and associated risk factors in long-lived elderly people

OBJECTIVE

To identify the prevalence of non-communicable chronic diseases: arterial hypertension, diabetes mellitus, and associated risk factors in long-lived elderly people from three Brazilian regions.

METHODS

This is a multicenter, cross-sectional, and comparative study conducted with elderly people aged 80 years or older.

RESULTS

Higher prevalence of arterial hypertension were observed among those who use polypharmacy (75.7%), among elderly people aged between 80 and 84 years (33.9%), as well as in elderly people who are overweight (78.2%). The prevalence of diabetes was 24% (RP: 0.76; 95% CI: 0.59-0.98) lower among women compared to men and 2.15 times higher among those who use five or more medications (RP: 2.15; 95% CI: 1.63-2.85).

CONCLUSIONS

In our sample, polypharmacy, body weight, and gender determine the prevalence of non-communicable chronic diseases: arterial hypertension and diabetes mellitus in long-lived elderly people.

Muscle performance in octogenarians: Factors affecting dynapenia

BACKGROUND

The muscle performance is associated with several health outcomes in adults, however modifiable and non-modifiable risk factors in octogenarians have not yet been fully investigated. The aim of this study was to analyze the potential risk factors that negatively affect muscle strength in octogenarians.

METHODS

This observational, descriptive, cross-sectional study included 87 older adult participants (56 women and 31 men) attending a geriatric clinic. General anthropometrics, health history, and body composition data were collected. Muscle strength was assessed by handgrip strength (HGS), appendicular skeletal muscle mass (ASMM) and the percentage of body fat were identified by Dual Energy X-ray Absorptiometry, and muscle quality index (MQI) was defined as the ratio of HGS by upper limbs ASMM. Multiple linear regression was conducted to determine predictive factors of the muscle strength.

RESULTS

Females had lower HGS (1.39 kg) than male participants (p = 0.034). An increase of one unit MQI was associated with an increase of 3.38 kg in the HGS (p = 0.001). Each additional year of age was associated with a decrease of 0.12 kg in the HGS (p = 0.047). Regarding ASMM, an increase of one unit was associated with an increase of 0.98 kg in the HGS (p = 0.001). There was no association between dynapenia, body fat percentage, diseases and polypharmacy (p > 0.05).

CONCLUSION

The gender, age, MQI, and ASMM influenced muscle strength of octogenarians. These intrinsic and extrinsic factors are relevant to improve our understanding of age-related complications and outline treatment guidance by healthcare professionals.

Field-Based Estimates of Muscle Quality Index Determine Timed-Up-and-Go Test Performance in Obese Older Women

Objective

The muscle quality index (MQI) is associated with numerous health outcomes in adults; however, the effects of distinct MQI on functional capacity in obese older women have not yet been fully investigated. Thus, we investigated the contribution of different muscle quality indices on TUG performance prediction in obese older women. We secondarily evaluated the association between MQI, aerobic capacity performance (Treadmill performance and 6-minute walk test), and obesity indices (BMI, body fat percentage, and neck, waist, and hip circumference).

Methods

Participants included 64 obese older women (mean age 67.05 ± 5.46 years, body fat ≥ 35%). General anthropometric, health history, body composition, treadmill exercise, and functional test (Time up and go) measures were collected. A hydraulic dynamometer was used to assess muscle strength, and Dual Energy X-ray Absorptiometry (DXA) to identify body fat percentage. The field MQI was defined as the highest reading divided by the subject's body mass index (BMI), while the laboratory MQI was obtained by the ratio of grip strength to the entire arm muscle in kilograms measured by DXA. A hierarchical multiple regression was performed to predict TUG-test performance.

Results

An increase in field MQI of one unit is associated with a decrease of 2.59 seconds in the TUG test (β = -0.540; p = 0.004). There was no association between laboratory MQI and TUG performance (β = 0.067; p = 0.712). Furthermore, field MQI displays a positive correlation (p < 0.05) with aerobic capacity performance (6-minute walk test and peak O₂ consumption) and a negative correlation (p < 0.05) with diverse obesity indices (neck and waist circumference, body fat, and BMI).

Conclusion

MQI displayed an important prediction with TUG-test, a positive correlation with aerobic capacity, and a negative correlation with obesity indices.

Religiosity/Spirituality and Mental Health in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Objectives

The present study investigated the association between religious and spiritual (RS) practices with the prevalence, severity, and incidence of mental health problems in older adults.

Methods

We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated older adults aged 60+ years and assessed RS using valid scales and questions from valid scales, and mental health according to validated multidimensional or specific instruments. Studies were retrieved from MEDLINE, LILACS, SCOPUS, CINAHL, and AgeLine databases until July 31, 2021. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS). A pooled effect size was calculated based on the log odds ratio (OR) and Z-scores. This study is registered on PROSPERO.

Results

One hundred and two studies that investigated 79.918 community-dwellers, hospitalized, and institutionalized older adults were included. Results indicated that high RS was negatively associated with anxiety and depressive symptoms, while a positive association was observed with life satisfaction, meaning in life, social relations, and psychological well-being. Specifically, people with high spirituality, intrinsic religiosity, and religious affiliation had a lower prevalence of depressive symptoms. In relation to longitudinal analysis, most studies supported that high RS levels were associated with a lower incidence of depressive symptoms and fear of death, as well as better mental health status.

Conclusion

Findings of the present study suggest that RS are significantly associated with mental health in older adults. People with high RS levels had a lower prevalence of anxiety and depressive symptoms, as well as reported greater life satisfaction and psychological well-being, better social relations, and more definite meaning in life. Data provided by an increasing number of longitudinal studies have supported most of these findings.

Body composition and functional performance of older adults

Objectives

To determine if anthropometric variables, body composition, medication and gender are associated with functional performance and to compare these variables between octogenarians with high and low functional performance.

Methods

Observational, cross-sectional study. Weight, height, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were evaluated. Handgrip strength (HGS) was assessed. Participants’ body composition was assessed by dual-energy X-ray absorptiometry (DXA) and functional performance by Short Physical Performance Battery (SPPB). A binomial logistic regression was performed.

Results

One hundred and twenty-two octogenarians were included and separated into high and low function groups. The high function group showed lower values of WHtR (mean difference [MD] = 0.047, P = 0.025) and body fat (BF%) (MD = 3.54, P = 0.032) and higher values of apendicular skeletal muscle mass (ALM) (MD = 3.03, P = 0.001), HGS (MD = 6.11, P = 0.001) and SPPB score (MD = 4.20, P = 0.001). Women were more likely to be classified as low function (OR = 3.66, P = 0.002) and males showed 5.21 odds ratio (P = 0.021) of having high functional performance compared to females. Also, each decrease in age and medication use displayed 1.30 (P = 0.007) and 1.26 odds ratio increases (P = 0.008) in high functional performance.

Conclusions

Older males display better functional performance than women, and decrements in age and medications increase the high functional performance odds ratio. Octogenarians with high functional performance displayed lower BF measurements and higher values of muscle mass and strength.

FATORES ASSOCIADOS A HOSPITALIZAÇÃO DE IDOSOS LONGEVOS RESIDENTES NO DISTRITO FEDERAL – BRASIL

O objetivo do presente estudo foi analisar os fatores associados a hospitalização de idosos com 80 anos e mais residentes no Distrito Federal - Brasil. Foram investigados 208 idosos longevos (80 anos e mais) atendidos em ambulatório do Distrito Federal entre os anos de 2016 a 2018. Utilizaram-se testes de rastreio cognitivo, desempenho funcional, fragilidade e questionários padronizados. A hospitalização no último ano foi associada a idade mais avançada, menor escolaridade, maior prevalência de declínio cognitivo, e possuir fragilidade nos domínios perda de peso e força de preensão manual. Após ajustes segundo modelo logístico múltiplo permaneceram associadas à hospitalização as variáveis escolaridade, fragilidade perda de peso e número de consultas médicas no último ano. Nesse contexto, para prevenção da hospitalização na velhice avançada faz-se necessário investimentos em medidas de gerenciamento de caso, qualificação da atenção em saúde, rastreio e manejo da fragilidade.

Monitoring Public Perception of Health Risks in Brazil and Italy: Cross-Cultural Research on the Risk Perception of Choking in Children

One of the most relevant public health issues among pediatric injuries concerns foreign body (FB) aspiration. The risk perception of choking hazards (CH) and risk perception, in general, are complex multifactorial problems that play a significant role in defining protective behavior. Risk prevention policies should take this aspect into account. A lack of scientific knowledge of FB injury risk perception may be evidenced in Brazil and other newly developed countries. This study aims to characterize the differences and peculiarities in risk perception of CH between Italian and Brazilian populations. The risk perception among adults in Italy and Brazil between September and October 2017 was investigated in a survey. A Multiple Correspondence Analysis was carried out to identify the latent components characterizing the risk perception in Italian and Brazilian population samples. The most relevant dimension characterizing risk perception is the "Professional-educational status and the related perception of Risk" (13% of factorial inertia). The Italians identify batteries and magnets as the most dangerous choking risks (20% of responses). On the other hand, Brazilian people, mainly manual laborers (22%) with secondary or primary education (94%), perceive coins as the most dangerous items (30% of responses, p < 0.001). Socio-economic issues characterize the subjective risk perception of Italian and Brazilian survey respondents. In this framework, data-driven prevention strategies could be helpful to tailor intervention strategies to the cultural context to which they are addressed.

Associação entre eventos estressores e citocinas inflamatórias e anti-inflamatórias em pessoas idosas longevas

Resumo Objetivo investigar a associação entre a frequência de eventos estressores e citocinas em pessoas idosas longevas. Métodos os participantes responderam a um questionário constituído de variáveis sociodemográficas, indicaram quais eventos estressores constantes no Inventário de Eventos Estressores de vida ocorreram nos últimos cinco anos e responderam a escala de depressão geriátrica (GDS). Foram dosados por citometria de fluxo: interleucina (IL) 10, IL-6, IL-4, IL-2, fator de necrose tumoral (TNF-α) e interferon gama (IFN-γ). A análise descritiva foi realizada para a caracterização da amostra. Para investigar a associação entre as variáveis foi desenvolvido um modelo de regressão linear múltipla, utilizando o método Backward. Resultados Participaram da pesquisa 91 pessoas idosas com média de idade de 82 anos. Mais da metade da amostra relatou morte de ente querido como o evento estressor mais prevalente (61%). Nessa amostra foi possível perceber que quanto mais eventos estressores foram relatados, menor o nível de IL-4 (p=0,046), da mesma forma que o estado civil viuvez, onde os dados mostraram que quem é viúvo tem menos eventos estressores em comparação a quem é casado (p=0,037). Conclusão Evidenciou-se a importância de um olhar mais cuidadoso dos profissionais de saúde na avaliação multidimensional da pessoa idosa, de forma que se obtenham subsídios para a implementação de programas e intervenções específicos que possam amenizar a percepção dos eventos estressores vivenciados, colaborando com menores danos decorrentes da imunossenescência.

Muscle Quality Is Associated with History of Falls in Octogenarians

OBJECTIVES

The aim of this study was to compare muscle quality (MQ) between octogenarians classified as non-fallers, fallers and recurrent fallers and identify confounding intrinsic and extrensic factors that impact likelihood for falls.

DESIGN

This observational, descriptive, cross-sectional study included older adults (N=220) aged 80 years or older.

MEASUREMENTS

The Short Physical Performance Battery (SPPB) was used to evaluate physical function and MQ was calculated using the ratio of grip strength to arm muscle mass (in kilograms) quantified by DXA. Variables related to sociodemographic, clinical, cognitive function, and falls were evaluated using a questionnaire and symptoms of depression were evaluated by the Geriatric Depression Scale (GDS). A Kruskal-Wallis H test was used to verify differences between groups. Binomial logistic regression was performed to determine the impact of age, depression, polypharmacy, balance, MQ, and sex on participants having more than four falls in their history.

RESULTS

Increasing MQ was associated with reduced likelihood of more than four falls in their history. Non-fallers were statistically younger (p = 0.012) and took more medications (p = 0.023) than recurrent fallers. Recurrent fallers had lower MQ when compared with fallers (p = 0.007) and non-fallers (p = 0.001) and had a lower GDS score when compared with fallers (p = 0.022). Finally, fallers presented lower scores for balance when compared to non-fallers (p = 0.013).

CONCLUSION

A higher MQ is associated with a reduction in the likelihood falls in octogenarians. Therefore, it may be advantageous for clinicians to evaluate MQ when the screening of the risk of falls in older adults.

Aposentadoria e planejamento para vida pós-trabalho: um estudo com servidores de um Instituto Federal de Educação

Resumo Objetivo Investigar fatores associados à construção de projeto de vida pós-trabalho em servidores do Instituto Federal do Tocantins e verificar temas de interesse para elaboração de um Programa de Preparação para a Aposentadoria. Método Tratou-se de um estudo exploratório, de natureza quantitativa e de corte transversal. Foram entrevistados 94 servidores dentre técnicos administrativos e docentes, que estavam com 5, 10 e 15 anos para se aposentarem. Os participantes foram avaliados por meio de questionário sociodemográfico, QWLQbref questionário de avaliação da qualidade de vida no trabalho (QVT) e Escala dos Fatores-Chave de Planejamento para a Aposentadoria (KFRP). Resultados Houve correlações estatisticamente significantes e positivas entre o subdomínio psicológico de QVT e o Fator Risco ou Sobrevivência, e entre o domínio profissional de QVT e o Fator Relacionamentos Familiares. O grupo de profissionais com 5 a 10 anos para se aposentar apresentou a maior média no domínio psicológico de QVT (p=0,039). Participantes do sexo feminino focalizaram mais o novo começo profissional do que os homens (p=0,023), e participantes sem companheiro(a) apresentaram menor pontuação no item relacionamento familiar como fator de planejamento pós-aposentadoria (p=0,027). Das temáticas para o Planejamento de Programa para Aposentadoria, destacaram-se: planejamento financeiro (13%), legislação específica sobre aposentadoria (11%), e entretenimento e qualidade de vida (7%). Conclusão O planejamento para aposentadoria associou-se a qualidade de vida relacionada ao trabalho, sexo e estado conjugal. Essas variáveis, em conjunto com as temáticas propostas pelos servidores, podem contribuir para o planejamento de um Programa de Preparação para a Aposentadoria.

Perfil cognitivo e associações entre idosos longevos em contexto ambulatorial no Distrito Federal

Objetivou investigar associações entre o declínio cognitivo de idosos longevos em contexto ambulatorial e variáveis sociodemográficas, desempenho funcional, doenças crônicas, número de hospitalizações e acesso aos serviços de saúde. Foram entrevistados idosos longevos (80 anos e mais) residentes no Distrito Federal, avaliados em contexto ambulatorial por questionários padronizados e pelo Miniexame do Estado Mental (MEEM). Nas análises bivariadas, o declínio cognitivo esteve associado à faixa etária (85 anos e mais), possuir uma ou mais limitações nas atividades básicas de vida diária (ABVD), residir em arranjos domiciliares bi e trigeracionais e ter maior número de hospitalizações no último ano. No modelo logístico múltiplo, permaneceram associados ao declínio cognitivo em longevos as ABVD e as hospitalizações no último ano. Por tratar-se de uma população com maior demanda assistencial de saúde, torna-se necessário delinear medidas de prevenção e a promoção de cuidados de longa duração.

Comparison of field- and laboratory-based estimates of muscle quality index between octogenarians and young older adults: an observational study

Muscle quality (the ratio of strength to lean muscle mass) might be a better indicator of muscle function than strength alone. Differences in muscle quality index (MQI) between octogenarians and young older adults remain unclear. The aims of the present cross-sectional study were to compare (1) MQI between octogenarians and young older adults, (2) lab versus field-based MQI tools, and (3) determine possible confounding factors affecting MQI in older adults. Compiled data from two cross-sectional studies included 175 younger and older adults (31 men and 144 women) with a mean age of 75.93±9.49 years. Participants with age ≥80 years old were defined as octogenarians (n=79) and <80 years was defined as young older adults (n=96). Laboratory MQI was derived from the ratio of grip strength to arm muscle mass (in kg) measured by dual-energy x-ray absorptiometry. Field-based MQI was quantified from the ratio of grip strength to body mass index (BMI). Octogenarians displayed lower field (P=0.003) and laboratory MQI (P<0.001) as compared with young older adults. There was a strong correlation effect between field MQI and laboratory MQI (P=0.001, R=0.85). BMI (P=0.001), and diabetes mellitus (P=0.001) negatively affected MQI. Women presented lower MQI (P=0.001) values than men. In light of this information, rehabilitation specialists should consider the use of field-based MQI as a tool for evaluation and follow-up of older population.

Gender differences in psychosocial predictors of self-perceived health status in the elderly: Evidence from a Brazilian community study

This article aims to identify the psychosocial factors associated with self-perceived health status in the Brazilian elderly population and to present differences related to gender. The data were collected by questionnaire, including sociodemographic and behavioral questions, and scales for psychological dimensions. Self-perceived health status is related to level of education, physical activity, and self-efficacy in the total population. Regarding gender differences, self-rated health status among men is related to education level and self-efficacy and in women to level of education, physical activity, social support, and self-efficacy. These results can inform future health promotion interventions.

Association between religiosity and functional capacity in older adults: a systematic review

Abstract Objective: To verify the association between religiosity and functional capacity in the elderly. Method: a systematic review of literature in the SciELO, Lilacs, MEDLINE/PubMed and the portal of CAPES Journals databases was performed. The descriptors were selected through the list of Descriptors in Health Sciences (Decs) and Medical Subject Headings (Mesh). Original articles in Portuguese and English, published between 2007 and 2017, with a sample composed of elderly persons aged 60 years or more were included. Systematic or integrative reviews, case studies, scale validation studies, dissertations and theses and studies on religious social support were excluded, as well as articles that included elderly persons and adults in the sample. Result: 280 articles were identified, of which six were included in this review. Religiosity was associated with improved functional capacity and coping with disability and the delay of functional decline in the elderly. Different aspects of religiosity were associated with functional capacity, such as participation in religious activities, religious leadership role performance and religious beliefs and traditions. In three articles the positive association between religiosity and functional capacity was linked only to public religious activities and not to intrinsic religious practices. Conclusion: religiosity is significantly and positively associated with the functional capacity of the elderly. The association between intrinsic religiosity and functional capacity is still unclear.

As crenças religiosas e espirituais no enfrentamento de desafios advindos das feridas crônicas em idosos

Este estudo objetiva investigar como as crenças religiosas, espirituais, e a fé do idoso podem contribuir para o enfrentamento de desafios advindos das feridas crônicas. Trata-se de um estudo do tipo descritivo observacional, com delineamento transversal e abordagem qualitativa e quantitativa. Os resultados permitiram identificar que os idosos portadores de feridas crônicas, além de recorrem à ajuda médica, valem-se da sua religiosidade e fé em busca da cura e da melhoria da sua qualidade de vida. 

[Workshops for cognitive stimulation adapted for elderly illiterate individuals with mild cognitive impairment]

The aim of this study was to assess the self-perception of memory in elderly illiterate with mild cognitive impairment, before and after workshops of cognitive stimulation adapted for illiterate individuals. The research was qualitative, held at the Health Unit of Taguatinga-DF, involving 63 elderly illiterate: 22 in the experimental group (EG), with 10 workshops; 21 in control group 1 (CG1), with 10 lectures; and 20 in the control group 2 (GC2), without intervention. Semi-structured interviews were carried on before and after the interventions, asking about memory status. The activities offered weekly to EG and CG1 have had two hours of duration. The mean age of the participants was 72.8 years, and 92% were female. In pre-intervention, 82% reported worsening memory during the last year. In post-intervention, CG1 and CG2 kept memory changes, while EG improved cognition. One concludes that the provided workshops and lectures improved functionality and socialization / integration.

Representação social do idoso do Distrito Federal e sua inserção social no mundo contemporâneo a partir da Internet

Sendo o estudo do uso da internet pelos idosos um tema recente na gerontologia, este artigo relata uma pesquisa que levou em consideração a inserção dos idosos na sociedade das tecnologias de informação e comunicação (TIC) a partir da teoria da representação social dos idosos, que residem no Distrito Federal e acessam a internet. Tem como objetivo discutir e analisar a construção das representações sociais dos idosos residentes no Distrito Federal sobre a internet, na busca de verificar se os idosos estão acompanhando as profundas transformações da sociedade das tecnologias informacionais e comunicacionais. Como procedimento metodológico adotou-se a observação, a entrevista semi-estruturada, o programa ALCESTE para a análise de conteúdo, que conta a quantidade de unidades de contexto elementares (UCE), que correspondem à idéia de frase mais calibrada em função do tamanho do texto, avaliada em número de palavras analisadas e conforme a ordem de prioridade. Verificou-se que há um rompimento da visão negativa de que a velhice é uma fatalidade e um tempo de solidão, porque novas possibilidades se abrem para os idosos com a internet, que pode inseri-los no mundo contemporâneo, permitindo-lhes criar novos laços de amizade e novas interações sociais.

Como vai a educação gerontológica nas escolas públicas do Distrito Federal?: um estudo com idosos e jovens

O presente artigo é fruto de uma pesquisa de campo quali-quantitativa que embasou uma dissertação de mestrado. A pesquisa buscou conhecer a opinião de alunos de escolas públicas do Ensino Fundamental e Médio do Distrito Federal (DF) e de idosos da mesma comunidade a respeito do envelhecimento e sua correlação com a existência ou não de preconceitos. Buscamos averiguar se um grupo de escolas desenvolve algumas ações voltadas à formação de hábitos, valores e atitudes direcionadas à superação de preconceitos e à aproximação entre as gerações (intergeracionalidade). Os dados foram coletados por meio de três instrumentos: 1) aplicação de um questionário sócio-demográfico e da Escala para Avaliação de Atitudes em Relação ao Idoso validada por Neri; 2) avaliação de oito propostas pedagógicas de escolas públicas do Ensino Fundamental e Médio do DF, que nos permitiram conhecer a dinâmica do contexto pesquisado; e 3) realização de 18 entrevistas, sendo cinco com jovens das escolas, oito com diretores (cujas propostas pedagógicas foram analisadas), e cinco com idosos (residentes na área central de Brasília). Diante dos resultados do presente estudo, podemos afirmar que predominaram atitudes mais positivas do que negativas em ambos os grupos. Não obstante, ao confrontá-los com as entrevistas, percebemos que os entrevistados responderam a questões similares às apresentadas na Escala Neri de forma mais negativa. Inferimos que este fato se deva à existência de preconceito implícito em relação ao idoso e à velhice. Outra constatação importante é a inexistência de atividades voltadas aos idosos, e/ou a aproximação destes com outras gerações nas escolas pesquisadas. Os dados obtidos com esta pesquisa sugerem que a educação gerontológica deve fazer parte do currículo escolar, visando a aproximar gerações e superar possíveis preconceitos, possibilitando a troca de experiências e a melhoria da qualidade de vida de todos.