Multimorbidity patterns: obesity as the main modifiable risk factor in adult women in Southern Brazil.

Objective: To identify multimorbidity patterns in women in southern Brazil, and its relationship with sociodemographic, lifestyle characteristics, and nutritional status, as well as to explore the main independent risk factor for the identified patterns. Subjects and methods: This is a cross-sectional, population-based study with 1,128 women (20-69 years), southern Brazil. Chronic conditions were identified using the therapeutic and chemical anatomical classification of continuous use of medications. Multimorbidity was assessed as ≥2 or ≥3 chronic conditions to identify dyads and triads. Poisson regression was used to explore risk factors in the different adjustment models. As independent variables evaluated, in addition to sociodemographic characteristics, lifestyle variables were included: consumption of fruits and vegetables, physical activity, alcohol consumption, smoking and nutritional status. Results: Eleven dyads (frequencies between 2.0% and 6.4%) and three triads (frequencies between 1.9% and 2.1%) of morbidities were identified in the study. Aging was related to a higher prevalence of all patterns, and obesity was a risk factor for multimorbidity patterns that contained conditions related to the cardiovascular and metabolic system and mental health. After adjustment, obesity increased the probability of "hypertension + common mental disorders (CMD)" (PR 3.63; 95% CI 1.94-6.78) and "dyslipidemia + CMD" (PR 3.69; 95% CI 1.08-12.65) by more than three times. Conclusion: This study identified common and important diseases in the patterns, associated with a common risk factor, obesity, that must be addressed by public health policies to prevent multimorbidity.

Multimorbidity patterns: obesity as the main modifiable risk factor in adult women in Southern Brazil

ABSTRACT Objective: To identify multimorbidity patterns in women in southern Brazil, and its relationship with sociodemographic, lifestyle characteristics, and nutritional status, as well as to explore the main independent risk factor for the identified patterns. Subjects and methods: This is a cross-sectional, population-based study with 1,128 women (20-69 years), southern Brazil. Chronic conditions were identified using the therapeutic and chemical anatomical classification of continuous use of medications. Multimorbidity was assessed as ≥2 or ≥3 chronic conditions to identify dyads and triads. Poisson regression was used to explore risk factors in the different adjustment models. As independent variables evaluated, in addition to sociodemographic characteristics, lifestyle variables were included: consumption of fruits and vegetables, physical activity, alcohol consumption, smoking and nutritional status. Results: Eleven dyads (frequencies between 2.0% and 6.4%) and three triads (frequencies between 1.9% and 2.1%) of morbidities were identified in the study. Aging was related to a higher prevalence of all patterns, and obesity was a risk factor for multimorbidity patterns that contained conditions related to the cardiovascular and metabolic system and mental health. After adjustment, obesity increased the probability of "hypertension + common mental disorders (CMD)" (PR 3.63; 95% CI 1.94-6.78) and "dyslipidemia + CMD" (PR 3.69; 95% CI 1.08-12.65) by more than three times. Conclusion: This study identified common and important diseases in the patterns, associated with a common risk factor, obesity, that must be addressed by public health policies to prevent multimorbidity.

Dietary pattern as a predictor of multimorbidity patterns: A population-based cross-sectional study with women.

BACKGROUND AND AIMS: Multimorbidity is a common health condition, and the relationship between different patterns of multimorbidity and food consumption through dietary patterns needs to be determined. This study aimed to investigate the association between dietary patterns and multimorbidity patterns in women. METHODS: This population-based cross-sectional study included 1128 women (aged 20-69 years) living in southern Brazil. We identified multimorbidity patterns using principal component analysis, and the main exposure of the study was three dietary patterns, as derived in a previous study: healthy, risk, and Brazilian patterns. Using Poisson regression with robust variance, the scores of multimorbidity patterns (high/low) were evaluated using different adjustment models. RESULTS: Three patterns of multimorbidity were derived: cardiometabolic (dyslipidemia, circulatory disorders, hypertension, diabetes), endocrine-articular (thyroid diseases, osteoporosis/osteopenia, rheumatic diseases), and psychosomatic (chronic pain, common mental disorders, acid-related digestive disorders). In the relationship between the dietary patterns and multimorbidity patterns, after adjustment, it was observed that a greater adherence to the Brazilian dietary pattern was associated with a lower probability of a high score for the cardiometabolic pattern (PR = 0.68; 95% CI: 0.51-0.89) and psychosomatic pattern (PR = 0.63; 95% CI: 0.47-0.84). Greater adherence to the healthy dietary pattern was associated with a higher probability of a high score for the cardiometabolic pattern (PR = 1.69; 95% CI: 1.27-2.25) and endocrine-articular pattern (PR = 2.05; 95% CI: 1.39-3.02). The risk dietary pattern did not demonstrate an association after adjustment was implemented. CONCLUSIONS: This study provides the first evidence of an association between dietary patterns and multimorbidity patterns. Greater adherence to the Brazilian dietary pattern was a protective factor for a high score for the cardiometabolic and psychosomatic pattern in women. Dietary orientation should be considered in guidelines related to multimorbidity, constituting part of the prevention and management strategies for this condition.

Dietary patterns and prevalence of multimorbidity in women in southern Brazil.

OBJECTIVE: This study aimed to investigate the association between dietary patterns and prevalence of multimorbidity in women. METHODS: This population-based cross-sectional study was conducted in 2015 and included 1,128 women aged 20 to 69 years living in the urban area of São Leopoldo municipality, southern Brazil. Multimorbidity was defined as the presence of two or more chronic conditions, among the 26 identified. Poisson regression with robust variance was used to investigate the association between the three dietary patterns (healthy, risk, and Brazilian), using different models adjusted for sociodemographic, behavioral, and nutritional status variables. RESULTS: The results showed differences in the prevalence of adherence to different dietary patterns and multimorbidity across age groups, with a prevalence of multimorbidity and a healthy dietary pattern showing a direct linear trend with age, whereas the risk dietary pattern showed an inverse linear trend with age. The prevalence of the Brazilian dietary pattern remained constant despite differences in age. After adjustment, we found that women with greater adherence to the Brazilian dietary pattern showed a 40% reduction in the prevalence of multimorbidity compared with those with less adherence (prevalence ratio, 0.60; 95% confidence interval, 0.40-0.86). CONCLUSION: The results revealed that the prevalence of multimorbidity was significantly lower in women with greater adherence to the Brazilian dietary pattern and highlight the importance of dietary interventions in early adulthood as a way to prevent multimorbidity in women.

Prevalence of sarcopenia in elderly users of the primary health care system / Prevalencia de la sarcopenia entre los ancianos usuarios del sistema de atención primaria

OBJECTIVE: to identify the prevalence of sarcopenia in elderly primary care users, and the relationship of nutritional status with sarcopenia. MATERIAL AND METHODS: the study was a cross-sectional study with elderly users of the primary health care network. The participants were evaluated for the diagnosis of sarcopenia, which involved calculation of muscle mass, grip strength, and walking speed, as well as sociodemographic, anthropometric and nutritional variables. Nutritional status was evaluated through the body mass index (BMI) and the Mini Nutritional Assessment (MNA) instrument. The study was conduted at eleven family health centers in Marau, Rio Grande do Sul, and included elderly subjects aged 65 years and over (n = 148). RESULTS: of the elderly subjects evaluated, 72.3 % were female; mean age was 73.6 years (SD: 5.5), ranging from 65 to 89 years. The prevalence of sarcopenia was 14.2 %, 47.3 % of the sample had low manual grip strength, and 53.7 % had inadequate walking speed. Regarding BMI, 10.8 % of participants were classified as underweight, and 75 % of these were diagnosed with sarcopenia. Sarcopenia was significantly associated with the oldest age group (p = 0.046) and with higher BMI (p < 0.001). CONCLUSIONS: results show the importance of assessing nutritional status and a potential diagnosis of sarcopenia, mainly since this syndrome is highly associated with inappropriate food intake, which is often impaired among the elderly because of economical and/or physiological reasons

OBJETIVO: identificar la prevalencia de la sarcopenia en personas mayores de atención primaria y la relación entre el estado nutricional y la sarcopenia. MATERIAL Y MÉTODOS: el estudio fue un estudio transversal de usuarios mayores de la red de atención primaria de salud. Los ancianos se evaluaron para ver si tenían diagnóstico de sarcopenia, lo que implica calcular la masa muscular, la fuerza de agarre y la velocidad al caminar, así como variables sociodemográficas, antropométricas y nutricionales. El estado nutricional se evaluó a través del índice de masa corporal (IMC) y el instrumento Mini Evaluación Nutricional (MNA). El estudio se llevó a cabo en once centros de salud familiar de Marau, Rio Grande do Sul, Brasil, y contó con ancianos de 65 o más años de edad (n = 148). RESULTADOS: de los ancianos evaluados, el 72,3 % eran mujeres; la edad media fue de 73,6 años (DE: 5,5) con un rango de 65 a 89 años. La prevalencia de la sarcopenia fue del 14,2 %, el 47,3 % de los ancianos tenían una fuerza de agarre manual baja y el 53,7 % tenían una velocidad de marcha insuficiente. Con respecto al IMC, el 10,8 % de los ancianos se clasificaron como de bajo peso y el 75 % de estos se diagnosticaron de sarcopenia. La sarcopenia se asoció significativamente al grupo de mayor edad (p = 0,046) y al de mayor IMC (p < 0,001). CONCLUSIONES: estos resultados muestran la importancia que tiene evaluar el estado nutricional junto con al posible diagnóstico de sarcopenia, principalmente porque el síndrome está relacionado con la ingesta inapropiada de alimentos, que muchas veces aparece deteriorada en las personas mayores por motivos económicos y/o fisiológicos

Prevalence of sarcopenia in elderly users of the primary health care system.

INTRODUCTION: Objective: to identify the prevalence of sarcopenia in elderly primary care users, and the relationship of nutritional status with sarcopenia. Material and methods: the study was a cross-sectional study with elderly users of the primary health care network. The participants were evaluated for the diagnosis of sarcopenia, which involved calculation of muscle mass, grip strength, and walking speed, as well as sociodemographic, anthropometric and nutritional variables. Nutritional status was evaluated through the body mass index (BMI) and the Mini Nutritional Assessment (MNA) instrument. The study was conduted at eleven family health centers in Marau, Rio Grande do Sul, and included elderly subjects aged 65 years and over (n = 148). Results: of the elderly subjects evaluated, 72.3% were female; mean age was 73.6 years (SD: 5.5), ranging from 65 to 89 years. The prevalence of sarcopenia was 14.2%, 47.3% of the sample had low manual grip strength, and 53.7% had inadequate walking speed. Regarding BMI, 10.8% of participants were classified as underweight, and 75% of these were diagnosed with sarcopenia. Sarcopenia was significantly associated with the oldest age group (p = 0.046) and with higher BMI (p < 0.001). Conclusions: results show the importance of assessing nutritional status and a potential diagnosis of sarcopenia, mainly since this syndrome is highly associated with inappropriate food intake, which is often impaired among the elderly because of economical and/or physiological reasons.

INTRODUCCIÓN: Objetivo: identificar la prevalencia de la sarcopenia en personas mayores de atención primaria y la relación entre el estado nutricional y la sarcopenia. Material y métodos: el estudio fue un estudio transversal de usuarios mayores de la red de atención primaria de salud. Los ancianos se evaluaron para ver si tenían diagnóstico de sarcopenia, lo que implica calcular la masa muscular, la fuerza de agarre y la velocidad al caminar, así como variables sociodemográficas, antropométricas y nutricionales. El estado nutricional se evaluó a través del índice de masa corporal (IMC) y el instrumento Mini Evaluación Nutricional (MNA). El estudio se llevó a cabo en once centros de salud familiar de Marau, Rio Grande do Sul, Brasil, y contó con ancianos de 65 o más años de edad (n = 148). Resultados: de los ancianos evaluados, el 72,3% eran mujeres; la edad media fue de 73,6 años (DE: 5,5) con un rango de 65 a 89 años. La prevalencia de la sarcopenia fue del 14,2%, el 47,3% de los ancianos tenían una fuerza de agarre manual baja y el 53,7% tenían una velocidad de marcha insuficiente. Con respecto al IMC, el 10,8% de los ancianos se clasificaron como de bajo peso y el 75% de estos se diagnosticaron de sarcopenia. La sarcopenia se asoció significativamente al grupo de mayor edad (p = 0,046) y al de mayor IMC (P < 0,001). Conclusiones: estos resultados muestran la importancia que tiene evaluar el estado nutricional junto con al posible diagnóstico de sarcopenia, principalmente porque el síndrome está relacionado con la ingesta inapropiada de alimentos, que muchas veces aparece deteriorada en las personas mayores por motivos económicos y/o fisiológicos.

Perfil sociodemográfico e clínico de idosos usuários das Estratégias de Saúde da Família / Sociodemographic and clinical profile of elderly users of family health strategies

Objetivo: descrever o perfil sociodemográfico e clínico de idosos usuários das Estratégias de Saúde da Família. Método: estudo descritivo, realizado com 148 idosos de 65 ou mais anos. A coleta de dados foi realizada por meio de entrevista individual e a análise dos dados foi descritiva, utilizando as frequências absolutas e relativas e intervalos de confiança de 95%. Resultados: verificou-se que 72,3% são mulheres, brancas, casadas. A idade mediana foi de 73 anos (P25: 69–P75:7). A maior prevalência de doenças crônicas foi de hipertensão (71,6%) e doenças cardiovasculares (36,5%). São obesos 37,8% dos idosos. Conclusão: os profissionais devem planejar ações que visem a melhorar a qualidade de vida e saúde dos idosos. Educação nutricional, atividade física regular e monitoramento do estilo de vida são necessários.

Processo de enfermagem aplicado a idosos com alzheimer que participamdo projeto estratégias de reabilitação / Nursing process applied to elderly with alzheimer’s who participate in the rehabilitation strategies project

Introdução: O aumento da população idosa em todo o mundo exige a capacitação de profissionais para o atendimento nesta área.Metodologia: Este é um estudo qualiquantitativo do tipo exploratório-descritivo realizado através da entrevista e exame físico feito nos idosos. Objetivos: O objetivo geral deste trabalho foi aplicar o processo de enfermagem nos idosos com alzheimer participantes do projeto da UNICRUZ. Os objetivos específicos foram: Realizara avaliação do estado de saúde atual destes idosos; Levantar os principais diagnósticos de enfermagem encontrados; Proporcionar aos sujeitos cuidados de enfermagem integral através da realiazação das prescrições de enfermagem. Resultados: Após a coleta de dados foram levantadas as informações em comum obtidas na entrevista e exame físico que apontam idade média dos sujeitos de 76 anos, 4 idosos têm o diagnóstico de alzheimer há 5 anos; 3 deles são hipertensos; 5 deles têm distúrbios do sono; 3 têm irmãos com alzheimer e todos têm falha de memória e limitação de amplitudede movivento. Dos diagnósticos de enfermagem, pode-se destacar - tensão do papel do cuidador e risco para o trauma. Dentre as principais prescrições de enfermagem estão - estimular cognição e memória, atividade física e participação social. Conclusão: Foi possível aplicar o processo de enfermagem nos idosos e com isso obter um maior conhecimento do estado de saúde deles, descrever os diagnósticos de enfermagem e levantar pontos de intervenção através da prescrição de enfermagem para promover cuidados como o estímulo à participação em grupos e encaminhamento ao odontólogo que poderão auxiliar no tratamento dos indivíduos e previnir complicações, oferecendo-os assistência e orientações de enfermagem e transdiciplinar.

Introduction: The aging population in the world requires the trainingof professionals providing care in this area. Methodology: This qualitative-quantitative study is of the exploratory-descriptive type conducted by interview and physical examination in the elderly Objectives: The aim of this work was to apply the nursing process in the elderly with Alzheimer's UNICRUZ project participants. The specific objectives were to perform the evaluation of current health status of elderly; Raise the main nursing diagnoses found; subjectproviding comprehensive nursing care through nursing realization prescriptions. Results: After data collection, it was raised together the information obtained in the interview and physical examination suggest that the average age of subjects 76 years, has four seniors diagnosed with Alzheimer's five years, three of them are hypertensive, five of them have disorders sleep, have three siblings with Alzheimer's and all have memory impairment and limitation of range of movivento. Of nursing diagnoses, can be ighlighted - the role of caregiver stress and risk for trauma. The main requirements are nursing - stimulate cognition and memory, physical activity and social participation. Conclusion: It was possible to apply the nursing process in the elderly and therefore gain a greater understanding of their health status, describing nursing diagnoses and raise points of intervention through the prescription of nursing care and to promote the stimulation of participation in groups and referral to a dentist that can help treat and prevent complications of individuals, offering them assistance and guidance to nursing and transdisciplinary.

Relatos de experiências: (com) vivência com idosos que apresentam alzheimer / Experiences reports: living with elderly people who present alzheimer

Este artigo trata do relato de um projeto de extensão que apresentacomo objetivo oferecer aos idosos com Alzheimer atividadesfísicas, fisioterápicas e arteterapia. Oportunizam-se aos cuidadoresatividades de apoio psicossocial. O projeto acontece há um ano eos resultados mostram o quanto é importante para os idosos, emboraa maioria desses já esteja na segunda fase da doença, poisas atividades oferecidas colaboram para a sua socialização, paramanutenção da sua capacidade funcional e percepções de sentimentos,afetos e lembranças. Aos cuidadores serve como apoiopara o enfrentamento desse momento difícil e pesaroso das suasvidas. Neste trabalho relatam-se resultados da experiência somentecom os idosos que apresentam diagnóstico possível e provável deAlzheimer.

This article treats about the report of an extention Project that showsas a purpose to give to the elderly people physical, physiotherapyand art-therapy activities. It has been given pychosocial support tothe people who are responsible for taking care of them. The projecthas been happening for one year and the results show how much itis important to the elderly people, although most of them are alreadyin the second level of the illness, because the activities offered helpfor their socialization, for the maintenance of their functional capacitiesand feeling perceptions, affection and memories. To the peoplewho are taking care of the elderly, the project serves as a supportto face this difficult and hard moment of their lives. In this paper arereported the results and experiences only with the old people whoshow possible and probable Alzheimer diagnosis.

Relatos de experiências: (com) vivência com idosos que apresentam alzheimer / Experiences reports: living with elderly people who present alzheimer

Este artigo trata do relato de um projeto de extensão que apresentacomo objetivo oferecer aos idosos com Alzheimer atividadesfísicas, fisioterápicas e arteterapia. Oportunizam-se aos cuidadoresatividades de apoio psicossocial. O projeto acontece há um ano eos resultados mostram o quanto é importante para os idosos, emboraa maioria desses já esteja na segunda fase da doença, poisas atividades oferecidas colaboram para a sua socialização, paramanutenção da sua capacidade funcional e percepções de sentimentos,afetos e lembranças. Aos cuidadores serve como apoiopara o enfrentamento desse momento difícil e pesaroso das suasvidas. Neste trabalho relatam-se resultados da experiência somentecom os idosos que apresentam diagnóstico possível e provável deAlzheimer.(AU)

This article treats about the report of an extention Project that showsas a purpose to give to the elderly people physical, physiotherapyand art-therapy activities. It has been given pychosocial support tothe people who are responsible for taking care of them. The projecthas been happening for one year and the results show how much itis important to the elderly people, although most of them are alreadyin the second level of the illness, because the activities offered helpfor their socialization, for the maintenance of their functional capacitiesand feeling perceptions, affection and memories. To the peoplewho are taking care of the elderly, the project serves as a supportto face this difficult and hard moment of their lives. In this paper arereported the results and experiences only with the old people whoshow possible and probable Alzheimer diagnosis.

Processo de enfermagem aplicado a idosos com alzheimer que participamdo projeto estratégias de reabilitação / Nursing process applied to elderly with alzheimer’s who participate in the rehabilitation strategies project

Introdução: O aumento da população idosa em todo o mundo exige a capacitação de profissionais para o atendimento nesta área.Metodologia: Este é um estudo qualiquantitativo do tipo exploratório-descritivo realizado através da entrevista e exame físico feito nos idosos. Objetivos: O objetivo geral deste trabalho foi aplicar o processo de enfermagem nos idosos com alzheimer participantes do projeto da UNICRUZ. Os objetivos específicos foram: Realizara avaliação do estado de saúde atual destes idosos; Levantar os principais diagnósticos de enfermagem encontrados; Proporcionar aos sujeitos cuidados de enfermagem integral através da realiazação das prescrições de enfermagem. Resultados: Após a coleta de dados foram levantadas as informações em comum obtidas na entrevista e exame físico que apontam idade média dos sujeitos de 76 anos, 4 idosos têm o diagnóstico de alzheimer há 5 anos; 3 deles são hipertensos; 5 deles têm distúrbios do sono; 3 têm irmãos com alzheimer e todos têm falha de memória e limitação de amplitudede movivento. Dos diagnósticos de enfermagem, pode-se destacar - tensão do papel do cuidador e risco para o trauma. Dentre as principais prescrições de enfermagem estão - estimular cognição e memória, atividade física e participação social. Conclusão: Foi possível aplicar o processo de enfermagem nos idosos e com isso obter um maior conhecimento do estado de saúde deles, descrever os diagnósticos de enfermagem e levantar pontos de intervenção através da prescrição de enfermagem para promover cuidados como o estímulo à participação em grupos e encaminhamento ao odontólogo que poderão auxiliar no tratamento dos indivíduos e previnir complicações, oferecendo-os assistência e orientações de enfermagem e transdiciplinar.(AU)

Introduction: The aging population in the world requires the trainingof professionals providing care in this area. Methodology: This qualitative-quantitative study is of the exploratory-descriptive type conducted by interview and physical examination in the elderly Objectives: The aim of this work was to apply the nursing process in the elderly with Alzheimer's UNICRUZ project participants. The specific objectives were to perform the evaluation of current health status of elderly; Raise the main nursing diagnoses found; subjectproviding comprehensive nursing care through nursing realization prescriptions. Results: After data collection, it was raised together the information obtained in the interview and physical examination suggest that the average age of subjects 76 years, has four seniors diagnosed with Alzheimer's five years, three of them are hypertensive, five of them have disorders sleep, have three siblings with Alzheimer's and all have memory impairment and limitation of range of movivento. Of nursing diagnoses, can be ighlighted - the role of caregiver stress and risk for trauma. The main requirements are nursing - stimulate cognition and memory, physical activity and social participation. Conclusion: It was possible to apply the nursing process in the elderly and therefore gain a greater understanding of their health status, describing nursing diagnoses and raise points of intervention through the prescription of nursing care and to promote the stimulation of participation in groups and referral to a dentist that can help treat and prevent complications of individuals, offering them assistance and guidance to nursing and transdisciplinary.(AU)