Association of Physical Performance with Mental and Physical Health-Related Quality of Life and Low Back Pain-Related Disabilities among Older Adults with Severe Obesity.

Background: Low back pain is one of the most prevalent musculoskeletal problems and continues to be the leading cause of disabilities worldwide. The aim of this study was to cross-sectionally investigate the association of physical performance with mental and physical health-related quality of life and low back pain-related disabilities among older adults with severe obesity. Methods: A total of 96 hospitalized older adults with severe obesity (45 males, 51 females, age: 69.7 ± 5.4 years; BMI: 43.7 ± 5.7 kg/m2) were recruited into the study. Physical performance, health-related quality of life, and low back pain-related disability were measured through physical performance tests, the 12-item short-form survey (SF-12), and the Oswestry disability index, respectively. Results: LBP-related disabilities, as well as physical health-related quality of life, were associated with all the physiological parameters measured by physical performance tests, including muscular strength, aerobic capacity, balance, and lower body flexibility (p < 0.05). In contrast, mental health-related quality of life was associated with fewer physiological parameters, such as primarily muscular strength (p < 0.05). Conclusions: These findings could provide important insights for developing rehabilitation strategies designed to improve LBP-related disabilities, as well as the physical and mental health-related quality of life, in older adults with severe obesity.

Sedentary Behavior, Obesity, and Disabilities in Community-Dwelling Older Adults: Analysis of the Brazilian National Health Survey 2019.

Research suggests that sedentary behavior (SB) and obesity are associated with disabilities in basic activities (BADL) and instrumental (IADL) activities of daily living. However, there is a lack of studies investigating this association in community-dwelling older adults. Thus, the aim of this study was to investigate the association between different SB typologies, isolated and in conjunction with obesity, and their associations with BADL and IADL disabilities in community-dwelling Brazilian older adults. This was a cross-sectional study using data from older adults (≥60 years) who participated in the Brazilian National Health Survey (2019). The exposures were obesity (BMI > 27 kg/m2) and the amount of time spent daily on SB watching television (SB TV < 3 and ≥3 h/day) and engaging in leisure activities (SB leisure < 3 and ≥3 h/day), analyzed both separately and jointly. The outcomes were BADL and IADL disabilities. The main results showed that isolated SB TV ≥ 3 h/day (OR: 1.26; 95% CI: 1.14; 1.39) and SB TV ≥ 3 h/day combined with obesity (OR: 1.55; 95% CI: 1.37; 1.75) increased the odds of BADL and IADL disabilities. Obesity alone (OR: 1.21; 95% CI: 1.07; 1.36) increased only the odds of BADL disabilities. Moreover, SB leisure ≥ 3 h/day without obesity reduced the odds of IADL disabilities (OR: 0.56; 95% CI: 0.41; 0.76). Ideally, older adults should be encouraged to prevent obesity, reduce excessive periods spent in SB watching TV, and increase the daily periods spent in leisure activities, thus minimizing the likelihood of disabilities in functional activities.

Analysis of sarcopenic obesity prevalence and diagnostic agreement according to the 2022 ESPEN and EASO Consensus in hospitalized older adults with severe obesity.

Background: Sarcopenic obesity (SO) is a clinical disorder characterized by increased adiposity and decreased muscle mass and function, commonly observed in older adults. However, most of the studies that investigated SO prevalence rates were not based on current standardized diagnostic methods. Thus, this study aims to estimate the prevalence rates of SO and their level of agreement using different instruments proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) Consensus, in a sample of hospitalized older adults with severe obesity. Methods: A cross-sectional study with 90 older adults (≥ 60 years) with severe obesity (body mass index ≥ 35 kg/m/²) seeking an in-hospital multidisciplinary body weight reduction program. Skeletal muscle function was assessed using the five-repetition Sit-Stand test (5-SSt) and Handgrip Strength (HGS). Body composition was evaluated by high percentages of fat mass (FM), low appendicular lean mass (ALM/W), and skeletal muscle mass (SMM/W), adjusted to body weight. The stage of SO was assessed on the presence of at least one comorbidity and specific cut-offs were adopted for each step. All analyses were performed according to gender and age range. Results: The prevalence rates of SO in the total sample were 23.3%, 25.5%, 31.1%, and 40.0% considering altered values of 5-SSt+FM+ALM/W, HGS+FM+ALM/W, 5-SSt+FMSSM/W, and HGS+FM+SSM/W, respectively. Higher prevalence rates were observed among female and old elderly subgroups, regardless of the diagnostic combination. There were weak agreements between the muscle function tests (5-SSt versus HGS) using both muscle mass indexes in the total sample and all subgroups. Moderate agreements were observed between muscle mass indexes (SMM/W versus ALM/W) in the total sample, male and younger older adults (using 5-SSt), and strong agreements for men and younger older adults (using HGS). Conclusion: The discrepancies observed between the prevalence rates and their levels of agreement reinforce the need for new studies in similar populations aiming for better standardization of SO assessment.

Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil.

This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.

Worldwide prevalence of sleep problems in community-dwelling older adults: A systematic review and meta-analysis.

The understanding of the prevalence of sleep problems in older adults can provide a broad and reliable perspective into the occurrence of such issues among older adults. This systematic review and meta-analysis aimed to estimate the worldwide prevalence of sleep problems in community-dwelling older adults. Studies that provide information on the prevalence of sleep problems in community-dwelling older adults (≥60 years) were screened between December 2022 and March 2023. A total of 20,379 studies were identified in database searches, from which 252 were included in this review. These studies covered the last 35 years (from 1988 to 2023) and pooled a sample of 995,544 participants from 36 countries. The most frequent sleep problem worldwide was obstructive sleep apnea (46.0%), followed by poor sleep quality (40.0%), other sleep problems (37.0%), insomnia (29.0%), and excessive daytime sleepiness (19.0%). No significant difference in the prevalence estimates of all sleep problems was observed between the sexes. This systematic review and meta-analysis showed a high prevalence of some sleep problems, mainly obstructive sleep apnea, poor sleep quality, and other sleep problems. Our estimates can be useful for managers and policymakers in planning healthcare strategies for sleep problems aimed at the older population.

Association between sleep problems and functional disability in community-dwelling older adults.

BACKGROUND: Sleep problems are frequently observed in older adults. They can lead to changes in the individual's physical, occupational, cognitive, and social functioning, compromising the performance of activities of daily living and contributing to the occurrence of functional disability. This study evaluated the association between sleep problems and functional disability in community-dwelling older adults. METHODS: This was a cross-sectional study with data from 10,507 Brazilian community-dwelling older adults participating in the 2013 National Health Survey. The exposure variable was self-reported sleep problems in the last two weeks. The outcome measure was functional disability assessed from self-reported questionnaires, categorized into basic activities of daily living (BADL) and instrumental activities of daily living (IADL), and defined as not being able to perform or having little or a lot of difficulty in at least one of the activities investigated in the domain of interest. RESULTS: Older adults who reported sleep problems had 1.53 (95%CI: 1.34; 1.75) and 1.42 (95%CI: 1.26; 1.59) greater odds of having a disability in BADL and IADL when compared to individuals who reported having no sleep problems. CONCLUSIONS: Older adults with sleep problems were more likely to have a functional disability, both in BADL and IADL. Thus, it is important to implement strategies to screen for sleep problems in older adults in primary health care as a preventive strategy for functional disability.

Association between self-perception of the neighborhood environment and sleep problems in older Brazilian adults: findings from ELSI-Brazil / Associação entre autopercepção do ambiente da vizinhança e problemas de sono em idosos brasileiros: resultados do ELSI-Brasil / Asociación entre la autopercepción del entorno del vecindario y los problemas de sueño en ancianos brasileños: resultados del ELSI-Brasil

Abstract: This study aimed to investigate associations between neighborhood perception and sleep problems in older Brazilian adults. A cross-sectional study was conducted with 5,719 community-dwelling older adults (≥ 60 years) from the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021). The outcomes were self-reported sleep problems: poor sleep quality, daytime sleepiness, primary insomnia complaints, difficulty staying asleep, and waking up at dawn. The exposure variables were questions about the perception of participants about the physical and social environment of the neighborhood. Logistic regression was used in data analysis. Garbage, rubbish, or tall grass on the streets and the desire to move were associated with higher odds of poor sleep quality. Concern about falling due to damaged sidewalks, concern about having difficulties taking transportation, and concern about having difficulties crossing the street were associated with higher odds of all sleep problems. Sound/noise of buses and cars was associated with higher odds of some sleep problems. Perceiving the neighborhood as a good place to live was associated with lower odds of daytime sleepiness and primary insomnia complaints. Trusting most people in the neighborhood and perceiving that kids and younger people treat adults with respect were associated with lower odds of daytime sleepiness, primary insomnia complaints, and waking up at dawn. Being a good place for kids to play and raise teenagers was associated with lower odds of daytime sleepiness. These results can assist public administrators in creating urban planning policies aimed at improving neighborhood environments as a means of health promotion.

Resumo: Este estudo teve como objetivo investigar associações entre percepções da vizinhança e problemas de sono em idosos brasileiros. Foi realizado um estudo transversal com 5.719 idosos da comunidade (≥ 60 anos) do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil, 2019-2021). Os desfechos foram problemas de sono autorreferidos: má qualidade do sono, sonolência diurna, queixas de insônia primária, dificuldade em manter o sono e acordar na madrugada. As variáveis de exposição foram: questões sobre a percepção dos participantes sobre o ambiente físico e social da vizinhança. Regressão logística foi utilizada na análise dos dados. Lixo, sujeira ou grama alta nas ruas e o desejo de mudar de onde mora foram associados a maiores chances de má qualidade do sono. Preocupação em cair devido a calçadas em má condição, preocupação com dificuldades para usar os meios de transporte e preocupação com dificuldades para atravessar a rua foram associadas a maiores chances de todos os problemas de sono. O som/ruído dos ônibus e carros foi associado a maiores chances de alguns problemas de sono. A percepção da vizinhança como um bom lugar para morar foi associado a menores chances de sonolência diurna e queixas de insônia primária. A confiança na maioria das pessoas da vizinhança e a percepção de que crianças e jovens tratam os adultos com respeito foram associados a menores chances de sonolência diurna, queixas de insônia primária e acordar na madrugada. Um bom lugar para as crianças brincarem e para os adolescentes crescerem foi associado a menores chances de sonolência diurna. Esses resultados podem ajudar os gestores públicos na criação de políticas de planejamento urbano voltadas a melhorias nos ambientes da vizinhança como forma de promoção da saúde.

Resumen: Este estudio tuvo como objetivo investigar las asociaciones entre las percepcion del vecindario y los problemas de sueño en ancianos brasileños. Se realizó un estudio transversal con 5.719 ancianos de la comunidad (≥ 60 años) del Estudio Longitudinal de Salud de los Ancianos Brasileños (ELSI-Brasil, 2019-2021). Los desenlaces fueron los siguientes: problemas de sueño autoinformados: mala calidad del sueño, somnolencia diurna, quejas de insomnio primario, dificultad para permanecer dormido y despertarse durante la madrugada. Las variables de exposición fueron las siguientes: preguntas sobre la percepción de los participantes sobre el entorno físico y social del vecindario. En el análisis de datos se utilizó la regresión logística. La basura, la suciedad o el césped alto en las calles y el deseo de cambiar el lugar donde viven se asociaron con mayores probabilidades de tener una mala calidad del sueño. La preocupación por las caídas debido a aceras en mal estado, la preocupación por las dificultades para utilizar los medios de transporte y la preocupación por las dificultades para cruzar la calle se asociaron con mayores probabilidades de sufrir todos los problemas de sueño. El ruido producido por los autobuses y automóviles se asoció con una mayor probabilidad de sufrir algunos problemas de sueño. La percepción del vecindario como un buen lugar para vivir se asoció con menores probabilidades de sufrir somnolencia diurna y quejas de insomnio primario. La confianza en la mayoría de la gente del vecindario y la percepción de que los niños y jóvenes tratan a los adultos con respeto se asociaron con menores probabilidades de sufrir somnolencia diurna, quejas de insomnio primario y despertarse durante la madrugada. Un buen lugar para que los niños jugaran y para que los adolescentes crecieran se asoció con menores probabilidades de sufrir somnolencia diurna. Estos resultados pueden ayudar a los gestores públicos a crear políticas de planificación urbana dirigidas a mejorar los entornos vecinales como forma de promover la salud.

Association Between Typologies of Sedentary Behavior and Muscle Strength, Gait Speed, and Balance in Community-Dwelling Older Adults.

Knowledge of how the different types of sedentary behaviors (SB) are associated with functional limitations can guide professionals who work with older adults on better recommendations about the amount of daily time that should be encouraged in each type of SB. The objective was to estimate the associations between two SB typologies (SB television [TV] and SB computer/internet) and the presence of handgrip strength, lower limb strength, gait speed, and balance limitations in Brazilian community-dwelling older adults. This is a cross-sectional study with 1,298 community-dwelling older adults (≥60 years). SB was assessed by self-reporting daily time spent watching TV or using computer/internet (categorized into <2, 3-4, and ≥5 hr/day). Outcomes were handgrip strength, lower limb strength, gait speed, and balance limitations considering referenced cutoff points. Older adults in SB TV ≥5 hr/day had 1.75 (95% confidence interval [CI] [1.07, 2.86]) and 1.88 (95% CI [1.02, 3.46]) times more chances of handgrip strength and gait speed limitations, respectively. On the other hand, those who spent 3-4 and ≥5 hr/day in SB computer/internet had 0.45 (95% CI [0.20, 0.99]) and 0.37 (95% CI [0.15, 0.93]) had less chances of lower limb strength and balance limitations, respectively. In conclusion, functional limitations would be associated differently depending on the type of SB in the older adults sampled.

[Screen time, obesity and cardiovascular disease among elderly Brazilians: 2013 and 2019 National Health Surveys]. / Tempo de televisão, obesidade e doenças cardiovasculares em idosos brasileiros: Pesquisas Nacionais de Saúde 2013 e 2019.

The scope of this paper was to analyze the association between the time spent watching television (TV) and the presence of obsessive-compulsive disorder (OCD) obesity and obesity associated with cardiovascular diseases (CVD) among elderly Brazilians, according to gender, comparing data from the 2013 and 2019 National Health Surveys (NHS). It involved a cross-sectional study, with data from 23,815 and 43,554 elderly people, respectively, from the 2013 and 2019 NHS. Self-reported TV screen time was categorized into: <3, 3-6, and ≥6 per day. Obesity was assessed by body mass index ≥27 kg/m² and CVD by self-reported medical diagnosis. In 2013, elderly women who watched TV ≥6 hours/day were more likely to have OCD obesity (OR=1.87; 95%CI=1.32;2.64) and obesity associated with CVD (OR=6.30; 95%CI=3.38;11.74). In 2019, elderly women who watched TV between 3-6 hours/day (OR=1.44; 95%CI=1.25;1.65) and ≥6 hours/day (OR=1.55; 95%CI=1.28;1.88) were more likely to have OCD obesity, while the incidence of obesity associated with CVD was higher for ≥6 hours/day (OR=2.13; 95%CI=1.48;3.06). In 2019, men were more likely to have obesity associated with CVD watching TV between 3-6 hours/day (OR=1.76; 95%CI=1.20;2.56) and ≥6 hours/day (OR=2.13; 95%CI=1.27;3.57). The importance of reducing screen time by the elderly is clearly evident.

Objetivou-se analisar a associação entre tempo assistindo televisão (TV) e a presença de obesidade isolada e associada às doenças cardiovasculares (DCV) de idosos brasileiros, conforme o sexo, comparando-se os dados das Pesquisas Nacionais de Saúde 2013 e 2019. Estudo transversal, com dados de 23.815 e 43.554 idosos das PNS 2013 e 2019, respectivamente. O autorrelato do tempo assistindo à TV foi categorizado em: <3, 3-6 e ≥6 horas diárias. A obesidade isolada foi avaliada pelo índice de massa corporal ≥27 kg/m² e a DCV pelo autorrelato de diagnóstico médico. Em 2013, as idosas que assistiam à TV ≥6 horas/dia apresentaram maiores chances de obesidade isolada (OR=1,87; IC95%=1,32;2,64) e associada à DCV (OR=6,30; IC95%=3,38;11,74). Em 2019, as idosas que assistiam à TV entre 3-6 horas/dia (OR=1,44; IC95%=1,25;1,65) e ≥6 horas/dia (OR=1,55; IC95%=1,28;1,88) tiveram maiores chances de obesidade isolada, já as chances de obesidade associada à DCV, foram maiores para ≥6 horas/dia (OR=2,13; IC95%=1,48;3,06). Em 2019, os homens tiveram maiores chances de obesidade associada às DCV assistindo à TV entre 3-6 horas/dia (OR=1,76; IC95%=1,20;2,56) e ≥6 horas/dia (OR=2,13; IC95%=1,27;3,57). Evidencia-se a importância em diminuir o tempo assistindo à TV dos idosos.

A nationwide study on sleep complaints and associated factors in older adults: ELSI-Brazil.

Sleep problems, such as difficulty falling asleep, staying asleep, early awakening with failure to continue sleep, and altered sleep-wake cycle, are common in the general population. This cross-sectional study with 6,929 older adults (≥ 60 years) aimed to estimate the prevalence of different types of sleep problems, their associated factors, and the population-attributable fraction of associated factors among older adults. The outcome variables consisted of self-reported sleep problems: insomnia (initial, intermediate, late, and any type of insomnia), poor sleep quality, and daytime sleepiness. The independent variables were sociodemographic and behavioral characteristics and health conditions. The prevalence proportions were initial insomnia (49.1%), intermediate insomnia (49.2%), late insomnia (45.9%), any type of insomnia (58.6%), poor sleep quality (15.6%), and daytime sleepiness (38.4%). Female sex, presence of two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health were positively associated with the sleep problems investigated. Consuming alcohol once a month or more was inversely associated with initial insomnia. Population attributable fraction estimates ranged from 3% to 19% considering two or more chronic diseases, not eating the recommended amount of fruits and vegetables, and regular and bad/very bad self-rated health. High prevalence of self-reported sleep problems was evinced in older adults. These results can be useful to guide public health services in the creation of informational, evaluative, and screening strategies for sleep problems in older Brazilian adults.