Effectiveness of Cardiac Rehabilitation With mHealth Through Smartphone Functionalities: A Systematic Review Protocol

Cardiovascular diseases are the leading cause of mortality worldwide, requiring support to manage symptoms and improve prognosis. Home-based cardiac rehabilitation is a realistic resource for this purpose, but it requires patients' self-management skills in order to change behaviours. Smartphones are considered mHealth technology (mobile technological resources in healthcare) and have the potential to provide modalities for delivery of cardiac rehabilitation. This systematic review aims to examine these modalities and identify those that are most effective for improving exercise capacity, quality of life, and patient compliance. Randomized controlled trials (1994 to 2022) performed with adults with coronary artery disease (post-myocardial infarction, angina, post-coronary artery bypass graft surgery) or heart failure eligible for home-based cardiac rehabilitation (mHealth) will be selected. Studies published in English, Spanish, or Portuguese that compare rehabilitation-specific mobile apps or smartphone-based features with conventional cardiac rehabilitation will be included. Searches will be conducted in MEDLINE, CENTRAL, EMBASE, LILACS, PEDro, grey literature, and ongoing or recently completed studies. Data and risk of bias will be assessed, and if appropriate, a meta-analysis will be carried out.

Craniocervical Pain, Sleep Quality, Depressive Symptoms, and Physical Activity in Healthcare Workers During COVID-19 Pandemic

BACKGROUND

An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE.

AIMS

To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil.

DESIGN

Cross-sectional study.

PARTICIPANTS

Healthcare workers.

SETTINGS

An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report).

METHODS

The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance.

RESULTS

Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05).

CONCLUSION

Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.

Pain symptoms and physical performance in older adults: cross-sectional findings from the International Mobility in Aging Study (IMIAS)

PURPOSE

To analyze the associations between pain and physical performance in different aging contexts.

METHODS

Data from 1725 older adults from Canada, Brazil, Colombia, and Albania from the 2014 wave of the IMIAS were used to assess the associations between Back Pain (BP) or Lower Limb Pain (LLP) and physical performance by the Short Physical Performance Battery (SPPB). Three binary logistic regression models adjusted for sex, age, study site, education, income sufficiency, BMI, depressive symptoms, and chronic conditions were used to estimate the associations between LLP or BP and SPPB. The SPPB was classified into good performance (8 points or more) and poor physical performance (< 8 points).

RESULTS

The mean age of the older men was 71.2 (± 3.0) and the mean age of the women was 71.2 (± 2.8) years. Older men (72.8%, p < 0.05) and women (86.1%, p-value < 0.05) from Albania had the highest frequencies of self-reported general pain. Older women in Colombia had the highest frequencies of LLP or BP (33.5%, p-value < 0.05). In the fully adjusted logistic regression model, LLP or BP was significantly associated with poor SPPB (OR = 0.48, 0.35 to 0.66 95% CI, p < 0.01).

CONCLUSIONS

Pain symptoms are associated with reduced physical performance in older people, even when adjusted for other clinical and sociodemographic factors. Protocols for aiming to increase the level of physical activity to manage pain should be incorporated into health care strategies.

Dissatisfaction with body image and weight gain in middle-aged women: A cross sectional study

OBJECTIVES

To investigate the relationship between weight gain and body image perception in in middle-aged women.

METHODS

Cross-sectional study with 453 women. Body image was assessed using the Stunkard scale, in which women were classified as: satisfied or dissatisfied (general, thinness or obesity). The identification of possible factors associated with body image dissatisfaction was performed using binary logistic regression analysis.

RESULTS

The mean age was 55.7 (±9.6) years; 80.8% were classified as dissatisfied with body image. As for body composition, women satisfied with their body image had lower values of body fat and higher values of lean mass. In the logistic regression, for general dissatisfaction and obesity, the associated variables were BMI, education and physical activity. As for "dissatisfaction with thinness", only BMI was associated.

CONCLUSION

Thus, the prevalence of body image dissatisfaction is high in women and part of associated factors are linked to lifestyle behaviors.

Diagnostic Accuracy of the Short Physical Performance Battery in Detecting Frailty and Prefrailty in Community-Dwelling Older Adults: Results From the PRO-EVA Study

BACKGROUND AND PURPOSE

The Short Physical Performance Battery (SPPB) is widely used for older adults since it has a high level of validity, reliability, and responsiveness in measuring function in this population. However, only a few studies of diagnostic accuracy have assessed SPPB capacity in detecting frailty and prefrailty by estimating more detailed measurement properties. Thus, the present study aimed to evaluate the SPPB's diagnostic accuracy in detecting frailty and prefrailty, in addition to identifying cut-off points for walking time and chair stand time.

METHODS

This is a cross-sectional study composed of 786 community-dwelling older adults 60 years or older, in which sociodemographic and anthropometric data, frailty phenotype, and total SPPB score, as well as walking time and chair stand time, were assessed. Analysis of a receiver operating characteristic curve was performed to identify the cut-off point, sensitivity, and specificity in the total SPPB score, as well as the walking time and chair stand time for frailty and prefrailty screening. Accuracy and positive and negative predictive values were subsequently calculated.

RESULTS AND DISCUSSION

The cut-off points identified for the total SPPB score, walking time, and chair stand time were 9 points or less (accuracy of 72.6%), 5 seconds or less, and 13 seconds or less, respectively, for frailty screening and 11 points or less (accuracy of 58.7%), 4 seconds or less, and 10 seconds or less, respectively, for prefrailty screening. The walking time showed greater frailty discriminatory capacity compared with the chair stand time (effect size = 1.24 vs 0.64; sensitivity = 69% vs 59%; and specificity = 84% vs 75%).

CONCLUSIONS

The total SPPB score has good diagnostic accuracy to discriminate between nonfrail and frail older adults using a cut-off point of 9 or less, being better to identify the true negatives (older adults who are not frail). Although the SPPB's diagnostic accuracy measures for detecting prefrailty were low to moderate, this instrument can help in screening prefrail older adults from the cutoff point of 11 or less in the total SPPB score. Identification of prefrail older adults enables implementing early treatment in this target audience and can prevent their advance to frailty.

Monitoring sarcopenia with wearable devices: a systematic review protocol

INTRODUCTION

Sarcopenia is a highly prevalent muscle dysfunction among older adults and is associated with adverse events. The periodic monitoring enables an early screening of patients at risk and control of the progression of muscle impairment. Wearable devices have been used as clinical support for sarcopenia detection. Therefore, this review aims to identify how wearable devices have been used to screen sarcopenia.

METHODS AND ANALYSES

Searches will be conducted from August 2023 on PubMed, CINHAL, Embase, Web of Science and SciELO databases. We will include cross-sectional and/or baseline data from prospective studies reporting the use of wearable devices to investigate sarcopenia. Studies that discuss only the development of algorithms or applications for the assessment of sarcopenia or unavailable full texts will be excluded. The main reviewer will conduct the initial search and exclusion of duplicates, while two independent reviewers will select studies, extract data and assess the methodological quality using the Appraisal tool for Cross-sectional Studies.

ETHICS AND DISSEMINATION

No previous ethical approval is required for this review. The findings of this review will be submitted to a scientific journal and disclosed at international scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42022356040.

Contributions of musculoskeletal rehabilitation in patients after chikungunya fever: a systematic review

INTRODUCTION

Chikungunya fever is an infection transmitted by the Chikungunya virus (CHIKV), which is an arbovirus that is transmitted by the mosquitoes Aedes aegypti and Aedes albopictus. The most common sequelae caused by CHIKV are chronic musculoskeletal pain, nerve damage, joint deformation and functional impairment.

OBJECTIVE

To systematically identify the literature on the contributions of physiotherapy in the treatment of patients with CHIKV sequelae.

MATERIALS AND METHODS

Systematic review of the literature, guided by the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). The databases used were PUBMED, LILACS, Scielo and PEDro. Experimental studies and/or full case studies published without language restriction or publication data were included, in which they stood out as contributions of musculoskeletal functional rehabilitation in the treatment of patients with the condition in question. Analytical observational studies, editorial letters, review protocols, reflective studies, literature reviews and articles that do not have an abstract and/or full text available online were excluded.

RESULTS

The search in the databases was carried out between July and August 2022. A total of 4,782 articles were found on the platforms used and 10 articles from the gray literature search. After the duplicate analysis, 2,027 studies were excluded, leaving 2,755 articles that had their titles and abstracts read, of which 600 articles were selected for full reading. After this step, a final sample of 13 articles was eligible for this review.

FINAL CONSIDERATIONS

The most consolidated approaches used in the literature demonstrate that kinesiotherapy, associated or not with electrothermophototherapy, the pilates method and auriculotherapy are useful resources in the treatment of these individuals, significantly inspired by pain relief, improved quality of life and of functionality.

HbA1c and physical performance in older adults from different aging epidemiological contexts: Longitudinal findings of the International Mobility in Aging Study (IMIAS)

OBJECTIVE

This study aimed to assess the longitudinal predictions between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging.

MATERIAL AND METHODS

Longitudinal data of 1,337 older people from three countries (Canada, Brazil and Colombia) of the International Mobility in Aging Study (IMIAS) were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c and covariates on SPPB scores.

RESULTS

At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value < 0.05) and women (8.52 ± 2.33; p-value <0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women.

CONCLUSION

High HbA1c levels at baseline were longitudinally associated in older adults from different countries, and this association was observed only in men and not in women. This study highlights a possible influence of gender on this relationship.

Frailty biomarkers under the perspective of geroscience: A narrative review

Cellular and molecular aging biomarkers might contribute to identify at-risk individuals for frailty before overt clinical manifestations appear. Although studies on the associations of aging biomarkers and frailty exist, no investigation has gathered this information using a structured framework for identifying aging biomarkers; as a result, the evidence on frailty and aging biomarkers is diffuse and incomplete. Therefore, this narrative review aimed to gather information on the associations of the hallmarks of aging and frailty under the perspective of geroscience. The literature on human studies on this topic is sparse and mainly composed of cross-sectional investigations performed in small study samples. The main putative aging biomarkers associated to frailty were: mitochondrial DNA copy number (genomic instability and mitochondrial dysfunction), telomere length (telomere attrition), global DNA methylation (epigenetic alterations), Hsp70 and Hsp72 (loss of proteostasis), IGF-1 and SIRT1 (deregulated nutrient-sensing), GDF-15 (mitochondrial dysfunction, cellular senescence and altered intercellular communication), CD4 + and CD8 + cell percentages (cellular senescence), circulating osteogenic progenitor (COP) cells (stem cell exhaustion), and IL-6, CRP and TNF-alpha (altered intercellular communication). IGF-1, SIRT1, GDF-15, IL-6, CRP and TNF-alpha presented more evidence among these biomarkers, highlighting the importance of inflammation and nutrient sensing on frailty. Further longitudinal studies investigating biomarkers across the hallmarks of aging would provide valuable information on this topic.

Exploring the relationships between anthropometric indices of adiposity and physical performance in middle-aged and older Brazilian women: a canonical correlation analysis

OBJECTIVES

This study analyzed the influence of anthropometric indices of adiposity on the physical performance of middle-aged and older women.

METHODS

A cross-sectional study was conducted among 368 women from 50 years to 80 years old. Anthropometric and biochemical characteristics were analyzed, and physical performance was evaluated. The statistical analysis used measures of central tendency and dispersion for descriptive data, Pearson correlations to demonstrate the initial associations between the variables, and canonical correlation (CC) to evaluate the relationship between the set of anthropometric adiposity indices and performance-related variables.

RESULTS

The participants had a mean age of 58.57±8.21 years, a visceral adiposity index of 7.09±4.23, a body mass index of 29.20±4.94 kg/m2, and a conicity index of 1.33±0.07. The average handgrip strength was 25.06±4.89 kgf, gait speed was 1.07±0.23 m/s, and the mean Short Physical Performance Battery (SPPB) score was 10.83±1.36. The first canonical function presented the highest shared variance, CC, and redundancy index (cumulative percentage of variance, 82.52; Wilks' lambda, 0.66; CC, 0.532; p<0.001). From the analysis of this canonical function, the conicity index (-0.59) displayed inverse correlations with handgrip strength (0.84) and the SPPB (0.68), as well as a direct correlation with gait speed (-0.43).

CONCLUSIONS

In middle-aged and older women, there was an inverse relationship between the conicity index and muscle strength and power, while a direct relationship was found between the same index and gait speed.

Physical performance as a predictor of mortality in nursing home residents: A five-year survival analysis

This study developed a five-year survival analysis to verify the relationship between the Short Physical Performance Battery (SPPB) and death in older adults residing in nursing homes (NHs). A total of 114 residents of NHs in Northeast Brazil participated in the follow-up. In addition to the SPPB, the older adults answered questions about sociodemographic and health condition information. The relationship between physical performance and mortality was evaluated using the Kaplan Meier survival curves and Cox proportional regression. As a result, 61.40% of the participants presented low performance and 41.22% died. Low physical performance increased the chance of death by 2.77 times in five years (adjusted Hazard Ratio 2.77; 95% CI 1.40-5.50; p < 0.01). Low SPPB Gait Speed Test also represented a 2.58-fold increased risk of dying (adjusted HR 2.58; 95% CI 1.38-4.83; p < 0.01). The results of this study showed that low physical performance can predict the mortality of older adults residing in NHs over five years.

Metabolic syndrome in middle-aged and older women: A cross-sectional study

Objective:

This study aims to compare the prevalence of metabolic syndrome between different age groups of middle-aged and older women and to assess whether these differences are independent of potential covariates.

Methods:

Study conducted with 510 women divided into three age groups: 45–54, 55–64 and 65–74 years. Socioeconomic, reproductive and lifestyle variables were self-reported. We defined metabolic syndrome using the National Cholesterol Education Program Adult Treatment Panel III criteria (abdominal obesity, diabetes, reduced high-density lipoprotein, elevated triglycerides, and hypertension). Logistic regression assessed the association between age groups, and metabolic syndrome was adjusted for covariates (socioeconomic variables, age at menarche and at first childbirth, parity, menopausal status, physical activity variables and smoking).

Results:

Women aged 55–64 years presented higher prevalence of all metabolic syndrome criteria than the other groups, except for abdominal obesity, which was higher in the oldest group. In the fully adjusted analysis, the 55–64 years age group continues to exhibit significantly higher odds of presenting metabolic syndrome when compared to the youngest group (45–54 years) (OR = 2.257; 95% CI = 1.20:4.24). There was no statistical difference in the odds of presenting metabolic syndrome when comparing the oldest and the youngest groups (OR = 1.500; 95% CI = 0.85:2.65).

Conclusion:

The higher prevalence of metabolic syndrome among those aged 55–64 years may indicate that middle-aged women become unhealthy earlier in the life course and that many of them may die prematurely. This result highlights the importance of screening metabolic syndrome earlier in the midlife and the need for public health policies aimed at reducing adverse effects in later years.

Mapping instruments for assessing and stratifying frailty among community-dwelling older people: a scoping review

OBJECTIVE

To map in the current literature instruments for the assessment and stratification of frailty in community-dwelling older people, as well as to analyse them from the perspective of the Brazilian context.

DESIGN

Scoping review.

STUDY SELECTION

The selection of studies took place between March and April 2020. Includes electronic databases: Medline, Latin American and Caribbean Literature in Health Sciences, Scopus, Web of Science and Cumulative Index of Nursing and Literature Health Alliance, in addition to searching grey literature.

DATA EXTRACTION

A data extraction spreadsheet was created to collect the main information from the studies involved, from the title to the type of assessment and stratification of frailty.

RESULTS

In summary, 17 frailty assessment and stratification instruments applicable to community-dwelling older people were identified. Among these, the frailty phenotype of Fried et al was the instrument most present in the studies (45.5%). The physical domain was present in all the instruments analysed, while the social, psychological and environmental domains were present in only 10 instruments.

CONCLUSIONS

This review serves as a guideline for primary healthcare professionals, showing 17 instruments applicable to the context of the community-dwelling older people, pointing out advantages and disadvantages that influence the decision of the instrument to be used. Furthermore, this scoping review was a guide for further studies carried out by the same authors, which aim to compare instruments.

Cutoff points of adiposity anthropometric indices for low muscle mass screening in middle-aged and older healthy women

Background

The reduction of female sex hormones causes changes in the contractile properties of muscles as well as infiltration of fat in the muscle tissue. This results in a consequent decline in muscle strength. These changes are related to higher levels of functional impairment and physical disability. In this sense, several anthropometric indices have been used to quantify body and visceral fat. Thus, the objective of this paper is to propose cutoff points for adiposity anthropometric indices in order to identify low muscle mass, as well as to analyze the relationship between these indices and low muscle mass in middle-aged and older women.

Methods

Cross-sectional analytical study carried out in the Northeast of Brazil. The sample was formed by 593 women between 40—80 years old. Data collection included anthropometric assessment (BMI: Body Mass Index – WC: Waist Circumference – WHR: Waist-to-hip Ratio – WHtR: Waist-to-height Ratio – CI: Conicity Index – BAI: Body Adiposity Index – VAI: Visceral Adiposity Index – LAP: Lipid Accumulation Product), bioimpedance test and biochemical dosage. Moreover, sociodemographic data and practice of physical activity were collected. Descriptive statistics, Student's t-test, ROC curves, chi-squared and logistic regression were performed.

Results

The participants had a mean age of 53.11 (8.89) years, BMI of 28.49 (5.17) kg/m² and WC of 95.35 (10.39). The prevalence of low muscle mass was 19.4%. Based on sensitivity and specificity of adiposity anthropometric indices, cutoff points were developed to identify the presence of low muscle mass (p < 0.05), except for VAI. After logistic regression, WC (OR = 6.2; CI 95%: 1.4—28.1), WHR (OR = 1.8; CI: 1.0—3.4), WHtR (OR = 5.0; CI 95%: 1.0—23.7) and BAI (OR = 14.5; CI 95%: 6.6—31.7) were associated with low muscle mass.

Conclusions

All anthropometric indices, except VAI, showed adequate accuracy in identifying low muscle mass in women, especially those that took into account WC. This suggests that they can become accessible and also be cost-effective strategies for assessing and managing health outcomes related to muscle mass analysis.

Relationship between anxiety symptoms, clinical control and quality of life of children with asthma: A cross-sectional study

OBJECTIVE

To investigate the relationship between anxiety symptoms and factors related to clinical control and quality of life of children with asthma aged 7-12 years.

METHODS

A cross-sectional comparative study involving children recruited from a reference center for asthma treatment in the city of Natal-RN. Diagnosis, control and severity were performed following GINA recommendations (2019). Sociodemographic information and spirometry results from a bronchodilator test were collected. Modified Fisher's scale, clinical control questionnaires (c-ACT and ACT), quality of life assessment (PAQLQ) (total score and domains) and anxiety symptoms assessment (SCAS) (total score and domains) were applied.

RESULTS

The sample consisted of 42 children with asthma. Symptoms of social phobia (as identified by SCAS), and household head education were related to clinical asthma control (p = .006; R ²  = .19). Total SCAS score, guardian's education and physical activity were related to total PAQLQ (p < .0001; R ²  = .33). SCAS was related to the activity limitation domain of PAQLQ (p = .004; R ²  = .17). SCAS, gender, and physical activity were related to the PAQLQ symptoms domain (p = .003; R ²  = .32). The guardian's education, physical activity practice, and the symptoms of separation anxiety, panic attack and agoraphobia (as identified by SCAS) were related to the emotional domain of PAQLQ (p = .004; R ²  = .45).

CONCLUSION

The present study shows evidence of an association between anxiety symptoms, poorer clinical control, and health-related quality of life in children with asthma.

Relationship between vestibular dysfunction and quality of life in climacteric women

The hormonal changes in climacteric women may affect the vestibular system; however, it is not clear in the literature whether the presence of vestibular dysfunction associated with climacteric is related to poorer quality of life. The study sample was composed of 374 women (40-65 years). Socioeconomic and demographic data, menopausal status, practice of physical exercises, presence or absence of vestibular dysfunction, hypertension and diabetes, anthropometric measurements and quality of life (using the Utian Quality of Life Scale - UQoL) were collected. Statistical analyses were performed using the Pearson test, Anova, T-test, and multiple regression considering a significance level of 5%. A significant relationship was found between vestibular dysfunction and health (p = 0.02) and emotional (p = 0.01) domains of the UQoL. In addition, physical activity, menopausal status, body mass index (BMI), waist-hip ratio (WHR), household income and diastolic blood pressure (DBP) mean also remained significantly related to quality of life. A relationship between vestibular dysfunction and quality of life for health and emotional domains in climacteric women was observed.

Capacidade de avaliação de testes de desempenho físico para identificar baixa massa muscular em mulheres de meia-idade e idosas

Resumo Objetivo Verificar a capacidade de avaliação de testes de desempenho físico na identificação da baixa massa muscular (MM) em mulheres de meia-idade e idosas. Método Estudo transversal realizado com 540 mulheres de meia-idade (40-59 anos) e idosas (≥60 anos), nos municípios de Parnamirim e Santa Cruz, no Rio Grande do Norte, Brasil. Foram avaliadas MM, força de preensão palmar, extensão de joelho e velocidade da marcha. A baixa MM foi definida pelo índice de massa muscular esquelética menor que os 20% mais baixos para cada grupo de idade. Foram utilizados os testes: t de Student, qui-quadrado, análise de curva ROC para calcular a área sob a curva e ponto de corte de cada teste na discriminação das participantes com baixa MM. Foi considerado p<0,05 e IC de 95%. Resultados Para o grupo de meia-idade, as forças de preensão palmar e de extensão do joelho apresentaram sensibilidade (71,6% e 72,5%, respectivamente) e especificidade (59,4% e 56,0%, respectivamente) moderadas na identificação de baixa MM. Para as idosas, a velocidade da marcha e a força de preensão manual apresentaram boa sensibilidade (77,8% e 81,6%, respectivamente) e especificidade moderada (51,4% e 64,5%, respectivamente). A capacidade discriminatória da velocidade da marcha para as mulheres de meia-idade e da força de extensão do joelho para as mulheres idosas foi insatisfatória. Conclusão As medidas de força muscular são úteis para a triagem de baixa MM em mulheres de meia-idade, enquanto os testes de força de preensão manual e velocidade de marcha são úteis para idosas.

Metabolic syndrome (MetS) and associated factors in middle-aged women: a cross-sectional study in Northeast Brazil

We determined the prevalence of Metabolic Syndrome (MetS) and associated factors in 419 women (aged 40 to 65 years) in Northeast Brazil in a cross-sectional study conducted from April to November 2013. We defined MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Socio-demographic variables, reproductive factors, lifestyle factors, anthropometrics, body composition, quality of life, and physical performance were assessed for their associations. We constructed multivariate Poisson regression models to estimate prevalence rate ratios (PRR) and 95% confidence intervals (CI). We identified 275 (65.6%) cases of MetS. The three most prevalent indicators were obesity (73.5%), reduced high-density lipoprotein level (63.0%), and elevated blood pressure (60.9%). In the final adjusted model, black race (PR 1.30, 95% CI: 1.07-1.57), lower grip strength/body mass index (PR 1.31, 95% CI: 1.15-1.50), and low estradiol levels (PR 1.17, 95% CI: 1.00-1.35) were associated with MetS. MetS is a long-term threat to the health of middle-aged women and a potential public health burden. These results may help in developing health promotion strategies to prevent morbidity and mortality associated with MetS in this vulnerable population.

Relationship between symptomatic pelvic organ prolapse and respiratory muscle strength in middle-aged and older women in Northeast Brazil: a cross-sectional study

Some respiratory muscles work in synergy with the pelvic floor (PF). Pelvic organ prolapse (POP) is characterized by weak PF muscles and has been associated with worse pulmonary ventilation function in women. To date no studies have investigated the association between respiratory muscle strength and POP. This study aimed to determine whether symptomatic POP is associated with respiratory muscle strength in middle-aged and older women. In this observational cross-sectional study, 204 community-dwelling women (41-80 years old) from Santa Cruz (Northeastern Brazil) provided information on socioeconomic characteristics, health behavior, reproductive history and symptomatic POP via a structured questionnaire. A digital manometer was used to measure their maximal inspiratory and expiratory pressures (MIP and MEP). Multiple linear regression analyses, adjusted for covariates (age, income, education, body mass index, and smoking), evaluated the association between POP and MIP/MEP. The results show that 14.7% of the sample reported symptomatic POP. These women exhibited lower mean MIP and MEP than those reporting no POP, but the intergroup difference was only significant for MEP (p = .01). The association between POP and MEP remained statistically significant, even after covariates (β = 11.9, p = .04) were adjusted. Symptomatic POP is associated with expiratory muscle strength in middle-aged and older women. This innovative research provides important information regarding the need to evaluate the integrity of PF muscles when assessing respiratory muscle strength, which may help clinicians devise preventive and treatment strategies to improve women's health during the aging process.

Symptoms of urinary incontinence and pelvic organ prolapse and physical performance in middle-aged women from Northeast Brazil: a cross-sectional study

Background

Reproductive history and urogynecological disorders have been associated with limitations in physical function. However, little is known about the relationship between symptoms of urinary incontinence and pelvic organ prolapse, and physical performance. Therefore, the purpose of this study was to examine whether symptoms of urinary incontinence and pelvic organ prolapse are independently associated factors with indicators of lower physical performance in middle-aged women from Northeast Brazil.

Methods

This is a cross-sectional study of 381 women between 40 to 65 years old living in Parnamirim, Northeast Brazil. Physical performance was assessed by gait speed, chair stand and standing balance tests. Urinary incontinence and pelvic organ prolapse were self-reported. Multiple linear regression analyses were performed to model the effect of self-reported urinary incontinence and pelvic organ prolapse on each physical performance measure, adjusted for covariates (age, family income, education, body mass index, parity).

Results

In the analysis adjusted for confounders, women reporting urinary incontinence spent, on average, half a second longer to perform the chair stand test (β = 0.505 95% CI: 0.034: 0.976). Those reporting pelvic organ prolapse shortened the balance time with eyes open by 2.5 s on average (β = − 2.556; CI: − 4.769: − 0.343).

Conclusions

Symptoms of pelvic organ prolapse and urinary incontinence are associated to worse physical performance in middle-aged women. These seemingly small changes in physical performance levels are of clinical importance, since these conditions may influence women’s physical ability, with implications for other tasks important to daily functioning and should be addressed by health policies targeting women’s health and functionality.

Relationship between maximal respiratory pressures and multiple childbearing in Brazilian middle-aged and older women: A cross-sectional community-based study

Objective

Previous studies show that multiparity and a number of chronic conditions are correlated among women. Also, low respiratory muscle strength has been associated to adverse health outcomes such as chronic lung disease and early mortality. This study aimed to investigate associations between the number of lifetime pregnancies and maximal inspiratory/expiratory pressures.

Methods

In a cross-sectional study, 204 women ages 41–80 years-old, from the rural community of Santa Cruz, Brazil, provided data regarding demographics, socioeconomic characteristics, health behaviors, and number of lifetime pregnancies (≤3, 4–6 or ≥7). Maximal respiratory pressures were measured with a digital manometer. Multiple linear regression analysis was used to examine the association of multiple childbearing on maximal respiratory pressures.

Results

Of the participants, 44.1% had ≤3 pregnancies, 30.4% had 4–6 pregnancies and 25.5% had >7 pregnancies. In the unadjusted analyses, maximal inspiratory and expiratory pressures varied significantly according to multiple childbearing categories. After adjustment, the values remained statistically significant only for maximal expiratory pressure. Compared to women with ≤3 lifetime pregnancies, those who had ≥7 pregnancies had significantly lower maximal expiratory pressure values (β = -18.07, p = 0.01)

Conclusion

Multiple childbearing appears to be negatively associated with maximal respiratory pressures; women with a higher number of lifetime pregnancies had lower values of maximal respiratory pressures when compared to those with fewer pregnancies. This association may be due to biomechanical changes in the respiratory muscles promoted by multiple lifetime pregnancies. This finding indicates a need to motivate women, from the prenatal to postpartum period, to safely exercise their respiratory muscles, including abdominal muscle exercises as well as respiratory muscle training.

Association between quality of life, severity of asthma, sleep disorders and exercise capacity in children with asthma: a cross-sectional study

OBJECTIVE

To assess the association between quality of life, asthma severity, sleep disorders and exercise capacity in children with asthma.

METHODS

We evaluated 45 children with asthma of both sexes aged between 7 and 12 years, diagnosed by a pediatrician/pulmonologist and classified according to the IV Brazilian Guidelines for Asthma Management: severity (intermittent/mild and moderate/severe) and control (controlled, partially controlled and uncontrolled). Quality of life (QoL), presence of sleep disorders and exercise capacity were respectively assessed using the following instruments: Pediatric Asthma Quality of Life Questionnaire (PAQLQ); Sleep Disturbance Scale for Children (SDSC); and six-minute step test (6MST).

RESULTS

Intermittent/mild and moderate/severe asthma were observed in 51.1% and 48.9% of the children evaluated, respectively. Only 8.89% of the sample had uncontrolled asthma. In the regression model, a better QoL was observed in children with lower asthma severity, lower SDSC total score and lower levels of dyspnea induced by the 6MST (β=-0.395, p=0.003; β=-0.338, p=0.011; β=-0.352, p=0.008; respectively). These factors explained 31% of the PAQLQ total score variation. Other variables (such as cardiorespiratory variables, spirometry, asthma control and number of steps in 6MST) did not predict quality of life.

CONCLUSIONS

Lower asthma severity (intermittent/mild), fewer symptoms of sleep disorder, and lower exercise-induced dyspnea predicts better quality of life in children with asthma.

APPLICABILITY OF A GENERIC QUESTIONNAIRE FOR QUALITY OF LIFE ASSESSMENT FOR ASTHMATIC CHILDREN

Objective:

To determine the applicability of the generic instrument Pediatric Quality of Life Inventory (PedsQL 4.0) to assess health-related quality of life of asthmatic children compared to the specific instrument Pediatric Asthma Quality of Life Questionnaire (PAQLQ).

Methods:

This research involved the evaluation of 30 children aged seven to eleven years, who had been diagnosed with asthma for at least six months prior to research. Both quality of life questionnaires were applied to children by an interviewer over the period of one day. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) 20.0, with significance level set at 5%.

Results:

No differences in quality of life was found when genders were compared. Asthmatic children classified as practitioners and non-practitioners of physical activity had different scores in the physical health-related domain (PedsQL 4.0). The scores of children with different levels of asthma severity and control were significantly different in two out of three domains evaluated by PAQLQ. When assessed by PedsQL 4.0, no significant difference was observed as to quality of life of children with different levels of asthma control and severity. Quality of life measurements of asthmatic children by PedsQL 4.0 and PAQLQ instruments had a moderate and significant correlation (r=0.415, p=0.02).

Conclusions:

PedsQL 4.0 could distinguish children practicing different levels of physical activity, but it was not sensitive enough to distinguish health-related quality of life among children with different levels of asthma severity and control.

Relationship between strength and muscle mass in middle-aged and elderly women: a cross-sectional study

Abstract Objective: to analyze the relationship between handgrip strength and lower limb strength and the amount of segmental skeletal muscle mass in middle-aged and elderly women. Methods: an observational, cross-sectional, observational study of 540 women aged between 40 and 80 years in the cities of Parnamirim and Santa Cruz, Rio Grande do Norte, was performed. Sociodemographic data, anthropometric measurements, handgrip dynamometry, knee flexors and extensors of the dominant limbs, as well as the segmental muscle mass of the limbs were evaluated. Data were analyzed using Student's t-Test, Chi-square test, Effect Size and Pearson's Correlation (CI 95%). Results: there were statistically significant weak and moderate correlations between handgrip strength and upper limb muscle mass, knee flexion strength and lower limb muscle mass, and between knee extension strength and lower limb muscle mass for the age groups 40-59 years and 60 years or more (p<0.05). Conclusions: muscle strength correlates with skeletal muscle mass. It could therefore be an indicator of the decrease in strength. It is not the only such indicator, however, as correlations were weak and moderate, which suggests the need for more studies on this theme to elucidate which components may also influence the loss of strength with aging.

Depressive symptomatology and cortisol concentrations in elderly community residents: a cross-sectional study

BACKGROUND

Researches seek to understand the links between adverse health outcomes and cortisol concentrations. However, the relationship between depressive symptomatology and cortisol concentrations is controversial in the literature.

AIM

To analyze the relationship between the depressive symptomatology and the cortisol concentrations in elderly community residents in the Brazilian Northeast.

METHODS

Cross-sectional study is composed of 256 elderly (≥65 years). Depressive symptomatology was evaluated by the Center for Epidemiologic Studies-Depression Scale and cortisol concentrations by salivary collection (upon waking, 30 and 60 min after waking, at 3 pm and before bed), in addition to composite measurements. Sociodemographic and health conditions were evaluated. For analysis of the cortisol measurements in relation to depressive symptomatology, and between genders, the Student's t test was used. For cortisol measurements in every curve, analysis of variance for repeated measurements with Bonferroni post hoc test was used.

RESULTS

There were significant salivary cortisol differences upon awakening, among elderly with and without depressive symptomatology (p = 0.04). There was no significance in relation to gender. Between measurements of each curve, elderly with depressive symptomatology showed no significant difference between the 1st measure in relation to the 2nd and 3rd, and also between the 4th and 5th, demonstrating higher cortisol night levels in elderly with depressive symptomatology, without decline, with curve plane aspect.

CONCLUSION

The relationship between depressive symptomatology and hypocortisolism throughout the day seems to exist. However, in Brazil, adverse life conditions can lead to chronic stress and be sufficient factors to superpose biggest differences that could exist in relation to the presence of depressive symptomatology.

Prevalência e fatores associados ao risco de quedas em idosos adscritos a uma Unidade Básica de Saúde do município de Natal, RN, Brasil

Resumo O objetivo deste artigo foi analisar a prevalência e os fatores associados a quedas em idosos adscritos a uma Unidade Básica de Saúde (UBS), no município de Natal/RN. Estudo transversal realizado com 280 idosos cujos dados foram coletados nas dependências da UBS. A associação entre os desfechos “queda” e “queda recorrente” e as variáveis independentes foi verificada mediante análise bivariada e regressão de Poisson, com cálculo das respectivas razões de prevalências. Prevaleceram os idosos do gênero feminino (68,2%), com média de idade de 71,6 anos (± 6,7), alfabetizados (54,6%), não aposentados (73,5%) e sedentários (87,1%). Registraram queda 53,6% dos idosos, porém 27,8% caíram duas ou mais vezes. O modelo preditivo de queda incluiu o gênero feminino (RP = 1,81), presença de doenças osteoarticulares (RP = 1,71) e comprometimento do equilíbrio (RP = 0,88), enquanto a mobilidade funcional (RP = 0,94), medo de cair (RP = 1,21) e déficit de equilíbrio (RP = 0,80) compuseram o modelo final de quedas recorrentes. Encontrou-se maior prevalência de episódio único de queda e os fatores associados incluíram variáveis sociodemográficas, de saúde e performance física. Por outro lado, associaram-se a ocorrência de duas ou mais quedas apenas as variáveis de performance física.

Early maternal age and multiparity are associated to poor physical performance in middle-aged women from Northeast Brazil: a cross-sectional community based study

Background

Adolescent childbirth and elevated parity are relatively common in middle and low-income countries and they may be related to the higher prevalence and earlier onset of physical decline documented in these settings, especially in women. The aim of this paper is to investigate whether reproductive history is associated with physical function in middle-aged women from Northeast Brazil.

Methods

The relationship between poor physical performance (grip strength, gait speed and chair stand), early maternal age at first birth (<18 years old), and multiparity (≥3 children) was evaluated in a community sample of 473 women living in Parnamirim (Northeast Brazil). Linear regression models were used to examine the relationship of interest; in addition, mediation analyses were employed to assess indirect effects of obesity and family income.

Results

Women who gave birth at less than 18 years of age took approximately 0.50 s longer to complete the chair stand test compared to women who gave birth at 18 years or older. Moreover, women who gave birth to < 3 children completed the chair stand test 0.42 s faster compared to those who had ≥ 3 children. The relation between reproductive history and physical performance was mediated by BMI. Reproductive history was not associated with performance in gait speed.

Conclusions

This study provides evidence that adolescent childbirth and multiparity are related to worse physical performance in middle-aged women from a low income setting. Reproductive history may partially account for earlier physical decline and greater disability in women from lower income settings.

Mobility, balance and muscle performance according to self-efficacy for falls in the elderly

Introduction Changes in mobility, postural balance and muscle strength in the aging process may cause a fall in the elderly by changing or not perceived self-efficacy in preventing falls, the goal is to compare mobility, body balance and muscle performance according to self-efficacy for falls in community-dwelling elderly women. Materials and methods A comparative study of cross-section, with 63 community-dwelling elderly. We evaluated sociodemographic data, cognition (Mini-Mental State Examination), efficacy for falls (International Efficacy Scale for Falls, Brazil), mobility (Timed Up and Go Test), body balance by Berg Balance Scale, Balance Master System: Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Tandem walk (TW) Sit to Stand (STS) and muscular performance by isokinetic dynamometry. Using the cutoff point at or above 23 points, two groups, G1 with low perceived efficacy in preventing falls (n = 36) and G2 with high perceived efficacy in preventing falls (n = 27) were allocated. Student’s t test was performed for comparison between groups, with p value of 0.05. Results Comparing the elderly women regarding the efficacy of falls, significant differences were observed in the variables Timed Up and Go Test (p = 0.04), speed of oscillation test mCTSIB (p = 0.01) and the isokinetic dynamometry knee extension movement, peak torque (p = 0.04) and power (p = 0.03). Conclusion Comparing community-dwelling elderly women with low and high efficacy for falls, significant differences were in variables related to mobility, body balance and muscle function.

Apoio social e síndrome da fragilidade em idosos residentes na comunidade

A fragilidade em idosos resulta da complexa interação entre fatores clínicos e sociais envolvidos na sua gênese. Porém, ainda não se sabe, de forma clara, se esta síndrome pode ser agravada devido à ausência do apoio social. Assim, o objetivo do presente estudo foi analisar a associação entre este e a síndrome da fragilidade em idosos residentes na comunidade. Trata-se de estudo observacional analítico de caráter transversal, com uma amostra de 300 idosos. Foram coletadas informações sobre os dados sociodemográficos e econômicos e de saúde física, fragilidade e apoio social. Para análise estatística, foram realizados o teste qui-quadrado de Pearson, o teste t de student e a regressão logística binária, adotando-se um nível de significância de 5%. Não foram observadas associações da fragilidade com as variáveis do apoio social, com exceção da modalidade tarefas domésticas (p = 0,04). Na regressão logística, permaneceram associadas a fragilidade à idade (OR = 1,19), à atividade física (OR = 2,56) e à saúde percebida (OR = 3,33). Acredita-se que mais estudos precisam ser desenvolvidos para uma caracterização da vulnerabilidade social, como também os serviços de saúde necessitam reconhecer a importância do apoio social como parte integrante da prestação de cuidados aos idosos.

A velocidade da marcha pode identificar idosos com medo de cair?

OBJETIVO: Este estudo teve como propósito analisar a capacidade da velocidade da marcha em identificar idosos com medo de cair. METODOLOGIA: Trata-se de estudo transversal analítico, realizado com amostra de 60 idosos da comunidade. Os dados foram obtidos por meio de questionário estruturado, análise da velocidade da marcha para percorrer a distância de 4,6 m e do medo de cair, avaliado pela escala de Autoeficácia de Quedas. A capacidade da velocidade da marcha em identificar idosos com medo de cair foi determinada por meio de regressão linear múltipla, com nível de significância p<0,05 e IC 95%. RESULTADOS: Em relação à velocidade da marcha, a média foi de 0,71 (± 0,21) m/s, enquanto que para a escala de Autoeficácia de Quedas a média do escore foi de 24,85 (± 6,68). Na análise de regressão linear múltipla, o escore total da escala de Autoeficácia de Quedas permaneceu significativamente associado (R²= 0,35) com a depressão autorrelatada, a limitação funcional para atividades básicas da vida diária e a velocidade da marcha. CONCLUSÃO: A velocidade da marcha, além da depressão autorrelatada e limitação funcional para atividades básicas da vida diária, têm capacidade de identificar idosos com medo de cair. Desta forma, a investigação das condições de saúde nessa população pode ser útil para detectar o medo de cair e identificar que cuidados e intervenções seriam prioritários para melhorar a funcionalidade e qualidade de vida desses idosos.

Salivary cortisol and frailty syndrome in elderly residents of long-stay institutions: a cross-sectional study

Analyze the relationship between frailty and cortisol in elderly residents of long-stay institutions. A cross-sectional study was conducted in the city of João Pessoa-PB-Brazil, on a sample of residents of long-stay institutions. Data were collected on frailty phenotype (weight loss, fatigue, slowness, weakness and low physical activity) and salivary cortisol (first measurement between 6 and 7a.m.; second measurement between 11 and 12a.m.; third measurement between 4 and 5p.m.). Statistical analysis applied Pearson's correlation test, Chi-square test, ANOVA and linear regression. The sample was composed of 69 elderly subjects, 37.7% men and 62.3% women, with a mean age of 77.5 (±7.8) years. The percentage of frail elderly was 45.8%. Frail aged subjects achieved higher cortisol values on the third measurement (p=0.04) and frailty load was significantly associated to the first measurement (r=0.25, p=0.04). Simple linear regression analysis showed a rate of determination (R(2)=0.05) between frailty load and the first cortisol measurement. Greater cortisol values in the morning and before bed among frail aged individuals suggest a positive correlation may exist between cortisol levels and frailty in elderly residents of long-stay institutions.

Fatores associados às alterações na velocidade de marcha e força de preensão manual em idosos institucionalizados

OBJETIVO: Este trabalho teve como propósito avaliar os fatores associados às alterações na velocidade de marcha e força de preensão manual em idosos institucionalizados da cidade de Natal-RN. METODOLOGIA: Trata-se de estudo transversal, realizado com uma amostra de 20 idosos (11 mulheres e 9 homens), selecionados de forma não aleatória por conveniência. Os dados foram obtidos através de questionário e mensurações da força de preensão manual e velocidade de marcha, que constituíram os testes físicos. RESULTADOS: Foram encontradas diferenças estatisticamente significativas (p<0,05) entre os sexos quanto ao tempo de institucionalização, sensação de fadiga autorrelatada, força de preensão e nível cognitivo. Também foram verificadas correlações entre a força de preensão manual com o tempo de asilo (r= -0,54), função cognitiva (MEEM) (r= 0,62), altura (r= 0,79) e massa corporal (r= 0,82); para a velocidade de marcha, houve correlação significativa com o MEEM (r= 0,45) e independência nas atividades instrumentais da vida diária (AIVDs) (r= 0,47). CONCLUSÃO: Alterações na força de preensão e velocidade de marcha são comuns entre os idosos institucionalizados, mais susceptíveis à síndrome da fragilidade e, portanto, a perdas funcionais e cognitivas, que favorecem a progressão de suas limitações. Desta forma, a investigação das condições de saúde desses indivíduos pode ser útil para detectar um perfil de fragilidade e identificar que tipo de cuidados e intervenções seriam prioritários para melhorar a funcionalidade e qualidade de vida destes idosos.

Influência dos fatores biopsicossociais sobre a capacidade funcional de idosos residentes no nordestes do Brasil

OBJETIVO: Analisar a influência dos fatores sociodemográficos, de saúde física e neuropsiquiátricos sobre a capacidade funcional de idosos residentes no município de Santa Cruz, Rio Grande do Norte, Brasil. MÉTODOS: Desenvolveu-se um estudo transversal, no qual uma amostra representativa de 310 idosos residentes na zona urbana da cidade de Santa Cruz-RN foi entrevistada, a partir da utilização de um questionário que continha informações sobre perfil sociodemográfico, condições de saúde física, função cognitiva e sintomatologia depressiva, além dos Índices de Katz e Lawton, que mediram as atividades básicas (ABVD's) e instrumentais (AIVD's) da vida diária. A análise estatística foi feita mediante análise bivariada (Qui-quadrado de Pearson), seguida de regressão logística binária na análise multivariada, com a respectiva odds ratio (OR), considerando nível de significância p< 0,05 e intervalo de confiança (IC) de 95%. RESULTADOS: Para o Índice de Katz teve-se que 86,9% eram independentes e no Índice de Lawton apenas 47,4%. Na análise multivariada houve associação com as ABVDs a idade (OR= 1,06) e má percepção de saúde (OR= 3,64). Nas AIVD's houve associação com a idade (OR= 1,18), sexo feminino (OR= 4,30), analfabetismo (OR= 3,78), estado civil (OR= 2,14), sintomatologia depressiva (OR= 4,54) e a má percepção de saúde (OR= 4,47). CONCLUSÃO: As variáveis associadas à incapacidade funcional revelam uma complexa relação entre o estado de saúde dos idosos e possíveis fatores de risco de declínio físico.

Prevalência e fatores associados à sintomatologia dolorosa entre profissionais da indústria têxtil

O trabalho tem um papel importante na vida do homem, pois, além de ser fonte do seu sustento, é onde ele pode sentir-se útil, produtivo e valorizado. Entretanto, quando realizado sob condições impróprias, pode provocar diversos níveis de prejuízo à saúde, como a dor músculo-esquelética, que é caracterizada ainda por possuir origem multifatorial. Desta forma, foi realizado um estudo transversal objetivando analisar a influência dos fatores sociodemográficos e aspectos relacionados ao trabalho e às condições de saúde sobre a sintomatologia dolorosa, em profissionais do setor têxtil. A amostra foi constituída de 162 funcionários que trabalhavam com corte-costura na divisão industrial da ACT (Associação Comunitária para o desenvolvimento do Trairi) no município de Santa Cruz - RN, Brasil. Após análise bivariada e multivariada observou-se associação independente da sintomatologia dolorosa com as variáveis sexo feminino (p= 0,013), tempo de ocupação há mais de seis meses (p= 0,005), presença de outros problemas de saúde (p= 0,002) e trabalhar em pé (p = 0,001). Nesse contexto, pode-se concluir que houve uma alta prevalência de dor entre os profissionais estudados, e que esta possui associação significativa com vários aspectos relacionados ao trabalho, e alguns fatores sociodemográficos e de saúde, sendo portanto necessária uma atuação interdisciplinar, multiprofissional e intersetorial, de forma a interferir positivamente no processo de trabalho e na saúde do trabalhador.

Prevalência e fatores associados à sintomatologia depressiva em idosos residentes no Nordeste do Brasil

OBJETIVO: Analisar a influência de fatores sociodemográficos, de saúde física, capacidade funcional e função cognitiva sobre a sintomatologia depressiva de idosos do município de Santa Cruz, no Rio Grande do Norte. MÉTODOS: Estudo com delineamento transversal de base populacional, incluindo 310 idosos, acima de 60 anos, residentes na zona urbana da cidade, nos quais se aplicou a Escala de Depressão Geriátrica (GDS-15).Aanálise estatística foi realizada com nível de significância p = 0,05, com cálculo da respectiva odds ratio (OR) na regressão logística binária. RESULTADOS: Encontrou-se uma prevalência de 25,5% de sujeitos considerados casos de depressão, nos quais, a partir de análise multivariada, verificou-se associação significativa com idade acima de 75 anos (p = 0,046), analfabetismo (p = 0,037), má percepção de saúde (p < 0,001) e dependência para atividades instrumentais da vida diária (AIVD) (p = 0,001). CONCLUSÕES: As variáveis idade acima de 75 anos, analfabetismo, má percepção de saúde e dependência para AIVD estiveram associadas de forma independente à presença de sintomatologia depressiva nos idosos da nossa população. Os autores discutem que a identificação de fatores que influenciam o surgimento de sintomas depressivos em idosos constitui passo fundamental para o planejamento das ações que visem reduzir os efeitos dessa enfermidade na qualidade de vida dessas pessoas.