Short Physical Performance Battery (SPPB) score as a discriminator of dynapenic abdominal obesity among community-dwelling older adults.

The aim of this study is to verify the utility of using physical performance to discriminate the presence of dynapenic abdominal obesity (DAO) in older adults. This cross-sectional study was conducted with 382 community-dwelling older adults. DAO was identified when dynapenia (cut-off points of <26 kilogram-force [kgf] for men and <16 kgf for women) was detected together with abdominal obesity (waist circumference >102 cm for men and >88 cm for women). Physical performance was assessed with the Short Physical Performance Battery (SPPB). SPPB scores and DAO were inversely associated even after adjustment (OR: 0.69; 95%CI: 0.58-0.83). Cut-off points of ≤9 for SPPB scores were the most efficient for discriminating the presence of DAO in both men (AUC= 0.836; 95%CI: 0.76-0.89; sensitivity: 90.91% and specificity: 60.33%) and women (AUC= 0.677; 95%CI: 0.62-0.73; sensitivity: 73.33% and specificity: 40.91%). Physical performance assessed with SPPB can discriminate DAO and be useful for the timely identification and management of this condition in older adults.

Anthropometric indicators as a discriminator of sarcopenia in community-dwelling older adults of the Amazon region: a cross-sectional study.

BACKGROUND: Sarcopenia is a geriatric syndrome associated with negative health outcomes and the use of viable alternative screening tools may help in the diagnosis of this condition. This study aimed to analyze the association of sarcopenia with anthropometric indicators among community-dwelling older adults and to identify cut-off points for such indicators as a discriminant criterion for predicting sarcopenia. METHODS: This was a cross-sectional study conducted on community-dwelling older adults ≥60 years old (n = 411) of both sexes from Macapá, Amapá, Brazil. Socioeconomic, clinical and anthropometric data (arm circumference - AC, waist circumference - WC, calf circumference - CC and body mass index - BMI) were collected using a structured form. Sarcopenia was identified according to the EWGSOP 2 consensus. The association between anthropometric indicators and sarcopenia was performed using logistic regression and cut-off points established from the ROC Curve. Statistical significance was defined as p ≤ 0.05. RESULTS: Adjusted analysis indicated an independent and inverse association between sarcopenia and the anthropometric indicators: AC (odds ratio, OR: 0.63; 95% confidence interval, 95%CI: 0.53-0.76), CC (OR: 0.73; 95%CI: 0.62-0.85), WC (OR: 0.93; 95%CI: 0.90-0.97) and BMI (OR: 0.64; 95%CI: 0.53-0.76). The following cut-off points for older men and women represented the discriminant criterion for the presence of sarcopenia: WC (≤97 and ≤ 86 cm), CC (≤33 and ≤ 31 cm), AC (≤27 cm) and BMI (≤24.8 kg/m2 and ≤ 24.5 kg/m2) (area under the ROC curve superior to 0.70). BMI and AC were the indicators with the highest ability to discriminate older adults of both sexes with sarcopenia. CONCLUSIONS: An increase of one unit of the indicators can reduce the probability of occurrence of sarcopenia. All indicators were considered to discriminate the occurrence of sarcopenia, with emphasis on BMI and AC, and could be used to screen for this condition among community-dwelling older adults.

Potentially inappropriate medication use and frailty phenotype among community-dwelling older adults: A population-based study.

AIMS AND OBJECTIVES: To investigate the association between potentially inappropriate medication use and frailty phenotype among community-dwelling older adults and to identify factors associated with the use of these drugs according to frailty condition. BACKGROUND: There is insufficient evidence about the association between inappropriate medication use and the condition of frailty, particularly among community-dwelling older adults. Therefore, data obtained from population surveys should be made available in order to support the development of clinical guidelines about the prevention of frailty. DESIGN: This was a cross-sectional study conducted according to the STROBE Checklist. METHODS: This population-based study was conducted on 1,607 older adults. Potentially inappropriate medication use was assessed according to Beers criteria and frailty syndrome was determined according to the phenotype proposed by Fried and colleagues. Data were analysed statistically using multinomial or binary logistic regression models. RESULTS: About 13.6% of the subjects were frail, and 36.8% used at least one inappropriate medication. The adjusted model indicated that, the more potentially inappropriate medication use, the higher the prevalence of frailty, prefrailty and the walking slowness component. Female gender, one or more years of schooling, five or more reported morbidities, and instrumental dependence regarding daily life activities were factors associated with potentially inappropriate medication use in the nonfrail group. CONCLUSION: Inappropriate medication use was prevalent among community-living older adults, and its presence was associated with the occurrence of frailty. RELEVANCE TO CLINICAL PRACTICE: Primary care nurses are the professionals with the greatest contact with the older adults in the community. Thus, the results support the inclusion of the assessment of potentially inappropriate medication use in the routine of nursing consultation. In case of a positive screening, the older person should be referred to geriatric evaluation in order to optimise drug treatment for the prevention of frailty.

Frailty Syndrome in Association with Depressive Symptoms and Functional Disability among Hospitalized Elderly.

We sought to examine the frailty association with depression and functional disability in hospitalized older adults. In particular, we compared non-frail, pre-frail, and frail elderly hospitalized individuals. We performed a cross-sectional study with 255 hospitalized Brazilian elderly patients. We used a structured instrument to assess socio-economic data, the Fried frailty phenotype and used morbidity scales (Geriatric Depression; Katz; Lawton and Brody). The adjusted analysis revealed that frail elderly exhibit increased odds ratios (OR) for depressive symptoms (OR = 2.72, 95% CI: 1.12-6.62), disability related to basic activities (OR = 3.50, 95% CI: 1.26-9.60), and instrumental daily living (OR = 2.70, 95% CI: 1.12-6.44). Frailty in hospitalized older adults is associated with depressive symptomatology and functional disability.

Evidence-based practice in undergraduate physiotherapy programs in Brazil: A cross-sectional document analysis study.

BACKGROUND AND PURPOSE: Physiotherapists worldwide are encouraged to integrate evidence-based practice (EBP) to provide safer and effective services. However, for professionals to consolidate this practice, the contact with EBP must begin at the university. In this study, we aimed to map and analyze the distribution of EBP courses and their characteristics in undergraduate physiotherapy programs in Brazil. METHODS: This web-based document analysis study analyzed the current curricula of undergraduate physiotherapy programs in Brazil according to their availability on university sites. The identification of curricular components and analysis of EBP course syllabi used evidence-based descriptive terms. A descriptive analysis was used to verify the frequency and the regional distribution of EBP courses. RESULTS: Of 1033 accredited programs in Brazil, 809 curricula were analyzed. Only 9.4% (76/809) of the analyzed curricula presented EBP courses; the mean duration of courses was 44.3 (SD 13.5) hours. Southeast region had the greatest number of undergraduate programs (46.5%, 376/809), and the north region had a proportionally greater number of EBP courses (24%, 12/50). In addition, 15.6% (10/64) and 8.9% (66/739) of the curricula of public and private institutions, respectively, provided EBP content. Critical appraisal was the most mentioned step among 15 undergraduate programs with complete EBP syllabi. DISCUSSION: Most undergraduate physiotherapy programs in Brazil did not offer an EBP course. Also, an unbalanced emphasis on the critical appraisal step was observed. The lack of EBP content and skills in the curricula of Brazilian undergraduate physiotherapy programs may negatively influence the training, decision-making, and clinical practice of physiotherapists. A re-evaluating of the current undergraduate programs and curricula for EBP-based education is needed.

Cross-Sectional Study on the Association Between Respiratory Muscle Strength and Dynapenic Abdominal Obesity in Community-Dwelling Older Adults.

Purpose: Impaired respiratory muscle strength has been associated with some geriatric syndromes. However, no studies have previously evaluated the relationship between respiratory muscle strength and dynapenic abdominal obesity. This study aimed to analyze whether there is an association between respiratory muscle strength and abdominal obesity, dynapenia and dynapenic abdominal obesity (DAO) in community-dwelling older adults. Patients and Methods: Cross-sectional study conducted with community-dwelling older adults (n=382 / 70.03 ± 7.3 years) from Macapá, Amapá, Brazil. Respiratory muscle strength was assessed by measuring maximal inspiratory and expiratory pressures (MIP and MEP, respectively), using an analog manovacuometry. DAO was defined as the combination of dynapenia (grip strength < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). We performed descriptive and inferential statistical analyses using the student's t-test for independent and related samples and linear regression model. Results: Older adults with abdominal obesity, dynapenia, and DAO presented lower mean values (obtained and obtained versus predicted; except abdominal obesity versus MIP) for maximal respiratory pressures compared to individuals without these conditions. However, the adjusted analysis only indicated an association between MIP and the following conditions: dynapenia (MIP - ß =-0.171; p<0.001), abdominal obesity (MIP - ß=0.102; p=0.042), and DAO (MIP - ß=-0.101; p=0.028). Conclusion: Older adults with abdominal obesity, dynapenia, and DAO showed impaired maximal respiratory pressures. The results of the adjusted analysis indicate that inspiratory muscle strength may require greater attention by health professionals aiming at preventing respiratory complications and improving respiratory health care in older people with these conditions.

Investigating Factors Associated with Fear of Falling in Community-Dwelling Older Adults through Structural Equation Modeling Analysis: A Cross-Sectional Study.

The scientific literature mentions the existence of factors associated with fear of falling in older adults. However, the direct and indirect paths of its predictors have not yet been fully explored. This study aimed to analyze the socioeconomic, clinical, and health factors directly and indirectly associated with fear of falling in community-dwelling older adults. This is a cross-sectional study conducted in older adults (n = 410 - 70.11 ± 7.22 years). Clinical and health-condition data were collected, as were data on fear of falling using the Falls Efficacy Scale International-Brazil (FES-I Brazil). It was found that being female and having a higher number of self-reported morbidities, worse physical performance, and a higher number of depressive symptoms were directly associated with greater fear of falling. Regarding indirect associations, physical inactivity, mediated by a greater number of morbidities, worse physical performance, and a greater number of depressive symptoms, was associated with greater fear of falling. In addition, worse self-rated health, mediated by a greater number of depressive symptoms, as well as older age, mediated by worse physical performance, were associated with the outcome. This study provides information on the predictors directly and indirectly associated with fear of falling, expanding current understanding of this relationship.

Prevalence of and risk factors for dynapenic abdominal obesity in community-dwelling older adults: a cross-sectional study.

This article aims to identify the prevalence of and factors associated with dynapenic abdominal obesity (DAO) in older adults in a city in the northern region of Brazil. A cross-sectional study was conducted with 382 community-dwelling older adults in Macapa, Amapa, Brazil. Socioeconomic, clinical, and health information were collected using a structured form. DAO was defined as a combination of dynapenia (handgrip strength of < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). Descriptive and inferential analyses were performed using chi-squared tests, Student's t-tests, and a Poisson regression. The prevalence of DAO was 10.73%. In the preliminary bivariate analysis, the variables of age range, marital status, number of diseases, functional disability for basic and instrumental activities of daily living, gait speed, and level of physical activity met the established criterion. The final model indicated that only gait speed was a predictor of DAO in older adults. DAO affects nearly 11% of community-dwelling older adults from northern Brazil; gait speed was a predictor of DAO and could be a useful tool for managing and monitoring this population's health.

Short Physical Performance Battery as a Measure of Physical Performance and Mortality Predictor in Older Adults: A Comprehensive Literature Review.

The association between the Short Physical Performance Battery (SPPB) score and several adverse health outcomes, including mortality, has been reported in the scientific literature. We conducted a comprehensive literature review of studies on the relationship between SPPB and mortality. The current paper synthesizes the characteristics and main findings of longitudinal studies available in the literature that investigated the role of the SPPB in predicting mortality in older adults. The studies (n = 40) are from North America, South America, Europe, and Asia; the majority (n = 16) were conducted with community-dwelling older adults and reported an association between lower SPPB scores and a higher risk of mortality, and between higher SPPB scores and higher survival. Nevertheless, few studies have analyzed the accuracy of the instrument to predict mortality. The only study that established cut-off points was conducted with older adults discharged from an acute care hospital. Although an SPPB score lower than 10 seems to predict all-cause mortality, further studies showing cut-off points in specific settings and loco-regional specificities are still necessary.

The basis of information to guide clinical decision-making in knee osteoarthritis management: A survey with Brazilian physical therapists.

RATIONALE, AIMS AND OBJECTIVES: Several health information sources are available to assist physical therapists in the clinical decision-making process, with a notable increase in the importance of using evidence-based practice (EBP). The aim of this study is to investigate the health information sources most used by Brazilian physical therapists to guide their clinical decision making for knee osteoarthritis (OA) management, use of Physiotherapy Evidence Database (PEDro), knowledge about the existence of clinical practice guidelines (CPGs), and associated factors. METHODS: A cross-sectional study using an electronic survey was conducted. Physical therapists registered in a Regional Physical Therapy Council in Brazil were invited to participate. Sociodemographic data, professional training, health information sources, frequency of use of PEDro, and knowledge about CPGs were collected. Descriptive analysis of the data was performed, and the chi square test and multinomial and binary logistic regression were used to verify association between the variables. RESULTS: The survey was completed by 370 professionals. The three health information sources most used by Brazilian physical therapists were clinical experience, courses, and books. Among these professionals, only 12.1% use PEDro frequently, and 60.5% know that CPGs for knee OA management exist. Level of education was associated with PEDro use and knowledge about the existence of CPGs (P < .05). CONCLUSIONS: The study results indicated a significant deficiency in engagement with research evidence by Brazilian physical therapists to guide their clinical decision making for knee OA. Further investigations on educational needs and the development of new strategies to narrow the gap between research evidence and clinical practice should be performed.

Association between frailty syndrome and sedentary behavior among community-dwelling older adults in the Amazon region: a cross-sectional study.

BACKGROUND: Existence of an association between sedentary behavior and frailty among older adults has been suggested. However, there is a lack of studies conducted in Brazil, especially in areas of the Amazon region. OBJECTIVE: To analyze the association between frailty syndrome and sedentary behavior among community-dwelling older adults. DESIGN AND SETTING: Cross-sectional study carried out in Macapá, state of Amapá, Brazil. METHODS: Frailty status was assessed using Fried's frailty phenotype, and sedentary behavior was evaluated using two questions concerning time spent in a seated position, from the International Physical Activity Questionnaire (IPAQ). A multinomial logistic regression model was used to verify the association between frailty syndrome and sedentary behavior. RESULTS: The final study sample was made up of 411 older adults with a mean age of 70.14 ± 7.25 years and an average daily duration of sedentary behavior of 2.86 ± 2.53 hours. The prevalence of non-frailty was 28.7%, prevalence of pre-frailty was 58.4% and prevalence of frailty was 12.9%. The adjusted analysis showed that there were independent associations between sedentary behavior and pre-frailty (odds ratio, OR = 1.18; 95% confidence interval, CI: 1.03-1.34) and between sedentary behavior and frailty (OR = 1.20; 95% CI: 1.02-1.40). CONCLUSION: Frailty and pre-frailty status were associated with sedentary behavior among community-dwelling older adults.

Factors associated with social isolation and loneliness in community-dwelling older adults during pandemic times: a cross-sectional study.

INTRODUCTION: Psychosocial aspects need to be discussed in the context of the Covid-19 pandemic. Currently, no studies have investigated the factors associated with social isolation and loneliness among community-dwelling older adults. Therefore, this study analyzed the association of social isolation and loneliness with socioeconomic, clinical, and health characteristics, and Covid-19-related variables, among community-dwelling older adults during the pandemic. METHODS: A cross-sectional study was conducted via a telephone survey of community-dwelling older adults aged ≥60 years in Macapa, Amapa, Brazil. A structured form was used to collect data. Descriptive and inferential analyses were performed using Pearson's correlation test and a linear regression model. RESULTS: Participants comprised 86 community-dwelling older adults with a mean age of 71.78+6.98 years. Among them, 9.3% were diagnosed with Covid-19, of whom 3.5% were hospitalized. Most participants reported no difficulty obtaining food, medicines, or attending routine medical appointments during the pandemic. Furthermore, 23.3% (n=20) were socially isolated, and 20.9% (n=18) reported feelings of loneliness. The mean values for fear, anxiety, and obsession were 19.01±7.25, 1.01±1.90, and 2.84±3.28, respectively. A moderate positive correlation was identified between loneliness and the number of diseases, and a weak positive correlation between loneliness and the number of medications and depressive symptoms and risk for sarcopenia. The linear regression model indicated that higher loneliness scores were associated with a greater number of diseases (ß=0.288; p=0.007). CONCLUSIONS: The findings suggest a probable resilience of the older population to Covid-19, despite the association of loneliness with many diseases in times of a pandemic.

Dyspnea is associated with poor physical performance among community-dwelling older adults: a population-based cross-sectional study.

BACKGROUND: Dyspnea and poorer physical performance are conditions that may be related and be present among the elderly. However, few studies have evaluated associations between these variables. OBJECTIVE: To determine whether there is an association between dyspnea and physical performance among community-dwelling older adults of both sexes (age 60 years and over). DESIGN AND SETTING: Cross-sectional study conducted in the city of Macapá, state of Amapá, Brazil. METHODS: Socioeconomic and health data were collected using a structured form. Frailty syndrome was assessed based on the frailty phenotype proposed by Fried et al. Dyspnea was measured using the modified Medical Research Council (mMRC) scale and physical performance was measured using the Short Physical Performance Battery (SPPB). Data were analyzed using a linear regression model. RESULTS: A total of 411 subjects (70.15 ± 7.25 years) were evaluated, most of them females (66.4%). It was observed from the mMRC scale that 30.9% (n = 127) of the subjects had some dyspnea symptoms: grade 1 was most frequent. The physical performance score from the SPPB was 9.22 ± 2.01. Higher dyspnea scores were associated with poor physical performance, both in the crude analysis (ß = -0.233; P = 0.028) and after adjustment for frailty condition (ß = -0.148; P = 0.002) and for the socioeconomic and health variables (age, sex, number of diseases, smoking habit and frailty status) (ß = -0.111; P = 0.025). CONCLUSION: Higher dyspnea score was independently associated with poor physical performance among community-dwelling older adults.

Covid-19: perspectives and initiatives in older adults health context in Brazil.

This article provides information about COVID-19, contextualizing the national and international scenario, with an emphasis on the health of the elderly. Perspectives and initiatives for this risk group are presented, reinforcing the need to consider the aging process and not just age as the main marker in the approach of this population.

Evidence of association between the use of drugs and community-dwelling older people frailty: a cross-sectional study.

BACKGROUND: The scientific literature has shown that an association between polypharmacy and frailty exists. However, few studies have also considered drug interactions and the use of potentially inappropriate medications. OBJECTIVE: To evaluate the association between the use of drugs and frailty among community-dwelling older people. DESIGN AND SETTING: Cross-sectional study carried out among 580 older people in Uberaba (MG). METHODS: Data were collected at these older people's homes using instruments validated in Brazil. Descriptive, bivariate and binary logistic regression analyses were performed (P < 0.05). RESULTS: Most of these individuals were classified as pre-frail (55.7%), while 13.1% were frail. It was found that 31.7% of them presented polypharmacy, 41.7% had drug interactions and 43.8% were using potentially inappropriate medications. In the initial model, polypharmacy (odds ratio, OR = 1.91; confidence interval, CI = 1.27-2.86) and use of potentially inappropriate medications (OR = 2.45; CI = 1.68-3.57) increased the chance that these older people would be pre-frail or frail. In the final adjusted model, use of potentially inappropriate drugs remained associated with the outcome (OR = 2.26; CI = 1.43-3.57). CONCLUSION: Use of potentially inappropriate medications was the independent variable that explained the occurrence of frailty in a representative sample of community-dwelling older adults.

Clinical and socioeconomic characteristics of older adults with COVID-19: A protocol for a rapid systematic review.

The aim of this rapid systematic review is to analyze the prevalence of clinical, socioeconomic, and demographic characteristics, laboratory and imaging findings, diagnostic tests, and treatment information of older adults with COVID-19. To conduct this systematic review, the Cochrane Handbook recommendations will be followed. Patients aged 60 years or older with a confirmed diagnosis of SARS-CoV-2 infection will be included. A comprehensive literature search will be performed in the following databases: MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS), Spanish Bibliographic Index on Health Sciences (IBECS) and Epistemonikos COVID-19 L·OVE platform. No language restrictions will be applied. To assess the methodological quality of the included studies and the certainty of the evidence, the Newcastle-Ottawa Scale, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach will be used. The meta-analysis will be performed using R software. We believe this rapid systematic review will be able to summarize the currently available evidence on clinical, socioeconomic characteristics, and management of COVID-19 in older adults. Therefore, it will help implement adequate strategies to fight the pandemic and assist in understanding the clinical profile of older patients with COVID-19, providing data with due scientific support upon which to base future choices of procedures and interventions.

Frailty-associated factors among Brazilian community-dwelling elderly people: longitudinal study.

BACKGROUND: Frailty among elderly people is associated with negative health outcomes. Through gaining better understanding of this syndrome over different time periods, healthcare actions that take predictive factors into consideration may be facilitated. OBJECTIVE: To identify factors associated with frailty syndrome among community-dwelling elderly people over a two-year follow-up. DESIGN AND SETTING: Longitudinal study on elderly people living in Uberaba (MG), Brazil.Methods: Elderly individuals were selected through multiple-stage conglomerate sampling from a national database. Participants were interviewed and evaluated in 2014 and again in 2016. Predictors were considered at the baseline, and frailty categories (frail, pre-frail or non-frail) at the follow-up. Frailty was identified based on the Fried criteria. Associations with socioeconomic factors, health status and physical performance were investigated using multinomial logistic regression. RESULTS: 353 individuals participated in both assessments. The final model showed that age over 80 years was predictive of both pre-frailty and frailty (odds ratio, OR 4.92; 95% confidence interval, CI: 1.57-15.38; OR 8.64; 95% CI: 2.05-36.35, respectively), while dependency regarding basic activities of daily living (OR 3.66; 95% CI: 1.22-11.02) and poor lower-limb physical performance (OR 7.87; 95% CI: 1.97-31.39) predicted frailty. A one-unit increased score for advanced activities of daily living decreased the frailty rate by 15% (OR 0.85; 95% CI: 0.74-0.99). CONCLUSION: Age over 80 years was predictive of pre-frailty and frailty, while dependency in basic activities of daily living and poor physical performance predicted frailty. A one-unit increased score for advanced activities of daily living decreased the frailty rate by 15%.

Prevalence of self-reported morbidities and associated factors among community-dwelling elderly in Uberaba, Minas Gerais, Brazil. / Prevalência de morbidades autorreferidas e fatores associados entre idosos comunitários de Uberaba, Minas Gerais, Brasil.

This study aimed to verify the prevalence and socioeconomic and health factors associated with morbidity among community-dwelling elderly. This is an analytical and cross-sectional survey conducted in 2012 with 1,691 elderly from Uberaba-MG. A tool structured for socioeconomic data and self-reported morbidities was used along with the Abbreviated Geriatric Depression, Katz and Lawton-Brody scales. We proceeded to a descriptive analysis and linear regression (p < 0.05). A high percentage (88.3%) of elderly reported two or more morbidities, with higher prevalence for systemic arterial hypertension (61.9%) and back problems (48.6%). Female gender (ß = 0.216; p< 0.001), functional disability in basic (ß = 0.240; p < 0.001) and instrumental activities of daily living (ß = 0.120; p < 0.001) and indicative of depression (ß = 0.209; p < 0.001) were associated with the highest number of morbidities. The presence of two or more comorbidities and the association with socioeconomic and health variables show the need for monitoring and control actions of the factors that interfere in the elderly in this condition.

Objetivou-se verificar a prevalência e os fatores socioeconômicos e de saúde associados a morbidades autorreferidas entre idosos da comunidade. Inquérito analítico e transversal, conduzido em 2012 com 1.691 idosos de Uberaba-MG. Utilizou-se instrumento estruturado para os dados socioeconômicos e morbidades autorreferidas; e Escalas (Depressão Geriátrica Abreviada, Katz e Lawton e Brody). Procedeu-se às análises descritivas e regressão linear (p < 0,05). Maior percentual (88,3%) de idosos referiram duas ou mais morbidades, com maior prevalência para hipertensão arterial sistêmica (61,9%) e problemas de coluna (48,6%). Foram associados ao maior número de morbidades: sexo feminino (ß = 0,216; p < 0,001), incapacidade funcional para atividades básicas (ß = 0,240; p < 0,001) e instrumentais (ß = 0,120; p < 0,001) de vida diária e indicativo de depressão (ß = 0,209; p < 0,001). A presença de duas ou mais morbidades e a associação com variáveis socioeconômicas e de saúde demonstram a necessidade de ações de monitoramento e controle desses fatores entre idosos nessa condição.

Incidence and predictive factors of falls in community-dwelling elderly: a longitudinal study. / Incidência e fatores preditivos de quedas em idosos na comunidade: um estudo longitudinal.

This study aimed to estimate the incidence of falls among the elderly and to determine the predictive factors of falls and recurrent falls. This is a longitudinal study (2014-2016) conducted with 345 elderly in the urban area of Uberaba-MG. A structured tool related to socioeconomic data and occurrence of falls, Katz and Lawton-Brody Scales, the Short Physical Performance Battery (SPPB) and Falls Efficacy Scale-International (FES-I) Brazil were used. The multinomial logistic regression analysis was performed (p < 0.05). The incidence of falls in the follow-up period was 37.1%, with 20% recurrent falls and 17.1% single-event falls. The final model showed that the increase in one SPPB unit decreased by approximately 15% and 17%, respectively, the probability of falls and recurrent falls. The highest FES-I Brazil score was associated with a higher occurrence of recurrent falls. The results found on the occurrence of falls and recurrent falls and their association with worse physical performance and fear of falling provide subsidies for actions directed to the monitoring and control of the interfering factors.

Objetivou-se estimar a incidência de quedas entre os idosos e determinar os fatores preditivos de quedas e quedas recorrentes. Estudo longitudinal (2014-2016) conduzido com 345 idosos da área urbana em Uberaba-MG. Utilizou-se: instrumento estruturado referente aos dados socioeconômicos e à ocorrência de quedas; Escalas de Katz e Lawton e Brody; Short Physical Performance Battery (SPPB) e Falls Efficacy Scale-International (FES-I) Brasil. Procedeu-se à análise de regressão logística multinomial (p < 0,05). A incidência de quedas no período de acompanhamento representou 37,1%, sendo 20% recorrentes e 17,1% em um único evento. O modelo final indicou que o aumento em uma unidade do SPPB diminuiu em aproximadamente 15% e 17%, respectivamente, a chance de quedas e quedas recorrentes. O maior escore da FES-I Brasil associou-se à maior ocorrência de quedas recorrentes. Os resultados encontrados sobre a ocorrência de quedas e quedas recorrentes e sua associação com pior desempenho físico e ao medo de cair fornecem subsídios para ações direcionadas ao monitoramento e controle dos fatores interferentes.

Assessment of intrinsic capacity in the Brazilian older population and the psychometric properties of the WHO/ ICOPE screening tool: a multicenter cohort study protocol / Avaliação da capacidade intrínseca da população idosa brasileira e das propriedades psicométricas do instrumento de triagem do ICOPE/OMS: protocolo de estudo de coorte multicêntrico

Introduction: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce. Objectives: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool. Methods: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months. Expected results: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq). Relevance: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil. (AU)

Introdução: A Organização Mundial da Saúde (OMS) propõe o monitoramento da capacidade intrínseca (CI) da população idosa como estratégia de saúde pública por meio do Programa ICOPE (Integrated Care for Older People). Embora construído com base em conceitos sólidos, a evidência científica sobre a aplicabilidade prática da proposta ainda é escassa. Objetivo: Avaliar a capacidade intrínseca da população idosa brasileira, sua trajetória e sua associação com variáveis sociodemográficas, de saúde e desfechos. Avaliar as propriedades psicométricas da ferramenta de triagem da estratégia ICOPE da OMS. Metodologia: Coorte multicêntrica prospectiva com seguimento de 36 meses. Serão recrutadas 3.838 pessoas com 60 anos ou mais, cadastradas nas unidades de saúde incluídas no estudo pelos centros participantes. Serão coletados dados sociodemográficos e de saúde e aplicados instrumentos para avaliação dos domínios da CI, tanto aqueles previstos no instrumento de triagem do ICOPE quanto a sequência de avaliações confirmatórias previstas no programa. Os participantes serão acompanhados semestralmente ao longo de 36 meses. Resultados esperados: Estabelecer o perfil da CI na população estudada, entender a sua trajetória e as variáveis associadas aos desfechos clínicos avaliados. Revelar as propriedades diagnósticas e o perfil psicométrico da ferramenta de triagem do ICOPE da OMS. O projeto tem financiamento do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Relevância: Compreensão sobre o potencial de utilização da estratégia ICOPE de saúde pública proposta pela OMS no âmbito do Sistema Único de Saúde (SUS) pela integração de diversos centros de pesquisa científica na área de Geriatria e Gerontologia de todo o Brasil. (AU)