Risk and protective factors for cognitive decline in Brazilian lower educated older adults: A 15-year follow-up study using group-based trajectory modelling.

BACKGROUND: Patterns of cognitive change and modifiable factors for cognitive decline versus stable cognitive trajectories have rarely been described in lower-educated older adults. OBJECTIVES: We aimed to identify long-term trajectories of cognitive functioning and possible factors associated with cognitive decline. DESIGN AND PARTICIPANTS: We used data from 1,042 adults aged ≥ 60 participating in the Health, Welfare and Aging Study (SABE), São Paulo, Brazil, without cognitive impairment at baseline. Data were collected across four waves (2000-2015). Group-based trajectory modelling was used to identify cognitive trajectories. Associations with socioeconomic variables, childhood background, lifestyle, and cardiovascular risk factors were explored using weighted multinomial logistic regressions. MEASUREMENTS: The abbreviated Mini-Mental State Examination was used to measure cognition. RESULTS: Three cognitive trajectories were identified: stable (n= 754, 68.6%), mild-decline (n= 183, 20.8%), and strong-decline (n= 105, 10.7%). At baseline, respondents in the strong-decline group were more likely to be older than those with stable and mild-decline trajectories. Furthermore, participants in both the mild and strong-decline groups were more likely to have no schooling, be divorced/separated, receive less than 4 monthly wages, and be underweight (BMI < 18.5) compared to the stable group. Finally, the mild-decline group was more likely to have lived in rural areas during childhood than participants located in a stable trajectory. CONCLUSIONS: Our findings suggest that interventions to reduce cognitive decline for low-educated older adults might include strategies addressing inequalities and improving modifiable risk factor burden.

Assessing the Risk Stratification of Breast Cancer Polygenic Risk Scores in a Brazilian Cohort.

Polygenic risk scores (PRSs) for breast cancer have a clear clinical utility in risk prediction. PRS transferability across populations and ancestry groups is hampered by population-specific factors, ultimately leading to differences in variant effects, such as linkage disequilibrium and differences in variant frequency (allele frequency differences). Thus, locally sourced population-based phenotypic and genomic data sets are essential to assess the validity of PRSs derived from signals detected across populations. Here, we assess the transferability of a breast cancer PRS composed of 313 risk variants (313-PRS) in a Brazilian trihybrid admixed ancestries (European, African, and Native American) whole-genome sequenced cohort, the Rare Genomes Project. We computed 313-PRS in the Rare Genomes Project (n = 853) using the UK Biobank (UKBB; n = 264,307) as reference. We show that although the Brazilian cohorts have a high European ancestry (EA) component, with allele frequency differences and to a lesser extent linkage disequilibrium patterns similar to those found in EA populations, the 313-PRS distribution is inflated when compared with that of the UKBB, leading to potential overestimation of PRS-based risk if EA is taken as a standard. Interestingly, we find that case controls lead to equivalent predictive power when compared with UKBB-EA samples with area under the receiver operating characteristic curve values of 0.66 to 0.62 compared with 0.63 for UKBB.

Microbiological characterization of kombucha and biocellulose film produced with black tea and cocoa bean shell infusion.

The food industry is increasingly striving to produce probiotics-based food and beverages using sustainable processes. Therefore, the use of by-products in product development has been investigated by several authors. The aim of this work was to investigate the effects of cocoa bean shell infusion in the production of kombucha through microbiological and genetic characterization. Three beverage formulations were prepared, one based on black tea (KBT), one based on cocoa bean shell infusion (KCS) and one containing 50 % black tea and 50 % cocoa shell infusion (KBL). The infusions were prepared with water, filtered, and sucrose was added. They were then homogenized and a portion of finished kombucha and SCOBY (symbiotic culture of bacteria and yeast) were added. Fermentation took place for 13 days and aliquots were collected every three days for physicochemical and microbial count analyses. Samples from the last day of fermentation were sent for DNA sequencing, extraction and quantification. The results were subjected to analysis of variance and compared by using Tukey's test (p < 0.05). The results show that there was a significant decrease in pH over time in all samples, while the titratable acidity increased, indicating an acidification of the beverage due to the production of organic acids. There was an increase in lactic acid bacterial colonies in all the formulations, which have a probiotic nature and are not always found in this type of beverage. Regarding the taxonomic classification of the samples, microorganisms of the kingdoms Fungi and Bacteria, of the families Saccharomycetaceae and Acetobacteraceae, were found in KBT, KCS and KBL, but with different microbiological compositions, with different amounts of yeasts and bacteria. Therefore, the use of by-products such as cocoa bean shell in the production of kombucha can contribute to the reduction of waste in the food industry and, at the same time, accelerate fermentation increasing the presence of lactic acid bacteria when compared to black tea.

Prevalence and incidence of decreased glomerular filtration rate and its variation over 6 years: Cohort study SABE 2010-2016.

The aging process and the rising prevalence of Chronic Noncommunicable Diseases (NCDs) contribute to the decline in kidney function among elderly individuals. The aim of this research was to assess prevalence and incidence of decreased glomerular filtration rate (GFR) (GFR <60mL/min/1.73m2) over six-year period in elderly residents of São Paulo. This study relied on data from 2010 and 2016 waves of the cohort SABE Study - Health, Wellbeing, and Aging, with a probabilistic and representative sample of elderly individuals residing in São Paulo. GFR was calculated using the 2021 Chronic Kidney Disease Epidemiology Collaboration creatinine (CKD-EPI) equation. Categorical variables were analyzed using chi-square test with Rao-Scott correction, and weighted means and standard errors were calculated for continuous variables. Logistic and linear regression models were constructed to analyse the data. Statistical analyses accounted for sample weights to ensure population representativeness. The prevalence of decreased GFR in 2010 was 17.3%, with mean GFR of 75.6 mL/min/1.73m2 (SE = 0.5). The incidence of decreased GFR between 2010 and 2016 was 14.9%, equivalent to an annual incidence of 2.5%. This incidence was associated with older age, hypertension, self-perceived fair/poor/very poor health, and greater number of comorbidities associated. Over the study period, 68.1% of the elderly participants experienced deterioration in GFR, with an average decline of 1 mL/min/1.73m2 each year. Renal function decline often occurs without noticeable symptoms, and the high prevalence of comorbidities contributes to the worsening of GFR. Therefore, monitoring renal function in the elderly is crucial for effectively managing the health of this population.

Role of pharmacist in the management of Hansen's Disease: A scoping review.

Background: Stakeholders and healthcare professionals have an essential role in the elimination of Hansen's Disease. Of these, pharmacists provide core services that assist the management of these patients with the supply of medicines and clinical actions. Objectives: To summarize evidence on the role of pharmacist in the management of Hansen's Disease. Methods: A literature search was performed in MEDLINE, Embase, Scopus, Web of Sciences, LILACS, and Google Scholar for studies published until September 29th, 2022 without language restriction. Studies that reported actions provided by pharmacists in the management of patients with Hansen's Disease were included. The pharmacist interventions identified in the studies were described based on key domains in DEPICT v.2. Two independent reviewers performed study selection and data extraction and any disagreements were resolved by third and fourth authors. Results: A total of 751 records were identified, of which 8 studies fully met the eligibility criteria. Most of them were conducted in Brazil (n = 5), in an ambulatory setting (n = 8) and the most common study design was descriptive cross-sectional (n = 6). Different roles of pharmacists were identified, such as medication review, therapeutic drug monitoring, patient education, drug information, and dispensing. All studies described pharmacist interventions for patients through one-on-one contact and face-to-face. Pharmacists were responsible for patient counseling (n = 8), suggestions for change in therapy (n = 2), and monitoring results report (n = 2). The studies reported benefits associated with pharmacist interventions, despite the limited descriptions regarding these actions. Conclusions: Few studies that described the activities of pharmacists in the management of Hansen's Disease were found. As the studies did not offer a satisfactory level of description and quality, further research should be conducted to strengthen this field.

Social participation and tooth loss, vision, and hearing impairments among older Brazilian adults.

BACKGROUND: Vision and hearing impairments can reduce participation in social activities. Given the prominent role of the mouth in face-to-face interactions, this study evaluated the associations of tooth loss, vision, and hearing impairments with social participation among older adults. METHODS: This analysis included 1947 participants, aged 60+ years, who participated in three waves (2006, 2010, and 2015) of the Health, Wellbeing and Aging Study (SABE) in Brazil. Social participation was measured by the number of formal and informal social activities (requiring face-to-face interaction) participants were regularly involved in. Teeth were counted during clinical examinations and categorized as 0, 1-19, and 20+ teeth. Reports on vision and hearing impairments were classified into three categories (good, regular, and poor). The associations of each impairment with the 9-year change in the social participation score were tested in negative binomial mixed-effects models adjusting for time-variant and time-invariant covariates. RESULTS: Each impairment was associated with the baseline social participation score and the annual rate of change in the social participation score. Participants with 1-19 (incidence rate ratio: 0.96, 95% CI: 0.91-1.01) and no teeth (0.92, 95% CI: 0.87-0.97), those with regular (0.98, 95% CI: 0.95-1.01) and poor vision (0.86, 95% CI: 0.81-0.90), and those with regular (0.94, 95% CI: 0.91-0.98) and poor hearing (0.91, 95% CI: 0.87-0.95) had lower baseline social participation scores than those with 20+ teeth, good vision, and good hearing, respectively. Furthermore, participants with 1-19 (0.996, 95% CI: 0.990-1.002) and no teeth (0.994, 95% CI: 0.987-0.999), those with regular (0.996, 95% CI: 0.992-0.999) and poor vision (0.997, 95% CI: 0.991-1.003), and those with regular (0.997, 95% CI: 0.992-1.001) and poor hearing (0.995, 95% CI: 0.990-0.999) had greater annual declines in the social participation score than those with 20+ teeth, good vision and good hearing, respectively. CONCLUSION: This 9-year longitudinal study shows that tooth loss, vision, and hearing impairments are associated with reduced social participation among older adults.

Head Shape Heritability in the Hungarian Meadow Viper Vipera ursinii rakosiensis.

Understanding heritability patterns in functionally relevant traits is a cornerstone for evaluating their evolutionary potential and their role in local adaptation. In this study, we investigated patterns of heritability in the head shape of the Hungarian meadow viper (Vipera ursinii rakosiensis). To this end, we used geometric morphometric data from 12 families composed of 8 mothers, 6 fathers and 221 offspring, bred in captivity at the Hungarian Meadow Viper Conservation Centre (Hungary). We separately evaluated maternal and paternal contributions to the offspring phenotype, in addition to additive genetic effects, all determined using a mixed animal model. Our results indicate a strong genetic and maternal contribution to head shape variations. In contrast, the paternal effects-which are rarely evaluated in wild-ranging species-as well as residual environmental variance, were minimal. Overall, our results indicate a high evolutionary potential for head shape in the Hungarian meadow viper, which suggests a strong contribution of this ecologically important trait in shaping the ability of this endangered species to adapt to changing conditions and/or habitats. Furthermore, our results suggest that maternal phenotypes should be carefully considered when designing captive breeding parental pairs for reinforcing the adaptive capacity of threatened populations, whereas the paternal phenotypes seem less relevant.

Sexual activity and satisfaction in older adults from a Brazilian cohort study.

Objectives: Although the majority of older adults experience sexual satisfaction regardless of their sexual activity, there are few studies that address sexuality in aging, especially in Latin America. The objective of this study was to assess the prevalence of sexual activity and satisfaction among older adults in two time-points, as well as their sociodemographic and health predictors.Method: We analyze data from 1,464 older adults aged 60 years or over from the Health, Well-Being, and Aging (SABE) cohort study conducted in Brazil. Multivariable regression models were used to determinate the factors associated with sexual activity and sexual satisfaction, stratified by gender. Results: Among older adults, the prevalence of sexual activity was 48%, while the vast majority reported feeling sexually satisfied (80%). Men had more sexual activity than women, while women presented greater sexual satisfaction than men. After the follow-up, older adults that were married were more likely to have sexual activity. In women, being older than 71 years was associated with lower sexual activity. In men, those with mobility problems and depression were less likely to have sexual activity. Regarding sexual satisfaction, having depression remained a leading factor for lower sexual satisfaction in men.Conclusion: Despite beliefs, a high percentage of older adults reported being sexually active and feeling sexually satisfied. Our results highlight the gender difference in the predictors of sexual activity and sexual satisfaction. Since sexuality is important for well-being throughout life, preventing factors that decrease sexual activity and sexual satisfaction in aging could help improve the quality of life of older adults.

Clinical nursing care protocol for convalescent plasma transfusion in patients with COVID-19.

Introduction: The treatment of COVID-19 is still challenge. So convalescent plasma can be an important alternative of treatment. Protocols with nursing care during infusion is very important to guide an effective and safety care. Objective: to analyze the evidence in the literature on the action of convalescent plasma, of the use of protocols with nursing care to use convalescent plasma and build a nursing care protocol for transfusion in patients with COVID-19. Methods: Methodological study carried out in two stages: scoping review. The search was done using the descriptors: convalescent plasma transfusion, convalescent plasma, and acute respiratory syndromes or COVID-19, to found protocols and effectiveness of convalescent plasm. Beside was done a specialist panel to build the protocol. Results: Low-evidence studies have shown improvement in the clinical signs of COVID-19 using Convalescent Plasma, reduction or elimination of viral load, benefits in the production of lymphocytes, decreases C-reactive protein, increases titers of anti-SARS-CoV-2 antibodies, positive evolution in lung involvement identified by X-rays, decrease in hospitalization. No studies were found in the databases on the protocol for clinical nursing care in plasma transfusion. Therefore, a protocol was developed with the description of clinical nursing care to be performed before, during and after the transfusion by plasma: checking of vital signs and indicative signs of transfusion reaction, measurement of oxygen saturation, assessment of venous access and checking of the level of consciousness. Conclusion: There are no evidence studies to support the use of plasma, nor anything related to bundles.

Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people.

BACKGROUND: Few studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences. OBJECTIVE: To evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil. METHODS: This is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%. RESULTS: The sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11-25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46-177.06) among those from São Paulo. CONCLUSION: The results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.

Higher hemoglobin levels are associated with better physical performance among older adults without anemia: a longitudinal analysis.

BACKGROUND: Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia. METHODS: The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015-2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,023 who had complete data and did not have anemia in 2010. In the follow-up, there were 567 without anemia. RESULTS: In analyses adjusted for age, education, comorbidities, body mass index, and physical inactivity, we found a differential association between hemoglobin concentration and SBBP by sex, with a positive interaction (ß Hb*female= 0.20, 95% CI 0.04,0.37). At lower levels of hemoglobin, women have lower levels of SPPB than men, but at higher levels of hemoglobin concentration, there are no sex differences in physical performance. In addition, higher age was negatively associated with SPPB levels and cardiometabolic diseases, other diseases, and physical inactivity. Education was positively associated with physical performance. CONCLUSION: Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older adults without anemia in Brazil. However, there were sex differences in this association. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia, and highlights sex differences.

Psychosocial aspects and support networks associated with disability in two longevous populations in Brazil: a cross-sectional study.

BACKGROUND: Among the oldest old, aged 80 years and over, the prevalence of disability is higher than in other age groups and can be considered a predictor of mortality. OBJECTIVE: To evaluate how psychosocial aspects and support networks influence the disability of these oldest-old individuals, performing a comparison between two longevous populations, one living in one of the poorest regions of Brazil, in the backlands of Paraíba, and another living in one of the largest urban centres in Latin America. METHOD: A cross-sectional study in which 417 oldest-old persons aged 80 years and older were interviewed, with data collected through the "Health, Welfare and Ageing" survey conducted in two Brazilian cities. Disability was assessed by reporting the need for assistance in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Bivariate and multiple analyses were performed using R statistical software. RESULTS: Food insufficiency in the first years of life had negative repercussions on the disability of oldest old people living in the northeast. On the other hand, in this region, older people have a higher rate of support and live longer with their peers, which may contribute to reducing feelings of loneliness, depressive symptoms, and worse self-perception of health. In the Southeast, financial constraints, subjective poverty, and unmet needs may favour the development of functional limitations between long-lived people. CONCLUSION: Our findings indicate that regional differences in Brazil may influence the disability of older people aged 80 and older. In northeast Brazil, having no partner may contribute to disability for ADLs and IADLs; while, in the longevous population of São Paulo, having a worse self-rated health may contribute to disability for IADLs.

Effect of education and multimorbidity on mortality among older adults: findings from the health, well-being and ageing cohort study (SABE).

OBJECTIVES: This study assessed the moderating role of education on the relationship between multimorbidity and mortality among older adults in Brazil. STUDY DESIGN: This was a cohort study. METHODS: This study used data from 1768 participants of the Health, Well-Being and Ageing Cohort Study (SABE) who were assessed between 2006 and 2015. The Cox Proportional Risks Model was used to evaluate the association between multimorbidity (two or more chronic diseases) and mortality. An interaction term between education and multimorbidity was included to test the moderating role of education in this association. RESULTS: The average follow-up time was 4.5 years, with a total of 589 deaths in the period. Multimorbidity increased the risk of mortality (hazard ratio [HR] 1.55, 95% confidence interval [CI] 1.27-1.91), and this association was not moderated by education (HR 1.06, 95% CI 1.00-1.13; P value = 0.07). CONCLUSIONS: The impact of education and multimorbidity on mortality emphasises the need for an integrated approach directed towards the social determinants of health to prevent multimorbidity and its burden among older adults.

Changes in prevalence of cognitive impairment and associated risk factors 2000-2015 in São Paulo, Brazil.

INTRODUCTION: Decreases in prevalence of cognitive impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. This study aimed to assess the cognitive impairment prevalence and explore associated factors among subjects aged >60 living in São Paulo, Brazil. METHOD: Data came from a population-based Health, Welfare and Aging survey conducted in 2000, 2006, 2010, and 2015. Cognitive impairment was detected using the abbreviated Mini-Mental State Exam corrected by formal education years. In total, there were 5922 respondents in the statistical analyses. RESULTS: Logistic regression models adjusted for age group, income, race, cardiovascular risk factors, and depression were used to estimate cognitive impairment prevalence. Between 2015 and 2000, respondents were more likely to report formal education, hypertension, diabetes, and overweight/obesity. Moreover, the weighted analyses showed that cognitive impairment prevalence was higher in 2015, even adjusting for sociodemographic and socioeconomic characteristics, cardiovascular risk factors, and depression. CONCLUSION: In contrast to decreases in cognitive impairment prevalence in other countries and despite increases in educational years, our findings suggest no secular improvements in cognitive health for the 2015 wave of older adults residing in São Paulo.

Tooth loss, dental prostheses use and cognitive performance in older Brazilian adults: The SABE cohort study.

AIM: To investigate the within- and between-person longitudinal effects of tooth loss and the use of dentures, clinically assessed by dentists, on cognitive decline in a representative sample of community-dwelling older Brazilian adults. METHODS: Data came from 1265, 1112 and 1021 individuals aged ≥60 years who participated in the second (2006), third (2010) and fourth (2015) waves, respectively, of the Health, Well-being and Aging study (SABE). Cognitive performance was evaluated with the abbreviated version of the Mini-Mental State Examination (MMSE). The number of natural teeth was classified according to three categories: none, 1-19 and ≥20 teeth. The presence of removable full or partial dentures in each dental arch (yes/no) was recorded. Hybrid regression models, adjusted for sociodemographic, behavior and health-related covariates, were used to estimate the between- and within-person effects of the longitudinal association between cognitive performance and oral health. RESULTS: Participants with 1-19 and no teeth had, respectively, 1.15 (95% CI 0.65-1.66) and 1.54 (95% CI 0.99-2.09) units lower MMSE score than those with ≥20 teeth. Denture wearers had 1.54 (95% CI 1.13-1.95) units greater MMSE score than non-denture wearers, and those who started wearing dentures during the follow up had 0.83 (95% CI 0.21-1.45) units greater MMSE score after the transition. CONCLUSION: Our main findings showed that the use of dental prostheses might be a protective factor for cognitive decline. Geriatr Gerontol Int 2021; 21: 1093-1098.

Synergic effects of ultrasound and laser therapies on mesentery for management of obesity and diabetes in rats.

Nowadays, the mesentery as a new organ was discovered. Mesenteric events may play an important role in the pathophysiology of several diseases. The aim of our study was investigate the synergic effects of ultrasound (US) and laser therapies on mesentery in obese-hyperglycemic rats. The 25 male Wistar rats were randomized into five groups. Obese nondiabetic (OND) group: obese rats without diabetes and no treatment conditions; SHAM group: obese-hyperglycemic rats treated with placebo; US group: obese-hyperglycemic rats treated with US; LASER group: obese-hyperglycemic rats treated with laser and; US+LASER group: obese-hyperglycemic rats treated with US plus laser. An animal model of type 2 diabetes based on a hyperlipidemic diet combined with a low dose of streptozotocin was used in this study. Body mass and biochemical measurements were performed. GOT and GPT level showed a significant reduction in the treated groups than SHAM. The total cholesterol, triglycerides and very low-density lipoprotein (VLDL) levels showed significantly lower values for the US+LASER group. There was also reduced risk of cardiovascular diseases evidenced by Castelli index in the treated groups than SHAM. This study showed that the US and laser treatment on mesentery resulted to an improvement in biochemical measurements of the obese-hyperglycemic rats, especially the total cholesterol, triglycerides and VLDL levels.

Selenium status and oxidative stress in obese: Influence of adiposity.

BACKGROUND: Selenium deficiency appears to limit antioxidant defense in obese individuals. This study evaluated the association between adiposity indices, selenium status, and oxidative stress in obese women. METHODS: This was a cross-sectional study involving 139 women who were divided into the following two groups: the case group (obese women, n = 63) and the control group (normal-weight women, n = 76). Plasma, erythrocyte, and urinary selenium levels were determined using inductively coupled plasma optical emission spectrometry. Body weight, height, waist circumference, hip circumference and neck circumference were measured. Body mass index, waist/height ratio, conicity index, body fat index, body adiposity index, body circularity index, and visceral adiposity index were calculated. Plasma levels of thiobarbituric acid reactive substances were determined. The erythrocyte glutathione peroxidase activity was determined using an automatic biochemical analyzer and Ransel kit. RESULTS: Obese women had selenium deficiency characterized by reduction in plasma and erythrocyte concentrations (P < .001). The urinary selenium excretion was higher in the case group compared to the control group (P < .001). Adiposity indices values and plasma concentrations of thiobarbituric acid reactive substances were significantly elevated in obese women (P < .001). There was a significant association between adiposity indices and selenium status (P < .001), and between erythrocyte selenium and erythrocyte glutathione peroxidase activity (P < .001). CONCLUSION: Obese women evaluated in the study have reduced plasma and erythrocyte concentrations of selenium and an increased urinary excretion of selenium. The correlation analysis reveals an association between intra-abdominal fat accumulation and selenium metabolism and oxidative stress.

Depression and frailty in older adults: A population-based cohort study.

BACKGROUND: Studies have shown an association between depression and frailty, even though the literature has not reached a consensus regarding how these syndromes interact. Although prospective cohort studies on this topic are still scarce, they could contribute to understanding this relationship. We aimed to observe whether depressive symptoms are risk factors for the onset of frailty among older adults living in São Paulo, Brazil. METHODS: Prospective cohort study using the "Health, Well-being and Aging" (SABE) Study databases of 2006 and 2010. The sample was representative of the community-dwelling older adults living in São Paulo, and it is composed of non-frail men and women aged 60 years and older without cognitive decline. We calculated the frailty incidence rate between older adults with and without depressive symptoms and calculated the incidence rate ratio. Multiple analysis was carried out through Poisson regression with robust variance estimation. RESULTS: The initial sample (n = 1,109) presented a mean age of 72 years (from 60 to 96) and 61.1% were women. The final sample was composed of 830 individuals, and the mean follow-up time in the study was 3.8 years. After adjusting the model, depressive symptoms did not predict the onset of frailty at follow-up. CONCLUSION: Depressive symptoms were not shown to be a risk factor for frailty among older adults living in São Paulo in this study.

Prevalence and factors associated to physical inactivity in elderly brazilians evaluated by accelerometry: evidence from the sabe study / Prevalência e fatores associados à inatividade física em idosos brasileiros avaliados pela acelerometria: evidências do estudo sabe

Background: Population studies using accelerometers to estimate physical inactivity in older people have been carried out in developed countries. In Brazil, these studies are limited to subjective measures. Objective: to identify through an accelerometer the prevalence and factors associated with physical inactivity in older people residents in São Paulo, Brazil. Methods: This is a cross-sectional population-base study conducted with 543 older people individuals (mean 73.8 years) using data from the SABE study (Health, Welfare and Ageing). The level of physical activity was measured using accelerometers, and the participants categorized into inactive with <30 minutes of moderate and/or vigorous activity daily; and active with > 30 minutes moderate and/or vigorous activity daily. The independent variables were sociodemographic, anthropometric, clinical, and lifestyle. The association of the dependent variable with the independent variables was conducted using multiple regression analysis. Results: Of the older people evaluated, 85.4% were physically inactive (men = 74.3% and women = 91.9%). Older people aged >75 years (OR=4.67 [1.87 to 11.66]), women (OR=2.26 [1.15 to 4.44]), with high waist circumference (OR=2.93 [1.41 to 6.12]), high number of comorbidities (OR=2.27 [1.22 to 4.23]), and chronic pain (OR=2.54 [1.32 to 4.88]) were associated independently with physical inactivity. Conclusion: The prevalence of physical inactivity in older people individuals aged 65 or over is appalling and associated with sociodemographic, anthropometric, and clinical variables.(AU)

Estudos populacionais utilizando acelerômetros para estimar a inatividade física em idosos têm sido realizados em países desenvolvidos. No Brasil, esses estudos se limitam a medidas subjetivas. Objetivo: identificar por meio de um acelerômetro a prevalência e os fatores associados à inatividade física em idosos residentes em São Paulo, Brasil. Métodos: Trata-se de um estudo transversal de base populacional realizado com 543 idosos (média de 73,8 anos) a partir dos dados do estudo SABE (Saúde, Bem-Estar e Envelhecimento). O nível de atividade física foi medido por meio de acelerômetros, e os participantes categorizados em inativos com <30 minutos de atividade moderada e / ou vigorosa diariamente; e ativo com> 30 minutos de atividade moderada e / ou vigorosa diariamente. As variáveis independentes foram sociodemográficas, antropométricas, clínicas e estilo de vida. A associação da variável dependente com as variáveis independentes foi realizada por meio de análise de regressão múltipla. Resultados: Dos idosos avaliados, 85,4% eram inativos fisicamente (homens = 74,3% e mulheres = 91,9%). Idosos com idade> 75 anos (OR = 4,67 [1,87 a 11,66]), mulheres (OR = 2,26 [1,15 a 4,44]), com circunferência da cintura elevada (OR = 2,93 [1,41 a 6,12]), elevado número de comorbidades (OR = 2,27 [1,22 a 4,23]) e dor crônica (OR = 2,54 [1,32 a 4,88]) foram associados de forma independente à inatividade física. Conclusão: A prevalência de inatividade física em idosos com 65 anos ou mais é preocupante e está associada a variáveis sociodemográficas, antropométricas e clínicas.(AU)

Selenium Nutritional Status and Glutathione Peroxidase Activity and Its Relationship with Hemodialysis Time in Individuals Living in a Brazilian Region with Selenium-Rich Soil.

Suboptimal selenium status may impair the antioxidant defense system in patients undergoing hemodialysis, compromising the selenoenzyme glutathione peroxidase activity. To evaluate the association between the duration of hemodialysis, nutritional selenium status, glutathione peroxidase activity (GPx), and thiobarbituric acid reactive substance (TBARS) levels in patients with chronic renal failure undergoing hemodialysis in a region of selenium-rich soils (Ceará, Northeast Brazil). The case-control study of 75 individuals aged 18 to 88 years was allocated between two groups: hemodialysis (n = 41) and control (n = 34). Plasma and erythrocytes selenium levels were determined by inductively coupled plasma optical emission spectrometry. The GPx activity and TBARS levels were also evaluated. In addition, the hemodialysis group was stratified according to the duration of treatment (≤ 59 months and ≥ 60 months). The Mann-Whitney test, Student's t test, and Pearson's or Spearman's correlation were applied according to the data distribution. Moreover, a quantile regression was performed. The significance level (p) was < 0.05. The hemodialysis group had lower selenium levels in their plasma and erythrocytes than the control group (p < 0.001). However, there was no difference in the GPx activity between the groups. Furthermore, an association between the hemodialysis group and selenium levels in plasma (coefficient - 16,343, p < 0.001) and erythrocytes (coefficient - 7839, p = 0.003) was observed by quantile regression, independent of age, sex, and body-mass index. In individuals who had undergone treatment for 60 months or more, GPx activity was lower (p = 0.026) and TBARS levels higher (p = 0.011) than in those who had undergone treatment for less than 60 months. The status of selenium was reduced in the hemodialysis group compared to the control group. The lower GPx activity and higher levels of TBARS in individuals who had undergone treatment for 60 months or more correlated with greater oxidative stress.