Depressive symptoms as an independent risk factor for mortality

Objective: To evaluate the relationship between presence of depressive symptoms and risk of death in older adults residing in a municipality in Southern Brazil. Methods: Between 2009 and 2014, 1,391 people participated in the EpiFloripa Aging Cohort Study, a population-based longitudinal study. Depressive symptoms were assessed through the Geriatric Depression Scale. The initial time was considered the age at the first interview, and the end time, the age at the last contact or death. Cox regression models were used to estimate the mortality risk associated with depressive symptoms, adjusted by sex, education, income, paid work, smoking status, alcohol consumption, morbidities, medication use, physical activity, disability, cognitive impairment, and body mass index. Results: The prevalence of depressive symptoms was 23.5% (95%CI 20.4-26.9). On crude analysis, the risk of mortality was 1.86 (95%CI 1.35-2.55) for individuals with depressive symptoms; in adjusted models, the risk of mortality was 1.67 (95%CI 1.15-2.40). Conclusion: Depressive symptoms are an independent risk factor for mortality in older Brazilian adults. Our findings highlight the importance of screening this population for depression and the practice of preventive actions.

Impacto do exercício físico no transtorno do espectro autista: uma revisão sistemática / Effectiveness of physical exercise in invasive development disorders in autism: a systematic review

Introdução: o transtorno do espectro autista, por vezes denominado como transtornos invasivos do desenvolvimento, apresenta características clínicas centrais que incluem déficits qualitativos na interação social e na comunicação, padrões de comportamento repetitivos e estereotipados e um repertório limitado de interesses e atividades. Esse transtorno geralmente está associado ao transtorno do desenvolvimento da coordenação. Objetivo: verificar evidências científicas do impacto do exercício físico no tratamento do indivíduo portador do transtorno do espectro autista, inclusive quanto à coordenação motora e desenvolvimento cognitivo. Métodos: foram realizadas buscas nas bases de dados pubmed, lilacs, scielo e pedro sem restrição de idiomas ou localização e tempo até maio de 2019. A pesquisa foi realizada na base de dados com descritores selecionados a partir do dicionário descritores em ciências da saúde (decs) medical subject heading terms (mesh)[(autistic disorder) and (asperger syndrome) and (exercise) and (cognition)], tendo como critério de inclusão o fato de tratarem-se de estudos com o uso de exercício físico. Foi verificada a qualidade metodológica dos artigos incluídos através do protocolo modificado de pithon. Resultados: foram identificados 655 artigos, dos quais soment e 7 cumpriram os critérios de inclusão estabelecidos. Cada um dos estudos retratou abordagens distintas dos exercícios físicos, sendo aeróbios, de força, aquáticos, ou com uso de tecnologias. A quantidade e duração das sessões dos exercícios variaram de estudo para estudo. Conclusão: os programas de exercícios físicos trazem benefícios em diversos aspectos dos pacientes. Os programas de exercícios no meio aquático aparentemente se mostraram os mais eficazes. Abre-se, assim, uma lacuna na literatura para novos estudos que busquem explicações para esses resultados...(AU)

Introduction: autism spectrum disorder, sometimes referred to as invasive dev elop mental disorders, has central clinical characteristics that include qualitative deficits in so cial in teraction and communication, repetitive and stereotyped behavior patterns and a limited reperto ire of in terest s and activities. This disorder is usually associated with developmental coordination diso rder. Objective: to verify scientific evidence of the impact of physical exercise on the treatment of individuals wit h autism spectrum disorder, including motor coordination and cognitive development. Metho ds: s earches were carried out in the pubmed, lilacs, scielo and pedro databases without restriction of languages o r lo cation and time until may 2019. The research was carried out in the database with descriptors selected fro m the health sciences descriptors dictionary ( decs) medical subject heading terms (mesh) [(autistic disorder) and (asperger syndrome) and (exercise) and (cognition)], having as inclusion criteria the fact that t hey are studies with the use of physical exercise. The methodological quality of the articles included was verified through the modified pithon protocol. Results: 655 articles were identified, o f wh ich o nly 7 m et t he established inclusion criteria. Each of the studies portrayed different approaches to phy sical ex ercises, being aerobic, strength, aquatic, or using technologies. The number and duration o f ex ercise sessio ns varied from study to study. Conclusion: physical exercise programs have benefits in sev eral asp ects o f patients. The exercise programs in the aquatic environment hav e ap paren tly p roved t o be t h e m ost effective. Thus, a gap in the literature opens up for new studies that seek explanations for these results...(AU)