ABSTRACT
BACKGROUND@#Maintenance of instrumental activities of daily living (IADL) and social role (SR) is crucial to keep independent life because the decline in SR and IADL was a significant predictor of dependence in basic ADL in later. The independent effect of physical and cultural leisure activities and their effect modification on the IADL remains unknown.@*METHODS@#We prospectively observed 3241 elderly with intact IADL at baseline for 5 years. Higher level functional capacity such as IADL and SR was assessed using the Tokyo Metropolitan Institute of Gerontology Index of competence (TMIG index).@*RESULTS@#The mean age of the participants was 72.3 years (standard deviation 5.1), and 46.9% were male, and 90.9% of them received a follow-up assessment. Of the participants, 10.4% developed an IADL decline. Engagement in leisure physical activity was associated with a significantly lower risk of IADL decline (adjusted risk ratio, 0.73; 95% confidence interval [CI], 0.60 to 0.89), and cultural leisure activity was also associated with lower risk of IADL decline (adjusted risk ratio, 0.77; 95% CI, 0.63 to 0.95) independent of potential confounders. We also found significant and positive interaction between physical and cultural leisure activities at risk for IADL decline (P = 0.024) and SR decline (P = 0.004).@*CONCLUSIONS@#We found an independent association of physical and cultural leisure activities with a lower risk for functional decline in IADL and SR with positive interaction. Combined engagement in physical and cultural activities may effectively prevent from IADL decline and SR decline.
ABSTRACT
Introdução: O aumento da importância das doenças crônicas não transmissíveis (DCNT) no perfil de saúde da população acarretou em demanda pela vigilância de seus fatores de risco e proteção. A população idosa vem experienciando uma grande expansão nas últimas décadas e sua vulnerabilidade majorada para as DCNT a classifica como alvo prioritário para essa vigilância. Objetivo: Analisar a tendência temporal da prática de atividade física no lazer entre a população idosa nas capitais brasileiras e no Distrito Federal, entre 2009 e 2017. Métodos: Dados do Vigitel coletados entre 2009 e 2017 (n= 129.967 idosos) (≥60 anos) foram utilizados. Informações acerca da intensidade, frequência semanal (dias/semana) e duração habitual (minutos/episódio) da prática de atividade física de lazer foram utilizados para a identificação do percentual de idosos, atendendo às recomendações atuais de prática (≥150min/semana). Essas informações foram estimadas para cada ano, para o conjunto completo da população e segundo estratos sociodemográficos e de saúde. Modelos de regressão Prais-Winsten foram usados para a análise da variação temporal. Resultados: A porcentagem dos idosos que referiu prática de atividade física nos 90 dias que antecederam a entrevista aumentou de 37,2% para 43,0% no período entre 2009 e 2017 (0,70 pontos percentuais (pp)/ano). A maioria dos idosos que já praticava atividade física relatou como opção atividade de intensidade moderada (93,9% em 2017). A porcentagem de idosos referindo não praticar atividade física ao menos um dia por semana diminuiu (de 64,2% para 59,4%, -0,73 pp/ano), com aumento nas faixas de prática entre 1 e 4 dias/semana. A duração habitual (minutos/episódio) da prática também aumentou, de 48,1% para 58,2% (0,62pp/ano), com a porcentagem de prática em 60 minutos ou mais por episódio. Com isso, a porcentagem de idosos atingindo nível recomendado de prática (≥150min/semana) aumentou de 23,2% para 25,8% (0,30 pp/ano), com maiores aumentos observados naqueles com idade entre 60 a 69 anos (0,39pp/ano), com escolaridade entre 0 e 8 anos de estudo (0,22pp/ano) e residentes nas capitais da região Norte (0,99pp/ano). De forma geral, maiores aumentos foram observados nos estratos com menor nível de prática no início do período estudado. Conclusão: A prática de atividade física evoluiu de forma favorável, com aumento da porcentagem de idosos atendendo às recomendações de prática.(AU)
Introduction: The increased importance of noncommunicable chronic diseases (NCDs) in the health profile of the population led to a demand for the surveillance of their risk factors and protection. The elderly population has been experiencing great expansion in recent decades and their increased vulnerability to NCDs classifies it as a priority target for this surveillance. Objective: To analyze the temporal tendency of leisure time physical activity among the elderly population in the Brazilian capitals and Federal District between 2009 and 2017. Methods: Vigitel data collected between 2009 and 2017 (n=129,967 elderly) (≥60 years) were used. Information related to the intensity, weekly frequency (days/week) and habitual duration (minutes/episode) of leisure physical activity practice were used to identify the percentage of elderly attending to the current recommendations of the practice (≥150min/week). This information was estimated for each year, for the entire population and according to socio-demographic and health strata. Prais-Winsten regression were used for temporal variation analysis. Results: The percentage of the elderly referring the physical activity practice in the 90 days before the interview increased from 37.2% to 43.0% in the period between 2009 and 2017 (0,70 percentage points (pp)/year). The majority of the elderly opted for moderate intensity activity (93.9% in 2017). The percentage of elderly individuals who reported not practicing physical activity at least one day per week decreased (from 64.2% to 59.4%, -0.73pp/year), with an increase in the practice ranges between 1 and 4 days/week. The usual duration of the practice also increased, with the percentage of practice in 60 minutes or more per episode, increasing from 48.1% to 58.2% (0.62pp/year). As a result, the percentage of elderly people reaching the recommended volume of leisure physical activity practice increased from 23.2% to 25.8% (0.30pp/year) with higher increases observed in those aged 60-69 years (0.39pp / year), with education between 0 and 8 years of study (0.22pp/year) and residents in the capitals of the North region (0.99pp /year).. In general, higher increases were observed in strata with lower level of practice at the beginning of the studied period. Conclusion: The practice of physical activity evolved favorably, with an increase in the percentage of elderly attending to the practice recommendations.(AU)