Risk of sarcopenia and mobility of older adults during the COVID-19 pandemic: the longitudinal data from the REMOBILIZE study.

BACKGROUND: We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS: We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS: Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION: Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.

Impact of the COVID-19 Pandemic on the Time of Utilitarian Walking and Walking as Exercise Among Brazilian Community-Dwelling Older Adults: The REMOBILIZE Study.

This study aimed to investigate behavioral changes related to utilitarian walking and walking as exercise among Brazilian older adults before and during the COVID-19 pandemic. Baseline data from the longitudinal REMOBILIZE study were used. The survey was online and comprised 1,482 adults aged 60 years and older. The outcome was the hours per week of walking time (for utilitarian purposes, as exercise, and total), estimated by the frequency and duration and analyzed by average and rate of decrease, comparing pre- and during the pandemic. Total walking time was used to estimate transition patterns between levels of walking intensity. A moderate reduction of 1.76 hr per week in the total walking time was observed, and 28.1% of the participants' walking transition patterns were from more to less physically active. Our findings demonstrate the need for gender-specific interventions and policies to increase the walking levels among older adults after the COVID-19 pandemic period.

Impact of COVID-19 Pandemic on Life-Space Mobility of Older Adults Living in Brazil: REMOBILIZE Study.

Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people. Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility. Design: Baseline data from a prospective cohort study (REMOBILIZE Study). Setting: Community. Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil. Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score. Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income. Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.

Inflammatory markers associated with fall recurrence and severity: The Bambuí Cohort Study of Aging.

BACKGROUND: The aim of this study was to analyze the association between inflammatory markers and recurrent and severe falls in 1304 community-dwelling older adults from the Bambuí Cohort Study of Aging. METHODS: Information about falls in the previous 12 months was collected, and classified based on recurrence (two or more falls) and severity (requirement of medical attention). The screened biomarkers included interleukins (IL-1ß, IL-6, IL-10, and IL-12, TNF), chemokines (CXCL8, CXCL9, CXCL10, CCL2, and CCL5), and high-sensitive C-reactive protein (hs-PCR). Potential confounders included sociodemographic, behavioral, and health indicators. Associations were evaluated through logistic regression, using odds ratios (OR) and 95% confidence intervals (95% CI), with Stata 13.1. RESULTS: The prevalence of recurrent and severe falls was 10.7% and 9.0%, respectively. After adjustments, elevated levels of IL-12 (OR: 1.92; 95% CI: 1.09-3.37) and CXCL9 (OR: 1.67; 95% CI: 1.05-2.66) were found to be associated with recurrent falls, while elevated levels of TNF (OR: 1.58; 95% CI: 1.01-2.50), IL-12 (OR: 2.04; 95% CI: 1.13-3.70), CXCL10 (OR: 1.75; 95% CI: 1.04-2.92), and CCL5 (OR: 1.90; 95% CI: 1.18-3.07) were associated with severe falls. CONCLUSIONS: The results highlight a wide range of biomarkers not yet explored in the literature and suggest that inflammation may be an important component of recurrent and severe falls.

Factors associated with the prevalence of sarcopenia and frailty syndrome in elderly university workers.

BACKGROUND: Frailty and sarcopenia are highly prevalent, as a part of geriatric syndrome, among elderly individuals. However, little is known about how these syndromes can affect elderly individuals who continue to work. OBJECTIVE: To estimate the prevalence of sarcopenia and frailty, and their individual and occupational factors among elderly individuals. METHODS: This cross-sectional study included elderly individuals working in a public university in Brazil, who were classified according to their sarcopenia and frailty profiles. They answered a structured questionnaire comprising potential explanatory variables: individual sociodemographic factors, work related factors, and health behaviors. Additionally, they performed a physical performance test. Multinomial logistic regression was used to estimate odds ratios and respective 95% confidence intervals (95% CIs). All analyses were conducted using the Stata 13.0 software, considering a significance of 5%. RESULTS: Respectively, 55.8% and 6.3% of the elderly participants were classified in the Sarcopenia and Severe Sarcopenia groups. Frailty prevalence was 9.4%, with 62.5% classified as Pre-frail. Sarcopenia prevalence was significantly higher among men, and among those living with a partner, with a university degree, exhibiting poor lower limb function, and with multiple work demands. Frailty prevalence was significantly higher among women, and among those living without a partner, having a low educational level, with less work experience, working in an unhealthy/dangerous environment, and whose job was predominantly physical. CONCLUSION: This study identified different potential trigger factors for the development of sarcopenia and frailty. These findings confirm that individual and work factors could explain the incidence of sarcopenia and frailty syndrome.

Virtual reality therapy for rehabilitation of balance in the elderly: a systematic review and META-analysis.

Virtual reality therapy (VRT) has clinical indications in rehabilitation programs for the elderly; however, there is still no consensus on the recovery of body balance. The objective of this review was to summarize the effects of physical therapy interventions with VRT in the rehabilitation of balance in the elderly. The studies were identified via a systematic search in the databases PubMed, SciELO, LILACS and PEDro from 2010 onward. Clinical trials with interventions that involved VRT in the elderly were included in the study and were subjected to methodological quality analysis using the PEDro scale. A random effects meta-analysis of the studies that analyzed balance using the Berg Balance Scale and the Timed Up and Go (TUG) test was performed. Ten articles met the inclusion criteria, which presented variability in relation to the types of interventions used (70%) and the outcomes analyzed (60%). The mean duration of the interventions was 13.90 (± 5.08) weeks, with at least two weekly sessions (± 0.73). There were positive results in relation to improvements in both dynamic and static balance (70% of the studies), mobility (80%), flexibility (30%), gait (20%) and fall prevention (20%). A summary of the meta-analysis showed mean effects on the Berg scale (standardized mean difference [SMD]: -0.848; 95% CI: -1.161; - 0.535) and the TUG test (SMD: 0.894; 95% CI: 0.341; 1.447). Individually, virtual reality is promising in rehabilitation programs for the elderly. The overall measures were sufficient to show beneficial effects of the therapy on balance in the elderly.