Exomic variants of an elderly cohort of Brazilians in the ABraOM database.

Brazilians are highly admixed with ancestry from Europe, Africa, America, and Asia and yet still underrepresented in genomic databanks. We hereby present a collection of exomic variants from 609 elderly Brazilians in a census-based cohort (SABE609) with comprehensive phenotyping. Variants were deposited in ABraOM (Online Archive of Brazilian Mutations), a Web-based public database. Population representative phenotype and genotype repositories are essential for variant interpretation through allele frequency filtering; since elderly individuals are less likely to harbor pathogenic mutations for early- and adult-onset diseases, such variant databases are of great interest. Among the over 2.3 million variants from the present cohort, 1,282,008 were high-confidence calls. Importantly, 207,621 variants were absent from major public databases. We found 9,791 potential loss-of-function variants with about 300 mutations per individual. Pathogenic variants on clinically relevant genes (ACMG) were observed in 1.15% of the individuals and were correlated with clinical phenotype. We conducted incidence estimation for prevalent recessive disorders based upon heterozygous frequency and concluded that it relies on appropriate pathogenicity assertion. These observations illustrate the relevance of collecting demographic data from diverse, poorly characterized populations. Census-based datasets of aged individuals with comprehensive phenotyping are an invaluable resource toward the improved understanding of variant pathogenicity.

Abdominal obesity as a risk factor for disability in Brazilian older adults.

OBJECTIVE: To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period. DESIGN: Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI. SETTING: São Paulo, Brazil. SUBJECTS: Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed. RESULTS: The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001). This pattern was observed in all BMI levels. In regression models, abdominal obesity remained associated with disability incidence (incidence rate ratio=1·90; P<0·03), even after controlling for BMI, gender, age, low grip strength, cognitive impairment, physical inactivity and chronic diseases. CONCLUSIONS: Abdominal obesity was strong risk factor for disability, showing a more significant effect than BMI, and thus should be an intervention target for older adults. Waist measure is simple, cost-effective and easily interpreted, and therefore can be used in several settings to identify individuals at higher risk of disability.

Expenditures of medicine use in hypertensive/diabetic elderly and physical activity and engagement in walking: cross secctional analysis of SABE Survey.

BACKGROUND: The literature shows the inverse association between physical activity level (PAL) and chronic diseases that have a significant burden over health care costs. However, in upper-middle income countries and in elderly population this information are scarce. OBJECTIVE: To describe the annual drug expenditures for the hypertensive and diabetic elderly population in Brazil and to analyze the association with PAL and engagement in walking. METHODS: This cross sectional study is part of SABE Survey and comprised 806 hypertensive and/or diabetic elderly (≥60 years old). The annual expenditures of medicine use was estimated for all medications for hypertension and/or diabetes they were taking. The PAL was considered insufficient when moderate physical activity was <150 min/week or vigorous physical activity was < 75 min/week. Engagement in walking was considered by at least 1 day a week. All expenditures were presented through the descriptive values (in American Dollars US$) according PAL and engagement in walking. The association analysis between annual expenditures, PAL and engagement in walking were performed by multiple logistic regression models adjusted for gender, age and body mass index. RESULTS: The average annual cost was higher in diabetic and insufficient physically activity elderly. The 1-year estimated.cost was US$ 73386,09 and 295% higher in insufficiently physically active. Older people who reported not walking had a higher risk to higher annual expenditures of medicine use (OR = 1.57, 95% CI 1.03-2.40). CONCLUSIONS: The annual expenditures of medicine use for controlling hypertension and diabetes of Brazilian elderly were higher and inversely associated with physical activity level and engagement in walking.

The prevalence of fecal incontinence and associated risk factors in older adults participating in the SABE study.

AIMS: To assess the prevalence of fecal incontinence (FI) and associated factors in older adults. METHODS: The prevalence and factors associated with FI in older adults were studied by means the SABE study (Health, Well-being, and Aging). A group of 1,345 subjects were interviewed during the third wave of the SABE study performed in Sao Paulo, in 2010. The study included 64.3% females; the mean age of the participants was 70.4 years. The dependent variable was the positive answer for the question "In the last 12 months, have you ever lost control of bowel movements or stools?". Descriptive analysis and hierarchical logistic regression were performed. The independent variables were as follows: (a) demographics: gender, age and (b) clinical characteristics: self-reported chronic diseases, presence of cognitive and/or functional decline, depression and urinary incontinence symptoms, and nutritional status. RESULTS: The overall prevalence of FI was 11,7%, being 8.3% and 13.2% for males and females respectively. Among male subjects, the presence of malnutrition was associated with FI and thus presented a high relative risk index for its occurrence. Among female subjects, age group 70-74 years and some self-reported diseases or conditions such as mild depression, heart disease, urinary incontinence, and polypharmacy were associated with FI. For the first time in literature, polypharmacy appeared as an associated factor for FI for female older adults. CONCLUSIONS: The prevalence of FI in older adults was 11.7% and was mainly associated with advanced age and presence of heart disease, symptoms of depression, polypharmacy and urinary incontinence and malnutrition. Neurourol. Urodynam. 35:959-964, 2016. © 2015 Wiley Periodicals, Inc.

Factors associated with lower gait speed among the elderly living in a developing country: a cross-sectional population-based study.

BACKGROUND: Among community-dwelling older adults, mean values for gait speed vary substantially depending not only on the population studied, but also on the methodology used. Despite the large number of studies published in developed countries, there are few population-based studies in developing countries with socioeconomic inequality and different health conditions, and this is the first study with a representative sample of population. To explore this, the association of lower gait speed with sociodemographic, anthropometric factors, mental status and physical health was incorporated participants' weight (main weight) in the analysis of population of community-dwelling older adults living in a developing country. METHODS: This was a cross-sectional population based on a sample of 1112 older adults aged 60 years and over from Health, Wellbeing and Aging Study cohort 2010. Usual gait speed (s) to walk 3 meters was stratified by sex and height into quartiles. Multiple regression analysis was performed to investigate the independent effect of each factor associated with a slower usual gait speed. RESULTS: The average walking speed of the elderly was 0.81 m/s-0.78 m/s among women and 0.86 m/s among men. In the final model, the factors associated with lower gait speed were age (OR = 3.56), literacy (OR = 3.20), difficulty in one or more IADL (OR = 2.74), presence of cardiovascular disease (OR = 2.15) and sedentarism. When we consider the 50% slower, we can add the variables handgrip strength, and the presence of COPD. CONCLUSIONS: Gait speed is a clinical marker and an important measure of functional capacity among the elderly. Our findings suggest that lower walking speed is associated with age, education, but especially with modifiable factors such as impairment of IADL, physical inactivity and cardiovascular disease. These results reinforce how important it is for the elderly to remain active and healthy.

Prevalence and characteristics of lesions in elderly people living in the community. / Prevalência e características das feridas em pessoas idosas residentes na comunidade.

Objective To describe the profile and the characteristics of elderly people with mobility restrictions who are residents in the community and have skin lesions. Method This was an exploratory and descriptive study that was part of the Health, Welfare and Ageing (SABE) study which assessed the presence of skin lesions in a probabilistic sample of elderly people living in the city of São Paulo in relation to factors such as socio-demographic issues, blood biomarkers, health conditions and the use of services. The analysis used the chi-square test with the Rao-Scott correction for complex samples, with a level of significance of 5%. Results In 2010, 20.7% of elderly people with restricted mobility had skin lesions due to this problem. The most common sites of these lesions were the sacral region for both sexes, the scapular region for women and the trochanteric region for men. Older age, multimorbidity and functional impairment were more prevalent among the elderly people with lesions, as well as greater levels of care that were required. Family dysfunction was associated with higher burdens on caregivers, which may affect the quality of care provided. It was observed that elderly people who are priorities for home care do not receive such care adequately. Conclusion The prevalence of skin lesions in the elderly with mobility restrictions living in the community was low; however, these elderly people require special attention, which is not currently being adequately provided. The reorganization of policies and care services appears to be essential.

Nutritional status and risk for disability in instrumental activities of daily living in older Brazilians.

OBJECTIVE: The aim of the present study was to examine the association between nutritional status and the incidence of disability regarding instrumental activities of daily living (IADL) among older adults. DESIGN: The study is part of the longitudinal SABE (Saúde, Bem-Estar e Envelhecimento; Health, Wellbeing and Ageing) Study that began in 2000 (first wave) with a multistage, clustered, probabilistic sample (n 2143) of older adults (≥60 years). The second wave was carried out in 2006, when 1115 elders were re-interviewed. The dependent variable was the occurrence of disability in 2006 (report of difficulty on ≥1 IADL). Nutritional status (measured at baseline) was classified on the basis of BMI: ≤23·0 kg/m2 (underweight); >23·0 and <28·0 kg/m2 (ideal range - reference); ≥28·0 and <30·0 kg/m2 (overweight); and ≥30·0 kg/m2 (obesity). SETTING: São Paulo, Brazil. SUBJECTS: One thousand and thirty-four individuals without difficulties regarding IADL in 2000 were selected, 611 of whom were re-interviewed in 2006. RESULTS: In the multiple logistic regression analysis adjusted for baseline variables (gender, age, number of chronic diseases, stroke, osteoarthritis and cognitive status), underweight (OR = 2·03; P = 0·034) and obesity (OR = 1·79; P = 0·022) remained associated with disability. CONCLUSIONS: Both underweight and obesity are associated with an increased risk of developing disability regarding IADL among older adults, in an independent fashion of other risk factors. Thus, adequate nutritional status is a key point to consider in the establishment of preventive measures.

Income inequality and mortality: results from a longitudinal study of older residents of São Paulo, Brazil.

OBJECTIVES: We determined whether community-level income inequality was associated with mortality among a cohort of older adults in São Paulo, Brazil. METHODS: We analyzed the Health, Well-Being, and Aging (SABE) survey, a sample of community-dwelling older adults in São Paulo (2000-2007). We used survival analysis to examine the relationship between income inequality and risk for mortality among older individuals living in 49 districts of São Paulo. RESULTS: Compared with individuals living in the most equal districts (lowest Gini quintile), rates of mortality were higher for those living in the second (adjusted hazard ratio [AHR] = 1.44, 95% confidence interval [CI] = 0.87, 2.41), third (AHR = 1.96, 95% CI = 1.20, 3.20), fourth (AHR = 1.34, 95% CI = 0.81, 2.20), and fifth quintile (AHR = 1.74, 95% CI = 1.10, 2.74). When we imputed missing data and used poststratification weights, the adjusted hazard ratios for quintiles 2 through 5 were 1.72 (95% CI = 1.13, 2.63), 1.41 (95% CI = 0.99, 2.05), 1.13 (95% = 0.75, 1.70) and 1.30 (95% CI = 0.90, 1.89), respectively. CONCLUSIONS: We did not find a dose-response relationship between area-level income inequality and mortality. Our findings could be consistent with either a threshold association of income inequality and mortality or little overall association.

Correlates of the incidence of disability and mortality among older adult Brazilians with and without diabetes mellitus and stroke.

BACKGROUND: The combined effect of diabetes and stroke on disability and mortality remains largely unexplored in Brazil and Latin America. Previous studies have been based primarily on data from developed countries. This study addresses the empirical gap by evaluating the combined impact of diabetes and stroke on disability and mortality in Brazil. METHODS: The sample was drawn from two waves of the Survey on Health and Well-being of the Elderly, which followed 2,143 older adults in São Paulo, Brazil, from 2000 to 2006. Disability was assessed via measures of activities of daily living (ADL) limitations, severe ADL limitations, and receiving assistance to perform these activities. Logistic and multinomial regression models controlling for sociodemographic and health conditions were used to address the influence of diabetes and stroke on disability and mortality. RESULTS: By itself, the presence of diabetes did not increase the risk of disability or the need for assistance; however, diabetes was related to increased risks when assessed in combination with stroke. After controlling for demographic, social and health conditions, individuals who had experienced stroke but not diabetes were 3.4 times more likely to have ADL limitations than those with neither condition (95% CI 2.26-5.04). This elevated risk more than doubled for those suffering from a combination of diabetes and stroke (OR 7.34, 95% CI 3.73-14.46). Similar effects from the combination of diabetes and stroke were observed for severe ADL limitations (OR 19.75, 95% CI 9.81- 39.76) and receiving ADL assistance (OR 16.57, 95% CI 8.39-32.73). Over time, older adults who had experienced a stroke were at higher risk of remaining disabled (RRR 4.28, 95% CI 1.53,11.95) and of mortality (RRR 3.42, 95% CI 1.65,7.09). However, risks were even higher for those who had experienced both diabetes and stroke. Diabetes was associated with higher mortality. CONCLUSIONS: Findings indicate that a combined history of stroke and diabetes has a great impact on disability prevalence and mortality among older adults in São Paulo, Brazil.

[Factors associated to the use of psychotropic drugs by community-dwelling elderly in São Paulo city]. / Fatores associados ao uso de psicotrópicos por idosos residentes no Município de São Paulo.

The objectives of study were to identify the prevalence and factors associated to the use of psychotropic drugs among elderly people in São Paulo city. It is a cross-sectional study. Data were used from the SABE survey (for Health, Well-being and Ageing). The sample was constituted of 1.115 elderly people, aging 65 and over, which were interviewed by standard method. In the data analysis, it was used univariate and multiple logistic regression, stepwise forward and level of significance of 5%. The prevalence of the use of psychotropic drugs of 12,2% and the factors associated were female gender (OR=3,04 IC95%= 1,76-5,23) and polypharmacy (OR=4,91 IC95%=2,74-8,79). The use of psychotropics drugs by the elderly must have their benefits and risks very well established. Elder women, especially those who were submitted to a polipharmacy, deserve special attention to adjust dosage and duration of the treatment, with the purpose of minimizing the adverse outcomes.

[Cross-cultural adaptation of the Vulnerable Elders Survey-13 (VES-13): helping in the identification of vulnerable older people]. / Adaptação transcultural do Vulnerable Elders Survey-13 (VES-13): contribuindo para a identificação de idosos vulneráveis.

To use the VES-13 a tool for identifying vulnerable older people cultural adaptation was performed, a process that seeks the equivalence between the original instrument and its version in another culture. The evaluation of semantic, idiomatic, cultural and conceptual equivalence obtained a general average agreement of 78%, 78%, 97.0% and 94.0% respectively. Kappa coefficient was used to verify the agreement in test-retest reliability, where variables were significant. The analysis of internal consistency was measured by using Cronbach's alpha coefficient, where 70% of the phenomenon under study are represented in the VES-13. The VES-13, translated and adapted, is a reliable instrument with respect to stability and internal consistency of their measurements. Its simple structure and easy to use may therefore contribute to the identification of vulnerable older people, thus contributing to the prioritization of monitoring health services.

Association between urinary incontinence in elderly patients and caregiver burden in the city of Sao Paulo/Brazil: Health, Wellbeing, and Ageing Study.

AIM: Some elderly patients with incontinence require the care of third parties, known as caregivers. Such care can occur on a daily basis leaving little opportunity for the caregiver to take care of himself/herself. The aims are to assess the association between urinary incontinence in elderly patients and caregiver burden and identify independent factors for caregiver's burden in the city of Sao Paulo, Brazil. METHODS: The Pan-American Health Organization and World Health Organization coordinated a multicenter study named Health, Wellbeing and Aging (SABE Study) in elderly people living in seven countries of Latin America and the Caribbean. In Brazil, the study population carried out in São Paulo in the year 2000 and reassessed in 2006 (COHORT A). Urinary incontinence was assessed by ICIQ-SF and caregiver burden by means of Zarit Burden Scale. RESULTS: A total of 327 patients with caregivers were included in the study. The general prevalence of urinary incontinence was 25.8%, higher among the women. There was a significant positive association between caregiver burden and incontinent patients, demonstrating that urinary incontinence in elderly patients produced greater caregiver burden. In the present study, the variables with significant correlations were assessed using the multivariate logistic regression model. Category 2 of the ICIQ-SF (incontinent patients) increased the chances of caregiver burden 1.96-fold in comparison to Category 1 (continent patients). Likewise, the category of impaired cognition increased the chances of caregiver burden 2.34-fold. CONCLUSIONS: Urinary incontinence and cognitive impairment in elderly patients were associated to an increase in caregiver burden.

[Self-rated hypertension and anthropometric indicators of body fat in elderly]. / Hipertensão arterial referida e indicadores antropométricos de gordura em idosos.

OBJECTIVE: To investigate the association between self-rated hypertension (sf-H) and anthropometric indicators of body fat and abdominal fat, in elderly of São Paulo. METHODS: Data on 1894 elderly were obtained from the Survey on Aging, Health and Well-being (SABE), 2000. The anthropometric indicators used were: body mass index (BMI), waist circumference (WC), waist/ hip ratio (WHR) and waist/height ratio (WHR). Binary logistic regression analysis, stratified by gender was used. RESULTS: In the final model (adjusted for age, education, smoking, physical activity and diabetes), for both genders BMI had a greater statistical strength, despite the fact that, in women, it is similar to other indicators. With the exception of WHR, in men, sf-H was positively and independently associated with other indicators. CONCLUSION: Results suggest the relevance of those indicators for an early detection of risks for the development of this disease as well as to intervene in its prevention and control.

Factors associated with the survival of elderly men in almost 15 years. / Fatores associados à sobrevida de homens idosos em quase 15 anos.

OBJECTIVE: To identify factors associated with a higher probability of survival for men aged 60 and over in the course of almost 15 years. METHODS: Prospective cohort study, where time zero is the year 2000 and deaths (final event) were measured until November 2014. The independent variables were obtained from personal characteristics, childhood life, educational status, lifestyle, social support, work history, socioeconomic situation, and health condition. RESULTS: At the end of the period, 25.8% of elderly men remained alive and the factors that stood out associated with a higher probability of survival were: performing 50% or more of the Basic and/or Instrumental Activities of Daily Living (95%CI 0.41 - 0.64), being the head of the family (95%CI 0.42 - 0.82), participating in the community (95%CI 0.52 - 0.88), working on their own (95%CI 0.54 - 0.88), and owning a home and goods (95%CI 0.56 - 0.92). CONCLUSION: Characteristics related to a greater autonomy of the elderly men, even after almost 15 years, contributed to an increase in the probability of survival.

OBJETIVO: Identificar fatores associados a maior probabilidade de sobrevida de homens com 60 anos ou mais em quase 15 anos. MÉTODOS: É um estudo de coorte prospectivo, em que o tempo zero é o ano de 2000 e cujos óbitos (evento final) foram mensurados até novembro de 2014. As variáveis independentes foram obtidas por meio de características pessoais, da vida na infância, da condição educacional, do estilo de vida, do apoio social, da história laboral, da situação socioeconômica e da condição de saúde. RESULTADOS: No final do período, 25,8% dos homens idosos permaneciam vivos, e os fatores que se destacaram para maior probabilidade de sobrevida foram: realizar 50% ou mais das atividades básicas e/ou instrumentais da vida diária (intervalo de confiança [IC] de 95% 0,41 - 0,64), ser chefe de família (IC95% 0,42 - 0,82), ter participação comunitária (IC95% 0,52 - 0,88), trabalhar por conta própria ou como proprietário (IC95% 0,54 - 0,88) e possuir casa própria e bens móveis (IC95% 0,56 - 0,92). CONCLUSÃO: Características relacionadas à autonomia do homem idoso, mesmo depois de quase 15 anos, contribuíram para aumentar a probabilidade de sobrevida.

[Violence perpetrated against the elderly and health-related quality of life: a populational study in the city of São Paulo, Brazil]. / Violência contra idosos e qualidade de vida relacionada à saúde: estudo populacional no município de São Paulo, Brasil.

The scope of this work was to identify the prevalence of domestic violence against non-institutionalized elderly individuals, and to establish if violence is an independent factor associated with the Physical Component (PC) and Mental Component (MC) scores of the Health-Related Quality of Life (HRQOL) of these elderly individuals. It is a cross-sectional epidemiologic and population-based investigation that is part of the SABE (Wellbeing, Health and Aging) study. A sample of 1,126 elderly individuals filled out the Short-Form 12 (SF-12) Health Survey, namely a generic instrument that assesses HRQOL through the Physical and Mental components. The prevalence of domestic violence against of the elderly was 10% (CI 95% 9.1-13.6). In the multiple analyses, violence against the elderly was significantly associated to the MC (ß = -3.03; p = 0.000) and to the PC (ß = -1.69; p = 0.017) of HRQOL, independently of the sociodemographic, health, family support, and functional incapacity covariables. The prevalence of domestic violence was high and compromised the physical and mental health of the elderly.

Objetivou-se identificar a prevalência da violência doméstica contra idosos não institucionalizados e verificar se esta é um fator independente associado aos Componentes Físico (CF) e Mental (CM) da Qualidade de Vida Relacionada à Saúde (QVRS) desses idosos. É um estudo epidemiológico transversal e de base populacional integrante do Estudo SABE (Saúde, Bem-Estar e Envelhecimento). A amostra foi de 1.126 idosos que responderam ao Short-Form 12 Health Related Survey (SF-12), instrumento genérico que avalia a QVRS em seus CF e CM. A prevalência da violência doméstica contra idosos foi de 10% (IC 95% 9,1 - 13,6). Na análise múltipla, a violência contra idosos permaneceu significativamente associada ao CM (ß = -3,03; p = 0,000) e ao CF (ß = -1,69; p = 0,017) da QVRS, independente de covariáveis sociodemográficas, de saúde, de apoio familiar e de incapacidade funcional. A prevalência da violência doméstica foi elevada e comprometeu a saúde física e mental dos idosos.

Early life conditions and current health status as per the study "Health, Well-being and Aging" (SABE). / Condições pregressas e saúde no estudo "Saúde, Bem-Estar e Envelhecimento" (SABE).

INTRODUCTION: Childhood conditions can influence some aspects of development of an individual and thus affect health in adult life. OBJECTIVE: To evaluateassociations between early life conditions and health, as reported by the survey SABE in 2000, 2006, and 2010. METHODS: Early or previous conditions refer to the situations before 15 years of age of the interviewees, such as economic condition, famine, health assessment, medical conditions, and having lived in the countryside for over 5 years. The control variables were gender, education, andincome. The outcome was self-reported health as "good" or "bad." This study focused on ages between 60 and 65years. RESULTS: Bivariate analysis showed significant associations of the individual's origin in all the three cohorts. Economic and famine conditions were also significant for cohort B (2006). Multivariate Poisson regression was used with prevalence ratio as an element of comparison. Rural origin was the only significant early condition in the initial model. Thecontrol variables - gender, cohort, and education - were also significant. In the final model, the significant variables in the initial model were included, plus relation between rural origin and the number of diseases. Cohorts, gender, education, and the number of diseases were still significant factors when individuals had rural origin, but were not associated with the outcome if their origin was urban. CONCLUSION: There were connections between early conditions of life and the health of the elderly, and this might be an important tool for health care for both the individual and the community.

INTRODUÇÃO: Condições da infância podem influenciar peculiaridades individuais do desenvolvimento e assim afetar a saúde dos adultos. OBJETIVO: Avaliar associações entre condições pregressas e saúde, como informadas nas pesquisas SABE de 2000, de 2006 e de 2010. MÉTODOS: Condições pregressas referem-se a situações anteriores aos 15 anos: a condição econômica, a fome, a avaliação da saúde, a presença de doenças e ter vivido em ambiente rural por mais de cinco anos. As variáveis de controle foram o sexo, a escolaridade e a renda. O desfecho é a autoavaliação da saúde nas categorias "Boa" e "Má". A análise abrangeu pessoas entre 60 e 65anos. RESULTADOS: A análise bivariada mostrou associações segundo a origem nas três coortes. Foram ainda significantes a condição econômica e ter passado fome, para os entrevistados em 2006. Na análise multivariada pela regressão de Poisson, o elemento de comparação foi a razão de prevalência. Origem rural foi a única entre as condições pregressas a apresentar significância no modelo inicial. As variáveis de controle- sexo, coorte, escolaridade - também apresentaram significância. No modelo final, foram consideradas as variáveis significantes no inicial e uma interação entre origem rural e número de doenças. Permaneceram significantes a coorte, o sexo, a escolaridade e o número de doenças quando o indivíduo teve origem rural. Estenúmero não foi associado ao desfecho se a origem fosse urbana. CONCLUSÃO: Há conexões entre as condições pregressas e a saúde do idoso, o que constitui em importante instrumento para a atenção à saúde, tanto para o indivíduo como para a comunidade.

Factors associated with balance disorders of elderly living in the city of São Paulo in 2006: evidence of the Health, Well-being and Aging (SABE) Study. / Fatores associados às alterações de equilíbrio em idosos residentes no município de São Paulo em 2006: evidências do Estudo Saúde, Bem-Estar e Envelhecimento (SABE).

OBJECTIVE: To analyze the influence of demographic, health condition, and lifestyle factors on body balance disorders among elderly subjects living in the city of São Paulo, Brazil, in 2006. METHODS: Thestudy was developed based on information provided by the Health, Well-being, and Aging (SABE) Study. Itincluded 60-year-old subjects, both men and women, or those over this age. The sample comprised 1,226 subjects that represented 930,639 elderly subjects. The dependent variable was the elderly's body balance disorder, which was measured using part of the Short Physical Performance Battery (SPPB). The independent variables were divided into three groups: demographic, health conditions, and lifestyle. The multiple binary logistic regression analysis was applied to estimate the association between balance disorders and demographic, health, and lifestyle variables in the elderly. RESULTS: Age, difficulties in at least one mobility, and performance of regular physical activities showed a significant influence on the elderly's body balance (p < 0.05). Age was the strongest related determiner. Being aged 75-79 years and 80 years or more increased 3.77 and 5.31 times, respectively, the chances of the elderly subjects present balance disorders in comparison with the 60- to 64-years-old. CONCLUSION: Preventive measures that aim at reversing a body instability condition should be preconized and incorporated in the elderly's health-care schedule.

OBJETIVO: O objetivo deste estudo foi investigar a influência dos fatores demográficos, de condições de saúde e de estilo de vida nas alterações do equilíbrio corporal dos idosos residentes no município de São Paulo em 2006. MÉTODOS: O estudo foi desenvolvido com base em dados provenientes do Estudo Saúde,Bem-Estar e Envelhecimento (SABE). Foram selecionados todos os indivíduos com 60 anos e mais de idade, de ambos os sexos. A amostra considerada era de 1.226 indivíduos, representando 930.639 idosos. A variável dependente foi a alteração de equilíbrio corporal do idoso. Para mensurá-la utilizou-se parte do Short Physical Performance Battery (SPPB). As variáveis independentes foram classificadas em três grupos: demográficas, de condições de saúde e de estilo de vida. Para estimar a associação entre as alterações de equilíbrio com as variáveis demográficas, de saúde e de estilo de vida em idosos foi realizada uma análise de regressão logística binária múltipla. RESULTADOS: Idade, dificuldades em pelo menos uma mobilidade e realização de atividade física regular exercem uma significativa influência no equilíbrio corporal dos idosos (p < 0,05). A idade foi o determinante mais fortemente relacionado. Ter idade entre 75 a 79 anos e 80 anos e mais aumenta em 3,77 e 5,31vezes a chance, respectivamente, de os idosos apresentarem alterações de equilíbrio em comparação às idades de 60 a 64 anos. CONCLUSÃO: Medidas preventivas e que visam reverter um quadro de instabilidade corporal devem ser preconizadas e incorporadas na agenda de atenção à saúde dos idosos.

10 Years of SABE Study: background, methodology and organization of the study. / 10 Anos do Estudo SABE: antecedentes, metodologia e organização do estudo.

The Health, Wellbeing and Aging Study (SABE) began in 2000 under the coordination of the Pan American Health Organization as a multicenter study developed in seven urban centers of Latin America and the Caribbean, to determine the health and living conditions of elderly in this region. In Brazil, the study was developed in the city of São Paulo, where 2,143 individuals (cohort A) aged 60 years or older were selected through probabilistic sampling. In 2006, 1,115 of these individuals were interviewed a second time, and a new probabilistic cohort of individuals aged 60 to 64 years was added (cohort B; n=298). Thus the SABE Study - Brazil was transformed into a multi-cohort longitudinal study, with the objective of identifying changes that occur in the aging process among different generations. In 2010, a longitudinal follow-up was developed with cohorts A and B, with the addition of a new cohort of individuals aged 60 to 64 years (cohort C; n=355). Thethree surveys (2000, 2006 and 2010) involved the application of a questionnaire, anthropometric evaluation and functional tests, with the subsequent inclusion of blood collection for the evaluation of biochemical, immunological and genetic variables, as well as an accelerometer for the measuring of caloric expenditure.

O Estudo Saúde, Bem-Estar e Envelhecimento (SABE) teve início em 2000 sob coordenação da Organização Pan-Americana da Saúde como um estudo multicêntrico desenvolvido em sete centros urbanos da América Latina e Caribe para traçar o perfil das condições de vida e saúde das pessoas idosas na região. No Brasil, foi realizado na cidade de São Paulo, onde foram entrevistadas 2.143 pessoas (coorte A), com idade igual ou superior a 60 anos, por amostra probabilística. Em 2006, o Estudo SABE - Brasil transformou-se em longitudinal. Nesse momento, foram localizadas e reentrevistadas 1.115 pessoas, introduzindo-se uma nova amostra probabilística de idosos com idade de 60 a 64 anos (coorte B, n = 298), o transformando em longitudinal de múltiplas coortes com o objetivo principal de identificar as transformações que ocorrem no processo de envelhecimento entre as diferentes gerações. No ano 2010 foi desenvolvido o seguimento longitudinal das coortes A e B e introduzida nova coorte de 60 a 64 anos (coorte C, n = 355). Nas três coletas (2000, 2006 e 2010) utilizou-se um instrumento sob a forma de questionário, avaliação antropométrica e testes funcionais, introduzindo-se a coleta de sangue para avaliação de parâmetros bioquímicos, imunológicos e genéticos e, também, o acelerômetro para medir objetivamente o gasto calórico dos idosos.

Social network and older people's functionality: Health, Well-being, and Aging (SABE) study evidences. / Redes sociais e funcionalidade em pessoas idosas: evidências do estudo Saúde, Bem-Estar e Envelhecimento (SABE).

INTRODUCTION: Possessing active social networks seems to positively influence the functional performance of elderly people. OBJECTIVE: To verify the association between the characteristics of social networks of the elderly people and the emergence of functional impairment. METHODS: This is a longitudinal population-based study, which used the 2006 (n = 1,413) and 2010 (n = 990) cohorts of the Health, Well-Being, and Aging (SABE) Study. To characterize the social networks, the following variables were used: number of members in the network; living arrangements; sex and age of the members; coresidence with children or only elderly individuals; satisfaction with the relationships; and receiving and offering social support (financial, material, emotional, performing tasks inside and outside the home, providing companionship, and personal care). Logistic regression was used to analyze the data. All ethical guidelines were followed. RESULTS: The social networks of the elderly people had an average of 8.15 members and consisted predominantly of family members aged between 15 and 59 years. Dependent elderly people received more material support, help in performing household tasks and those outside the home, and personal care, while the independent elderly people received more emotional support and companionship. Provision of social support (OR = 0.32, 95%CI 0.14 - 0.71) decreased the chances of developing dependency, independent of sociodemographic and health conditions. CONCLUSION: The strengthening of social networks in old age should be encouraged since confidence in informal care offered, mainly by families, may not be the best option for dealing with the growing demand for care that accompanies the aging of the population.

INTRODUÇÃO: Possuir redes sociais ativas parece influenciar positivamente o desempenho funcional de idosos. OBJETIVO: Verificar a associação entre as características das redes sociais de idosos e o surgimento de comprometimento funcional. MÉTODOS: Estudo longitudinal de base populacional que utilizou as coortesde2006 (n = 1.413) e 2010 (n = 990) do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). Para caracterização das redes sociais utilizou-se as seguintes variáveis: número de integrantes da rede; arranjo domiciliar; sexo e idade dos integrantes; co-residência com criança ou apenas com idosos; satisfação com a relação; recebimento e oferecimento de apoio social (financeiro, material, emocional, realização de tarefas dentro e fora de casa, companhia e cuidados pessoais). Utilizou-se regressão logística para a análise dos dados. Todos os cuidados éticos foram observados. RESULTADOS: As redes sociais dos idosos possuem, em média, 8,15 integrantes e são constituídas predominantemente por familiares com idade entre 15 e 59 anos. Idosos dependentes recebem mais apoio material, para realização de tarefas domésticas, fora de casa e cuidados pessoais, enquanto os idosos independentes recebem mais apoio emocional e companhia. Oferecer apoio social (OR = 0,32; IC95% 0,14-0,71) diminuiu as chances de desenvolver dependência, independente de condições sociodemográficas e de saúde. CONCLUSÃO: Deve-se estimular o fortalecimento das redes sociais na velhice, uma vez que a confiança no cuidado informal, oferecido, principalmente pelas famílias, pode não ser a melhor opção para lidar com a demanda de cuidado crescente que acompanha o envelhecimento da população brasileira.

Non-Japanese, Japanese and Japanese descendant older adults in the Health, Wellbeing and Aging Study: functional and health conditions. / Idosos não japoneses, japoneses e descendentes de japoneses no Estudo Saúde, Bem-Estar e Envelhecimento: condições funcionais e de saúde.

INTRODUCTION: The city of São Paulo has the largest community of Japanese descendants outside of Japan. OBJECTIVES: To compare the demographic, economic, functional, and health conditions of non-Japanese, Japanese, and their descendants; and to analyze comparatively the functional and health conditions of older adults born in Japan and their descendants born in Brazil. METHODS: A cross-sectional study was carried out in the city of São Paulo, in 2010, with 1,345 older adults (≥ 60 years) participants in the SABE Study (Health, Welfare and Aging). The participants were classified as non-Japanese (not born in Japan), Japanese (born in Japan) or have reported being a direct descendant of Japanese. For the data analysis, χ2 test with Rao-Scott correction was used. RESULTS: Of the 1,345 older adults, 3.3% were Japanese or descendants. These differed from non-Japanese in terms of higher education and reported income sufficiency. Among older adults born in Japan, there was a higher proportion of oldest old (38.8%), cardiovascular diseases (48.9%) and cognitive decline (26.7%). CONCLUSION: It is noted that Japanese and descendants older adults presented better functionality when compared to non-Japanese. Among Japanese and descendants, differences in the profile of diseases were observed. It is believed that such results may be due to cultural influences.

INTRODUÇÃO: A cidade de São Paulo conta com a maior comunidade de descendentes japoneses fora do Japão. OBJETIVOS: Comparar as condições demográficas, econômicas, funcionais e de saúde de idosos não japoneses, japoneses e descendentes de japoneses, bem como analisar comparativamente as condições funcionais e de saúde de idosos nascidos no Japão e de seus descendentes nascidos no Brasil. MÉTODOS: Estudo transversal realizado no município de São Paulo, no ano de 2010, com 1.345 idosos (≥ 60 anos) participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). Os idosos foram classificados em não japoneses (não nascidos no Japão), japoneses (nascidos no Japão) ou descendentes diretos de japoneses. Para a análise dos dados, utilizou-se o teste do χ2 com correção Rao-Scott. RESULTADOS: Dos 1.345 idosos, 3,3% eram japoneses ou descendentes. Esses se diferenciavam dos não japoneses quanto à escolaridade mais elevada e suficiência de renda. Entre os idosos nascidos no Japão, houve maior proporção de longevos (38,8%), portadores de doenças cardiovasculares (48,9%) e de declínio cognitivo (26,7%). CONCLUSÃO: Nota-se que os idosos japoneses/descendentes apresentaram melhor funcionalidade quando comparados aos não japoneses. Já entre japoneses e descendentes, observou-se diferenças no perfil das doenças. Acredita-se que tais resultados possam ser decorrentes das influências culturais.