Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study / Prevalência e fatores de risco para obesidade abdominal dinapênica em idosos residentes na comunidade: um estudo transversal

Abstract This article aims to identify the prevalence of and factors associated with dynapenic abdominal obesity (DAO) in older adults in a city in the northern region of Brazil. A cross-sectional study was conducted with 382 community-dwelling older adults in Macapa, Amapa, Brazil. Socioeconomic, clinical, and health information were collected using a structured form. DAO was defined as a combination of dynapenia (handgrip strength of < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). Descriptive and inferential analyses were performed using chi-squared tests, Student's t-tests, and a Poisson regression. The prevalence of DAO was 10.73%. In the preliminary bivariate analysis, the variables of age range, marital status, number of diseases, functional disability for basic and instrumental activities of daily living, gait speed, and level of physical activity met the established criterion. The final model indicated that only gait speed was a predictor of DAO in older adults. DAO affects nearly 11% of community-dwelling older adults from northern Brazil; gait speed was a predictor of DAO and could be a useful tool for managing and monitoring this population's health.

Resumo O objetivo deste artigo é identificar a prevalência e os fatores associados à obesidade abdominal dinapênica (OAD) em idosos de uma cidade da região Norte do Brasil. Estudo transversal realizado com 382 idosos comunitários residentes em Macapá, Amapá, Brasil. As informações socioeconômicas, clínicas e de saúde foram coletadas por meio de um formulário estruturado. A OAD foi definida pela combinação de dinapenia (força de preensão manual < 26 kgf para homens e < 16 kgf para mulheres) e obesidade abdominal (circunferência abdominal > 102 cm para homens e > 88 cm para mulheres). As análises descritivas e inferenciais foram realizadas utilizando os testes qui-quadrado, t de Student e regressão de Poisson. A prevalência de OAD foi de 10,73%. Na análise bivariada preliminar, as variáveis faixa etária, estado conjugal, número de doenças, incapacidade funcional para atividades básicas e instrumentais de vida diária, velocidade da marcha e nível de atividade física atenderam ao critério estabelecido. O modelo final indicou que apenas a velocidade da marcha foi um preditor para a OAD em idosos. A OAD afeta quase 11% dos idosos residentes nessa comunidade do Norte do Brasil; e a velocidade de marcha é um preditor que pode ser uma ferramenta útil para gerenciar e monitorar a saúde desta população.

Association between frailty syndrome and sedentary behavior among community-dwelling older adults in the Amazon region: a cross-sectional study

ABSTRACT BACKGROUND: Existence of an association between sedentary behavior and frailty among older adults has been suggested. However, there is a lack of studies conducted in Brazil, especially in areas of the Amazon region. OBJECTIVE: To analyze the association between frailty syndrome and sedentary behavior among community-dwelling older adults. DESIGN AND SETTING: Cross-sectional study carried out in Macapá, state of Amapá, Brazil. METHODS: Frailty status was assessed using Fried's frailty phenotype, and sedentary behavior was evaluated using two questions concerning time spent in a seated position, from the International Physical Activity Questionnaire (IPAQ). A multinomial logistic regression model was used to verify the association between frailty syndrome and sedentary behavior. RESULTS: The final study sample was made up of 411 older adults with a mean age of 70.14 ± 7.25 years and an average daily duration of sedentary behavior of 2.86 ± 2.53 hours. The prevalence of non-frailty was 28.7%, prevalence of pre-frailty was 58.4% and prevalence of frailty was 12.9%. The adjusted analysis showed that there were independent associations between sedentary behavior and pre-frailty (odds ratio, OR = 1.18; 95% confidence interval, CI: 1.03-1.34) and between sedentary behavior and frailty (OR = 1.20; 95% CI: 1.02-1.40). CONCLUSION: Frailty and pre-frailty status were associated with sedentary behavior among community-dwelling older adults.

Associação entre qualificação profissional de fisioterapeutas e a percepção sobre o tratamento de osteoartrite de joelho: um estudo transversal / Association between professional qualification of physical therapists and perception of knee osteoarthritis treatment: a cross-sectional study

INTRODUÇÃO: A Osteoartrite (OA) é a forma mais prevalente de artrite e requer intervenção terapêutica adequada. A Fisioterapia desempenha um importante papel no manejo desta doença. No entanto, pouco se sabe sobre as crenças e intervenções de fisioterapeutas que tratam OA no Brasil e fatores relacionados às decisões clínicas. OBJETIVO: Determinar se existe associação entre a qualificação profissional de fisioterapeutas na região Norte do Brasil e a percepção de eficiência ou ineficiência de intervenções terapêuticas para OA de joelho. MATERIAIS E MÉTODOS: Uma pesquisa transversal online foi realizada com fisioterapeutas de cinco estados do Norte do Brasil e a percepção sobre 20 intervenções foi avaliada por meio de um caso hipotético de OA de joelho. O teste qui-quadrado e regressão logística binária com nível de significância de 5% foram utilizados para a análise estatística. RESULTADOS: 370 profissionais com média de idade de 32,16 ± 6,89 responderam a pesquisa. Houve associação significativa entre qualificação e percepção de eficiência das intervenções. Fisioterapeutas apenas graduados apresentaram menos chances de reconhecer ultrassom, ondas curtas, neuroestimulação elétrica transcutânea e estimulação elétrica, crioterapia, calor, fortalecimento muscular, kinesio taping e repouso como intervenções ineficazes. O mesmo ocorreu com as intervenções ultrassom, fortalecimento muscular e kinesio taping para especialistas. CONCLUSÃO: O menor grau acadêmico leva à uma chance menor de perceber como pouco eficientes ou ineficientes algumas intervenções não recomendadas para OA de joelho.

INTRODUCTION: Osteoarthritis (OA) is the most prevalent form of arthritis, which requires appropriate therapeutic intervention. Physical therapy plays a central role in its management. However, little is known about the beliefs and interventions of physical therapists who treat OA in Brazil and factors related to clinical decisions. OBJECTIVE: To determine whether there is an association between the professional qualification of physical therapists in the North Region of Brazil and their perception of efficiency or inefficiency of therapeutic interventions for knee OA. METHODS: A cross-sectional online survey was conducted with physical therapists from five states in northern Brazil, and their perception about 20 interventions was assessed through a hypothetical case of knee OA. Statistical analyses were performed using the chi-square test and binary logistic regression with a significance level of 5%. RESULTS: 370 professionals with a mean age of 32.16 ±6.89 responded to the survey. There was a significant association between qualification and perceived efficiency of interventions. Graduated physiotherapists were less likely to recognize ultrasound, short waves, transcutaneous electrical neurostimulation and electrical stimulation, cryotherapy, heat, muscle strengthening, kinesio taping, and rest as ineffective interventions. The same occurred for ultrasound, muscle strengthening, and kinesiology tape for specialists. CONCLUSION: The lower academic degree leads to a lower chance to perceive as poorly efficient or inefficient some not recommended interventions for knee OA.

Associação entre sarcopenia e qualidade de vida relacionada à saúde em idosos comunitários / Relación entre sarcopenia y calidad de vida respecto a la salud de adultos mayores de una comunidad / Association between sarcopenia and health-related quality of life in community-dwelling older adults

Resumo Objetivo O objetivo deste estudo foi comparar a qualidade de vida entre idosos sarcopênicos e não sarcopênicos e verificar a associação entre sarcopenia e qualidade de vida em idosos residentes na comunidade. Métodos Estudo transversal conduzido com idosos residentes na comunidade (n = 378) de Macapá, Amapá, Brasil. A qualidade de vida foi avaliada por meio do Short Form (36) Health Survey. O algoritmo proposto pelo Grupo de Trabalho Europeu sobre Sarcopenia em Pessoas Idosas (EWGSOP) foi usado para avaliar a sarcopenia. Foram realizadas análises descritivas, inferenciais e modelo de regressão linear. Resultados Os idosos sarcopênicos apresentaram escores de qualidade de vida significativamente mais baixos nos domínios função física, dor corporal, estado geral de saúde e função social. Após o ajuste, a sarcopenia associou-se inversamente ao funcionamento físico (β = -0,125; p = 0,010) e ao estado geral de saúde (β = -0,112; p = 0,028). Conclusão Os resultados deste estudo sugerem um provável declínio na qualidade de vida em idosos sarcopênicos, principalmente nos domínios funcionamento físico e estado geral de saúde.

Resumen Objetivo El objetivo de este estudio fue comparar la calidad de vida entre adultos mayores con sarcopenia y sin sarcopenia y verificar la relación entre sarcopenia y calidad de vida en adultos mayores residentes de la comunidad. Métodos Estudio transversal llevado a cabo con adultos mayores residentes de la comunidad (n = 378) de Macapá, estado de Amapá, Brasil. La calidad de vida fue evaluada mediante el Short Form (36) Health Survey. El algoritmo propuesto por el Grupo Europeo de Trabajo sobre la Sarcopenia en Personas de Edad Avanzada (EWGSOP) fue utilizado para evaluar la sarcopenia. Se realizaron análisis descriptivos, inferenciales y modelo de regresión lineal. Resultados Los adultos mayores con sarcopenia presentaron una puntuación de calidad de vida significativamente más baja en los dominios función física, dolor corporal, estado general de salud y función social. Luego del ajuste, la sarcopenia se relacionó inversamente con el funcionamiento físico (β = -0,125; p = 0,010) y con el estado general de salud (β = -0,112; p = 0,028). Conclusión Los resultados de este estudio sugieren un probable deterioro en la calidad de vida de adultos mayores con sarcopenia, principalmente en los dominios funcionamiento físico y estado general de salud.

Abstract Objective This study aimed to compare quality of life between sarcopenic and non-sarcopenic older adults and to verify the association of sarcopenia and quality of life in community-dwelling older adults. Methods This was a cross-sectional study conducted in community-dwelling older adults (n = 378) from Macapá, Amapá, Brazil. Quality of life was assessed using the Short Form (36) Health Survey. The algorithm proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) was used to assess sarcopenia. Descriptive, inferential analyses and linear regression model were performed. Results Sarcopenic older adults presented significantly lower quality of life scores in the domains of physical functioning, bodily pain, general health status, and social functioning. After adjustment, sarcopenia was inversely associated with physical functioning (β = -0.125; p = 0.010) and general health status (β = -0.112; p = 0.028). Conclusion The results of this study suggest a probable decline in the quality of life in sarcopenic older adults, especially in the physical functioning and general health status domains.

Factors associated with social isolation and loneliness in community-dwelling older adults during pandemic times: a cross-sectional study

Abstract INTRODUCTION: Psychosocial aspects need to be discussed in the context of the Covid-19 pandemic. Currently, no studies have investigated the factors associated with social isolation and loneliness among community-dwelling older adults. Therefore, this study analyzed the association of social isolation and loneliness with socioeconomic, clinical, and health characteristics, and Covid-19-related variables, among community-dwelling older adults during the pandemic. METHODS: A cross-sectional study was conducted via a telephone survey of community-dwelling older adults aged ≥60 years in Macapa, Amapa, Brazil. A structured form was used to collect data. Descriptive and inferential analyses were performed using Pearson's correlation test and a linear regression model. RESULTS: Participants comprised 86 community-dwelling older adults with a mean age of 71.78+6.98 years. Among them, 9.3% were diagnosed with Covid-19, of whom 3.5% were hospitalized. Most participants reported no difficulty obtaining food, medicines, or attending routine medical appointments during the pandemic. Furthermore, 23.3% (n=20) were socially isolated, and 20.9% (n=18) reported feelings of loneliness. The mean values for fear, anxiety, and obsession were 19.01±7.25, 1.01±1.90, and 2.84±3.28, respectively. A moderate positive correlation was identified between loneliness and the number of diseases, and a weak positive correlation between loneliness and the number of medications and depressive symptoms and risk for sarcopenia. The linear regression model indicated that higher loneliness scores were associated with a greater number of diseases (β=0.288; p=0.007). CONCLUSIONS: The findings suggest a probable resilience of the older population to Covid-19, despite the association of loneliness with many diseases in times of a pandemic.

Dyspnea is associated with poor physical performance among community-dwelling older adults: a population-based cross-sectional study

ABSTRACT BACKGROUND: Dyspnea and poorer physical performance are conditions that may be related and be present among the elderly. However, few studies have evaluated associations between these variables. OBJECTIVE: To determine whether there is an association between dyspnea and physical performance among community-dwelling older adults of both sexes (age 60 years and over). DESIGN AND SETTING: Cross-sectional study conducted in the city of Macapá, state of Amapá, Brazil. METHODS: Socioeconomic and health data were collected using a structured form. Frailty syndrome was assessed based on the frailty phenotype proposed by Fried et al. Dyspnea was measured using the modified Medical Research Council (mMRC) scale and physical performance was measured using the Short Physical Performance Battery (SPPB). Data were analyzed using a linear regression model. RESULTS: A total of 411 subjects (70.15 ± 7.25 years) were evaluated, most of them females (66.4%). It was observed from the mMRC scale that 30.9% (n = 127) of the subjects had some dyspnea symptoms: grade 1 was most frequent. The physical performance score from the SPPB was 9.22 ± 2.01. Higher dyspnea scores were associated with poor physical performance, both in the crude analysis (β = -0.233; P = 0.028) and after adjustment for frailty condition (β = -0.148; P = 0.002) and for the socioeconomic and health variables (age, sex, number of diseases, smoking habit and frailty status) (β = -0.111; P = 0.025). CONCLUSION: Higher dyspnea score was independently associated with poor physical performance among community-dwelling older adults.

Covid-19: perspectives and initiatives in older adults health context in Brazil / Covid-19: perspectivas e iniciativas no contexto da saúde do idoso no Brasil

Abstract This article provides information about COVID-19, contextualizing the national and international scenario, with an emphasis on the health of the elderly. Perspectives and initiatives for this risk group are presented, reinforcing the need to consider the aging process and not just age as the main marker in the approach of this population.

Resumo Este artigo fornece informações sobre a COVID-19, contextualizando o cenário nacional e internacional, com ênfase na saúde do idoso. São apresentadas perspectivas e iniciativas voltadas para esse grupo de risco, reforçando a necessidade de considerar o processo de envelhecimento e não apenas a idade como o principal marcador na abordagem dessa população.

Clinical and socioeconomic characteristics of older adults with COVID-19: A protocol for a rapid systematic review

SUMMARY The aim of this rapid systematic review is to analyze the prevalence of clinical, socioeconomic, and demographic characteristics, laboratory and imaging findings, diagnostic tests, and treatment information of older adults with COVID-19. To conduct this systematic review, the Cochrane Handbook recommendations will be followed. Patients aged 60 years or older with a confirmed diagnosis of SARS-CoV-2 infection will be included. A comprehensive literature search will be performed in the following databases: MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), Spanish Bibliographic Index on Health Sciences (IBECS) and Epistemonikos COVID-19 L·OVE platform. No language restrictions will be applied. To assess the methodological quality of the included studies and the certainty of the evidence, the Newcastle-Ottawa Scale, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used. The meta-analysis will be performed using R software. We believe this rapid systematic review will be able to summarize the currently available evidence on clinical, socioeconomic characteristics, and management of COVID-19 in older adults. Therefore, it will help implement adequate strategies to fight the pandemic and assist in understanding the clinical profile of older patients with COVID-19, providing data with due scientific support upon which to base future choices of procedures and interventions.

RESUMO O objetivo desta rápida revisão sistemática é analisar a prevalência de características clínicas, socioeconômicas e demográficas, achados laboratoriais e de imagem, testes de diagnóstico e informações de tratamento de idosos com COVID-19. Para conduzir esta revisão sistemática, serão seguidas as recomendações do Manual Cochrane. Pacientes com 60 anos ou mais com diagnóstico confirmado de infecção por Sars-CoV-2 serão incluídos. Uma pesquisa bibliográfica abrangente será realizada nas seguintes bases de dados: Medline via PubMed, Embase, Cochrane Central Register of Controlled Trials (Central), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Índice Bibliográfico Espanhol em Ciências da Saúde (Ibecs) e Epistemonikos Plataforma COVID-19 L · OVE. Nenhuma restrição de idioma será aplicada. Para avaliar a qualidade metodológica e a certeza das evidências dos estudos incluídos, serão utilizadas a Escala Newcastle-Ottawa e a abordagem Grading of Recommendations Assessment, Development and Evaluation (Grade). A meta-análise será realizada no software R. Acreditamos que esta revisão sistemática rápida será capaz de resumir as evidências atualmente disponíveis sobre as características clínicas, socioeconômicas e sobre o manejo de idosos com COVID-19. Portanto, ajudará a implementar estratégias adequadas para combater a pandemia e ajudará a entender o perfil clínico de pacientes idosos com COVID-19, fornecendo dados com o devido apoio científico sobre o qual basear futuras escolhas de procedimentos e intervenções.

Functional capacity assessment of upper limbs in healthy young adult subjects / Avaliação da capacidade funcional de membros superiores em indivíduos adultos jovens saudáveis

Abstract Introduction Assessing the functional capacity of the upper limbs (UL) is essential to direct treatments in clinical practice but there is a lack of research on specific methods for this end. Objective To verify the relationship of physical activity, grip strength (GS) and body mass index (BMI) with performance on 6-minute Pegboard and Ring Test (6PBRT) in healthy subjects. Methods Cross-sectional, exploratory and quantitative study. Apparently healthy adults were evaluated, both sexes, according to sociodemographic and anthropometric aspects, health conditions, physical activity level (IPAQ - short version), GS and functional capacity of the upper limbs (6PBRT). The data were analyzed descriptively using means, standard deviations, absolute figures and percentages. Correlations were found between variables using Spearman's correlation coefficient (p < 0.05). The Statistical Package for Social Sciences (SPSS) for Windows, version 17.0 was used for analysis purposes. Results In total, 50 individuals were evaluated, the majority classified as active (54%). The mean GS was 30.70 ± 9,47kgf and the average number of loops moved during the 6PBRT was 277.6 ± 34.48. There was no correlation between the number of rings moved in 6PBRT and the level of physical activity (r = 0.076; p = 0.602), GS (r = -0.008; p = 0.956) or BMI (r = 0.031; p = 0.829). Conclusion The level of physical activity, GS and BMI did not influence the performance on 6PBRT, demonstrated by the lack of correlation between these variables.

Resumo Introdução A avaliação da capacidade funcional de membros superiores (MMSS) é fundamental para o direcionamento de tratamentos na prática clínica, porém apresenta escassez de pesquisas que abordem métodos específicos para tal objetivo. Objetivo Verificar a relação do nível de atividade física (NAF), da força de preensão palmar (FPP) e do índice de massa corporal (IMC) com o desempenho no 6-minute Pegboard and Ring Test (6PBRT) em indivíduos saudáveis. Métodos Estudo descritivo, transversal, analítico e quantitativo. Foram avaliados indivíduos adultos saudáveis, ambos os gêneros, segundo aspectos sociodemográficos, condições de saúde, antropométricos, NAF (IPAQ - versão curta), FPP e capacidade funcional de MMSS (6PBRT). Os dados foram analisados descritivamente por meio de médias, desvios padrão, números absolutos e porcentagens e foram verificadas as correlações entre as variáveis pelo coeficiente de correlação de Spearman (p < 0,05). Resultados Totalizaram 50 indivíduos avaliados, sendo a maioria classificados como ativos (54%). A média da FPP foi de 30,70 ± 9,47kgf e a média do número de argolas movidas durante o PBRT foi de 277,6 ± 34,48. Não houve correlação entre o número de argolas movidas no PBRT com o NAF (r = 0,076; p = 0,602), com a FPP (r = -0,008; p = 0,956) e nem com o IMC (r = 0,031; p = 0,829). Conclusão O NAF, a FPP e o IMC não influenciaram no desempenho do 6PBRT, demonstrado pela ausência de correlação entre essas variáveis.