Incidence of memory complaints during the COVID-19 pandemic in Southern Brazil: findings from PAMPA cohort / Incidência de queixas de memória durante a pandemia de COVID-19 no sul do Brasil: dados da coorte PAMPA

ABSTRACT. Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

RESUMO. Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio — HR 1,49; intervalo de confiança — IC 95% 1,16-1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06-2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49-2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57-0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

Incidence of multimorbidity and associated factors during the COVID-19 pandemic in Brazil: a cohort study

ABSTRACT BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, access to healthcare services may have become difficult, which may have led to an increase in chronic diseases and multimorbidity. OBJECTIVES: To assess the incidence of multimorbidity and its associated factors among adults living in the state of Rio Grande do Sul, Brazil. DESIGN AND SETTING: Cohort study conducted in Rio Grande do Sul, Brazil. METHODS: We included data from the two waves of the Prospective Study About Mental and Physical Health (PAMPA). Data were collected via online questionnaires between June and July 2020 (wave 1) and between December 2020 and January 2021 (wave 2). Multimorbidity was defined as the presence of two or more diagnosed medical conditions. RESULTS: In total, 516 individuals were included, among whom 27.1% (95% confidence interval, CI: 23.5-31.1) developed multimorbidity from wave 1 to 2. In adjusted regression models, female sex (hazard ratio, HR: 1.97; 95% CI: 1.19-3.24), middle-aged adults (31-59 years) (HR: 1.78; 95% CI: 1.18-2.70) and older adults (60 or over) (HR: 2.41; 95% CI: 1.25-4.61) showed higher risk of multimorbidity. Back pain (19.4%), high cholesterol (13.3%) and depression (12.2%) were the medical conditions with the highest proportions reported by the participants during wave 2. CONCLUSION: The incidence of multimorbidity during a six-month period during the COVID-19 pandemic was 27.1% in the state of Rio Grande do Sul, Brazil.

Managing noncommunicable diseases during the COVID-19 pandemic in Brazil: findings from the PAMPA cohort / Manejo de doenças crônicas não-transmissíveis durante a pandemia de COVID-19: resultados da coorte PAMPA

Abstract The objective was to identify the impact of social distance in the management of noncommunicable diseases (NCD) in the adult population from the state of Rio Grande do Sul, southern Brazil. This is an ambispective, population-based cohort study. Descriptive analysis and Poisson regression models were used and the results were reported as prevalence ratio and 95% confidence intervals. From a total of 1,288 participants, 43.1% needed medical care and 28.5% reported impaired management of NCDs during social distance. Female sex, age between 18 and 30 years old, living in the Serra region (central region of the state), people with depression and multimorbidity were more likely to have impaired management of NCDs. Being physically active reduced the probability of having impaired management of NCD by 15%. Reduced monthly income was associated with the difficulty in accessing prescription medicine and avoidance of seeking in-person medical assistance. Depression was associated with difficulties in accessing medications, while avoidance of seeking in-person medical assistance was more likely for people with multimorbidity, arthritis/arthrosis/fibromyalgia, heart disease, and high cholesterol.

Resumo O objetivo foi identificar o impacto do distanciamento social no manejo das doenças crônicas não transmissíveis (DCNT) na população adulta do estado do Rio Grande do Sul, sul do Brasil. Este é um estudo de coorte ambispectivo de base populacional. Foi utilizada análise descritiva e modelos de regressão de Poisson, os resultados são apresentados em razão de prevalência e intervalos de confiança de 95%. De um total de 1.288 participantes, 43,1% necessitaram de cuidados médicos e 28,5% relataram manejo prejudicado de DCNT durante o distanciamento social. Sexo feminino, idade entre 18 e 30 anos, residente na região da Serra (região central do estado), pessoas com depressão e multimorbidade apresentaram maior chance de manejo prejudicado das DCNT. Ser fisicamente ativo reduziu a probabilidade de ter gerenciamento prejudicado de DCNT em 15%. A redução da renda mensal esteve associada à dificuldade de acesso a medicamentos prescritos e a deixar de buscar atendimento médico presencial. A depressão foi associada a dificuldades de acesso a medicamentos, enquanto deixar de buscar assistência médica pessoalmente foi mais provável para pessoas com multimorbidade, artrite/artrose/fibromialgia, doenças cardíacas e colesterol alto.