Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Walking pace could be considered an early risk marker of cognitive impairment in older people. Objective: To determine the association between walking pace and cognitive impairment in older Chilean adults. Methods: 1,788 adults older than 60 years from the 2016-2017 Chilean National Health Survey with data available in the exposure and outcome were included in this cross-sectional study. Walking pace was self-reported and categorised as slow, average and brisk. Cognitive impairment was assessed using the Abbreviated Mini-Mental questionnaire. Logistic regression analyses were performed to investigate the association between walking pace and cognitive impairment, logistic regression analyses - adjusted for sociodemographic, lifestyle and health-related covariates. Results: In the minimally adjusted model and compared to older adults who self-reported a brisk walking pace, those in the slow walking pace category were 2.67 times more likely to have cognitive impairment (OR: 2.67 [95% CI: 1.62, 4.42]). When the analyses were adjusted, the association was attenuated but remained significant (OR: 1.78 [95% CI: 1.15 3.17]). No associations were found between average pace walkers and cognitive impairment. Conclusion: Older adults who self-reported a slow walking pace having a higher likelihood of cognitive impairment than their counterparts who had a brisk walking pace. Considering that cognitive impairment is a geriatric syndrome with a high prevalence in the elderly, there is a need to emphasise strategies for an early diagnosis. Therefore, walking pace may be a useful marker to identify individuals at high risk of cognitive impairment.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores / Handgrip strength as a predictor of adverse health outcomes

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

Validade de testes de campo para estimativa da aptidão cardiorrespiratória em crianças e adolescentes: uma revisão sistemática / Validity of field tests to estimate cardiorespiratory fitness in children and adolescents: a systematic review

RESUMO Objetivo: Revisar sistematicamente a literatura para verificar a validade dos testes de campo para avaliação da aptidão cardiorrespiratória (ACR) em crianças e adolescentes. Fontes de dados: Foram utilizadas as bases de dados: Medline (PUBMED), SPORTDiscus, Scopus, Web of Science, além das bases latino-americanas LILACS e SciELO. A busca compreendeu todo o período de existência das bases até fevereiro de 2015, em idioma inglês e português. Todas as etapas do processo foram previstas de acordo com o PRISMA. Síntese dos dados: Após verificação dos critérios de inclusão, elegibilidade e qualidade dos estudos, 43 trabalhos foram analisados na íntegra, sendo obtidos 38 por meio da busca nas bases de dados eletrônicas e cinco por meio de biblioteca particular e referências de outros artigos. Do total dos artigos, apenas 13 foram considerados de alta qualidade segundo os critérios adotados. O teste mais investigado na literatura foi o shuttle run de 20 metros (SR-20 m), contabilizando 23 trabalhos, seguido pelos testes de distâncias entre 550 metros e 1 milha com 9 estudos, os testes com tempos de 6, 9 e 12 minutos também com 9 estudos e, por fim, os protocolos de banco e novas propostas de teste representados por 7 trabalhos. Conclusões: O teste SR-20 m parece ser o mais apropriado para avaliação da ACR de jovens, com a equação de Barnett, recomendada para estimativa do VO2pico. Como segunda alternativa para avaliação da ACR, indica-se o teste de 1 milha e, a equação proposta por Cureton, para estimativa do VO2pico.

ABSTRACT Objective: To systematically review the literature to verify the validity of field-tests to evaluate cardiorespiratory fitness (CRF) in children and adolescents. Data sources: The electronic search was conducted in the databases: Medline (PubMed), SPORTDiscus, Scopus, Web of Science, in addition to the Latin American databases LILACS and SciELO. The search comprised the period from the inception of each database until February 2015, in English and Portuguese. All stages of the process were performed in accordance with the PRISMA flow diagram. Data synthesis: After confirming the inclusion criteria, eligibility, and quality of the studies, 43 studies were analyzed in full; 38 obtained through the searches in the electronic databases, and 5 through private libraries, and references from other articles. Of the total studies, only 13 were considered high quality according to the adopted criteria. The most commonly investigated test in the literature was the 20-meter shuttle run (SR-20 m), accounting for 23 studies, followed by tests of distances between 550 meters and 1 mile, in 9 studies, timed tests of 6, 9, and 12 minutes, also 9 studies, and finally bench protocols and new test proposals represented in 7 studies. Conclusions: The SR-20-m test seems to be the most appropriate to evaluate the CRF of young people with the equation of Barnett, recommended to estimate VO2 peak. As an alternative for evaluating CRF, the 1-mile test is indicated with the equation proposed by Cureton for estimating VO2 peak.

Condición física y riesgo cardiovascular futuro en niños y adolescentes argentinos: una introducción de la batería ALPHA / Physical fitness and future cardiovascular risk in argentine children and adolescents: an introduction to the ALPHA test battery

Introducción. Altos niveles de condición física están relacionados con la salud cardiovascular de niños y adolescentes. Actualmente, en Argentina, no existe la aplicación sistemática de una batería para evaluar la condición física en el ámbito escolar. El propósito principal del estudio fue aplicar la batería ALPHA para determinar la condición física en una muestra de niños y adolescentes argentinos, y establecer la proporción de sujetos con nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro. Población y métodos. Una muestra de 1867 participantes (967 mujeres) de entre 6 y 19,5 años fueron evaluados con la batería ALPHA. Se midieron cuatro componentes de la condición física: 1) morfológico: estatura, peso corporal y perímetro de cintura; 2) muscular: test salto de longitud; 3) motor: test de velocidad/agilidad (carrera 4 x 10 m); 4) cardiorrespiratorio: test course navette de 20 m y cálculo del consumo máximo de oxígeno. Se calcularon los percentiles 5, 25, 50, 75 y 95 para los principales tests. Resultados. El índice de masa corporal medio fue 20,8 kg/m², y el 7,8% se clasificó en la categoría obesidad. Además, los participantes masculinos, en comparación con los femeninos, obtuvieron un mayor rendimiento en todos los tests de condición física (P < 0,001). En el 31,6% de los participantes se observó un nivel de capacidad aeróbica indicativo de riesgo cardiovascular. Conclusiones. La muestra de niños y adolescentes argentinos de sexo masculino presentó mayores niveles de condición física. Estas diferencias se incrementaron con la edad. Aproximadamente, 1 de cada 3 participantes tuvo un nivel de capacidad aeróbica indicativo de riesgo cardiovascular futuro.

Introduction. A high level of physical fitness is associated with cardiovascular health in children and adolescents. At present, there is no systematic implementation of a test battery to assess physical fitness at schools in Argentina. The main objective of this study was to implement the ALPHA test battery to determine the physical fitness of a sample made up of Argentine children and adolescents and to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk. Population and methods. A sample of 1867 participants (967 girls) aged 6 to 19.5 years old assessed using the ALPHA test battery. Four components of physical fitness were measured: 1) morphological component: height, body weight, and waist circumference; 2) musculoskeletal component: standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption. The 5th, 25th, 50th, 75th, and 95th percentiles were estimated for the main tests. Results. The mean body mass index was 20.8 kg/m2, and 7.8% of participants were classified as obese. In addition, male participants had a better performance in all physical fitness tests when compared to girls (p< 0.001). An aerobic capacity indicative of cardiovascular risk was observed in 31.6% of all participants. Conclusions. Argentine male children and adolescents included in the sample showed higher levels of physical fitness. Such differences increase with age. Approximately one every three participants had an aerobic capacity indicative of future cardiovascular risk.