Impact of multidimensional interventions on quality of life and depression among older adults in a primary care setting in Brazil: a quasi-experimental study

Objective: To evaluate the impact of multidimensional interventions on quality of life (QoL) and depressive symptoms in Brazilian older adults living in the community. Methods: Longitudinal, quasi-experimental study of older adults receiving conventional primary health care (PHC). The interventions were designed in response to a first round of data collection and validated through pilot testing in groups of older adults from another community. The validated interventions were then applied to an intervention group (IG). To measure their effect, we used the Medical Outcomes Short-Form Health Survey (SF-36) quality of life scale and the Geriatric Depression Scale (GDS-30). Results: The sample comprised 118 participants. IG participants exhibited significant improvement in several QoL domains (SF-36): mental health (p = 0.010), general health perceptions (p = 0.016), and physical functioning (p = 0.045). No such improvement occurred in controls (p > 0.050). The prevalence of depression (GDS-30) fell from 36.7 to 23.3% in the IG, despite no significant difference (p = 0.272). Controls also reported a reduction in depressive symptoms, but only from 44.8 to 41.4% (p = 0.112). Conclusions: This multidimensional intervention was associated with significant improvement in mental health, general health perceptions, and physical functioning in a sample of Brazilian older adults. Clinical trial registration: RBR-92dbtx.

Sedentary behavior is associated with physical activity, functional capacity, and a history of stroke in patients with heart failure. A cross-sectional study

Sedentary behavior (SB) has emerged as an important risk factor for poor health. Evidence showed that patients with heart failure (HF) exhibit high levels of SB, and that high SB increases mortality among such patients. We aimed to identify factors associated with SB in HF patients. Methods: A cross-sectional study was carried out with adults with HF and categorized under New York Heart Association (NYHA) functional class I-III. Sociodemographic, clinical, and health information were gathered. Evaluation of SB (by sitting time) and moderate-to-vigorous physical activity (MVPA) was performed by self-reported measures. Functional capacity was assessed using the Duke Activity Status Index. Simple and multivariate linear regression analyses were performed to identify the most suitable predictive model. Results: The sample (n = 80) comprised predominantly of patients in functional class I, men, and with an average age of 50.8 years. Time spent on SB totaled to 7.69 ± 2.35 h/day. Weekly volume of MVPA, functional capacity, and previous stroke were predictors of higher SB. Using simple linear regression analysis, the variables body mass index, quality of life, NYHA functional class, total comorbidities, dyslipidemia, MVPA in the leisure domain, and the use of diuretics, statins, and sildenafil were shown to have a statistically significant association with SB. Conclusion: In patients with HF, a longer time spent in SB was associated with low volumes of MVPA, low functional capacity, and history of stroke. More studies are needed to corroborate these findings.(AU)