Leukocyte Telomere Length and Chronic Conditions in Older Women of Northeast Brazil: A Cross-Sectional Study.

This study assessed whether telomere length is related to chronic conditions, cardiovascular risk factors, and inflammation in women aged 65 to 74 from Northeast Brazil. Participants were selected from two sources, a representative sample of the International Mobility in Aging Study (n = 57) and a convenience sample (n = 49) recruited at senior centers. Leukocyte telomere length was measured by quantitative polymerase chain reaction from blood samples in 83 women. Natural log-transformed telomere/single copy gene ratio was used as the dependent variable in the analysis. Blood analyses included inflammatory markers (high-sensitivity C-reactive protein and interleukin-6), total, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, glucose and glycosylated hemoglobin. Self-rated health, chronic conditions, cardiovascular risk factors and inflammatory markers were not associated with telomere length. No significant independent association was found between telomere length and anthropometric measures or blood markers, even after adjusting for age, education and adverse childhood events among these older women in Northeast Brazil. Our results did not confirm the hypothesis that chronic conditions, cardiovascular risk factors or inflammation are associated with shorter telomere length in these women who have exceptional survival relative to the life expectancy of their birth cohort.

Contextual factors associated with life-space mobility in community-dwelling older adults based on International Classification of Functioning, Disability and Health: protocol for a systematic review.

INTRODUCTION: Mobility decline compromises functionality and quality of life in old age. Life-Space Assessment (LSA) evaluates mobility considering interaction between person and environment. The International Classification of Functioning, Disability and Health (ICF) is a reference to identify and categorise the personal and environmental contextual factors associated to the LSA. Our objective is identifying contextual factors that may influence life-space mobility of older community-dwelling adults based on ICF. METHODS AND ANALYSIS: A systematic review of literature will be performed to identify studies published between 1 January 2001 and 10 May 2017 which investigates life-space mobility among older adults. Keywords will be entered into the electronic databases of MEDLINE (PubMed), EMBASE (OVID), CINHAL (EBSCO), Cochrane Central Register of Controlled Trials Cochrane Central (OVID), PsycINFO (EBSCO) and COCH (OVID). Five investigators will work on search databases and standardised screening of the articles. Mobility predictors will be separated into personal and environmental aspects, according to the ICF model. The results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and then a meta-analysis will be performed, if applicable. DISCUSSION: Knowledge about life-space mobility in community-dwelling older adults by examining related risk and protective aspects may help practitioners better approach older adults' mobility and prevent their decline in old age. Furthermore, researchers will have more clues for investigations into factors related to life-space mobility. TRIAL REGISTRATION NUMBER: CRD42017064552.

Lifecourse Adversity and Telomere Length in Older Women from Northeast Brazil.

We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a region with substantial socioeconomic inequalities. The low education sample was selected from a representative survey at local neighborhood health centers, while the high education group consisted of a convenience sample recruited by advertising in community centers and centers affiliated with the local university. Relative leukocyte TL was measured by quantitative polymerase chain reaction from blood samples. ACEs were self-reported. Spline linear regression was fitted to assess the strength of the associations between ACEs and TL. Among women with low education, median TL was 1.02 compared with 0.64 in the high education group (p = 0.0001). Natural log-transformed T/S ratio as the dependent variable was used in analysis. Women with low education had been exposed to more ACEs, and among them those experiencing two or more ACEs had longer TL than women exposed to ≤1 ACEs (p = 0.03); among women with high education, this difference was not significant (p = 0.49). In analyses adjusted by age, education, and parental abuse of alcohol, the linear trend of higher TL with increasing ACEs was confirmed (p = 0.02), and the mean difference in TL between groups remained significant (p = 0.002). The unexpected positive relationship between low education and ACEs with TL suggests that older adults who have survived harsh conditions prevailing in Northeast Brazil have the longest TL of their birth cohort.

Systematic review of the association between chronic social stress and telomere length: A life course perspective.

Our aim was to examine whether chronic social stress is associated with telomere length throughout the life course, following our protocol published in 2014. Structured searches were conducted in MEDLINE (PubMed interface), EMBASE (OVID interface), Cochrane Central (OVID interface) and grey from their start date onwards. Reference lists of retrieved citations were hand searched for relevant studies. Eighteen studies published until May 1, 2015 investigating the association between chronic social stress (as defined by poverty, exposure to violence, or family caregiving) and telomere length in healthy or diseased adults and children were independently selected by 2 reviewers. Sixteen of those studies were cross-sectional and two had a longitudinal design. Studies differed in type of stress exposure, method to measure telomere length and cell type. As meta-analysis could not be conducted, the data were synthesized as a narrative review. Based on this comprehensive review, chronic social stress accompanies telomere shortening in both early and adult exposures, with most eligible studies showing a significant relationship. We discuss the significance of chronic stress of social origin and the potential for social interventions through public policies and we recommend methodological improvements that would allow for future meta-analysis.

Impacto da doença coronariana no cotidiano das mulheres / Impact of coronary heart disease in the daily lives of women / Impacto de la enfermedad coronaria en la vida cotidiana de las mujeres

Objetivo: analisar o impacto da doença coronariana no cotidiano das mulheres. Método: pesquisa qualitativa realizadaem um Hospital Universitário entre janeiro e abril de 2014. Utilizou-se o método de Análise Temática. Resultados:a manifestação da doença coronariana vem acompanhada de restrições e readaptações à vida pessoal, levandoa novos estilos de vida; existem mulheres que não conseguem realizar as modificações que a patologia requernos hábitos de vida. Conclusão: as mulheres reconheceram a gravidade da doença coronariana e demonstrarammudanças que se relacionavam ao impacto físico, emocional e afetivo no seu cotidiano.

Objective: to analyze the impact of coronary heart disease in the daily lives of women. Method: qualitative researchconducted at a University Hospital between January and April, 2014. The Thematic Analysis method was used.Results: the manifestation of coronary heart disease is accompanied by restrictions and readapting personal life,leading to new styles of life; there are women who cannot carry out he modifications that the pathology requires intheir life habits. Conclusion: women recognized the severity of coronary heart disease and showed changes related tophysical, emotional and affective impact in their daily lives.

Objetivo: analizar el impacto de la enfermedad coronaria en la vida cotidiana de las mujeres. Método: Investigacióncualitativa realizada en un Hospital Universitario entre enero y abril de 2014. Se usó el método de análisis temático.Resultados: la manifestación de la enfermedad cardíaca coronaria viene acompañada de restricciones y readaptacióna la vida personal, conduce a nuevos estilos de vida; hay mujeres que no pueden realizar los cambios que la patologíarequiere en los hábitos de vida. Conclusión: las mujeres reconocen la gravedad de la enfermedad cardíaca coronariay mostraron cambios relacionados con el impacto físico, emocional y afectivo en su vida diaria.

Fisioterapia Motora no recém-nascido prematuro em Unidade Intensiva Neonatal: uma revisão sistemática / Physical therapy for the premature newborn in neonatal intensive care unit: a systematic review

Introdução: Recém-nascidos prematuros (RNPT) apresentam maior vulnerabilidade a desfechos adversos decorrentes da própria imaturidade e da hospitalização. Dessa forma, é importante investigar as repercussões clínicas e benefícios da fisioterapia nesta população. Objetivo: Desenvolver uma revisão sistemática para verificar as repercussões clínicas e potenciais benefícios da fisioterapia motora nos RNPT internados em unidade de terapia intensiva. Métodos: As bases de dados Lilacs, Pubmed e Scopus foram consultadas. Dois revisores independentes realizaram a seleção e análise dos artigos elegíveis e avaliação do risco de viés. Resultados: Quatro artigos foram incluídos na revisão. A conduta fisioterapêutica foi considerada segura, sendo observada redução da dor, melhora da qualidade do sono, do ganho de peso e da função do sistema nervoso autônomo. Conclusões: A fisioterapia motora pode contribuir para o desenvolvimento e conforto dos RNPT sem trazer riscos. No entanto, esta revisão foi limitada pela qualidade dos dados existentes e reduzido número de estudos avaliados.

Introduction: Preterm infants are more vulnerable to adverse outcomes resulting from their own immaturity and hospitalization. Thus, it is important to investigate the clinical implications and benefits of physical therapy in this population. Objective: To develop a systematic review to investigate the clinical implications and potential benefits of physical therapy in premature newborns hospitalized in the intensive care unit. Methods: Lilacs, Pubmed and Scopus databases were consulted. Two independent reviewers performed the selection of eligible studies and risk of bias assessment. Results: Four studies were included in the review. Physical therapy was considered safe, and it was possible to observe reducing pain, improvement in sleep quality, weight gain and autonomic nervous system function. Conclusion: Physical Therapy may contribute to the development and comfort of premature newborns without harms. Nevertheless, this review was limited by the existing data and by the small number of studies assessed.

Validity and applicability of a video-based animated tool to assess mobility in elderly Latin American populations.

AIM: To assess the reliability and the validity of Portuguese- and Spanish-translated versions of the video-based short-form Mobility Assessment Tool in assessing self-reported mobility, and to provide evidence for the applicability of these videos in elderly Latin American populations as a complement to physical performance measures. METHODS: The sample consisted of 300 elderly participants (150 from Brazil, 150 from Colombia) recruited at neighborhood social centers. Mobility was assessed with the Mobility Assessment Tool, and compared with the Short Physical Performance Battery score and self-reported functional limitations. Reliability was calculated using intraclass correlation coefficients. Multiple linear regression analyses were used to assess associations among mobility assessment tools and health, and sociodemographic variables. RESULTS: A significant gradient of increasing Mobility Assessment Tool score with better physical function was observed for both self-reported and objective measures, and in each city. Associations between self-reported mobility and health were strong, and significant. Mobility Assessment Tool scores were lower in women at both sites. Intraclass correlation coefficients of the Mobility Assessment Tool were 0.94 (95% confidence interval 0.90-0.97) in Brazil and 0.81 (95% confidence interval 0.66-0.91) in Colombia. Mobility Assessment Tool scores were lower in Manizales than in Natal after adjustment by Short Physical Performance Battery, self-rated health and sex. CONCLUSIONS: These results provide evidence for high reliability and good validity of the Mobility Assessment Tool in its Spanish and Portuguese versions used in Latin American populations. In addition, the Mobility Assessment Tool can detect mobility differences related to environmental features that cannot be captured by objective performance measures.

A velocidade da marcha pode identificar idosos com medo de cair? / Can the gait speed identify elderly with fear of falling?

OBJETIVO: Este estudo teve como propósito analisar a capacidade da velocidade da marcha em identificar idosos com medo de cair. METODOLOGIA: Trata-se de estudo transversal analítico, realizado com amostra de 60 idosos da comunidade. Os dados foram obtidos por meio de questionário estruturado, análise da velocidade da marcha para percorrer a distância de 4,6 m e do medo de cair, avaliado pela escala de Autoeficácia de Quedas. A capacidade da velocidade da marcha em identificar idosos com medo de cair foi determinada por meio de regressão linear múltipla, com nível de significância p<0,05 e IC 95%. RESULTADOS: Em relação à velocidade da marcha, a média foi de 0,71 (± 0,21) m/s, enquanto que para a escala de Autoeficácia de Quedas a média do escore foi de 24,85 (± 6,68). Na análise de regressão linear múltipla, o escore total da escala de Autoeficácia de Quedas permaneceu significativamente associado (R²= 0,35) com a depressão autorrelatada, a limitação funcional para atividades básicas da vida diária e a velocidade da marcha. CONCLUSÃO: A velocidade da marcha, além da depressão autorrelatada e limitação funcional para atividades básicas da vida diária, têm capacidade de identificar idosos com medo de cair. Desta forma, a investigação das condições de saúde nessa população pode ser útil para detectar o medo de cair e identificar que cuidados e intervenções seriam prioritários para melhorar a funcionalidade e qualidade de vida desses idosos.

OBJECTIVE: This paper aimed to analyze the predictive ability of gait speed in identifying elderly with fear of falling. METHODS: This is a cross-sectional analytical study conducted with a sample of 60 community elders. Data were collected through structured questionnaire, analysis of gait speed to walk a distance of 4.6 m and the fear of falling, which was assessed by the Falls Efficacy Scale. The predictive ability of the gait speed was determined by multiple linear regression, with significance level p <0.05 and CI 95%. RESULTS: In relation to gait speed, the average was 0.71 (± 0.21) m / s, while for scale of self-efficacy of falls the average score was 24.85 (± 6.68). In multiple linear regression analysis, the total score of the Falls Efficacy Scale remained significantly associated (R² = 0.35) with self-reported depression, functional limitation for basic activities of daily living and gait speed. CONCLUSION: The gait speed beyond depression and self-reported functional limitation in basic activities of daily living, are able to identify elderly people with fear of falling. Thus, the investigation of the health in this population could be useful to detect the fear of falling, and identify what precautions are priority interventions to improve the functionality and quality of life of elderly people.