Factors associated with fear of falling in older women with knee osteoarthritis: A cross-sectional study.

Knee instability in patients with knee osteoarthritis (KOA) is associated with fear of falling (FoF). This study aimed to investigate the prevalence and the factors associated with FoF in older women with KOA. A cross-sectional study was conducted with 93 older women with KOA. Sociodemographic variables, medical conditions, handgrip strength, and anthropometric and body composition measurements were assessed. The Short Physical Performance Battery was used to measure functional performance. The Western Ontario and McMaster Universities Osteoarthritis Index was applied to assess pain, stiffness, and disability. FoF was assessed by the Falls Efficacy Scale-International. The prevalence of FoF was high (88.2 %). Disability, history of falls, handgrip strength, obesity, number of medications, and pain were independently associated with FoF. Our findings suggest that health professionals should investigate FoF when evaluating older women with KOA and address these risk factors when developing strategies to prevent or minimize FoF in this population.

Is waist circumference associated with fear of falling in community-dwelling older adults? A cross-sectional study.

INTRODUCTION: Fear of falling (FOF) is a prevalent condition among older adults and several variables have been pointed out as risk factors. OBJECTIVES: To identify the cut-off point on waist circumference (WC), capable of discriminating between older adults with and without FOF, and to test the association between WC and FOF. METHODS: A cross-sectional observational study was carried out with older adults of both sexes from Balneário Arroio do Silva, Brazil. We used Receiver Operating Characteristic (ROC) curves to determine the cut-off point on WC and logistic regression adjusted for potential confounding variables to test the association. RESULTS: Older women with WC >93.5 cm [area under the curve: 0.61 (95%CI 0.53; 0.68)] had 3.30 (95%CI 1.53; 7.14) greater chances of having FOF compared with older women with WC ≤93.5 cm. WC was not able to discriminate FOF in older men. CONCLUSION: WC values >93.5 cm are associated with higher chances of FOF in older women.

Home-based gait speed and the association with sociodemographic and anthropometric variables: A national study (ELSI-Brazil).

OBJECTIVES: To investigate home-based gait speed performance for men and women stratified by age group and its associations with sociodemographic and anthropometric variables. METHODS: Data from the 2nd wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2019-2021) were used. Gait speed was tested twice at home over 3.0 meters at usual pace. Associations of sociodemographic and anthropometric variables with gait speed were evaluated using gamma regression. RESULTS: Median gait speed value reduced with increasing age in both sexes [men: 0.70 m/s (50-59 years) to 0.53 m/s (≥80 years); women: 0.68 m/s (50-59 years) to 0.48 m/s (≥80 years)] and was significantly lower in women than men in the age groups of 60-69 and 70-79 years. Age group and education among men and age group, education, and waist circumference among women were significantly associated with gait speed. CONCLUSIONS: Our findings may be helpful as reference values to identify mobility limitation among older Brazilians.

Loneliness and social disconnectedness in the time of pandemic period among Brazilians: evidence from the ELSI COVID-19 initiative.

Objectives: This study aimed at estimating the pre-pandemic and pandemic prevalence of loneliness and investigating the association of loneliness with social disconnectedness during social distancing strategies in the time of the COVID-19 pandemic period.Methods: We used data from the ELSI COVID-19 initiative with participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which comprised 4,431 participants aged 50 years and over. Loneliness (hardly ever/some of the time/often) was assessed by the question "In the past 30 days, how often did you feel alone/lonely?". Social disconnectedness included information on social contacts through virtual talking (i.e. telephone, Skype, WhatsApp, or social media) and outside-home meetings with people living in another household. Covariates included sociodemographic and health related characteristics. Multinomial logistic regression models were used to estimate odds ratios (OR) with their 95% confidence interval (CI).Results: The overall prevalence of loneliness during the pandemic was 23.9% (95% CI 20.7-27.5); lower than in the pre-pandemic period (32.8%; 95% CI 28.6-37.4). In the pandemic period, 20.1% (95% CI 16.9-23.6) reported some of the time feeling lonely and 3.9% (95% CI 3.1-4.8) reported often feeling lonely. In the fully adjusted model, virtual talking disconnectedness (OR=1.67; 95% CI 1.09-2.56) was positively associated with some of the time feeling lonely and outside-home disconnectedness (OR=0.33; 95% CI 0.18-0.60) was negatively associated with often feeling lonely.Conclusion: Individuals with virtual talking disconnectedness and without outside-home disconnectedness are at higher risk of loneliness during the time of COVID-19 pandemic. Stimulating virtual talking connectedness might have the potential to diminish loneliness despite steep outside-home disconnectedness.

Do Older Brazilian Women Who Participate in a Regular Physical Exercise Program Have Higher Habitual Physical Activity Levels? A Cross-Sectional Study Based on Accelerometer Data.

A cross-sectional study was conducted to compare the habitual physical activity level, measured by accelerometry, gait performance, assessed by the GAITRite® system, handgrip strength, and static balance between older Brazilian women who participate (n = 50; 70.7 ± 5.5 years) and do not participate (n = 50; 70.1 ± 5.6 years) in a regular physical exercise program, and to investigate whether participation in a regular exercise program ensures compliance with physical activity recommendations. Older women who participated in a regular physical exercise program had significantly shorter sedentary activity time (effect size [ES] = 0.54), longer moderate activity time (ES = 0.85), and higher energy expenditure (ES = 0.64), number of steps (ES = 0.82), gait speed (ES = 0.49), and step length (ES = 0.45). However, regular participation in an exercise program did not guarantee compliance with physical activity recommendations. Behavioral changes to increase physical activity levels among older women who do and do not participate in a regular exercise program are necessary.

Perceived Neighborhood and Walking Among Older Brazilian Adults Living in Urban Areas: A National Study (ELSI-Brazil).

The study goal was to examine the association between perceived neighborhood characteristics and walking in urban older adults in Brazil. A cross-sectional study including 4,027 older adults from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) was performed. Walking was measured using the International Physical Activity Questionnaire. Neighborhood characteristics were questions about physical disorder, noise pollution, safety, violence, social cohesion, services, concerns with community mobility, and pleasantness. Multinomial logistic regression was used. Concern about taking the bus, subway, or train was inversely associated with walking for men. Violence (victim of theft, robbery, or had home broken into) and social cohesion (trust in neighbors) were positively and inversely associated with walking for women, respectively. A significant interaction term between social cohesion and number of chronic diseases was observed for women. These findings demonstrate the need for sex-specific interventions and policies to increase the walking levels among older Brazilian adults.

Influence of the number and severity of comorbidities in the course of acute non-specific low back pain in older adults: longitudinal results from the Back Complaints in the Elders (BACE-Brazil).

BACKGROUND: The presence of comorbidities is quite common in older adults. However, the effects of comorbidities on the course of acute low back pain (LBP) are not fully understood. OBJECTIVE: To investigate the effects of the number and severity of comorbidities on the severity of pain and disability 3 months from baseline in people with an acute episode of non-specific LBP. METHODS: Data from the Back Complaints in the Elders study, a cohort that enrolled 602 community-dwelling older adults with acute LBP at baseline, were used in these analyses. Comorbidities, pain intensity and disability were assessed using the Self-Administered Comorbidities Questionnaire (SCQ), the Numeric Rating Scale (NRS) and the Roland-Morris Disability Questionnaire (RMDQ), respectively. Age, sex, marital status, education, income and body mass index were covariates. RESULTS: The mean age of participants was 67.6 ± 7.0 years. Both pain and disability scores decreased from 7.2 (95% confidence interval [95% CI] 7.0-7.4) to 5.8 (95% CI 5.5-6.1) in NRS and from 13.5 (95% CI 13.0-14.1) to 12.0 (95% CI 11.4-12.7) in RMDQ 3 months from baseline. The linear regression analysis showed a significant association between SCQ scores at baseline and pain (coefficient = 0.16, 95% CI 0.08-0.24; P < 0.001) or disability (coefficient = 0.29, 95% CI 0.16-0.41; P < 0.001) scores at the 3-month follow-up, after adjusting for confounders. Participants with highest SCQ scores were less likely to report improvement of at least 30% in pain (OR: 0.41, 95% CI 0.22-0.79; P = 0.008) and disability (OR: 0.42, 95% CI 0.28-0.85; P = 0.015). CONCLUSION: The presence and severity of comorbidities were independently associated with the prognosis of acute non-specific LBP in older adults.

The geriatric depression scale and the timed up and go test predict fear of falling in community-dwelling elderly women with type 2 diabetes mellitus: a cross-sectional study.

BACKGROUND: Fear of falling is a common and potentially disabling problem among older adults. However, little is known about this condition in older adults with diabetes mellitus. The aims of this study were to investigate the impact of the fear of falling on clinical, functional and gait variables in older women with type 2 diabetes and to identify which variables could predict the fear of falling in this population. METHODS: Ninety-nine community-dwelling older women with type 2 diabetes (aged 65 to 89 years) were stratified in two groups based on their Falls Efficacy Scale-International score. Participants with a score < 23 were assigned to the group without the fear of falling (n = 50) and those with a score ≥ 23 were assigned to the group with the fear of falling (n = 49). Clinical data included demographics, anthropometrics, number of diseases and medications, physical activity level, fall history, frailty level, cognition, depressive symptoms, fasting glucose level and disease duration. Functional measures included the Timed Up and Go test (TUG), the five times sit-to-stand test (5-STS) and handgrip strength. Gait parameters were obtained using the GAITRite® system. RESULTS: Participants with a fear of falling were frailer and presented more depressive symptoms and worse performance on the TUG and 5-STS tests compared with those without a fear of falling. The group with the fear of falling also walked with a lower velocity, cadence and step length and increased step time and swing time variability. The multivariate regression analysis showed that the likelihood of having a fear of falling increased 1.34 times (OR 1.34, 95 % CI 1.11-1.61) for a one-point increase in the Geriatric Depression Scale (GDS-15) score and 1.36 times (OR 1.36, 95 % CI 1.07-1.73) for each second of increase in the TUG performance. CONCLUSIONS: The fear of falling in community-dwelling older women with type 2 diabetes mellitus is associated with frailty, depressive symptoms and dynamic balance, functional mobility and gait deficits. Furthermore, both the GDS-15 and the TUG test predict a fear of falling in this population. Therefore, these instruments should be considered during the assessment of diabetic older women with fear of falling.

Validation of the human activity profile questionnaire as a measure of physical activity levels in older community-dwelling women.

The purpose of this study was to assess the validity of the Human Activity Profile (HAP) by comparing scores with accelerometer data and by objectively testing its cutoff points. This study included 120 older women (age 60-90 years). Average daily time spent in sedentary, moderate, and hard activity; counts; number of steps; and energy expenditure were measured using an accelerometer. Spearman rank order correlations were used to evaluate the correlation between the HAP scores and accelerometer variables. Significant relationships were detected (rho = .47-.75, p < .001), indicating that the HAP estimates physical activity at a group level well; however, scatterplots showed individual errors. Receiver operating characteristic curves were constructed to determine HAP cutoff points on the basis of physical activity level recommendations, and the cutoff points found were similar to the original HAP cutoff points. The HAP is a useful indicator of physical activity levels in older women.

Validation of the Human Activity Profile Questionnaire as a Measure of Physical Activity Levels in Older Community-Dwelling Women.

The purpose of this study was to assess the validity of the Human Activity Profile (HAP) by comparing scores with accelerometer data and by objectively testing its cutoff points. This study included 120 older women (age 60-90 years). Average daily time spent in sedentary, moderate, and hard activity; counts; number of steps; and energy expenditure were measured using an accelerometer. Spearman rank order correlations were used to evaluate the correlation between the HAP scores and accelerometer variables. Significant relationships were detected (rho = .47-.75, p < .001), indicating that the HAP estimates physical activity at a group level well; however, scatterplots showed individual errors. Receiver operating characteristic curves were constructed to determine HAP cutoff points on the basis of physical activity level recommendations, and the cutoff points found were similar to the original HAP cutoff points. The HAP is a useful indicator of physical activity levels in older women.