Association between cardiovascular risk factors and cognitive impairment in adults aged 60 years or older from Chile: a cross-sectional study

BACKGROUND

Few studies in Latin America have examined the association between cardiovascular risk factors and cognitive impairment (CI) in a nationally representative sample. Therefore, this study aimed to estimate the prevalence of CI in a nationally representative sample of adults aged 60 years or older from Chile and to investigate the association between cardiovascular risk factors and CI.

METHODS

Data from the cross-sectional 2016-2017 National Health Survey of Chile, which included 2031 adults (63.7% women) was used. Body mass index, metabolic syndrome (blood pressure, triglycerides, fasting glucose or treatment for diabetics, waist circumference, and HDL cholesterol), risk of cardiovascular disease (history and measured variables, using the Framingham risk score), tobacco use, and physical activity were measured. CI was assessed using the Mini-Mental Status Examination (MMSE).

RESULTS

Overall, the prevalence of CI was 12.2% at the national level. Significant differences in CI were observed by age, education level, risk of cardiovascular disease, and smoking. High risk of cardiovascular disease was associated with higher odds of CI (OR: 2.04; 95%CI: 1.20-3.45) compared to low risk. Smoking was significantly associated with a lower likelihood of CI (OR: 0.56; 95%CI: 0.36-0.87) compared to never smoking. Body mass index, metabolic syndrome, and physical activity were not associated with CI.

CONCLUSIONS

This study provided additional support for previous findings on the relationship between cognitive decline and an elevated risk of cardiovascular disease. Worse CI was associated with the group with the highest risk of cardiovascular disease, and the presence of lifestyle factors, such as obesity and physical inactivity, exacerbate this relationship, but not being a current smoker.

Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries

This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.

Coalitions and networks: facilitating global physical activity promotion

This article aims to synthesise the experience of coalitions and networks working for physical activity promotion. By introducing the concept of partnerships, especially within the Brazilian context, the authors outline the factors that comprise a successful partnership, describing key elements, such as, financing, membership and methods of empowerment. Agita São Paulo, the Physical Activity Network of the Americas-RAFA-PANA and Agita Mundo are used as examples. The article shows that local, national and global programmes, partnerships and networks at all levels are essential to guarantee the success of physical activity promotion as a public health strategy.

The Agita São Paulo Program as a model for using physical activity to promote health

The "Agita São Paulo" Program applies a multilevel intervention approach to promoting physical activity among the 37 million inhabitants of the state of São Paulo, Brazil. The verb "agita" means to move the body, but the term also suggests changing the way of thinking and becoming a more active citizen. Since being launched in 1996, the Program has been widely copied throughout Brazil and in other countries of Latin America, and the World Health Organization has characterized it as a model for other developing countries. The Program aims to disseminate a clear and simple message to the community as well as establish partnerships with governmental and nongovernmental organizations and other entities. The Agita São Paulo message encourages people to adopt an active lifestyle by accumulating at least 30 minutes of moderate physical activity per day, on most days of the week. The Program has three main target groups: students, workers, and the elderly. The Program organizes "mega-events" that simultaneously reach and involve large numbers of people, and it also conducts ongoing activities with institutions that become partners of the Program. Intervention studies that the Program has carried out on specific, small groups have found both changes in behavior and an increasing awareness of the Program's name and message. In addition, surveys have found that a growing number of persons in the state of São Paulo have become aware of the Program and its message and have changed their physical activity level. A number of the special features of and lessons learned from the Agita São Paulo Program may have contributed to its success, including: a multisectorial approach; broad use of partnerships; the inclusion principle (avoiding messages or attitudes that might exclude any social group); the scientific basis for all the Program activities; the extensive free media coverage that the Program has received; a "two-hats" approach, using either governmental or nongovernmental methodologies to promote physical activity, depending on the circumstances; cultural adaptation (using local culture to disseminate the message and make its assimilation easier); encouraging activities that are pleasurable; the clear, simple, feasible message of promoting physical activity; and evaluation of the various Program efforts. These distinctive characteristics help make the Agita São Paulo Program a model that could be used in other countries as an effective way to promote health through physical activity.

Evolução do perfil neuromotor e capacidade funcional de mulheres fisicamente ativas de acordo com a idade cronológica

FUNDAMENTOS E OBJETIVO: Poucos estudos longitudinais têm sido feitos em mulheres fisicamente ativas para determinar o impacto do envelhecimento na aptidão física e capacidade funcional. O objetivo deste estudo foi comparar a evolução do perfil neuromotor e capacidade funcional de mulheres ativas no período de um ano, de acordo com a idade cronológica. MÉTODOS: A amostra foi composta por 117 mulheres de 50 a 79 anos de idade (<img border=0 width=10 height=13 id="_x0000_i1026" src="../../../img/revistas/rbme/v9n6/18935x01.gif" align=absmiddle>: 65 ± 6,6 anos) participantes de um programa de exercícios aeróbicos, duas vezes por semana, 50 minutos por sessão durante 5,4 ± 3,0 anos e divididas pela idade em: 50-59 (n: 23); 60-69 (n: 60); 70-79 (n: 34). Os testes neuromotores e de mobilidade incluíram: força muscular dos membros inferiores e superiores, agilidade, flexibilidade do tronco, velocidade de levantar-se da cadeira, equilíbrio estático, velocidade normal de andar e velocidade máxima de andar. Os resultados iniciais e nas duas avaliações seguintes, feitas a intervalos de seis meses, foram comparados usando ANOVA two way, com post-hoc Bonferroni. RESULTADOS: Em um ano não houve nenhuma alteração no desempenho neuromotor; já a velocidade de levantar da cadeira e a velocidade de andar evidenciaram diferenças significativas nos grupos de 50-59 e 60-69 anos, apresentando resultados 10-20% melhores; quanto à velocidade máxima de andar, houve melhora (8%) nos grupos de 60 a 79 anos. CONCLUSÃO: A evolução da aptidão física e capacidade funcional teve comportamento similar, em mulheres fisicamente ativas, independentemente da idade cronológica. Essa evolução fortalece a hipótese de um efeito favorável da atividade física regular na promoção da saúde, estratégia fundamental do envelhecimento saudável.