Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people.

BACKGROUND: Few studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences. OBJECTIVE: To evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil. METHODS: This is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%. RESULTS: The sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11-25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46-177.06) among those from São Paulo. CONCLUSION: The results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.

Teste de força máxima de preensão palmar em pessoas idosas longevas do sudeste brasileiro: definição de pontos de corte / Maximum handgrip strength test in long-lived elderly people from southeastern Brazil: definition of cutoff points

Resumo Objetivo Definir pontos de corte para os valores do teste de força máxima de preensão palmar (FMPP) em pessoas idosas longevas. Método Estudo transversal com amostra de pessoas idosas longevas, octogenárias e nonagenárias, saudáveis e independentes funcionais (grupo robusto) e frágeis (grupo frágil). O teste de FMPP foi realizado em triplicata, sendo considerado o maior valor obtido. Os valores de sensibilidade, especificidade e os pontos de corte foram calculados por meio da Curva Característica de Operação do Receptor (ROC). Foram utilizados os pontos de corte brasileiros e os do Consenso Europeu de Sarcopenia para estudo da comparação. Resultados Foram avaliadas 121 pessoas idosas, com idade média de 84,5±5,3 anos, 65 (53,7%) do sexo feminino, sendo 46 (38%) do grupo frágil e 75 (62%) do grupo robusto. Foram encontrados os pontos de corte para FMPP de 27 kgf para homens e 19 kgf para mulheres. Os valores de sensibilidade e especificidade para os pontos de corte masculinos foram 94,44 e 65,79, respectivamente. Para o sexo feminino foram de 85,71 e 67,57. A partir desses pontos de corte, 23 (38,3%) pessoas idosas do grupo robusto foram classificadas com força inadequada, e, portanto, com provável sarcopenia, ao passo que, de acordo com os pontos de corte brasileiros e europeus, o número é de 35 (44,3%) e 14 (33,3%), respectivamente. Conclusão O estudo definiu pontos de corte para a população longeva e mostrou que os pontos de corte definidos até o momento para a população idosa brasileira não se mostraram adequados para longevos.

Abstract Objective To define cut-off points for the values ​​of the Maximum Handgrip Strength (MGS) test in long-lived elderly people. Method Cross-sectional study with a sample of long-lived elderly people, octogenarians and nonagenarians, healthy and functionally independent (robust group) and frail (fragile group). The MHS test was performed in triplicate, with the highest value obtained being considered. Sensitivity, specificity and cut-off values ​​were calculated using the Receiver Operating Characteristic Curve (ROC). The Brazilian cut-off points and those of the European Consensus on Sarcopenia were used for the comparison study. Results 121 elderly people were evaluated, with a mean age of 84.5±5.3 years, 65 (53.7%) female, 46 (38%) from the frail group and 75 (62%) from the robust group. Cut-off points for MHS of 27 kgf for men and 19 kgf for women were found. Sensitivity and specificity values ​​for men's cutoffs were 94.44 and 65.79, respectively. For woman, they were 85.71 and 67.57. Based on these cutoff points, 23 (38.3%) individuals from the robust group were classified as having competitive strength, and therefore with probable sarcopenia, while according to the Brazilian and European cutoff points, the number is 35 (44.3%) and 14 (33.3%). Conclusion The study defined cut-off points for the oldest-old population and showed that the cut-off points defined so far for the Brazilian elderly population were not adequate for the oldest-old.

Determinantes da relação entre percepção do funcionamento do sistema urinário atrapalhar a vida e a qualidade de vida de longevos / Determinants of the relationship between perception of urinary system function annoys the life and quality of life in oldest-old

Objetivo: este estudo buscou avaliar a relação entre a percepção do funcionamento do sistema urinário atrapalhar a vida de modo geral com a análise do questionário Kings Health Questionnaire (KHQ) em longevos. Métodos: estudo transversal e analítico. Foram investigadas características sociodemográficas e clínicas, bem como, o impacto da incontinência urinária (IU) na Qualidade de vida (QV) pelo instrumento KHQ. Frequências, médias e desvio-padrão, testes de qui-quadrado, t de student e regressões logísticas foram calculadas, aceitando como significativos valores de p<0,05. Resultados: participaram 82 longevos, 68% mulheres, idade média de 92,3±2,7 anos, 71% incontinentes e 43% referindo que a funcionalidade pélvica atrapalhava a vida. Indivíduos incontinentes relataram mais frequentemente a queixa investigada. Os domínios, impacto da IU, emoções, limitação físico-social, limitação no desempenho de tarefas do KHQ e seu escore total foram relacionados com a queixa. Indivíduos que relataram limitação de tarefas fora de casa, em viagens, vontade forte de urinar e difícil de controlar, sentimento de depressão e ansiedade ou nervosismo tinham aumento significativo na chance de relatar que a funcionalidade pélvica atrapalhava a vida. Conclusão: o KHQ foi relacionado com a chance de relato de que o funcionamento do sistema urinário atrapalhava a vida. Mesmo assim, boa parte dos incontinentes não relatava que a condição atrapalhava a vida. Por isso, os resultados demonstram que mesmo na ausência de afirmação positiva de ausência de IU, o funcionamento do sistema urinário pode comprometer a QV. Os achados sugerem que, ou os participantes realmente tinham IU e não a percebiam como tal, ou que é necessário investigar outras questões como frequência miccional, por exemplo. O uso do KHQ permitiu identificar que mesmo na ausência de relato de IU o funcionamento do sistema urinário pode interferir na QV de longevos.

Aims: this study aimed to evaluate the relationship between the perception that urinary system function annoys the life in general with the analysis of the Kings Health Questionnaire (KHQ) in old age. Methods: cross-sectional and analytical study. Sociodemographic and clinical characteristics were investigated, as well as the impact of urinary incontinence (UI) on Quality of Life (QOL) by the KHQ instrument. Frequencies, means and standard deviation and chi-square, student t tests and logistic regressions were calculated, accepting as significant p values <0.05. Results: 82 elderly, 68% women, mean age 92.3 ± 2.7 years, 71% incontinent and 43% reporting that the pelvic functionality disrupted life. Incontinent individuals most frequently reported the investigated complaint. The domains, UI impact, emotions, physical and social limitation, KHQ task performance limitation and its total score were related to the complaint. Individuals who reported limitation of tasks away from home, travel, strong desire to urinate and difficult to control, feelings of depression and anxiety or nervousness had a significant increase in the chance of reporting that pelvic functionality was disruptive to life. Conclusion: KHQ was related to the chance of reporting that the urinary system function was disruptive to life. Even so, most incontinents did not report that the condition disrupted life. Therefore, the results show that even in the absence of a positive statement of absence of UI, the urinary system function can compromise QOL. The findings suggest that either participants actually had UI and did not perceive UI as such, or that further questions such as voiding frequency need to be investigated, for example. The use of KHQ allowed us to identify that even in the absence of UI report, the urinary system function can interfere with the QoL of the oldest old.