Allostatic load and stress biomarkers in a sample of community-dwelling older adults.

BACKGROUND: The idea that cumulative levels of stress can have deleterious effects on health and longevity has led investigators to discuss individual differences in the accumulation of Allostatic Load (AL) during life. Our aim was to evaluate the AL indices and stress biomarkers between genders and to determine which factors were more associated with AL indices. METHODS: We evaluated 256 subjects, including 88 men and 168 women, aged 65 years or more. AL was measured by 10 biomarkers, including systolic and diastolic blood pressure, waist-hip ratio, glycosylated hemoglobin, salivary cortisol, salivary dehydroepiandrosterone sulphate, urinary epinephrine and norepinephrine, total cholesterol and total cholesterol/HDL. Sociodemographic and clinical characteristics, cognitive function and physical functional variables were additionally analyzed. RESULTS: The mean age of the participants was 74.1 ± 6.7 years. The AL index was 2.30 ± 1.68, without a significant difference between gender. The final linear regression model controlling for gender, age, years of study and living arrangement showed that AL was associated to a number of chronic conditions (ß = 0.24; 95 % CI: 0.08-0.40), mobility disability (ß = 0.58; 95 % CI: 0.06-1.14), and handgrip strength (ß = 0.06; 95 % CI: 0.06-1.14). CONCLUSION: As a result of this investigation, Allostatic load was shown to be associated with poor health or physical function for community-dwelling older adults.

Depressive symptoms and functional decline in an elderly sample of urban center in Northeastern Brazil.

OBJECTIVE: To examine the association between depressive symptoms and functional status in elderly people living in an urban center in northeastern Brazil. METHODS: In this cross-sectional, observational, analytic study, 313 community-dwelling elderly (age≥65 years) individuals of both sexes who resided in Natal, Rio Grande do Norte, were evaluated. The Brazilian version of the Center for Epidemiologic Studies Depression Scale was used to screen for depressive symptoms. Physical performance was assessed using the Short Physical Performance Battery. A multivariate linear regression model adjusted for clinical and socioeconomic variables was used to analyze the association between depressive symptoms and functional performance. RESULTS: Our findings showed that the presence of depressive symptoms influenced functional performance, even when analyses controlled for variables such as age, sex, poor perceived health, cognitive status, and body mass index (BMI). CONCLUSION: The results of this study reinforce the association between depressive symptoms and functional performance in an elderly population in an urban center in northeastern Brazil. These findings provide useful information for the identification of potential targets for research and therapeutic interventions aimed at preventing a decline in mobility in elderly individuals.

Efeitos do treinamento de dupla tarefa no controle do equilíbrio dinâmico e estático de idosas pré-frágeis: um estudo piloto / Effects of a dual-task training on dynamic and static balance control of pre-frail elderly: a pilot study

Introdução: Este estudo quase-experimental justificou-se pela necessidade de determinar os efeitos de uma estratégia de intervenção que vise melhorar o equilíbrio em idosas pré-frágeis. A hipótese era que o treinamento em esteira tipo dupla tarefa, comparado a um treinamento simples em esteira, pudesse promover diferença no controle postural do grupo. Objetivos: Este estudo teve como objetivo verificar as medidas de controle postural em um grupo de idosos pré-frágeis após um programa de intervenção fisioterapêutica com base no treinamento em esteira tipo dupla tarefa. Materiais e métodos: Foram selecionados seis idosos pré-frágeis, do sexo feminino, residentes em comunidade. A pesquisa foi realizada duas vezes por semana por 45 minutos, durante quatro semanas. A intervenção na condição de tarefa simples consistiu no treino em esteira, enquanto a condição de dupla tarefa consistiu em treino em esteira associado a estímulos visuais. Apenas o grupo de intervenção foi submetido ao treino tipo de dupla tarefa. Resultados: Os grupos apresentaram melhoras nas variáveis de equilíbrio em diferentes tarefas, especialmente naquelas do equilíbrio estático. Ambos os grupos apresentaram as mudanças mais notáveis nas variáveis relacionadas à marcha.As variáveis de Berg e as baropodométrica mostraram que o grupo experimental manteve todos os valores similares ou melhores, mesmo um mês após a conclusão do treinamento, ao contrário do grupo controle.Conclusões: O desempenho da dupla tarefa não teve nenhum valor adicional em relação à melhora do equilíbrio em geral, porém observamos que a eficácia da estimulação visual tende a ocorrer na manutenção do equilíbrio das variáveis de curto prazo

INTRODUCTION: This quasi-experimental study is justified by the need to determine the effects of an intervention strategy aimed at improving the static and dynamic balance in pre-frail elderly women. We hypothesized that dual-task training on a treadmill, compared to simple training on a treadmill,may promote statistical difference in postural control of this group. OBJECTIVES: This study aimed to verify the measures of postural control in a group of pre-frail elderly after a physical therapy intervention program based on dual-task treadmill training.MATERIALS AND METHODS: We selected six female pre-frail elderly subjects living in the community. The research was conducted twice a week for 45 minutes, for four weeks. The simple task training consisted only in the use of a treadmill and the dual-task training consisted on the use of a treadmill associated with visual stimuli. Only the intervention group was submitted to the dual-task training. RESULTS: Groups showed improvements in the variables of balance in different tasks, especially on static balance. Both groups showed the most notable changes in the variables related to gait. The BBS scores and the baropodometric variables showed that the experimental group could keep all values similar or better even one month after completion of training, unlike the control group.CONCLUSION: The dual-task performance had no additional value in relation to the improvement of balance in general, but we observed that the effectiveness of visual stimulation seems to occur in the maintenance of short-term balance variables.

Translation, cultural adaptation and psychometric evaluation of the Leganés cognitive test in a low educated elderly Brazilian population.

OBJECTIVE: To validate the Leganés cognitive test (LCT) for cognitive screening in low educated elderly Brazilians. METHODS: The study sample was composed of 59 elderly residents from the city of Santa Cruz, in Brazil, with low schooling levels. Reliability was analyzed with a two-day interval between assessments, and concurrent validity was assessed using the Mini Mental State Examination (MMSE). RESULTS: According to the LCT, the prevalence of dementia was 11.8%. The scale items showed a moderate to strong correlation between domains (p<0.01), and inter-rater reliability exhibited ICC=0.81, 95%CI=0.72-0.88. The factor analysis resulted in two factors: memory and orientation. Interscale agreement was considered poor (k=-0.02), supporting the hypothesis of an educational impact on final MMSE scores. CONCLUSION: The results suggest that LCT has acceptable levels of reliability for use in low-educated Brazilian elderly.

Translation, cultural adaptation and psychometric evaluation of the Leganés cognitive test in a low educated elderly Brazilian population / Tradução, adaptação cultural e avaliação psicométrica da prova cognitiva de Leganés em uma população idosa brasileira com baixo nível educacional

OBJECTIVE: To validate the Leganés cognitive test (LCT) for cognitive screening in low educated elderly Brazilians. METHODS: The study sample was composed of 59 elderly residents from the city of Santa Cruz, in Brazil, with low schooling levels. Reliability was analyzed with a two-day interval between assessments, and concurrent validity was assessed using the Mini Mental State Examination (MMSE). RESULTS: According to the LCT, the prevalence of dementia was 11.8 percent. The scale items showed a moderate to strong correlation between domains (p<0.01), and inter-rater reliability exhibited ICC=0.81, 95 percentCI=0.72-0.88. The factor analysis resulted in two factors: memory and orientation. Interscale agreement was considered poor (k=-0.02), supporting the hypothesis of an educational impact on final MMSE scores. CONCLUSION: The results suggest that LCT has acceptable levels of reliability for use in low-educated Brazilian elderly.

OBJETIVO: Validar a prova cognitiva de Leganés (PCL) para rastreio cognitivo em população idosa brasileira com baixa escolaridade. MÉTODOS: A amostra foi composta por 59 idosos residentes no município de Santa Cruz, no Rio Grande do Norte. A confiabilidade foi analisada com intervalo de dois dias entre as avaliações; a validade concorrente foi feita utilizando o Mini-Exame do Estado Mental (MEEM). RESULTADOS: De acordo com a PCL, a prevalência de demência foi de 11,8 por cento. Os itens da escala mostraram correlações de moderada à forte entre os domínios (p<0,01). A confiabilidade intraexaminador foi considerada boa, com ICC=0,81, CI95 por cento=0,72-0,88. A análise fatorial mostrou dois domínios distintos: memória e orientação. A concordância entre a PCL e o MEEM foi considerada ruim (k=-0,02), reforçando a hipótese da influência educacional no escore do MEEM. CONCLUSÃO: A PCL apresenta boa confiabilidade para uso em população idosa brasileira com baixo nível de escolaridade.