Handgrip strength: An effective screening instrument for anemia in the elderly women.

OBJECTIVE: The objectives of this study were to discover associations between anemia and functional performance indicators, and to identify the best functional performance test to screen for anemia in the elderly. METHODS: A cross-sectional study analyzed data from 109 elderly residents in the community. For statistical analysis, the Logistic Regression and the Receiver Operating Characteristic (ROC) curve was used. RESULTS: The prevalence of anemia in the elderly was 13.9%. There was an inverse association between handgrip strength (HGS) and anemia in women; the HGS test was an effective screening tool for anemia in the elderly. CONCLUSION: The HGS test can be used to screen for anemia in the elderly women.

Habitual physical activity and sedentary behavior as predictors of dynapenia in older adults: a cross-sectional study.

BACKGROUND: Dynapenia is a risk factor of mortality. Therefore, the development of low-cost and easy-to-apply tools is essential to optimize the health surveillance actions of older people. OBJECTIVES: To compare the time spent on habitual physical activity (HPA) and sedentary behavior (SB) among dynapenic and non-dynapenic older adults and ascertain the predictive ability of these behaviors on outcome. DESIGN AND SETTING: A cross-sectional population epidemiological survey was conducted involving 208 older adults. METHODS: HPA and SB were quantified using the International Physical Activity Questionnaire, and dynapenia was identified by handgrip strength (women: 18.37 kgf; men: 26.75 kgf). RESULTS: The prevalence was 24.50%. In both sexes, dynapenic individuals reported a HPA median time of 70.00 minutes/week (min/wk), while non-dynapenic women and men reported HPA median times of 240.00 and 280.00 min/wk, respectively (P < 0.05). For SB among dynapenic individuals, a median of 388.75 min/day was observed in women and 428.57 min/d in men. In contrast, non-dynapenic women and men had 291.42 and 274.28 min/day in SB (P < 0.05), respectively. The best cutoff HPA to discriminate the outcome was 150.00 min/wk in women (sensitivity: 73.30%; specificity: 60.67%) and 140.00 min/wk in men (sensitivity, 71.43%; specificity, 61.54%). The best cutoff SB was 381.43 min/day in women (sensitivity, 53.30%; specificity, 84.80%) and 351.43 min/day in men (sensitivity, 71.43%; specificity, 73.85%). CONCLUSION: Older individuals with dynapenia spent less time on HPA and more time in SB. Furthermore, HPA was found to be a better discriminator of dynapenic individuals, and SB better discriminated non-dynapenic individuals.

The D allele of angiotensin-converting enzyme gene is associated with a worse autonomic heart control in community-based older adults.

The relationship between the Renin-Angiotensin-Aldosterone System (RAAS) and modulation of the Autonomic Nervous System (ANS) is reported as complex and bidirectional. Thus, the present study aimed to compare autonomous heart control, through symbolic analysis parameters, in the older adults carrying different ACE I/D gene polymorphisms (rs4646994). Two hundred four older adults comprised the study population and were grouped according to the ACE I/D gene polymorphism: II + ID genotype and DD genotype. Successive RR intervals were recorded along 5 min and analyzed with Symbolic Analysis (SA) method. 0 V%, 1 V% and 2 V% patterns were quantified and compared between groups. A linear mixed model analysis was used to determine between-group differences in symbolic analysis parameters (0 V%, 1 V% and 2 V%), taken groups as fixed factor and sex, use of ACE inhibitors and Angiotensin II receptor type I blockers as random factors. The Bayesian analysis was carried out to check the magnitude of the evidence. The results of this study indicate that older adults carrying the DD genotype have statistically greater sympathetic modulation (0 V%) and poor sympathovagal balance (1 V%), but the Bayesian analysis indicate only an anecdotal effect. Sympathetic predominance is recognized a worrying condition, since may predisposes to cardiovascular risk.

Craniofacial geometric morphometrics in the identification of patients with sickle cell anemia and sickle cell trait.

OBJECTIVE: The aims of this study were to identify the main characteristics regarding the shape and size of the craniofacial region in patients with sickle cell anemia (SCA) and sickle cell trait (SCT) and in unaffected patients using geometric morphometrics and to check the efficiency of this method. MATERIAL AND METHODS: A cross-sectional analytical study of 45 patients (15 in each group) was performed. Lateral radiographs of the skull were used for the analysis. Seventeen landmarks and semilandmarks were placed for the measurements. The Pocrustes analysis of variance (ANOVA), regression analysis, multivariate analysis of variance, canonical variate analysis, Mahalanobis and Procrustes distances and unweighted pair group method with arithmetic mean (UPGMA) clustering were performed. Allometric effects and sex characteristics were not statistically significant (p > 0.05). RESULTS: There were, however, significant differences (p < 0.05) in craniofacial shape among SCA, SCT and unaffected individuals. Those with SCA showed variations in the shape of the external auditory meatus and at the base of the occipital bone, in addition to the mandibular setback and upper incisor inclination, with a tendency towards prognathism. The individuals with SCT exhibited a similar craniofacial shape to those with SCA, but with slighter variations. Moreover, those with SCT were statistically closer in resemblance to unaffected individuals, given that SCT is not regarded as a disease. CONCLUSION: This demonstrates the efficiency of geometric morphometrics in the categorization of the assessed groups.

Hyperuricemia is associated with sympathovagal imbalance in older adults.

PURPOSE: This study aimed to compare heart rate variability (HRV) parameters obtained through symbolic analysis (SA), between older adults with and without hyperuricemia. METHODS: This is a cross-sectional study including 202 community-dwelling old adults, which was clinically stratified as with or without hyperuricemia, according to the cutoff point of serum uric acid ≥ 6 mg/dL for women and ≥ 7 mg/dL for men. Successive RR intervals were recorded along 5 min and analyzed with SA method. 0 V%, 1 V% and 2 V% patterns were quantified and compared between groups. Comparisons were carried out through parametric or nonparametric tests, according to the data distribution characteristics, evaluated by Kolmogorov-Smirnov test. The significance level was set as p ≤ 0.05 for all statistical procedures. RESULTS: The prevalence of hyperuricemia was 67.8 %, and the hyperuricemic older adults exhibited significant higher values for V0% and lower values for V2% parameters when compared to normouricemic older adults. CONCLUSION: These results suggesting a sympathovagal imbalance in hyperuricemic older adults, characterized by greater sympathetic predominance (0 V%) and lower vagal modulation (2 V%) at rest conditions.

Clinical and epidemiological aspects of scorpionism in the interior of the state of Bahia, Brazil: retrospective epidemiological study.

BACKGROUND: Scorpion accidents have gained great visibility around the world because of the high frequency and severity with which they occur, and have become a global medical-sanitary problem. OBJECTIVE: The aim of this study was to describe the sociodemographic, clinical and epidemiological profile of scorpionism in the municipality of Jequié, Bahia, Brazil, from 2007 to 2015. DESIGN AND SETTING: Retrospective epidemiological study in the municipality of Jequié, Bahia, Brazil. METHODS: This study was based on data collected from the epidemiological investigation notification forms of the injury information system. RESULTS: There was an increase in the coefficient of incidence of scorpion accidents in Jequié from 23.4/100,000 in 2007 to 413.6/100,000 in 2015. There were 3565 cases: 54.9% were female, 58.8% were aged 20-59 years, 63.5% had brown skin color and 48.6% had incomplete primary education. Most accidents occurred in urban areas (93.1%). Homes were the main place of occurrence (84.5%) and upper limbs were the commonest sting sites (53.0%). Regarding clinical aspects, 66.4% of the cases received hospital assistance within one hour after the bite, 84.1% presented mild severity, 97.1% had local manifestations and 10.2% had systemic symptoms. Serum therapy was administered in 17.3% of the cases, and 99.9% evolved to cure. CONCLUSION: There was an increase in the incidence of scorpion accidents in the municipality, which demonstrates the need for investment in actions that reduce the morbidity and mortality caused by these accidents, such as educational campaigns and improvements in socioeconomic and health conditions.

Habitual physical activity and sedentary behavior as predictors of dynapenia in older adults: a cross-sectional study

ABSTRACT BACKGROUND: Dynapenia is a risk factor of mortality. Therefore, the development of low-cost and easy-to-apply tools is essential to optimize the health surveillance actions of older people. OBJECTIVES: To compare the time spent on habitual physical activity (HPA) and sedentary behavior (SB) among dynapenic and non-dynapenic older adults and ascertain the predictive ability of these behaviors on outcome. DESIGN AND SETTING: A cross-sectional population epidemiological survey was conducted involving 208 older adults. METHODS: HPA and SB were quantified using the International Physical Activity Questionnaire, and dynapenia was identified by handgrip strength (women: 18.37 kgf; men: 26.75 kgf). RESULTS: The prevalence was 24.50%. In both sexes, dynapenic individuals reported a HPA median time of 70.00 minutes/week (min/wk), while non-dynapenic women and men reported HPA median times of 240.00 and 280.00 min/wk, respectively (P < 0.05). For SB among dynapenic individuals, a median of 388.75 min/day was observed in women and 428.57 min/d in men. In contrast, non-dynapenic women and men had 291.42 and 274.28 min/day in SB (P < 0.05), respectively. The best cutoff HPA to discriminate the outcome was 150.00 min/wk in women (sensitivity: 73.30%; specificity: 60.67%) and 140.00 min/wk in men (sensitivity, 71.43%; specificity, 61.54%). The best cutoff SB was 381.43 min/day in women (sensitivity, 53.30%; specificity, 84.80%) and 351.43 min/day in men (sensitivity, 71.43%; specificity, 73.85%). CONCLUSION: Older individuals with dynapenia spent less time on HPA and more time in SB. Furthermore, HPA was found to be a better discriminator of dynapenic individuals, and SB better discriminated non-dynapenic individuals.

Factors associated with the work capacity of motorcycle taxi drivers. / Fatores associados à capacidade para o trabalho de mototaxistas.

This study evaluated the work capacity of motorcycle taxi drivers and its association with sociodemographic and work and quality of life factors. This is a cross-sectional study realized with 392 motorcycle taxi drivers that used a form containing demographic and labor data, Work Capacity Index, the WHOQOL-bref. We employed a descriptive and inferential analysis. The moderate/good prevalence work capacity was 51%. Motorcycle taxi drivers aged 40 years and over recorded a 31% increase in low work capacity (PR: 1.31; 95% CI: 1.07; 1.61) compared to younger workers. Motorcycle taxi drivers aged 21-29 and 30-39 years evidenced a higher median for absenteeism (p = 0.023) and self-prognosis regarding future work capacity (p < 0.001). A greater proportion of diseases diagnosed among those with five or more years of service (p = 0.003) and of self-prognosis in those with five years or less of service (p < 0.001) was observed. Motorcycle taxi drivers with moderate/good capacity showed better perception of quality of life in the physical realm (p < 0.001). Work capacity of motorcycle taxi drivers was associated with higher exposure to noxious factors that affect their quality of life and work force. Priority public policies and educational actions are required to minimize this exposure.

Objetivou-se avaliar a capacidade para o trabalho de mototaxistas e sua associação com fatores sociodemográficos, laborais e qualidade de vida. Estudo transversal, realizado com 392 mototaxistas, utilizando-se formulário com dados sociodemográficos, laborais, Índice de Capacidade de Trabalho e o WHOQOL-bref. Empregou-se análise descritiva e inferencial. A prevalência de capacidade para o trabalho moderada/boa foi de 51%. Mototaxistas com 40 ou mais anos tiveram aumento de 31% na capacidade baixa para o trabalho (RP: 1,31; IC 95%: 1,07; 1,61) comparados aos mais jovens. Mototaxistas de 21 a 29 e de 30 a 39 anos apresentaram maiores medianas para absenteísmo (p = 0,023) e prognóstico próprio sobre a capacidade de trabalho no futuro (p < 0,001). Houve maior proporção para doenças diagnosticadas entre aqueles com cinco anos ou mais na profissão (p = 0,003) e para prognóstico próprio naqueles com cinco anos ou menos (p < 0,001). Mototaxistas com capacidade moderada/boa apresentaram melhor percepção de qualidade de vida no domínio físico (p < 0,001). A capacidade baixa para o trabalho de mototaxistas foi associada à maior exposição aos fatores nocivos que afetam sua qualidade de vida e força de trabalho. É necessário priorizar políticas públicas e ações educativas para minimizar essa exposição.

Prevalência e fatores associados à suspeição de transtornos mentais comuns em idosos: um estudo populacional / Prevalence and factors associated with suspicion common mental disorders in older adults: a population study

RESUMO Objetivo Investigar a prevalência e os fatores associados à suspeição de transtornos mentais comuns (TMCs) em idosos de um município de pequeno porte do Nordeste brasileiro. Métodos Estudo epidemiológico populacional, com delineamento transversal, realizado com idosos da área urbana de Aiquara-BA. As informações sociodemográficas, de hábitos de vida e de condições de saúde foram coletadas, em entrevistas, a partir de um instrumento próprio. O nível de atividade física foi averiguado por meio do International Physical Activity Questionnaire. Foram considerados insuficientemente ativos os entrevistados que despendiam tempo < 150 mim/sem em atividade física. A identificação da suspeição de TMCs foi realizada pelo Self-Reporting Questionnaire, com ponto de corte de sete ou mais respostas positivas. Para as análises inferenciais, utilizou-se o teste qui-quadrado de Pearson, regressão logística multivariada e seus respectivos intervalos de confiança (ICs) de 95,0% (p ≤ 0,05). Resultados Participaram do estudo 232 idosos (58,6% mulheres), com média de idade de 71,6 ± 7,5 anos e prevalência de suspeição de TMCs de 32,6%. No modelo final de regressão, foi observado que estiveram associadas à suspeição de TMCs: as mulheres (RP: 2,49; IC95%: 1,27-4,88); os idosos com autopercepção negativa de saúde (RP: 2,73; IC95%: 1,46-5,10); os idosos que referiram ter distúrbios do sono (RP: 3,12; IC95%: 1,56-6,21); e os insuficientemente ativos (RP: 2,30; IC95%: 1,20-4,41). Conclusão Em Aiquara-BA, identificou-se elevada prevalência de suspeição de TMCs, principalmente em mulheres, nos avaliados com autopercepção de saúde negativa, entre os que referiram ter distúrbios do sono e nos participantes insuficientemente ativos.

ABSTRACT Objective To investigate the prevalence and factors associated with suspected common mental disorders (CMD) in older adults in a small municipality in Northeastern Brazil. Methods Population epidemiological cross-sectional study carried out with older adults from the urban area of Aiquara, BA. Sociodemographic information, lifestyle and health conditions were collected in interviews, using a specific instrument. The level of physical activity was assessed using the International Physical Activity Questionnaire. Respondents who dismissed time < 150 min/wk in physical activity were considered insufficiently active. The identification of suspected CMD was performed using the Self-Reporting Questionnaire, with a cut-off point of seven or more positive responses. For inferential analyses, Pearson's chi-square test and multivariate logistic regression were used, and their respective 95% confidence intervals (CIs) (p ≤ 0.05). Results A total of 232 older adults (58.6% women), with a mean age of 71.6 ± 7.5 years participated in the study and 32.6% exhibited suspected CMD. In the final regression model, it was observed that women were associated with suspected CMD (PR: 2.49; 95% CI: 1.27-4.88); older adults with self-perceived poor health (PR: 2.73; 95%CI: 1.46-5.10); the older adults who reported experiencing sleep disorders (PR: 3.12; 95%CI: 1.56-6.21) and those who were insufficiently active (PR: 2.30; 95%CI: 1.20-4.41). Conclusion In Aiquara, BA, a high prevalence of suspected common mental disorders was identified, especially in women, in patients evaluated with negative self-perceived health, among those who reported having sleep disorders and in insufficiently active participants.

Sarcopenia is associated to an impaired autonomic heart rate modulation in community-dwelling old adults.

PURPOSE: The aims of this study were to compare the autonomic heart control parameters from sarcopenic and non-sarcopenic community-dwelling elders. METHODS: This is a cross-sectional study including 76 community-dwelling old adults, which was clinically stratified as sarcopenic or non-sarcopenic, according to the current recommendations. They were submitted to 5-min recordings of successive RR intervals. The analysis of the RR intervals variability was carried out in time (mean RR, RMSSD, pNN50, SDNN and triangular index) and frequency domains (LFnu, HFnu and LF/HF ratio), and with nonlinear methods (SD1, SD2, and D2). The parameters of autonomic heart rate modulation (AHRM) were adjusted for potential confounders: sex, diabetes, beta-blockers use, cardiovascular disease, body mass index and physical activity level, smoking habit. Normality of the data was tested by Kolmogorov-Smirnov test and, since most variables did not exhibit a normal distribution the Mann-Whitney test was used to compare the parameters of AHRM. The significance level was set as p ≤ 0.05 and all statistical procedures were performed with SPSS®. RESULTS: Adjusted parameters of AHRM obtained from time domain and nonlinear methods were significantly different between sarcopenic and non-sarcopenic elders (p < 0.05), while parameters obtained from frequency domain analysis did not were different between groups (p > 0.05). CONCLUSION: Sarcopenic old adults exhibited lower parasympathetic-associated modulation, suggesting a poor cardioprotection associated to this condition.

Improving the comprehension of sarcopenic state determinants: An multivariate approach involving hormonal, nutritional, lifestyle and genetic variables.

It is known that sarcopenia is a multifaceted phenomenon, which involves genetic, nutritional, hormonal and living habits aspects. Then, an integrated analysis, as a multivariate approach, could improve the comprehension about the determinants of sarcopenic state in old adults. The present study aimed to investigate the interaction among serum vitamin D, daily caloric and protein intake, lifestyle habits, ACE I/D gene polymorphism and sarcopenic state in community-dwelling old adults. One hundred one community-dwelling old adults were clinically stratified as sarcopenic or non-sarcopenic. Serum vitamin D, daily caloric and protein intake, lifestyle habits (smoking, physical activity level and sedentary behavior) and ACE I/D gene polymorphism were recorded. A multivariate logistic regression technique was applied to investigate the interaction among the selected independent variables and the sarcopenic state. The independent variables age, smoking, serum Vitamin D and ACE I/D polymorphism achieved the statistical criteria to be inserted in the multivariate analysis. After a stepwise procedure from the multivariate logistic regression, the variables age, serum Vitamin D and ACE I/D polymorphism remained, together, in the final model. Sarcopenic state was significantly associated to older age, II-genotype and low serum Vitamin D in old adults from 60 years old.

Physical fitness according to the level of physical activity in older people: a cross-sectional analysis / Aptidão física de acordo com o nível de atividade física em pessoas idosas: uma análise transversal

Abstract Introduction Aging is marked by physiological changes and a decrease in physical activity. These aspects can have repercussions, namely declining functionality and increasing likelihood of adverse events. Objective To compare performance in physical fitness tests of sufficiently and insufficiently active older people. Methods Epidemiological population study, cross-sectional, carried out with 209 older people (58.4% women) from Aiquara/BA. Sociodemographic information was obtained by means of interviews. Physical fitness was measured by means of the following tests: handgrip strength, chair stand, arm curl, timed up and go, sit and reach and step in place. The level of physical activity was checked by the International Physical Activity Questionnaire (<150 min/week physical activity = insufficiently active). Comparisons were made using the Student t-test or Mann-Whitney U-test, according to the distribution of normality determined by the Kolmogorov-Smirnov test (p ≤ 0.05). Results We found that 51.70% of the participants were insufficiently active (men: 66.66%; women: 40.98%). In addition, insufficiently active participants of both sexes performed less well in the handgrip strength, chair stand, arm curl, timed up and go and step in place tests (p < 0.05). Moreover, insufficiently active men showed lower performance in the sit and reach test than sufficiently active men (p < 0.05). Conclusion Insufficiently active older women and men have lower muscle strength/resistance, dynamic balance/agility and cardiorespiratory endurance. Furthermore, insufficiently active men show less flexibility than those sufficiently active.

Resumo Introdução O envelhecimento é marcado por alterações fisiológicas e diminuição do tempo em atividade física (AF). Tais aspectos podem repercutir no declínio da funcionalidade e propiciar maior probabilidade para eventos adversos. Objetivo Comparar o desempenho em testes de aptidão física de pessoa idosas suficiente e insuficientemente ativas. Métodos Estudo epidemiológico populacional, transversal, realizado com 209 pessoas idosas (58,40% mulheres) de Aiquara/BA. As informações sociodemográficas foram obtidas a partir de entrevistas. A aptidão física foi mensurada por meio dos seguintes testes: força de preensão manual; levantar e sentar da cadeira; flexão do antebraço; levantar, caminhar 2,44 m e sentar; sentar e alcançar o pé; e marcha estacionária. O nível de atividade física foi averiguado pelo International Physical Activity Questionnaire (< 150 min/sem em AF = insuficientemente ativo). As comparações foram feitas por meio dos testes t de Student ou U de Mann-Whitney, conforme a distribuição de normalidade averiguada pelo teste de Kolmogorov-Smirnov (p ≤ 0,05). Resultados A prevalência do nível de AF insuficiente foi de 51,70% (homens: 66,66%; mulheres: 40,98%). Verificou-se, em ambos os sexos, que os insuficientemente ativos demonstraram menor desempenho na força de preensão manual; sentar e levantar da cadeira; flexão do antebraço; levantar, caminhar e sentar; e marcha estacionária (p < 0,05). Além do mais, os homens insuficientemente ativos apresentaram menor desempenho no teste sentar e alcançar o pé em relação aos suficientemente ativos (p < 0,05). Conclusão Identificou-se que os idosos insuficientemente ativos, de ambos os sexos, apresentaram menor força/resistência muscular, equilíbrio dinâmico/agilidade e resistência cardiorrespiratória. Ademais, os homens insuficientemente ativos demonstraram menor flexibilidade do que os suficientemente ativos.

Association of physical activity combined with sedentary behavior with dynapenia in older adults / Associação da atividade física combinada ao comportamento sendentário com a dinapenia em idosos

ABSTRACT This research aimed to analyze the association of physical activity (PA) level combined with exposure to sedentary behavior (SB) with dynapenia in older people. Epidemiological, cross-sectional study, conducted with 208 older adults in Aiquara, Bahia, Brazil. Habitual PA and SB were quantified using the International Physical Activity Questionnaire. Based on this information, participants were divided into groups (G): G1) sufficiently active and low SB; G2) sufficiently active and high SB; G3) insufficiently active and low SB; and G4) insufficiently active and high SB. Assessment of dynapenia was performed based on the values of the handgrip strength measured in kilogram-force (kgf) (women: 18.37 kgf; men: 26.75 kgf). Descriptive analysis was conducted using absolute and relative frequencies, mean and standard deviation. For the inferential analysis, Poisson regression was used, with a robust estimator, calculation of Prevalence Ratios (PRs) and their relevant Confidence Intervals (CIs) of 95.0%. It was observed that the mean age of women and men were, respectively, 71.0 ± 6.7 and 72.3 ± 8.1 years and the prevalence of dynapenia observed was about 24.5%. Furthermore, it was found that the insufficiently active older adults with low SB (G3) (PR: 2.28; 95%CI: 1.09-4.76), and those insufficiently active with high SB (G4) (PR: 4, 14; 95%CI: 1.95-8.70), were more likely to experience the assessed outcome. Evidence showed that, among the older adults in Aiquara the prevalence of dynapenia was high in the presence of an insufficient level of PA, especially when combined with greater exposure to SB

RESUMO Esta pesquisa teve como objetivo analisar a associação do nível de atividade física (AF) combinado à exposição ao comportamento sedentário (CS) com a dinapenia em idosos. Estudo epidemiológico, transversal, conduzido com 208 idosos de Aiquara, Bahia, Brasil. A AF habitual e o CS foram quantificados pelo International Physical Activity Questionnaire. A partir destas informações, dividiu-se os participantes em grupos (G): G1) suficientemente ativos e baixo CS; G2) suficientemente ativos e elevado CS; G3) insuficientemente ativos e baixo CS; e G4) insuficientemente ativos e elevado CS. A avaliação da dinapenia foi realizada a partir dos valores, em quilograma-força (kgf), da força de preensão manual (mulheres: 18,37 kgf; homens: 26,75 kgf). A análise descritiva foi conduzida por meio de frequências absolutas e relativas, média e desvio padrão. Para a análise inferencial utilizou-se a regressão de Poisson, com estimador robusto, cálculo das Razões de Prevalência (RP) e de seus respectivos Intervalos de Confiança (IC) de 95,0%. Observou-se que as médias de idade das mulheres e dos homens, foram, respectivamente, 71,0 ± 6,7 e 72,3 ± 8,1 anos e a prevalência de dinapenia observada foi na ordem de 24,5%. Ademais, averiguou-se que os idosos insuficientemente ativos com baixo CS (G3) (RP: 2,28; IC95%: 1,09-4,76), e os insuficientemente ativos com elevado CS (G4) (RP: 4,14; IC95%: 1,95-8,70), apresentaram maior probabilidade ao desfecho analisado. As evidências verificadas mostraram que, entre os idosos de Aiquara, a prevalência de dinapenia foi elevada na presença do nível de AF insuficiente, especialmente quando combinado a uma maior exposição ao CS.

Anthropometric indicators of adiposity as predictors of systemic arterial hypertension in older people: a cross-sectional analysis / Indicadores antropométricos de adiposidade como preditores de hipertensão arterial sistêmica em pessoas idosas: uma análise transversal

ABSTRACT Objective: To analyze the association of anthropometric indicators of adiposity in older people, according to sex, with hypertension; to compare the scores of these variables between participants with and without hypertension; and to identify among them those with better predictive ability for screening the outcome. Methods: Epidemiological, population-based, cross-sectional study conducted with 210 older people. The anthropometric indicators analyzed were: body mass index, waist circumference, abdominal circumference, body adiposity index, triceps skinfold, waist-to-hip ratio, waist-to-height ratio, and conicity index. Hypertension diagnosis was self-reported. Results: The indicators of adiposity increased the probability of hypertension. Additionally, hypertensive older people of both sexes showed higher scores on adiposity indicators than non-hypertensive subjects (p < 0.05). For men, the most sensitive indicator for the outcome was conicity index (81.82%; cut-off point: 1.30) and the most specific was body mass index (69.77%; cut-off point: 25.05 kg/m2). For women, the most sensitive indicator for the outcome was the body adiposity index (86.08%; cut-off point: 31.03%), and the most specific was the abdominal circumference (82.82%; cut-off point: 98.70 cm). Conclusion: In both sexes, the indicators of adiposity were positively associated with hypertension; hypertensive participants showed higher values in the scores of the indicators. Additionally, the body adiposity index (women) and conicity index (men) demonstrated greater ability to screen for hypertension, while the abdominal circumference and body mass index demonstrated greater ability to screen for non-hypertensive women and men, respectively.

RESUMO Objetivo: Analisar a associação de indicadores antropométricos de adiposidade com a hipertensão, em pessoas idosas, de acordo com o sexo; comparar os escores dessas variáveis entre os participantes com e sem hipertensão; e identificar os indicadores com melhor capacidade preditiva à triagem do desfecho. Métodos: Estudo epidemiológico, populacional, transversal, realizado com 210 pessoas idosas. Os indicadores antropométricos analisados foram: índice de massa corporal, circunferência da cintura, circunferência abdominal, índice de adiposidade corporal, dobra cutânea tricipital, relação cintura/quadril, relação cintura/altura e índice de conicidade. O diagnóstico de hipertensão arterial foi autorreferido. Resultados: Observou-se que os indicadores de adiposidade aumentaram a probabilidade à hipertensão. Além disso, as pessoas idosas hipertensas, de ambos os sexos, apresentaram maiores escores nos indicadores de adiposidade quando comparadas às não hipertensas (p < 0,05). Para os homens, o indicador mais sensível ao desfecho foi o índice de conicidade (81,82%; ponto de corte: 1,30) e o mais específico foi o índice de massa corporal (69,77%; ponto de corte: 25,05 kg/m2). Nas mulheres, o indicador mais sensível ao desfecho foi o índice de adiposidade corporal (86,08%; ponto de corte: 31,03%) e o mais específico foi a circunferência abdominal (82,82%; ponto de corte: 98,70 cm). Conclusão: Em ambos os sexos, os indicadores de adiposidade mostraram-se positivamente associados à hipertensão; os participantes hipertensos apresentaram valores mais elevados nos escores dos indicadores. Ademais, identificou-se para os sexos, feminino e masculino, que os indicadores com melhor capacidade de rastrear a hipertensão, foram, respectivamente, o índice de adiposidade corporal e índice de conicidade. Enquanto a circunferência abdominal e o índice de massa corporal mostraram maior capacidade de rastrear, respectivamente, as mulheres e os homens não hipertensos.

Functional performance indicators associated with hypertension in older people / Indicadores de desempenho funcional associados à hipertensão em pessoas idosas

Abstract Introduction During aging, changes occur in the human body that increase the probability of arterial hypertension which can potentiate deleterious effects on functional performance. Objective To analyze the association of functional performance indicators with hypertension in older people. Methods An epidemiological, population-based, cross-sectional survey was conducted with 209 older adults (58.40% women). Functional performance was assessed by the following tests: handgrip strength; chair stand test; arm curl test; timed up and go (TUG); sit and reach test; and step in place test (SPT). Diagnosis of arterial hypertension was self-reported. Results The prevalence of hypertension was found to be 58.90% (males: 51.70%; females: 63.90%). It was also observed that the hypertensive individuals of both sexes had worse performance in SPT and TUG (p < 0.05). Furthermore, it was found that each additional second for TUG increased by 11% the probability of hypertension in men (PR:1.11; 95%CI: 1.03-1.20) and by 7% in women (PR: 1.07; 95%CI: 1.04-1.12), while each step performed in the SPT decreased the probability for the outcome by 2% (men and women = PR: 0.98; 95%CI: 0.97-0.99). Conclusion TUG was found to be positively associated with hypertension, while SPT was inversely associated with hypertension.

Resumo Introdução Durante o envelhecimento ocorrem modificações no corpo humano, as quais aumentam a probabilidade de hipertensão arterial sistêmica (HAS),o que pode potencializar efeitos deletérios no desem-penho funcional. Objetivo Analisar a associação de indicadores de desempenho funcional com a HAS em pessoas idosas. Métodos Inquérito epidemiológico, populacional, transversal, conduzido com 209 idosos (58,40% mulheres). O desempenho funcional foi averi-guado pelos seguintes testes: força de preensão manual; levantar e sentar da cadeira; flexão do antebraço; levantar, caminhar e sentar (LCS); sentar e alcançar o pé; e marcha estacionária (ME). O diagnóstico da HAS foi autorreferido. Resultados Averiguou-se a prevalência de HAS em 58,9% dos participantes (homens: 51,7%; mulheres: 63,9%). Observou-se, também, que os hipertensos de ambos os sexos apresentaram pior desempenho na ME e LCS (p < 0,05). Além disso, verificou-se que cada segundo a mais despendido para LSC aumentou em 11% e 7%, respectivamente, a probabilidade de HAS nos homens (RP: 1,11; IC95%: 1,03-1,20) e nas mulheres (RP: 1,07; IC95%: 1,04-1,12), enquanto cada passo a mais realizado na ME diminuiu em 2% a probabilidade para o desfecho (homens e mulheres = RP: 0,98; IC95%: 0,97-0,99). Conclusão Identificou-se que o teste de LCS esteve positivamente associado à HAS. Ademais, a ME apresentou-se inversamente associada à HAS.

[Pharmacotherapeutic profile and factors associated with polypharmacy among the elderly in Aiquara, Bahia, Brazil, 2014]. / Perfil farmacoterapêutico e fatores associados à polifarmácia entre idosos de Aiquara, Bahia, em 2014.

Objective: to describe the drugs used and analyze the factors associated with polypharmacy in the elderly, in Aiquara, Bahia, Brazil. Methods: this is a census cross-sectional study, conducted in February 2014, through an interview using standardized form. Results: among the 272 elderly respondents, 53.3% used only prescribed medication and 31.6% used at least one medication not prescribed; the prevalence of polypharmacy was 29.0%; cardiovascular drugs were the most used in polypharmacy (n=390; 37.6%); after adjusted analysis, the factors that remained associated with polypharmacy were female sex (OR=2.20 - 95%CI 1.11;4.35), private health insurance (OR=2.18 - 95%CI 1.05;4.55), hospitalization in the previous year (OR=2.34 - 95%CI 1.18;4.65) and having four or more self-reported diseases (OR=3.18 - 95%CI 1.60;6.29). Conclusion: there was a high prevalence of polypharmacy, associated with sex, private health insurance, having four or more self-reported diseases and hospitalization in the previous year, with higher use of cardiovascular drugs.

Lower limb strength, but not sensorial integration, explains the age-associated postural control impairment.

INTRODUCTION: The aging process leads to functional decline of sensorial organs, muscle mass and strength, as well as the sensorimotor integration, culminating in age-associated postural control impairments. The purpose of this study was to compare the balance, the sensorial integration process and the lower limb strength among three old aged groups. METHODS: Eighty-one community-dwelling healthy old people (58% women), assigned into three age groups [60-69 years (n=30), 70-79 years (n=40), and ≥80 years (n=11)], participated in this study. All participants were submitted to anthropometric and stabilometric evaluation, and carried out a Chair stand test. Stabilometric parameters obtained from time [amplitude displacement of center of pressure (CoP)] and frequency (oscillations of CoP at sub 0.3 Hz and 1-3 Hz bands) domain analysis were used as the indicators of balance performance and sensorial integration, respectively. RESULTS: Our results revealed that the CoP amplitude displacement was significantly greater in the older aged group, without differences in spectral bands, while the performance in the Chair stand test was smaller in the older aged group. CONCLUSION: These data indicate that the age-associated postural control impairment is explained by the lower limb strength declines, but not by the age-associated changes in sensorial integration. LEVEL OF EVIDENCE: III.

The smoking habit negatively influences autonomic heart control in community-dwelling elderly adults.

OBJECTIVE: The present study aimed to analyze the influence of smoking on heart autonomic control in elderly adults who did and did not smoke. METHODS: In a population-based study, all community-dwelling elderly adults (≥60 years old) from Aiquara, Bahia, Brazil, were invited to participate in the study. Two-hundred-thirty-two (232) elderly adults provided information about their smoking habits and underwent 5-min recordings of successive RR intervals. Analysis of the variability of the RR intervals was performed in time and frequency domains and with nonlinear methods. The HAC parameters were adjusted for the following potential confounders: age, sex, diabetes, beta-blocker use, cardiovascular disease, body mass index and physical activity level. After exclusions, 210 elderly adults were divided into 2 groups, nonsmokers or those who stopped smoking (NSMOK [n=190]) and current smokers (SMOK [n=20]). Owing to the absence of a normal distribution, the Mann-Whitney test was used for group comparisons. RESULTS: For unadjusted HAC parameters, a significant difference was observed (p<0.05) between groups for the following parameters in the time domain: CV_RR; SDNN; RMSSD; pNN50; triangular index TINN; and nonlinear parameters SD1, SD2 and D2. All of the adjusted HAC parameters (including the Mean RR and frequency domain parameters) were significantly different between the groups. CONCLUSION: Together, the HAC parameters indicated a higher variability of successive RR intervals in NSMOK elderly adults. Notwithstanding, adjustment of the HAC parameters was an important step to improve data analysis. These results indicate an impaired sympathovagal balance on the heart of elderly adult smokers.

Visão bioética na quarentena no contexto da covid-19: revisão integrativa / Bioethics view in the quarantine in the COVID-19 context: an integrative review / Visión bioética en la cuarentena en el contexto del Covid-19: una revisión integradora

Resumo Este estudo busca relacionar as questões bioéticas acerca da quarentena como ferramenta de mitigação da pandemia de covid-19 na sociedade. Trata-se de revisão integrativa da literatura, seguindo os critérios da Preferred Reporting Items for Systematic Reviews and Meta-Analyses nas etapas pertinentes. A busca foi realizada nas bases de dados Biblioteca Virtual em Saúde, PubMed e SciELO, procurando textos publicados entre 2019 e 2020, em inglês, espanhol e português. Dentre os artigos identificados, sete foram selecionados para compor este trabalho, sendo dois dos Estados Unidos, dois da Espanha, um da Finlândia, um da Austrália e um de Bangladesh. Os estudos ressaltam que, apesar de a quarentena e o isolamento serem as únicas estratégias conhecidas até o momento, é necessário desenvolver políticas que levem em consideração os princípios bioéticos, focando, por exemplo, populações em situação de vulnerabilidade social, que necessitam de suporte para estabelecer tal medida.

Abstract This study seeks to relate the bioethical questions about the quarantine as a mitigation tool of the COVID-19 pandemic in society. It is an integrative review, following criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses at the pertinent phases. The search was carried out in the databases Biblioteca Virtual em Saúde, PubMed and SciELO, searching texts published between 2019 and 2020, in English, Spanish and Portuguese. Among the identified articles, seven were selected to be part of this work, of those, two are from the United States, two from Spain, one from Finland, one from Australia, and one from Bangladesh. The studies show that, despite the quarantine and the distancing being the only strategies known up to this moment, developing politics that consider bioethical principles, focusing on, for example, socially vulnerable populations, who need support to establish this measure, is necessary.

Resumen Este estudio pretende relacionar las cuestiones bioéticas sobre la cuarentena como herramienta de mitigación para la pandemia del Covid-19. Esta es una revisión integradora de la literatura basada en los criterios del Preferred Reporting Items for Systematic Reviews and Meta-Analyses en las etapas correspondientes. Se realizó en las bases de datos Biblioteca Virtual en Salud, PubMed y SciELO una búsqueda de artículos publicados entre 2019 y 2020, en inglés, español y portugués. Entre los artículos identificados, se seleccionaron siete: dos de Estados Unidos, dos de España, uno de Finlandia, uno de Australia y uno de Bangladesh. Los estudios destacan que, aunque la cuarentena y el aislamiento son las únicas estrategias conocidas hasta el momento, es necesario desarrollar políticas que tengan en cuenta los principios bioéticos, centrándose, por ejemplo, en las poblaciones en situación de vulnerabilidad social, que necesitan apoyo para cumplir tal medida.

Factors associated with dynapenia in older adults in the northeast of Brazil / Fatores associados à dinapenia em idosos do nordeste brasileiro

ABSTRACT This study identified factors associated with dynapenia in older adults residing in a small town in northeastern Brazil. It is a population-based study conducted with 208 senior citizens (58.7% women) from Aiquara, BA. Sociodemographic, behavioral and health information were obtained from face-to-face interviews, and nutritional status was assessed by body mass index. To measure their level of physical activity and sedentary behavior, the International Physical Activity Questionnaire was used. Dynapenia was diagnosed by sex, from the 25th percentile of handgrip strength, by means of a hydraulic dynamometer. For inferential analyses, Poisson regression was used, with a robust estimator, calculation of Prevalence Ratios (PRs) and their respective 95% Confidence Intervals (CIs). The prevalence of dynapenia was higher in older adults aged 70-79 (PR: 3.21; 95%CI: 1.55-6.64) and ≥80 years (PR: 4.91; 95%CI: 2.32-10.39), in those with low weight (PR: 2.20; 95%CI: 1.26-3.82), in those who are insufficiently active (PR: 1.99; 95%CI: 1.12-3.54), and among those with high level of sedentary behavior (PR: 1.88; 95%CI: 1.19-2.98). The factors identified as being associated with dynapenia were: age between 70 and 79 and ≥80 years, insufficient level of physical activity; high level of sedentary behavior, and low weight.

RESUMO Este estudo identificou os fatores associados à dinapenia em idosos residentes em um município de pequeno porte do Nordeste brasileiro. Trata-se de um estudo populacional, conduzido com 208 idosos (58,7% mulheres) de Aiquara-BA. As informações sociodemográficas, comportamentais e de condições de saúde foram obtidas em entrevistas face a face, e o estado nutricional foi avaliado pelo índice de massa corporal. Para mensuração do nível de atividade física e do comportamento sedentário, utilizou-se o International Physical Activity Questionnaire. O diagnóstico da dinapenia foi realizado por sexo, a partir do percentil 25 da força de preensão manual, averiguada com um dinamômetro hidráulico. Para análises inferenciais foi utilizada a regressão de Poisson, com estimador robusto, cálculo das Razões de Prevalência (RP) e de seus respectivos intervalos de confiança de 95% (IC). A prevalência de dinapenia foi maior nos idosos com idade entre 70-79 (RP: 3,21; IC95%: 1,55-6,64) e ≥80 anos (RP: 4,91; IC95%: 2,32-10,39), nos com baixo peso (RP: 2,20; IC95%: 1,26-3,82), nos insuficientemente ativos (RP: 1,99; IC95%: 1,12-3,54) e entre os com elevado comportamento sedentário (RP: 1,88; IC95%: 1,19-2,98). Identificou-se que os fatores associados à dinapenia foram: idade entre 70-79 e ≥80 anos, nível de atividade física insuficiente; elevado comportamento sedentário e baixo peso.