Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009-2010.

OBJECTIVE: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. DESIGN: Prospective study. SETTINGS: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0-2 points), moderately healthy (3-4 points) and the healthiest (5-7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. PARTICIPANTS: 2706 participants from the Chilean National Health Survey 2009-2010. RESULTS: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. CONCLUSION: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults.

Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009-2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.

Valores de referencia y factores de riesgo de la condición física en personas mayores chilenas físicamente activas / Reference values and risk factors in the deterioration of the physical fitness of physically active older chilean adults

BACKGROUND: Physical fitness assessment of older adults is essential because it is a key component of functional independence and healthy aging. AIM: To establish physical fitness reference values for physically active older Chilean adults of both sexes and identify the variables associated with the deterioration of their physical condition. MATERIAL AND METHODS: Cross-sectional study that included 342 older adults aged 60 and over. Their physical fitness was assessed with the Senior Fitness Test (SFT). The timed up and go (TUG), chair stand (CS), arm curl (AC), and aerobic resistance (2 min) tests were evaluated. RESULTS: Performance in the physical fitness tests by age group decreased in all tests as older adults advanced in age. Scores for men were more evenly distributed across the different age groups. The main risk factors for the deterioration of physical fitness were age, sex, and body mass index (BMI) (p-value < 0.05). The primary risk factor for men was age and for women age and BMI. CONCLUSIONS: Performance of both men and women in the different SFT tests decreased as older adults aged. Age, sex, and BMI were the main risk factors for the deterioration of the physical fitness of physically active older adults.

[Levels of physical activity and sitting time in elderly people with fragility: results of the 2016-2017 National Health Survey]. / Niveles de actividad física y tiempo sedente en personas mayores con fragilidad: resultados de la Encuesta Nacional de Salud 2016-2017.

Introduction: Background: fragility is characterized by loss of biological reserves and vulnerability to adverse outcomes. An intervention with beneficial effects on the prevention and management of frailty is the regular practice of physical activity (PA). Objective: to determine the association between levels of PA, sedentary time and frailty in older Chileans by sex. Methodology: 232 people over 60 years of age from the metropolitan region participating in the National Health Survey 2016-2017 were included. Frailty was assessed based on the Fried Phenotype Scale criteria and PA level and sedentary time with the Global Physical Activity Questionnaire (GPAQ v2). The association between levels of PA with the different states of frailty was investigated with linear regression analysis. Results and conclusion: elderly people with frailty have less total PA (ß = -292.6 min/day [95 % CI: 399.5; -185.7], p = 0.001), occupational PA (ß = -5821.8 min/day [95 % CI: 8680.8, -2962.8], p = 0.001), transportation (ß = -68.0 min/day [95 % CI: -105.4, -30.62], p = 0.001). A lower amount of moderate AF was also found (ß = -137.7 min/day [95 % CI: -202.0, -73.5], p = 0.001); vigorous (ß = -43.4 min/day [95 % CI: -81.6; -5.20], p = 0.026) and longer time seated (ß = 3.55 hours/day [95 % CI: - 1.97, 5.14], p = 0.001). Frail older people have lower PA levels compared to their peers without frailty. Considering that the Chilean population will experience an increase in the number of older people, it is essential to implement preventive measures to delay the onset of frailty, such as promoting the practice of PA at all levels.

Introducción: Antecedentes: la fragilidad se caracteriza por la pérdida de reservas biológicas y la vulnerabilidad a resultados adversos. Una intervención con efectos beneficiosos sobre la prevención y el manejo de la fragilidad es la práctica regular de actividad física (AF). Objetivo: caracterizar los niveles de AF y tiempo sedente en personas mayores con fragilidad. Metodología: se incluyó a 232 personas mayores de 60 años de la región metropolitana, participantes en la Encuesta Nacional de Salud 2016-2017. La fragilidad se evaluó en base a los criterios de la escala de fenotipos de Fried y el nivel de AF y tiempo sedentario con el cuestionario Global Physical Activity Questionnaire (GPAQ v2). Los niveles de AF según el fenotipo de fragilidad se determinaron con análisis de regresión lineal. Resultados y conclusiones: las personas mayores con fragilidad realizan menos AF total (ß = -292,6 min/día [IC 95 %: 399,5; -185,7], p = 0,001), laboral (ß = -5821,8 min/día [IC 95 %: 8680,8; -2962,8], p = 0,001), de transporte (ß = -68,0 min/día [IC 95 %: -105,4; -30,62], p = 0,001). También se observó menor cantidad de AF moderada (ß = -137,7 min/día [IC 95 %: -202,0; -73,5], p = 0,001); vigorosa (ß = -43,4 min/día [IC 95 %: -81,6; -5,20], p = 0,026) y mayor tiempo sedente (ß = 3,55 hora/día [IC 95 %: -1,97; 5,14 ], p = 0,001). Las personas mayores frágiles presentan niveles más bajos de AF en comparación con sus pares sin fragilidad. Considerando que la población chilena experimentará un aumento en el número de personas mayores, es imprescindible implementar medidas preventivas que permitan retrasar la aparición de la fragilidad, como fomentar la práctica de AF en todos sus niveles.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Asociación entre velocidad de marcha y deterioro cognitivo en personas mayores: resultados de la Encuesta Nacional de Salud 2016-2017

Antecedentes: La velocidad de la marcha podría considerarse un marcador temprano de riesgo de deterioro cognitivo en personas mayores. Objetivo: Determinar la asociación entre velocidad de la marcha y sospecha de deterioro cognitivo en población mayor chilena. Métodos: Se incluyeron 1788 personas mayores de la Encuesta Nacional de Salud (ENS) 2016-2017 que tenían información sobre velocidad de marcha y sospecha de deterioro cognitivo. La velocidad de la marcha fue autorreportada y categorizada como marca lenta, normal y rápida. Sospecha de deterioro cognitivo fue evaluado a través del cuestionario Mini Mental abreviado. La asociación entre marcha y deterioro cognitivo fue investigada mediante análisis de regresión logística. Resultados: En comparación a las personas mayores que reportaron una velocidad de marcha rápida, aquellas que reportaron una marcha lenta presentaron 2,67 veces mayor probabilidad de tener deterioro cognitivo (OR: 2,67 [95% IC:1,62; 4,42], p<0,001). Al ajustar los modelos por variables de confusión sociodemográficas, estilos de vida y salud, la asociación disminuyó, pero, permaneció significativa (OR: 1,78 [95% IC:1,15; 3,17], p=0,047). Mientras que las personas mayores que reportaron tener una velocidad de marcha normal no presentaron asociación con deterioro cognitivo. Conclusión: Personas mayores que reportan una velocidad de marcha lenta presentaron una mayor probabilidad de sospecha de deterioro cognitivo. Considerando que el deterioro cognitivo es un síndrome geriátrico con alta prevalencia en población mayor, existe la necesidad de enfatizar en estrategias para un diagnóstico temprano, por lo cual la velocidad de marcha podría ser un instrumento útil.

Background: Walking pace could be considered an early risk marker of cognitive impairment in older people. Objective: To determine the association between walking pace and cognitive impairment in older Chilean adults. Methods: 1,788 adults older than 60 years from the 2016-2017 Chilean National Health Survey with data available in the exposure and outcome were included in this cross-sectional study. Walking pace was self-reported and categorised as slow, average and brisk. Cognitive impairment was assessed using the Abbreviated Mini-Mental questionnaire. Logistic regression analyses were performed to investigate the association between walking pace and cognitive impairment, logistic regression analyses - adjusted for sociodemographic, lifestyle and health-related covariates. Results: In the minimally adjusted model and compared to older adults who self-reported a brisk walking pace, those in the slow walking pace category were 2.67 times more likely to have cognitive impairment (OR: 2.67 [95% CI: 1.62, 4.42]). When the analyses were adjusted, the association was attenuated but remained significant (OR: 1.78 [95% CI: 1.15 3.17]). No associations were found between average pace walkers and cognitive impairment. Conclusion: Older adults who self-reported a slow walking pace having a higher likelihood of cognitive impairment than their counterparts who had a brisk walking pace. Considering that cognitive impairment is a geriatric syndrome with a high prevalence in the elderly, there is a need to emphasise strategies for an early diagnosis. Therefore, walking pace may be a useful marker to identify individuals at high risk of cognitive impairment.

Asociación del fitness cardiorrespiratorio con marcadores de adiposidad corporal: estudio de corte transversal de la Encuesta Nacional de Salud Chile 2016-2017 / Association of cardiorespiratory fitness with adiposity markers

BACKGROUND: Cardiorespiratory fitness (CRF) is inversely associated with metabolic diseases and adiposity markers. Aim: To assess the association of CRF with body mass index (BMI), waist circumference (WC) and obesity in a representative sample of the Chilean population. MATERIAL AND METHODS: Data from 5,958 participants in the Chilean National Health Survey 2016-1027 aged 15 years or above were analyzed. CRF was estimated by an equation that included sociodemographic, anthropometric and health-related data and expressed in metabolic equivalent units (METs). The association between CRF and adiposity was assessed using linear and Poisson regression models and the results were presented as Prevalence Ratio (PR). RESULTS: One MET increment in CRF was associated with a 3.27 kg/m2 (95% confidence intervals (CI): -3.35; -3.2) and 4.56 kg/m2 (95% CI: -4.67; -4.46) lower BMI in men and women, respectively. Waist circumference was 6.7 cm [95% CI: -6.98; -6.42] and 9 cm [95% CI: -9.33; -8.67] lower per 1-MET increment in CRF. With one MET increment, the probability of being obese was 34% (PR = 0.66 [95%CI: 0.63; 0.69]) and 36% (PR = 0.64 [95%CI: 0.61; 0.67]) lower in men and women, respectively. The probability of having a central obesity was 26% (PR = 0.74 [95%CI: 0.71; 0.77]) and 30% (PR = 0.70 [95%CI: 0.68; 0.73]) lower in men and women, respectively. Conclusions: A higher estimated CRF was associated with lower adiposity levels and a lower risk of being obese in both men and women. Public health policies aiming to increase physical activity are needed to increase the CRF of the Chilean population.

Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores / Handgrip strength as a predictor of adverse health outcomes

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

Relación entre fuerza de prensión manual, función física y riesgo de caídas en personas mayores / Relationship between handgrip strength, physical function, and risk of falls in older people

RESUMEN Introducción: La fuerza de prensión manual permite evaluar debilidad muscular en personas mayores y presenta correlación con la fuerza general y masa muscular, por lo que podría ayudar en la detección precoz del deterioro de la función física y riesgo de caídas. Objetivo: Relacionar la fuerza de prensión manual con la función física y riesgo de caídas en personas mayores. Métodos: Estudio descriptivo, correlacional. Evaluó 87 personas mayores (24 hombres y 63 mujeres) entre 65 y 75 años, de 4 organizaciones sociales de Talca, Chile, seleccionados por un muestreo no probabilístico por conveniencia. Para medir la fuerza de prensión manual se utilizó́ un dinamómetro de mano, para valorar la función física se usó la prueba Short Physical Performance Battery; con las pruebas de estación unipodal y time up and go se evaluó riesgo de caídas. Resultados: Se observaron relaciones significativas moderadas entre la fuerza de prensión manual y el test Short Physical Performance Battery (p= 0,001; r= 0,473) y con todas las pruebas que componen esta batería. Se evidenció una relación entre la fuerza de prensión y la prueba de estación unipodal (p= 0,001; r= 0,472), mientras que la relación con la prueba time up and go fue inversa débil (p= 0,002; r= -0,398). Conclusión: Existe relación entre la fuerza de prensión manual con la función física y el riesgo de caídas personas mayores. Este hallazgo sugiere que la fuerza de prensión manual podría usarse en la práctica clínica como instrumento de detección precoz de la pérdida de la función física y riesgo de caídas.

ABSTRACT Introduction: Handgrip strength is a way to evaluate muscle weakness in older people and it has been seen to show a high correlation with general strength and body muscle mass, which is why it could help in the early detection of deterioration in physical function. loss of lower limb strength and risk of falls. Objective: To relate handgrip strength with physical function and risk of falls in older people. Methods: Descriptive, correlational study. It evaluated 87 older people (24 men and 63 women) between 65 and 75 years old, from 4 social organizations in the city of Talca, Chile, selected through a non-probabilistic convenience sampling. To measure the handgrip strength, a hand dynamometer was used, to assess physical function the Short Physical Performance Battery test was used, and the unipodal station and time up and go tests were used to evaluate balance static and dynamic respectively. Results: Moderately significant relationships were observed between the handgrip strength in the Short Physical Performance Battery test (p = 0.001; r = 0.473) and with all the tests that make up this battery. A moderate one was also evidenced between the grip strength and the unipodal station test (p = 0.001; r= 0.472), while the relationship with the time up and go test was weak inverse (p = 0.002; r = -0.398). Conclusion: There is a relationship between handgrip strength with physical function and the risk of falls in older people. This finding is important because it suggests that handgrip strength could be used in clinical practice as an indirect indicator or as an early detection tool for loss of general strength capacity, physical fitness, and risk of falls.

Asociación entre la condición física y calidad de vida con la fragilidad en personas mayores / Association between physical fitness and quality of life with frailty in elderly

RESUMEN Introducción: El envejecimiento patológico provoca cambios anatomofisiológicos responsables de generar deterioro en la condición física y calidad de vida de las personas mayores. Así también se ha observado un aumento en la presencia de síndromes geriátricos como la fragilidad física. Objetivo: Determinar si existe asociación entre la condición física y calidad de vida con la fragilidad en personas mayores. Métodos: Estudio correlacional. Se incluyeron 84 personas mayores de 65 años (62 mujeres y 22 hombres) entre agosto y septiembre del año 2021 en las regiones metropolitana y Maule, Chile. Se midieron la condición física, calidad de vida y fragilidad. La condición física se evaluó con la batería Senior Fittnes Test y la calidad de vida fue medida con el cuestionario World Health Organization Quality of Life Old (WHOQOL-OLD). La fragilidad se determinó con el fenotipo de Fried. Se utilizaron tablas de contingencia para asociar las variables de estudio con la fragilidad a través de la prueba de ji cuadrado. Resultados: La fragilidad se asoció con algunos componentes de la condición física como fuerza del tren superior (p= 0,038), fuerza del tren inferior (p= 0,018), flexibilidad del tren inferior (p= 0,004), resistencia aeróbica (p= 0,038), agilidad y equilibrio dinámico (p= 0,002). También, se observaron asociaciones significativas con dimensiones de calidad de vida como autonomía (p= 0,007), actividades del pasado, presente y futuro (p= 0,018), participación social (p= 0,006) e intimidad (p= 0,038). Conclusión: Existe asociación entre fragilidad con dimensiones de calidad de vida y con variables de la condición física.

ABSTRACT Introduction: Pathological aging causes anatomophysiological changes responsible for generating deterioration in the physical condition and quality of life of the elderly. Thus, an increase in the presence of geriatric syndromes such as physical frailty has also been observed. Objective: To determine if there is an association between physical condition and quality of life with the frailty in older adults. Methods: Correlational study. 84 people over 60 years of age (62 women and 22 men) were included. Physical fitness, quality of life and frailty were measured. Physical fitness was assessed with the Senior Fitness Test battery and quality of life was measured with the World Health Organization Quality of Life Old (WHOQOL-OLD) questionnaire. Frailty was determined with the Fried phenotype. Contingency tables were used to associate the study variables with frailty through the Chi-square test. Results: Frailty was associated with some components of physical fitness such as upper body strength (p= 0.038), lower body strength (p= 0.018), lower body flexibility (p= 0.004), aerobic endurance (p= 0.038), agility and dynamic balance (p= 0.002). Also, significant associations were observed with quality of life dimensions such as autonomy (p= 0.007), past, present and future activities (p= 0.018), social participation (p= 0.006) and intimacy (p= 0.038). Conclusion: There is an association between frailty with dimensions of quality of life and with variables of physical fitness.

Cumplimiento de las Guías Alimentarias en personas mayores chilenas: Un estudio descriptivo de la Encuesta Nacional de Salud 2016-2017

RESUMEN Chile es uno de los países de Latinoamérica que exhibe un mayor envejecimiento poblacional, por lo que es necesario visualizar distintas herramientas que direccionen estilos de vida saludables en esta etapa de la trayectoria vital. Las Guías Alimentarias Basadas en Alimentos (GABA) entregan recomendaciones que permiten mejorar la calidad de vida de personas mayores. Por lo anterior, el objetivo del estudio fue determinar el nivel de cumplimiento de recomendaciones de las GABA y su asociación con variables antropométricas, metabólicas y de estilos de vida en 1.789 personas mayores de 60 años que participaron en la Encuesta Nacional de Salud 2016-2017. Se realizó un estudio descriptivo de corte transversal, en donde los participantes se subdividieron en cuatro grupos según cumplimiento de las GABA: no cumple, cumple con 1, 2 o a lo menos 3 recomendaciones de consumo de legumbres, frutas y verduras, lácteos, agua y pescado. Como resultado, el 43,8% de las personas mayores que participaron no cumplieron ninguna de las recomendaciones GABA evaluadas; estos últimos, realizaban menos actividad física y presentaban, además, una mayor probabilidad de pasar más tiempo sentados (p-tendencia: <0,001). Como conclusión, se destaca que cerca del 50% de las personas mayores en Chile no adhieren a las recomendaciones de las GABA, lo que podría repercutir en implicaciones en la salud y bienestar de la población mayor.

ABSTRACT Chile is one of the Latin American countries that exhibits the greatest increase in the aging population, thus it is necessary to visualize different tools that guide healthy lifestyles at this stage of life. Food-Based Dietary Guidelines (abbreviated as GABA, for initials in Spanish) provide recommendations that allow improving the quality of life in older people. This study aimed to determine the level of compliance with GABA recommendations and their association with anthropometric, metabolic and lifestyles factors in 1,789 people over 60 years who participated in the 2016-2017 National Health Survey. A descriptive cross-sectional study was carried out, in which participants were subdivided into four groups according to compliance with GABA: does not comply, complies with 1, 2 or at least 3 recommendations for consumption of legumes, fruits, vegetables, dairy, water and fish. As a result, 43.8% of older participants did not meet any of the GABA recommendations evaluated. These participants also performed less physical activity and had a longer sitting time (P-trend: <0.001). In conclusion, we highlight that close to 50% of elderly Chileans do not adhere to GABA recommendations, which could have implications for the health and well-being.

Efectos en la capacidad funcional de un programa de ejercicio físico terapéutico basado en telesalud en personas con diagnóstico de osteoartritis de rodilla y cadera / Effects of a telehealth-based physical exercise program on functional capacity in patients with osteoarthritis

BACKGROUND: Telehealth is a novel therapeutic alternative. Aim: To determine the effects of a remote therapeutic physical exercise program (TPEP), based on telehealth, on functional physical capacity in people with knee or hip osteoarthritis. PATIENTS AND METHODS: An eight-week TPEP was undertaken by 36 participants with a mean age of 68 years. The control group received printed exercise instructions, while the experimental group received the same instructions plus TPEP using tutorial videos and voice messaging via WhatsApp. Both groups were evaluated at baseline and the end of the intervention with the Lower Extremity Functional Scale (LEFS), Barthel index (BI), Short Physical Performance Battery (SPPB), senior fitness test and with the Visual Analog Scale for pain (VAS). RESULTS: The experimental group decreased the VAS score and improved tandem balance, three-meter walk, sit and stand 5 times, sit and stand in 30 seconds, push-ups in 30 seconds, two minutes' walk, join the right hand behind the back and SPPB general score. The control group increased the BI score and improved the three meters walking test, sitting, and standing 5 times, sit and stand 30 seconds chair test, 2 minutes walking test and the SPPB general score. No differences between groups were observed for the LEFS scale, BI, VAS and functional capacity. CONCLUSIONS: A TPEP based on telehealth has similar effectiveness than a TPEP based on traditional paper-based intervention to improve functional physical capacity in patients with OA. (Rev Med Chile 2022; 150: 33-45)

[Handgrip strength as a predictor of adverse health outcomes]. / Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores.

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

A healthy eating score is inversely associated with depression in older adults: results from the Chilean National Health Survey 2016-2017.

OBJECTIVE: To investigate the relationship of a healthy eating score with depression in Chilean older adults. DESIGN: Cross-sectional study. SETTING: Older adults from the Chilean National Health Survey 2016-2017. Associations were analysed using complex samples multivariable logistic regressions adjusted for age, sex, socio-demographic, lifestyles (physical activity, smoking, alcohol consumption and sleep duration), BMI and clinical conditions (hypertension, diabetes, hypercholesterolaemia and cardiovascular diseases). PARTICIPANTS: The number of participants was 2031 (≥ 60 years). The Composite International Diagnostic Interview-Short Form was applied to establish the diagnosis of major depressive episode. Six healthy eating habits were considered to produce the healthy eating score (range: 0-12): consumption of seafood, whole grain, dairy, fruits, vegetables and legumes. Participants were categorised according to their final scores as healthy (≥ 9), average (5-8) and unhealthy (≤ 4). RESULTS: Participants with a healthy score had a higher educational level, physical activity and regular sleep hours than participants with an average and unhealthiest healthy eating score. Participants classified in the healthiest healthy eating score had an inverse association with depression (OR: 0·28, (95 % CI 0·10, 0·74)). Food items that contributed the most to this association were legumes (15·2 %) and seafood (12·7 %). CONCLUSION: Older adults classified in the healthiest healthy eating score, characterised by a high consumption of legumes and seafood, showed a lower risk for depression in a representative sample of Chilean population.

Niveles de actividad física y tiempo sedente según ingreso económico en Chile: resultados de la Encuesta Nacional de Salud 2016-2017

Background: The Chilean population reports high levels of physical inactivity. The relationship between income level, physical activity (PA) and sedentary behaviors is not well known. Aim: To describe the levels of PA and sedentary time, according to income levels in the Chilean population. Material and Methods: Analysis of data from the Chilean National Health Survey 2016-2017, which included 5,130 participants (52.9% women). The levels of PA and sedentary time were measured by the Global Physical Activity Questionnaire. Income levels were established according to the self-reported income per capita of the households and presented as quintiles. PA levels according to income levels were estimated by linear regression analyses. Results: Transport-related PA was higher in the lowest income quintiles (p = 0.039). There were no trends for income levels and PA domains including moderate, vigorous, total, occupational and leisure PA. The prevalence of leisure and occupational physical inactivities were higher in the lowest quintiles of income. Sitting time was higher in the higher income levels (p < 0.01). Conclusions: People in the lowest quintile for income spent more time in transport-related PA and less time sitting. However, physical inactivity prevalence during leisure and work time were higher in people with lower income.

Fuerza de prensión manual y calidad de vida en personas mayores autovalentes / Hand grip strength and quality of life in functional elderly

Introducción: Durante el envejecimiento se observa involución de algunos sistemas corporales. Entre estos cambios, los que afectan al sistema osteomuscular como la sarcopenia y la debilidad muscular, pueden alterar el desarrollo de actividades de la vida diaria, y por lo tanto, afectar la calidad de vida relacionada con la salud. Objetivo: Determinar la relación entre la fuerza de prensión manual y la calidad de vida relacionada con la salud en personas mayores. Métodos: Estudio descriptivo, correlacional. Evaluó 79 personas mayores (63 mujeres y 16 hombres) entre 65 y 78 años, de tres organizaciones sociales de la ciudad de Talca, Chile, seleccionados a través de un muestreo no probabilístico por conveniencia. Para medir la fuerza de prensión manual se utilizó un dinamómetro de mano y el cuestionario SF-36 fue usado para valorar la calidad de vida relacionada con la salud. Resultados: Se observaron relaciones significativas entre la fuerza de prensión manual y las dimensiones de la calidad de vida función física (p = 0,03; r = 0,76), dolor corporal (p = 0,01; r = 0,44) y salud general (p = 0,05; r = 0,48). Conclusiones: Existe relación entre la fuerza de prensión manual y tres dimensiones de la calidad de vida relacionada con la salud de personas mayores. Estos hallazgos corroboran la relevancia de evaluar la fuerza muscular en personas mayores como un marcador de salud y calidad de vida en estas(AU)

Introduction: During aging, involution of some body systems is observed. Among these changes, those that affect the musculoskeletal system such as sarcopenia and muscle weakness can alter the development of activities of daily life, and therefore affect health-related quality of life. Objective: to determine the relationship between hand grip strength and quality of life in elderly. Methods: Cross-sectional study. A total of 79 elderly (63 women and 13 men) between 65 and 78 years of age from three social organizations of Talca, Chile was included. A non-probabilistic convenience sample was used. To measure manual grip strength and the SF-36 questionnaire was used. Results: Significant relationships between hand grip strength and dimensions of quality of life, physical function (p = 0,03; r = 0,76), body pain (p = 0,01; r = 0,44) and general health (p = 0,05; r = 0,48) were observed. Conclusions: There is a relationship between hand grip strength and three measurements of quality of life in elderly. These findings corroborate the relevance of evaluating muscle strength in older people as a marker of health and quality of life in elderly(AU)

Nivel de actividad física en personas mayores chilenas que han sufrido caídas

RESUMEN Antecedentes: Las caídas limitan las actividades de la vida diaria. Actualmente se desconoce cómo los niveles de actividad física (AF) varían luego de sufrir una caída. Objetivo: investigar los niveles de práctica de actividad física de personas mayores que han reportado caídas en los últimos 12 meses. Métodos: Se incluyeron 1.254 participantes ≥ 60 años de Encuesta Nacional de Salud (ENS) 2009-2010. La prevalencia de caídas en los últimos 12 meses se determinó mediante auto reporte. Los niveles de AF y el tiempo sedente se determinaron a través del cuestionario Global Physical Activity Questionnaire (GPAQ). La asociación entre caídas y AF fue investigada mediante regresión lineal. Resultados: El 70,5% [95% IC: 68,0; 72,8] de las personas mayores no reportaron caídas, mientras que un 19,4% [95% IC: 17,4; 21,5] reportó haber sufrido entre 1-2 caídas y un 10% [95% IC: 8,4; 11,8] ≥3 caídas en los últimos 12 meses. En comparación al grupo que reportó no sufrir caídas, aquellos que sufrieron ≥3 caídas realizaban 79,2 minutos menos de AF total/día. Resultados similares fueron observados para AF de transporte y AF moderada. No se encontraron diferencias para tiempo sedente o AF vigorosa. Conclusión: Personas mayores que sufrieron caídas en los últimos 12 meses reportaron realizar menos actividad física que sus contrapartes que no experimentaron caídas. A mediano y largo plazo, estos cambios en la actividad física podrían contribuir a resultados de salud adversos en una población.

ABSTRACT Background: Falls among older adults are associated with important changes in lifestyle. However, there is no evidence about the physical activity levels of older adults who have experienced falls. The aim of this study, therefore, was to describe physical activity levels in older adults who have experienced falls in the last 12 months. Methods: 1,254 older adults (aged ≥60 years) from the National Health Survey 2009-2010 were included in this study. Number of falls during the last 12 months was self-reported and physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). The association between falls and physical activity was investigated using regression analyses. Results: 70.5% [95% CI: 68.0; 72.8] of the older adults included in this study did not report any falls during the last 12 months. However, 19.4% [95% CI: 17.4; 21.5] reported 1-2 falls and 10% [95% CI: 8.4; 11.8] reported ≥3 falls in the last 12 months. In comparison to those who reported no falls, those who experienced ≥3 falls in the last 12 months did 79.2 fewer minutes/day of physical activity. Similar results were found for moderate and transport-related physical activity, but no associations were found for vigorous or sedentary behaviours. Conclusion: Older adults who suffered falls in the last 12 months reported doing less physical activity than their counterparts who did not experience any falls. In the middle and long term, these changes in physical activity could contribute to adverse health outcomes in an already frail population.

Efectos de un programa de ejercicio multicomponente en personas mayores que viven en comunidad / Effects of a multicomponent exercise program in older people living in the community

RESUMEN Fundamento: una intervención basada en ejercicio multicomponente favorecería la funcionalidad. Sin embargo, son escasos los estudios locales, en Chile, que los han utilizado. Objetivo determinar los efectos del ejercicio multicomponente en la disminución del riesgo de caída y riesgo de deterioro cognitivo, la mejora del equilibrio, fuerza muscular, capacidad funcional y calidad de vida en personas mayores que viven en comunidad. Métodos: estudio preexperimental pre-post sin grupo control. La muestra fue intencionada (n=17; 47,1 % mujeres; 70 años de mediana). Se aplicó un plan de ejercicio multicomponente durante nueve semanas. Pre y post ejercicio se evaluó equilibrio dinámico con el test Timed Up and Go, equilibrio estático con un oscilógrafo postural y la prueba de Estación Unipodal, fuerza muscular con el test de Sentarse y Levantarse, capacidad funcional con el test de Marcha 6 Minutos, calidad de vida con el Cuestionario SF-36 y sospecha de deterioro cognitivo con el Mini Mental State. Para determinar diferencias pre-post ejercicio se aplicó la prueba de Wilcoxon. Resultados: después de los ejercicios se observó un mejor rendimiento en las pruebas: Timed Up and Go (p=0,004), Estación Unipodal (p=0,023 pierna derecha, p=0,005 pierna izquierda), Sentarse y Levantarse (p=0,014), Marcha de 6 Minutos (p=0,006) y en el Cuestionario SF-36: dolor corporal (p=0,003), salud mental (p=0,000) y puntaje total (p=0,002). Conclusiones: un programa de ejercicio multicomponente de nueve semanas logró disminuir el riesgo de caídas, mejorar equilibrio, fuerza muscular, capacidad funcional y calidad de vida de personas mayores que viven en comunidad.

ABSTRACT Background: a multicomponent exercise-based intervention would favor functionality. However, there are few local studies, in Chile, that have used them. Objective to determine the effects of multicomponent exercise in reducing the falling and cognitive deterioration risks, improving balance, muscle strength, functional capacity and life quality in elderly people living in the community. Methods: pre-post experimental study without control group. The sample was intentional (n = 17; 47.1% women; median 70 years old). A multicomponent exercise plan was applied for nine weeks. Pre and post exercise, dynamic balance was evaluated with the Timed Up and Go test, static balance with a postural oscillograph and the Unipodal Station test, muscle strength with the Sit and Stand test, functional capacity with the 6 Minute Walk test, quality life with the SF-36 Questionnaire and suspected cognitive impairment with the Mini Mental State. To determine pre-post exercise differences, the Wilcoxon test was applied. Results: after the exercises, a better performance was observed in the tests: Timed Up and Go (p = 0.004), Unipodal Station (p = 0.023 right leg, p = 0.005 left leg), Sitting and Getting up (p = 0.014), 6-Minute Walk (p = 0.006) and in the SF-36 Questionnaire: body pain (p = 0.003), mental health (p = 0.000) and total score (p = 0.002). Conclusions: a nine-week multicomponent exercise program was able to reduce the risk of falls, improve balance, muscle strength, functional capacity and quality of life in older people living in the community.

Impacto de un contexto de pandemia sobre la calidad de vida de adultos jóvenes / Impact of a pandemic context on the quality of life of young adults

Introducción: La cuarentena y el aislamiento social son las medidas más recomendadas por las autoridades de salud con el objetivo de reducir la interacción social entre las personas y disminuir el riesgo de contagio por la COVID-19 en la comunidad. Sin embargo, estas restricciones y limitaciones pueden traer consecuencias en la calidad de vida relacionada con la salud de adultos jóvenes. Objetivo: Comparar la calidad de vida autorreportada entre un entorno sin pandemia vs. un contexto bajo alerta sanitaria por la COVID-19, en adultos jóvenes. Métodos: Estudio retrospectivo; 157 adultos jóvenes (63 mujeres y 94 hombres), de entre 18 y 28 años, respondieron el cuestionario de salud SF-36 en 2 situaciones: contexto sin pandemia (septiembre de 2019) y contexto de pandemia (abril de 2020). El SF-36 incluye 36 preguntas agrupadas en 8 ítems: función física, rol físico, dolor corporal, salud general, vitalidad, función social, rol emocional y salud mental. Resultados: Al comparar las evaluaciones entre los contextos con y sin pandemia, se observó una disminución de la calidad de vida en las dimensiones vitalidad (p = 0,004), función social (p = 0,001), rol emocional (p = 0,001), salud mental (p = 0,003) y salud general (p = 0,001). Las dimensiones más alteradas fueron el rol emocional y la salud general, las cuales disminuyeron un 39,5 por ciento y 21,0 por ciento, respectivamente. Conclusión: La calidad de vida relacionada con la salud de adultos jóvenes se ve disminuida en un contexto de cuarentena por la COVID-19, principalmente, en las dimensiones psicológicas y sociales(AU)

Introduction: Quarantine and social isolation are the actions most recommended by health authorities with the aim of reducing social interaction between people and reducing the risk of COVID-19 infection in the community. However, these restrictions and limitations can have consequences on the health-related quality of life of young adults. Objective: To compare the self-reported quality of life between a pandemic-free environment versus a context of COVID-19 pandemic in young adults. Methods: Retrospective study; 157 young adults (63 women and 94 men) between 18 and 28 years old answered the SF-36 health questionnaire in 2 situations: context without pandemic (September 2019) and context of pandemic (April 2020). The SF-36 includes 36 questions grouped into 8 items: physical function, physical role, body pain, general health, vitality, social function, emotional role, and mental health. Results: When comparing the evaluations between the contexts with and without a pandemic, a decrease in the quality of life was observed in the vitality dimensions (p = 0,004), social function (p = 0,001), emotional role (p = 0,001), health mental (p = 0,003) and general health (p = 0,001). The most altered dimensions were emotional role and general health, which decreased by 39,5 percent and 21,0 percent, respectively. Conclusions: This study determined that the health-related quality of life of young adults is diminished in context of quarantine by COVID-19, mainly in the psychological and social dimensions(AU)