Examining the factors associated with functional capacity of community-dwelling older adults using the ICF framework: a cross-sectional study from the Frailty in Brazilian Older Adults Study (FIBRA).

BACKGROUND: There are many factors associated with functioning and disability in older adults and these relationships are not clear. OBJECTIVE: To explore the factors associated with functional capacity of older adults using the framework of the International Classification of Functioning, Disability, and Health (ICF). METHODS: This is a cross-sectional study with a dataset from a survey of 1 377 community-dwelling older adults (≥ 65 years) in a middle-income country. Three functional outcomes were selected to represent the functioning domains: 1) muscle strength for body function; 2) walking speed for activity; and 3) advanced activities of daily living (ADL) for participation. Demographic, clinical, and social information was selected to represent the domains of health conditions and contextual factors (i.e. personal and environmental factors). Multivariate models tested the impact of these factors on each outcome. RESULTS: Depressive symptoms, age, and physical activity were associated with the three outcomes. Muscle strength was also associated with urinary incontinence, visual deficits, female sex, and employment. Walking speed was also associated with urinary incontinence, obesity, fractures due to falls, female sex, health professionals' visits, and walking aid devices. Advanced ADL were also associated with stroke, visual deficits, education, employment, health perception, social support, and walking aid devices. CONCLUSION: Functional capacity of older adults is associated with some non-modifiable factors, such as age and sex. The modifiable factors must be addressed by health professionals and policymakers in the geriatric area, especially depression, obesity, physical inactivity, and social support.

Nutritional Risk is Associated with Chronic Musculoskeletal Pain in Community-dwelling Older Persons: The PAINEL Study.

Malnutrition is a risk factor for noncommunicable diseases related to ageing, and it can also contribute to musculoskeletal health. This study investigated whether nutritional risk is associated with chronic musculoskeletal pain in community-dwelling older persons. Nutritional risk was assessed by the DETERMINE Checklist. Chronic musculoskeletal pain was defined as the presence of pain in the past six months that did not disappear for at least 30 consecutive days. Multivariate logistic regression including confounding variables was used for the analysis. The sample was comprised of 383 participants (age 75.6 ± SD 6.1); the majority were at moderate-to-high nutritional risk (69%) and approximately one third presented chronic musculoskeletal pain (30%). The nutritional risk score was independently associated with chronic musculoskeletal pain: adding one unit in the risk score produces an 11% increment in the odds of presenting pain (OR 1.109, 95% CI 1.022-1.204). Individuals classified into moderate- or high-risk categories also had substantially higher odds (∼90%) of presenting chronic musculoskeletal pain when compared to those in the low-risk category, although our findings were only marginally significant. This is the first study to demonstrate the association between nutritional risk and chronic musculoskeletal pain above and beyond the contributed effects from relevant confounders.

O impacto das quedas na qualidade de vida dos idosos / The impact of falls in quality of life of the elderly

Introdução: As quedas, no contexto do crescente envelhecimento, surgem como eventos importantes que podem afetar a qualidade de vida dos idosos. Objetivos: Realizar uma revisão de literatura sobre o impacto que as quedas têm na qualidade de vida dos idosos. Métodos: Foi feita uma pesquisa bibliográfica nas bases de dados PubMed, Lilacs e Scielo, no período de maio a agosto de 2009. Resultados: Foram incluídos 11 artigos. As consequências físicas das quedas foram fraturas, hospitalização, imobilização e lesão neurológica, e as funcionais citadas, restrição de mobilidade, modificação de hábitos e dependência. Medo de cair, mudança de domicílio, rearranjo familiar, isolamento social, depressão e diminuição de autoestima mostram o impacto psicossocial do evento. Conclusão: As quedas entre idosos são frequentes e determinam complicações múltiplas. Neste trabalho, mostrou-se que há consequências físicas, funcionais e psicossociais decorrentes de quedas que podem afetar direta ou indiretamente a qualidade de vida do indivíduo.

Introduction: Falls, in the aging context, emerge as important events that may affect quality of life of the elderly. Objectives: To review the literature about the impact falls can have on quality of life of older people. Methods: It was performed a literature search in Portuguese, Spanish and English through the databases PubMed, Lilacs and Scielo. Results: Eleven articles were included. Among physical consequences of falls, there are fractures, hospitalization, immobilization and spinal cord injury. The functional consequences cited were restricted mobility, change of habits and loss of independence. Fear of falling, change of address, family rearrangement, social isolation, depression and decreased self-esteem show the psychosocial impact of the event. Conclusion: Falls in the elderly are common and determine multiple complications. This study showed that there are physical, functional and psychosocial consequences of falling that may directly or indirectly affect the elderly quality of life.