Adiposity and physical activity are among the main determinants of serum vitamin D concentrations in older adults: the EpiFloripa Aging Cohort Study.

The identification of factors associated with 25-hydroxycholecalciferol (25(OH)D) concentration can help suggest more specific interventions for older adults. In this cross-sectional study of older adults from southern Brazil, we hypothesized that some sociodemographic, behavioral, and health factors positively or negatively influence the 25(OH)D concentration in this population. This analysis was performed using data from the second wave of the EpiFloripa Aging Cohort Study (2013-2015). Serum 25(OH)D levels were classified according to the guidelines of the Endocrine Society. Multinomial logistic regression was performed to evaluate the relative risks of sociodemographic, behavioral, and health factors in each 25(OH)D category. A total of 574 older adults (aged 63-93 years) participated in this study. The prevalence of insufficiency (21-29 ng/mL) was 43.7% and that of deficiency (≤20 ng/mL) was 23.5%. In the adjusted analysis, female sex, higher levels of low-density lipoprotein cholesterol (LDL-C ≥160 mg/dL), obesity by adiposity (body fat percentage [%fat], male ≥31%; female ≥43%), and body mass index (BMI, >30 kg/m2) presented higher relative risks for insufficiency than for sufficiency. For those with deficiency, the associated factors were female sex, disability in 4 or more activities of daily living (ADLs), LDL-C ≥100 mg/dL, and obesity by %fat and BMI. A protective factor against insufficiency and deficiency was active leisure-time physical activity (PA, ≥150 min/week). Our results demonstrated that being female and having modifiable factors, such as high levels of LDL-C, obesity, and disability on ADLs, were negatively associated with hypovitaminosis D. On the other hand, leisure-time PA was positively associated with adequate serum vitamin D concentration.

Does cognitive impairment precede self-reported poor hearing? Results from the English longitudinal study of ageing.

OBJECTIVE: To investigate whether cognitive impairment precedes self-reported poor hearing in adults aged 50 and older over a 14-year period. DESIGN: Biennial longitudinal study. STUDY SAMPLE: The data came from the English Longitudinal Study of Ageing carried out in England between 2002 and 2016, with 11,391 individuals aged 50 years and older. For this study, ELSA participants who had a positive perception of hearing at the beginning of the analysis in 2002 (n = 8,895) were eligible. The dependent variable was self-reported poor hearing, and the exposure measure was cognitive impairment. The analyses were performed using Generalised Estimation Equations and adjusted for gender, age, educational level, household wealth, smoking, alcohol consumption, depressive symptoms, ADL/IADL disability, physical activity level, diabetes, and cardiovascular disease. RESULTS: The results showed 33% increased odds of self-reported poor hearing in individuals with cognitive impairment. In the fully adjusted model, individuals who presented cognitive impairment in the previous wave had, over time, 10% increased odds (95% CI: 1.02; 1.19) of presenting self-reported poor hearing. CONCLUSIONS: The exposure to cognitive impairment was associated with a subsequent self-reported poor hearing. These data represent important tools for improving cognitive and hearing impairment diagnosis and treatment.

Metabolic syndrome and its association with changes in modifiable risk factors: Epifloripa aging study.

Purpose: To estimate the prevalence of Metabolic Syndrome (MetS) and its association with changes in modifiable risk factors in older adults from southern Brazil. Methods: A longitudinal study was performed with data from EpiFloripa Aging study. We defined MetS by the existence of three or more of the following risk factors for cardiovascular disease (CVD): waist circumference (WC) (≥ 92 cm in men and ≥ 87 cm in women); fasting glucose (≥100 mg/dl); decreased HDL cholesterol (<40 mg/dl in men and <50 mg/dl in women); hypertriglyceridemia (≥150 mg/dl) and blood pressure (≥130/85 mmHg). We evaluated the changes in modifiable risk factors (smoking, alcohol consumption, fruit and vegetable consumption, physical activity, and body mass index) between the two moments of the study (2009/10 and 2013/14). Directed acyclic graph and logistic regression models were used. Results: Among the 599 participants, the prevalence of MetS was 64.0% (95% CI, 58.7-68.9). In the adjusted analysis, those who remained or became persons who are overweight (OR = 4.59; 95% CI: 3.05-6.89) and those who remained or became insufficiently active (OR = 1.92; 95% CI: 1.23-2.98) were more likely to present MetS. Conclusion: Our findings suggest that being or becoming overweight and being or becoming insufficiently active are modifiable factors associated with MetS. These results highlight the need for developing preventive strategies for the observed risk indicators to mitigate the prevalence of MetS in older adults.

Association between physical activity and vitamin D is partially mediated by adiposity in older adults: EpiFloripa Aging Cohort Study.

Studies have found that physical activity (PA) could be a protective factor and adiposity a risk factor for low serum 25-hydroxycholecalciferol (25(OH)D) concentration. This cross-sectional study hypothesized that PA could have a direct effect on 25(OH)D, and adiposity could be a mediating factor. Data from the second wave of the EpiFloripa Aging longitudinal study, collected during 2013 and 2014 (n = 1197) in Florianopolis, Santa Catarina, Brazil, was used. PA was measured using an accelerometer and classified as light PA (LPA), moderate and vigorous PA (MVPA), and total PA (TPA); 25(OH)D levels were measured using the microparticle chemiluminescence method. Body fat composition (%fat) was assessed using dual-energy X-ray absorptiometry. Structural equation modeling was performed to analyze the total, direct, and indirect effects of PA on %fat and 25(OH)D levels, presented using the standardized coefficient (ß). Participants with complete data were included in the analysis (n = 574, 66.7% female). MVPA showed a direct (ß = 0.11; P < .05) and total positive effect on 25(OH)D (ß = 0.12; P < .05). All models of PA had a direct negative effect on %fat. Additionally, a direct negative effect of %fat on 25(OH)D was observed in all models. A marginal and partial effect of %fat as a mediator of the relationship between MVPA and 25(OH)D was noted (ß = 0.01, P = .09). Our results show that PA presents a direct effect on serum 25(OH)D. %fat has a small contribution as a mediator of this relationship. These data suggest that an increase in MVPA and a decrease in %fat could be strategies to increase 25(OH)D levels in older adults.

The association between vitamin D and BDNF on cognition in older adults in Southern Brazil

ABSTRACT OBJECTIVE To estimate the association between vitamin D and the cognitive decline of older adults and evaluate whether this association is mediated by brain-derived neurotrophic factor (BDNF) serum concentration. METHODS Cross-sectional study nested in a population-based cohort. Of the 604 participants in the complementary examination of the EpiFloripa Study, 576 older adults (60 years or older) were eligible for the study. The outcome is cognitive decline evaluated by the Mini-Mental State Examination, the exposure is vitamin D, and BDNF is the mediator. The control variables are age, sex, per capita family income, and educational level. The direct effect of vitamin D and BDNF on cognitive decline and the indirect effect mediated by BDNF was evaluated using path analysis, with the estimation of standardized coefficients. RESULTS Among the participants, we observed a direct and positive effect of vitamin D on cognitive function (Coef: 0.06; 95%CI: 0.02 to 0.11; p < 0.001) and serum BDNF concentration (Coef: 21.55; 95%CI: 9.92 to 33.17; p = 0.002), i.e., the higher the vitamin D, the higher the cognitive function and serum level of BDNF. CONCLUSION There was an association between vitamin D on serum BDNF and on cognitive decline in older adults. Moreover, BDNF did not have an effect on cognitive decline, so BDNF was not a mediator of the vitamin D effect on cognitive decline.

Individual and Combined Association Between Healthy Lifestyle Habits With Muscle Strength According to Cardiovascular Health Status in Adults and Older Adults.

BACKGROUND: The authors aimed to identify the effect of adherence to healthy lifestyle habits on muscle strength (MS) according to a distinct health status. METHODS: Longitudinal analysis using data from 2 population-based cohorts in Brazil (EpiFloripa adult, n = 862, 38.8 [11.4] y-6 y of follow-up length; EpiFloripa Aging, n = 1197, 69.7 [7.1] y-5 y of follow-up length). MS was assessed by handgrip strength (kgf). Information assessed by questionnaire regarding adequate physical activity levels, regular consumption of fruit and vegetables, low alcohol consumption, and nonsmoking habits were analyzed in the relationship with MS according to the health status. The participants were grouped into 3 health status categories: (1) with cardiovascular disease (CVD); (2) at risk of CVD (abdominal obesity or overweight/obesity, high blood pressure, hyperglycemia, and dyslipidemia); and (3) healthy individuals (without CVD and risk of CVD). RESULTS: Simultaneous adherence of 4 healthy lifestyle habits was directly associated with MS among healthy individuals (ß = 10.0, 95% CI, 2.0-18.0, SE = 4.0), at risk of CVD (ß = 5.5, 95% CI, 0.3-12.6, SE = 3.6), and those with CVD (ß = 11.4, 95% CI, 5.8-16.7, SE = 2.8). CONCLUSIONS: Adopting a healthy lifestyle can contribute to increased MS in adults and older adults, regardless of health status.

Depressive symptoms as an independent risk factor for mortality.

OBJECTIVE: To evaluate the relationship between presence of depressive symptoms and risk of death in older adults residing in a municipality in Southern Brazil. METHODS: Between 2009 and 2014, 1,391 people participated in the EpiFloripa Aging Cohort Study, a population-based longitudinal study. Depressive symptoms were assessed through the Geriatric Depression Scale. The initial time was considered the age at the first interview, and the end time, the age at the last contact or death. Cox regression models were used to estimate the mortality risk associated with depressive symptoms, adjusted by sex, education, income, paid work, smoking status, alcohol consumption, morbidities, medication use, physical activity, disability, cognitive impairment, and body mass index. RESULTS: The prevalence of depressive symptoms was 23.5% (95%CI 20.4-26.9). On crude analysis, the risk of mortality was 1.86 (95%CI 1.35-2.55) for individuals with depressive symptoms; in adjusted models, the risk of mortality was 1.67 (95%CI 1.15-2.40). CONCLUSION: Depressive symptoms are an independent risk factor for mortality in older Brazilian adults. Our findings highlight the importance of screening this population for depression and the practice of preventive actions.

Association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil: a cross-sectional study.

BACKGROUND: Being active has been shown to have beneficial effects for the health of individuals with chronic diseases. However, data on the association between multimorbidity and physical activity are limited. OBJECTIVE: To investigate the association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil, according to sex. DESIGN AND SETTING: Cross-sectional population-based and household-based study derived from the second wave (2013-2014) of the EpiFloripa Aging Cohort Study. METHODS: Insufficiency of physical activity (outcome) was ascertained using the long version of the International Physical Activity Questionnaire (≤ 150 minutes/week). Eleven self-reported chronic diseases were identified. Multimorbidity was defined from the number of chronic diseases (none; 2 or 3; or 4 or more). The adjustment variables were age, schooling, marital status, income, smoking, alcohol consumption and cognition. Additionally, each chronic disease was adjusted for the others. Associations were tested using logistic regression (crude and adjusted). RESULTS: Among the 1197 participants (≥ 63 years), women (54.0%) were more likely than men (39.6%) to be insufficiently active. In the adjusted analysis, women and men with depressive symptoms, and men with diabetes, were more likely to be insufficiently active than those without symptoms. Multimorbid women were more likely to be insufficiently active, and the magnitude of the effect was strongest for 4 or more diseases. CONCLUSION: This study indicates that the associations were sex-specific. Depressive symptoms and multimorbidity were associated with insufficient physical activity among women, while diabetes was associated with insufficient physical activity among men.

Sarcopenia, bone mineral density, and vitamin D: EpiFloripa aging study 2013/2014 / Sarcopenia, densidade mineral óssea e vitamina D: Estudo EpiFloripa Idoso 2013/2014

OBJECTIVE: To verify associations between osteopenia/osteoporosis and vitamin D and sarcopenia in the older adult population of Florianópolis, Brazil. METHODS: A cross-sectional population-based study, with 604 older adults (60 years and over). The appendicular muscle mass index (AMMI) was used to identify sarcopenia, with cutoffs of AMMI (Kg/m2) < 7.26 kg/m2 for men and < 5.50 kg/m2 for women indicating inadequate values (sarcopenia). The independent variable osteopenia/osteoporosis was measured using bone mineral density (BMD, g/cm2): T-Scores for whole body BMD, lumbar spine BMD, and femoral neck BMD, categorized as normal (BMD > -1 SD) or osteopenia/osteoporosis (BMD < -1 SD from the mean of the young adult reference population). Fasting serum samples were collected and assayed using the microparticle chemiluminescence (CMIA)/Liaison method. Vitamin D concentrations of < 30 ng/mL were defined as hypovitaminosis. Crude and adjusted logistic regression analyses were performed. RESULTS: Osteopenia/osteoporosis in the lumbar spine and femoral neck were associated with higher odds of sarcopenia in women and men. Osteopenia/osteoporosis in the whole body was associated with sarcopenia in women only. Vitamin D was not associated with sarcopenia in either sex. CONCLUSIONS: Having osteopenia/osteoporosis was associated with sarcopenia in this older adult population.

OBJETIVO: Verificar a associação entre osteopenia/osteoporose e vitamina D com a sarcopenia na população idosa de Florianópolis. METODOLOGIA: Estudo transversal de base populacional, com 604 idosos (60 anos ou mais). O índice de massa muscular apendicular (IMMA) foi utilizado para identificar a sarcopenia, onde o IMMA (Kg/m2) ­ < 7,26 kg/m2 para homens e < 5,50 kg/m2 para mulheres ­ indicava valores inadequados (sarcopenia). A variável independente osteopenia/ osteoporose foi medida pela densidade mineral óssea (DMO, g/cm2), foram calculados os T-escores para DMO corporal total, DMO da coluna lombar e DMO do colo femoral, categorizados como normais (DMO até -1 DP) ou osteopenia/osteoporose (DMO < -1 DP da média da população adulta jovem de referência). Amostras de soro em jejum foram coletadas pelo método de quimioluminescência de micropartículas (CMIA)/Liaison. Concentrações de vitamina D < 30 ng/mL foram definidas como hipovitaminose. Foi realizada análise de regressão logística bruta e ajustada. RESULTADOS: Osteopenia/osteoporose na coluna lombar e colo do fêmur foram associadas a maiores chances de sarcopenia em mulheres e homens. Osteopenia/ osteoporose no corpo total foi associada à sarcopenia apenas em mulheres. A vitamina D não foi associada à sarcopenia em ambos os sexos. CONCLUSÕES: A presença de osteopenia/osteoporose associou-se à sarcopenia nesta população de idosos.

Risk factors associated with mortality in young and long-lived older adults in Florianópolis, SC, Brazil.

This article aims to investigate risk factors associated with mortality in young (< 80 years) and long-lived (≥ 80 years) older adults in Florianópolis. A longitudinal population-based study of 1702 older adults participants of the EpiFloripa Ageing Study. Deaths were identified through searches in the Mortality Information System. The probability of survival was estimated using the Kaplan-Meier and Log-Rank methods. The effect of risk factors for mortality was evaluated using Cox Regression models, adjusted for gender, family income, leisure physical activity, depressive symptoms, functional disability, falls, smoking, cardiovascular disease, stroke, and diabetes mellitus. The overall survival probability was 89.9% and 52.6% for the young and long-lived older adults, respectively. For younger older adults, the risk of death was higher for males, ex-smokers and those with moderate/severe disability. For the long-lived older adults, only those with depressive symptoms had a higher risk of death. These results reveal different risk profiles of death among younger and older adults and the need for a differentiated look in the health care of this population.

Education and Income Levels are Associated With Energy and Micronutrient Intake.

Introduction: According to the literature, education and income are determinants factors of diet quality and consequently of micronutrient intake. However, this association is still little known among adults who live in middle-income countries. Objective: To estimate energy and micronutrients intake by men and women living in a capital city in southern Brazil, according to education and income levels, and to identify prevalence of inadequate micronutrient intake according also to education and income levels. Method: This is a second wave cross-sectional analysis of a population-based longitudinal study, the EpiFloripa Adultos, including 1,222 individuals of 22-63 years. Data on food consumption were obtained through applying two 24-hour dietary recalls, and the prevalence of inadequate micronutrient intake, following the recommendations of the Institute of Medicine and from the National Research Council. Results: A tendency of increased intake with an increase in income (calcium, vitamins C, E) and education levels (calcium, vitamins A, C, D) was observed for most of the micronutrients analyzed (p<0.05 in all cases); still, a prevalence of inadequacy according to Estimated Average Requirement (EAR) between 85.5-100% in intake of vitamins A, D and E were found for the whole sample. Iron inadequate intake was associated with education level and among women less than 50 years of age (p=0.018). Conclusion: The results showed an influence of the education and income levels on micronutrient intake, point to the need of daily food consumption, of minimally processed and in natura foods (as fruits, vegetables, whole grains, milk and its derivatives) as a means to reduce the encountered inadequacies.

Prevalence and simultaneity of cardiovascular risk factors in elderly participants of a population-based study in southern Brazil. / Prevalência e simultaneidade de fatores de risco cardiovasculares em idosos participantes de um estudo de base populacional no sul do Brasil.

OBJECTIVE: To investigate the prevalence of simultaneity of cardiovascular risk factors and their association with socio-demographic characteristics in older adults in Southern Brazil. METHODS: Cross-sectional study with 1.553 elderly participants of the EpiFloripa study in Florianópolis-SC. The risk factors evaluated were: Inadequate fruit and vegetable consumption, insufficient leisure-time physical activity, alcohol consumption and smoking. The construction of the outcome was performed by combining all of the factors mentioned and then categorized. Bivariate and multivariate analyzes were performed using the Poisson regression. RESULTS: It was found that 57.6% of the elderly coexist with the simultaneity of cardiovascular risk factors. The combination of inadequate fruit and vegetable consumption and insufficient leisure-time physical activity was the most prevalent. The highest prevalence observed in women and men was the insufficient leisure-time physical activity and inadequate fruit and vegetable consumption of 46.4 and 28.1%, respectively. The observed prevalence of the four factors was higher among men (2.5%), whereas for women (0.3%). Men were 11.0% more likely to accumulate risk factors compared to women. And each additional year of schooling represents 4.0% less probability of accumulating cardiovascular risk factors. CONCLUSIONS: The differences between the simultaneity of risk factors and sociodemographic aspects should be considered in the approach for older adults, both at the individual level and in the construction of public policies.

OBJETIVO: Investigar a prevalência da simultaneidade de fatores de risco cardiovasculares e sua associação com características sociodemográficas em idosos no sul do Brasil. METODOLOGIA: Estudo transversal com 1.553 idosos participantes do Estudo Epidemiológico das Condições de Saúde dos Idosos de Florianópolis (EpiFloripa Idoso), Santa Catarina. Os fatores de risco foram: insuficiência no consumo de frutas, legumes e vegetais (FLV), insuficiência de atividade física no lazer, consumo abusivo de álcool e tabagismo. Construiu-se a variável desfecho através da combinação de todos os fatores, categorizada em nenhum, um, dois, três e quatro fatores de risco. Foram realizadas análises bivariadas e multivariadas empregando-se a regressão de Poisson. RESULTADOS: Constatou-se que 57,6% dos idosos convivem com a simultaneidade de fatores de risco para doenças cardiovasculares. A maior prevalência observada tanto nas mulheres quanto nos homens foi da insuficiência de atividade física com a insuficiência no consumo de FLV, sendo de 46,4 e 28,1%, respectivamente. A prevalência observada dos quatro fatores simultâneos foi maior entre os homens (2,5%) em comparação às mulheres (0,3%). O sexo masculino apresentou 11,0% mais probabilidade de acumular fatores de risco comparado ao sexo feminino. E cada ano a mais de escolaridade representa 4,0% a menos de probabilidade de acumular fatores de risco cardiovasculares. CONCLUSÕES: As diferenças entre a simultaneidade de fatores de risco e aspectos sociodemográficos devem ser consideradas na abordagem do idoso tanto em nível individual quanto na construção de políticas públicas.

Incidence and prevalence of diabetes self-reported on elderly in south of Brazil: results of EpiFloripa Ageing Study / Incidência e prevalência de diabetes autorreferido em idosos do sul do Brasil: resultados do estudo EpiFloripa Idoso

Abstract This study investigated the prevalence and incidence of diabetes self-referred in the elderly. Longitudinal population-based study (EpiFloripa Ageing Study), with 1.702 elderly in 2009/10 and 1.197 in 2013/14 of Florianópolis, SC. Self-reported and anthropometric data were collected at home. The prevalence of diabetes self-referred in 2009/10 was 22.1% (95%CI 20.1-24.1). The characteristics were: no formal schooling (2.30; CI95% 1.32-4.00); 5 to 8 years of schooling (OR = 1.70, CI95% 1.07-2.69); increased waist circumference (OR = 3.31, CI95% 2.05-5.34) and hypertension (OR = 2.38, CI95%: 1.68-3.36). The incidence of diabetes self-reported after four years of follow-up was 8.3% (95% CI, 6.7-10.3). After adjustment: increased waist circumference (OR= 2.23, CI95% 1.09-4.57) at baseline was associated with the incidence of diabetes. The prevalence and incidence of diabetes were high among the elderly. Interventions must be performed especially with elderly with low and without formal schooling, with increased waist circumference and hypertension, thus they were the subgroups with higher odds ratio of reporting and developing diabetes.

Resumo Este estudo investigou a prevalência e a incidência de diabetes autorreferido em idosos. Estudo longitudinal de base populacional (Estudo EpiFloripa Idoso), com 1.702 idosos em 2009/10 e 1197 em 2013/14, de Florianópolis, SC. Os dados autorrelatados e antropométricos foram coletados no domicílio. A prevalência de diabetes em 2009/10 foi de 22,1% (IC 95%: 20,1-24,1). As características associadas com a prevalência de diabetes foram: não possuir escolaridade formal (OR = 2,30; IC95% 1,32-4,00); ter 5 a 8 anos de estudo (OR = 1,70, IC95% 1,07-2,69); circunferência da cintura aumentada (OR = 3,31, IC95% 2,05-5,34) e hipertensão (OR = 2,38, IC95%: 1,68-3,36). A incidência de diabetes autorreferida após quatro anos de acompanhamento foi de 8,3% (IC95% 6,7-10,3), e apresentar circunferência da cintura aumentada (OR = 2,23, IC95% 1,09-4,57) na linha de base foi associado à incidência de diabetes. A prevalência e incidência de diabetes foram elevadas entre os idosos. Intervenções devem ser realizadas especialmente com idosos de baixa ou sem escolaridade formal, com maior circunferência da cintura e hipertensão, pois foram os subgrupos com maiores chances de relatar e desenvolver diabetes.

Estudo Longitudinal EpiFloripa Idoso - Rotinas de organização e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional / EpiFloripa Ageing Longitudinal Study - Organizational routines and protocols related to the collection, analysis and storage of biological material, image exams and physical-functional capacity

Resumo Introdução Exames complementares podem contribuir para a compreensão da etiologia de agravos à saúde de idosos. Objetivo Descrever os aspectos operacionais e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional. Método Estudo longitudinal, de base populacional, com 604 idosos (≥ 60 anos) do estudo EpiFloripa Idoso, em 2014. Foram coletados dados de material biológico, composição corporal, densitometria óssea, ultrassonografia da espessura íntima média das artérias carótidas, força de preensão manual e a atividade física. Resultados A taxa de resposta foi de 50,4%. Houve perda de seguimento em relação à faixa etária, estado cognitivo e atividades de vida diária. Os indivíduos que realizaram os exames eram mais novos, trabalhavam no momento da entrevista, ingeriam álcool, eram fisicamente ativos. Além de apresentarem menor grau de dependência, ausência de déficit cognitivo, ausência de sintomas depressivos e ausência de dificuldade na mobilidade. Conclusão Espera-se que a descrição das rotinas aplicadas possa auxiliar no desenvolvimento de novas pesquisas semelhantes em grupos de idosos. Assim, poderá ser acompanhado o processo de envelhecimento da população, seus fatores de risco e proteção.

Abstract Background Complementary exams may contribute to the understanding of the etiology of health problems in older adults. Objective To describe the operational aspects and protocols used to collect, analyze and storage biological materials, image exams and physical-functional capacity tests. Method This is a longitudinal and population-based study with 604 older adults (≥ 60 years) from EpiFloripa Ageing Study, in 2014. Data of biological material, body composition, bone densitometry, ultrasonography of the carotid artery intima average thickness, hand grip strength and physical activity were collected. Results The response rate was 50.4%. There was loss of follow-up in relation to age, cognitive status, and activities of daily living. The individuals who performed the tests were younger, worked by the time of the interview, ingested alcohol and were physically active. Also, they were less dependent, absence of cognitive impairment, absence of depressive symptoms and absence of difficulty in mobility. Conclusion It is expected that the description of the applied routines may help in the development of new similar research in the older adult population. Thus, the aging process of the population, its risk and protection factors can be followed.

Indicadores antropométricos associados à demência em idosos de Florianópolis - SC, Brasil: Estudo EpiFloripa Idoso / Anthropometric indicators associated with dementia in the elderly from Florianópolis - SC, Brazil: EpiFloripa Ageing Study

Resumo O objetivo deste artigo é investigar a associação entre demência e indicadores antropométricos em idosos de Florianópolis. Estudo transversal, de base populacional, realizado com 1.197 idosos (≥ 60 anos) em 2013/2014. A demência foi considerada como a presença conjunta de escore baixo no Miniexame do Estado Mental (MEEM) e a incapacidade funcional moderada/grave nas atividades de vida diária (AVD). As variáveis independentes avaliadas foram: índice de massa corporal (IMC), perímetro da cintura (PC), índice de conicidade e relação cintura/estatura (RCEst). A regressão logística (bruta e ajustada) foi utilizada para identificar os fatores associados. A prevalência estimada de demência foi de 15,1%. Após ajustes para características sociodemográficas, estilo de vida e sintomas depressivos, a demência foi positivamente associada aos tercis superiores do IMC (OR: 2,32; IC95%: 1,26-4,25), PC (OR: 2,22; IC95%: 1,20-4,11) e RCEst. (OR: 2,30; IC95%: 1,19-4,43). De acordo com os resultados, tanto a obesidade quanto a gordura abdominal foram associados ao desfecho, sugerindo que o IMC, o PC e a RCEst. devam ser considerados na investigação dessa relação.

Abstract Objective To investigate the association between dementia and anthropometric indicators in the elderly from Florianópolis. Method This is a cross-sectional population-based survey performed with 1,197 elderly (≥ 60 years) in 2013/2014. Dementia was defined as the combined evidence of low MMSE (Mini-Mental State Examination) score and moderate/severe disability in the activities of daily living. The independent variables were body mass index (BMI), waist circumference (WC), conicity index and waist-to-height ratio (WHtR). Logistic regression (crude and adjusted) was performed to identify associated factors. Results Dementia prevalence was estimated at 15.1%. After adjustment for sociodemographic characteristics, lifestyle and depressive symptoms, dementia was positively associated with the upper tertiles of the BMI (OR: 2.32; CI95%: 1.26-4.25), WC (OR: 2.22; CI95%: 1.20-4.11) and WHtR (OR: 2.30; CI95%: 1.19-4.43). Conclusion Results have shown that both obesity and abdominal fat were associated with the outcome, suggesting that BMI, WC and WHtR should be considered in the investigation of this relationship.

Consumption of fruits and vegetables and association with life habits and nutritional status: a prospective study in a cohort of the elderly. / Consumo de frutas, legumes e verduras e associação com hábitos de vida e estado nutricional: um estudo prospectivo em uma coorte de idosos.

The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis-SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor.

O objetivo foi estimar a associação entre hábitos de vida e o consumo adequado de frutas, legumes e verduras (FLV) após quatro anos de seguimento entre os idosos de uma coorte em Florianópolis, Santa Catarina. Trata-se de um estudo longitudinal de base populacional sendo a amostra constituída por indivíduos de 60 anos ou mais, moradores da zona urbana da cidade de Florianópolis-SC. A linha de base do estudo ocorreu em 2009-2010 e a segunda onda em 2013-2014. O consumo adequado foi avaliado considerando a frequência de ingestão de FLV ao menos cinco vezes ao dia em pelo menos cinco vezes na semana. Foi realizada associação com hábitos de vida (tabagismo, consumo de álcool, atividade física e uso de internet) e uma variável biológica (estado nutricional). Nas análises estatísticas utilizou-se regressão logística multinível. Observou-se um aumento de 5,23 % no consumo de FLV de uma onda para outra. Na análise ajustada, o uso de internet foi associado à maior chance de consumo regular de FLV (OR = 1,48 IC95% 1,09 - 2,01), enquanto o excesso de peso foi associado à menor chance do desfecho (OR = 0,76 IC95% 0,61-0,95). Conclui-se que utilizar a internet demonstrou ser um hábito de vida que contribui significativamente para uma dieta mais adequada em FLV, bem como o excesso de peso um fator de risco.

Consumo de frutas, legumes e verduras e associação com hábitos de vida e estado nutricional: um estudo prospectivo em uma coorte de idosos / Consumption of fruits and vegetables and association with life habits and nutritional status: a prospective study in a cohort of the elderly

Resumo O objetivo foi estimar a associação entre hábitos de vida e o consumo adequado de frutas, legumes e verduras (FLV) após quatro anos de seguimento entre os idosos de uma coorte em Florianópolis, Santa Catarina. Trata-se de um estudo longitudinal de base populacional sendo a amostra constituída por indivíduos de 60 anos ou mais, moradores da zona urbana da cidade de Florianópolis-SC. A linha de base do estudo ocorreu em 2009-2010 e a segunda onda em 2013-2014. O consumo adequado foi avaliado considerando a frequência de ingestão de FLV ao menos cinco vezes ao dia em pelo menos cinco vezes na semana. Foi realizada associação com hábitos de vida (tabagismo, consumo de álcool, atividade física e uso de internet) e uma variável biológica (estado nutricional). Nas análises estatísticas utilizou-se regressão logística multinível. Observou-se um aumento de 5,23 % no consumo de FLV de uma onda para outra. Na análise ajustada, o uso de internet foi associado à maior chance de consumo regular de FLV (OR = 1,48 IC95% 1,09 - 2,01), enquanto o excesso de peso foi associado à menor chance do desfecho (OR = 0,76 IC95% 0,61-0,95). Conclui-se que utilizar a internet demonstrou ser um hábito de vida que contribui significativamente para uma dieta mais adequada em FLV, bem como o excesso de peso um fator de risco.

Abstract The aim of this study was to estimate the association between life habits and adequate consumption of fruits and vegetables (F&V) after four years of follow-up among elderly of a cohort in Florianópolis, Santa Catarina. This is a longitudinal population-based study, the sample being composed of individuals 60 years of age or older living in the urban area of the city of Florianópolis-SC. The baseline study took place in 2009-2010 and the second wave in 2013-2014. Adequate consumption was assessed by considering the frequency of ingestion of F&V at least five times a day at least five times a week. Life habits (smoking, alcohol consumption, physical activity and Internet use) and a biological variable (nutritional status) were associated. Multilevel logistic regression was used for the statistical analysis. There was a 5.23% increase in F&V consumption between evaluations. In the adjusted final models, internet use was associated with a greater chance of regular consumption of F&V (OR = 1.48, 95% CI: 1.09 - 2.01), while overweight was associated with a lower chance of outcome (OR = 0.76, 95% CI: 0.61 - 0.95). In conclusion, using the internet has proven to contribute significantly to a more adequate diet in F&V, as well as being overweight has shown to be a risk factor.

Contextual income and incidence of disability: results of EpiFloripa Elderly Cohort / Renda contextual e incidência de incapacidade: resultados da Coorte EpiFloripa Idoso

ABSTRACT OBJECTIVE: Evaluate the association between contextual income and the incidence of disability in basic and instrumental activities of daily living. METHODS: This is a cohort study, with sample of elderly individuals (n = 1,196) residing in Florianópolis, state of Santa Catarina, Brazil. The incidence of disabilities was evaluated using reports of difficulty or inability to perform six basic activities of daily living and nine instrumental activities of daily living after four years. Contextual income was obtained from the 2010 Census. We conducted multilevel logistic regression analyses with adjustment models for individual variables. RESULTS: The incidence of disability in basic activities of daily living was 15.8% (95%CI 13.8-17.9) and in instrumental activities of daily living incidence was 13.4% (95%CI 11.6-15.5). We observed significant association between contextual income and incidence of disability in basic activities of daily living. Having as reference the elderly living in the lower income tercile, those who lived in the intermediary terciles and in that of highest income had 37% (95%CI 0.41-0.96) and 21% (95%CI 0.52-1.19) lower chances of developing disability, respectively. For the incidence of disability in instrumental activities of daily living we observed no statistically significant associations. CONCLUSIONS: Contextual income influences the development of disability in basic activities of daily living in the elderly and should be the subject of actions to reduce socioeconomic inequalities and promote longevity with independence.

RESUMO OBJETIVO: Avaliar a associação entre a renda contextual e a incidência de incapacidade nas atividades básicas e instrumentais da vida diária. MÉTODOS: Trata-se de estudo de coorte, com amostra de idosos (n = 1.196) residentes em Florianópolis, SC. As incidências de incapacidades foram avaliadas por meio do relato de dificuldade ou inabilidade para realizar seis atividades básicas da vida diária e nove atividades instrumentais da vida diária após quatro anos. A renda contextual foi obtida a partir do Censo Demográfico 2010. Foram realizadas análises de regressão logística multinível com modelos de ajuste para variáveis individuais. RESULTADOS: A incidência de incapacidade nas atividades básicas da vida diária foi de 15,8% (IC95% 13,8-17,9) e nas atividades instrumentais da vida diária de 13,4% (IC95% 11,6-15,5). Houve associação significativa entre a renda contextual e a incidência de incapacidade nas atividades básicas da vida diária. Tendo como referência os idosos residentes no tercil inferior de renda, aqueles que moravam nos tercis intermediários e no de maior renda tiveram 37% (IC95% 0,41-0,96) e 21% (IC95% 0,52-1,19) menores chances de desenvolver incapacidade, respectivamente. Para a incidência de incapacidade nas atividades instrumentais da vida diária não foram verificadas associações estatisticamente significativas. CONCLUSÕES: A renda contextual influencia no desenvolvimento de incapacidade nas atividades básicas da vida diária em idosos, devendo ser alvo de ações para redução de iniquidades socioeconômicas e promoção da longevidade com independência.

Mobilidade urbana ativa de adultos com perda auditiva e a percepção sobre o ambiente: um estudo multicêntrico / Movilidad urbana activa de adultos con pérdida auditiva y percepción sobre el ambiente: un estudio multicéntrico / Active urban mobility in adults with hearing loss and their perception of the environment: a multicenter study

Resumo: O objetivo deste estudo foi estimar a associação entre perda auditiva e mobilidade urbana ativa (a pé e/ou de bicicleta), segundo a percepção sobre o ambiente em adultos de três capitais brasileiras. Trata-se de um estudo transversal com 2.350 adultos (18-59 anos) residentes das cidades de Brasília (Distrito Federal), Florianópolis (Santa Catarina) e Porto Alegre (Rio Grande do Sul), avaliados pelo estudo multicêntrico Mobilidade Urbana Saudável (MUS), em 2017 e 2018. A variável de desfecho foi a mobilidade urbana ativa (≥ 10 minutos/semana), e a exposição principal foi a perda auditiva autorreferida. As análises foram estratificadas pela variável percepção do ambiente - percepção dos lugares para caminhar e andar de bicicleta (negativa; positiva). Utilizou-se a análise de regressão logística, estimando-se as odds ratio (OR) brutas e ajustadas, com intervalos de 95% de confiança (IC95%). A prevalência de perda auditiva autorreferida e de mobilidade urbana ativa foi de 17% (IC95%: 15,4; 18,4) e 55,4% (IC95%: 53,4; 57,4), respectivamente. Adultos com perda auditiva e que percebiam o ambiente de forma negativa para caminhar e andar de bicicleta possuíam 34% menos chance de realizar mobilidade urbana ativa ≥ 10 minutos/semana (OR = 0,66; IC95%: 0,45; 0,97). Conclui-se que houve associação entre perda auditiva e mobilidade urbana ativa dos adultos das três capitais brasileiras, segundo a percepção negativa sobre o ambiente. Pessoas com perda auditiva que percebem negativamente o bairro tendem a se deslocar menos por meios de transportes ativos.

Resumen: El objetivo de este estudio fue estimar la asociación entre la pérdida auditiva y la movilidad urbana activa (a pie y/o en bicicleta), según la percepción sobre el ambiente en adultos de tres capitales brasileñas. Se trata de un estudio transversal con 2.350 adultos (18-59 años), residentes en las ciudades de Brasília (Distrito Federal), Florianópolis (Santa Catarina) y Porto Alegre (Rio Grande do Sul), evaluados por el estudio multicéntrico Movilidad Urbana Saludable (MUS), en 2017 y 2018. La variable de resultado fue la movilidad urbana activa (≥ 10 minutos/semana) y la exposición principal fue la pérdida auditiva autoinformada. Los análisis fueron estratificados por la variable percepción del ambiente -percepción de los lugares para caminar y montar en bicicleta (negativa; positiva). Se utilizó el análisis de regresión logística, estimando las odds ratio (OR) brutas y ajustadas, con intervalos de 95% de confianza (IC95%). La prevalencia de pérdida auditiva autoinformada y de movilidad urbana activa fue de un 17% (IC95%: 15,4; 18,4) y 55,4% (IC95%: 53,4; 57,4), respectivamente. Adultos con pérdida auditiva y que percibían el ambiente de forma negativa para caminar y montar en bicicleta poseían un 34% menos de oportunidad de realizar movilidad urbana activa ≥ 10 minutos/semana (OR = 0,66; IC95%: 0,45; 0,97). Se concluye que hubo asociación entre la pérdida auditiva y la movilidad urbana activa de los adultos de las tres capitales brasileñas, según la percepción negativa sobre el ambiente. Las personas con pérdida auditiva que perciben negativamente el barrio tienden a desplazarse menos a través de medios de transportes activos.

Abstract: This study aimed to estimate the association between hearing loss and active urban mobility (walking and/or bicycling), according to perception of the environment in adults in three Brazilian capital cities. This was a cross-sectional study of 2,350 adults (18-59 years) residing in Brasília (Federal District), Florianópolis (Santa Catarina), and Porto Alegre (Rio Grande do Sul), assessed by the multicenter study Healthy Urban Mobility (MUS) in 2017 and 2018. The outcome variable was active urban mobility (≥ 10 minutes/week), and the principal exposure was self-reported hearing loss. The analyses were stratified by the variable "perception of the environment" - perception of places for walking and bicycling (negative; positive). Logistic regression was used to estimate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI). Prevalence rates for self-reported hearing loss and active urban mobility were 17% (95%CI: 15.4; 18.4) and 55.4% (95%CI: 53.4; 57.4), respectively. Adults with hearing loss and that perceived the environment negatively for walking and bicycling showed 34% lower odds of active urban mobility ≥ 10 minutes/week (OR = 0.66; 95%CI: 0.45; 0.97). In conclusion, there was an association between hearing loss and active urban mobility in adults in the three capital cities, according to negative perception of the environment. Persons with hearing loss that perceived the neighborhood negatively tend to circulate less by active means.

Programa intergeracional de estimulação cognitiva: Benefícios relatados por idosos e monitores participantes / Intergenerational cognitive stimulation program: Benefits reported by elderly and monitors participating

Resumo Investigaram-se os benefícios percebidos pelos idosos e monitores participantes do programa intergeracional de manutenção, estimulação e/ou reabilitação cognitiva, mediado pelo uso de computadores e prática de atividades físicas "Oficina da Lembrança". Realizou-se uma pesquisa qualitativa descritiva, com dez idosos e seis monitores participantes da Oficina da Lembrança. Aplicou-se entrevista semiestruturada, interpretada pela análise de conteúdo. Os idosos relataram: aprendizagem do uso de computadores, melhora da memória, sociabilização, ter atividade de lazer, emagrecimento, melhora da qualidade de vida, saúde e sociabilização. Monitores: contato com idosos, melhora da relação com pessoas/pacientes, preparação para situações diversas e conhecimentos sobre idosos. Conclui-se que a Oficina da Lembrança pode proporcionar vários benefícios para seus praticantes e para seus monitores, principalmente a intergeracionalidade.

Abstract We investigated the benefits perceived by older people and monitors participants of the intergenerational program intergenerational of maintenance, stimulation/rehabilitation cognitive, mediated by the use of computers and physical activity "Oficina da Lembrança". We performed a descriptive qualitative research with ten elderly and six monitors participants of Oficina da Lembrança. We applied semi-structured interviews, which were interpreted by content analysis. The elderly related: learning the use of computers, improved memory, socialization, having leisure activity, weight loss, improved quality of life, health and socialization. Monitors: contact with elderly, improvement of the relationship with people and patients, preparation for different situations and acquiring more knowledge about the elderly. In conclusion, Oficina da Lembrança can provide several benefits to its practitioners and monitors, especially the intergenerationality.