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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; Braz. J. Psychiatry (São Paulo, 1999, Impr.);46: e20233153, 2024. tab, graf
مقالة ي الانجليزية | LILACS-Express | LILACS | ID: biblio-1574148

الملخص

Objective: To evaluate the direct, indirect, and total prospective effects of serum concentrations of 25-hydroxycholecalciferol (25[OH]D) on depressive symptoms in older adults. Methods: Data from the second (2013-2015) and third (2017-2019) waves of the EpiFloripa Aging Cohort Study (≥ 60 years) were analyzed. Depressive symptoms were assessed with the 15-item Geriatric Depression Scale. 25(OH)D levels were measured using the microparticle chemiluminescence method. A directed acyclic graph was constructed to identify the minimum set of adjustments. Structural equation modeling analysis was used to determine the effects of 25(OH)D on depressive symptoms. Results: Data from 574 older adults (63.1% female) were analyzed. In the follow-up (n=390), 16.2% of them presented severe depressive symptoms (≥ 6 points). Structural equation modeling analysis revealed that 25(OH)D had a small direct negative effect (β = -0.11, p < 0.05) and an overall negative effect (β = -0.13; p < 0.05) on depressive symptoms in wave 3 (increased 25[OH]D led to decreased depressive symptoms). No direct or indirect effect on depressive symptoms was found in wave 2. Conclusion: Our findings indicate a prospective association between 25(OH)D and depressive symptoms, suggesting a long-term effect in older adults from southern Brazil.

2.
Cad. Saúde Pública (Online) ; 39(3): e00127622, 2023. tab
مقالة ي الانجليزية | LILACS-Express | LILACS | ID: biblio-1430071

الملخص

This study aimed to investigate the association between self-reported hearing loss and cognitive impairment in older adults in a city in Southern Brazil. In this cross-sectional, population-based cohort study of older adults, data were collected in the third wave of the EpiFloripa Aging study (2017/2019), which had been performed since 2009 in the city of Florianópolis, Santa Catarina State. Cognitive impairment was the dependent variable analyzed by the Mini-Mental State Examination (MMSE), and self-reported hearing loss, which was included in the cohort only in the last wave, was the main exposure variable. Logistic regression analyses were conducted, considering the study design and sample weights. Data from 1,335 older adults were evaluated. The prevalence was 20.5% for cognitive impairment and 10.7% for hearing loss. Older adults with hearing loss were 2.66 (95%CI: 1.08-6.54) times more likely to have cognitive impairment than older adults without hearing loss. The association between hearing loss and cognitive impairment highlights the need to integrate the early identification of these problems into primary care, as both are risk factors for healthy aging and potentially preventable and/or treatable conditions.


Este estudo teve como objetivo investigar a associação entre perda auditiva autorreferida e comprometimento cognitivo em idosos de uma cidade do sul do Brasil. Trata-se de um estudo transversal de coorte de base populacional com idosos. Os dados foram coletados na terceira onda do estudo EpiFloripa Idoso (2017/2019), realizado desde 2009 na cidade de Florianópolis, Santa Catarina. A variável dependente comprometimento cognitivo foi analisada pelo Mini-Exame do Estado Mental (MEEM), sendo a principal variável de exposição a perda auditiva (autorreferida), incluída na coorte apenas na última onda. Foram realizadas análises de regressão logística levando em consideração o desenho do estudo e os pesos amostrais. Foram avaliados dados de 1.335 idosos. A prevalência de comprometimento cognitivo foi de 20,5% e de perda auditiva, 10,7%. Idosos com perda auditiva tem 2,66 (IC95%: 1,08-6,54) vezes mais chances de ter comprometimento cognitivo quando comparados a idosos sem perda auditiva. A associação encontrada entre perda auditiva e comprometimento cognitivo é um alerta quanto à necessidade de integrar a identificação precoce desses problemas na atenção primária, pois ambas as dimensões analisadas são fatores de risco para o envelhecimento saudável e potencialmente evitáveis e/ou tratáveis.


Este estudio tuvo como objetivo investigar la asociación entre la pérdida auditiva autorreportada y el deterioro cognitivo en personas mayores de una ciudad del sur de Brasil. Se trata de un estudio transversal de cohorte de base poblacional con personas mayores. Los datos se recabaron de la tercera ola del estudio EpiFloripa Anciano (2017/2019), realizado desde 2009 en la ciudad de Florianópolis, Santa Catarina. La variable dependiente deterioro cognitivo se analizó mediante el Miniexamen del Estado Mental (MEEM), y tuvo como principal variable de exposición la pérdida auditiva (autorreportada), incluida en la cohorte solo en la última ola. Se realizaron análisis de regresión logística teniendo en cuenta el diseño del estudio y los pesos de la muestra. Se evaluaron datos de 1.335 personas mayores. La prevalencia de deterioro cognitivo fue del 20,5%; y la de pérdida auditiva, del 10,7%. Las personas mayores con pérdida auditiva tienen 2,66 (IC95%: 1,08-6,54) veces más probabilidades de tener deterioro cognitivo en comparación con las personas mayores sin pérdida auditiva. La asociación encontrada entre pérdida auditiva y deterioro cognitivo llama la atención para la importancia de identificar precozmente estos problemas en la atención primaria, ya que ambas dimensiones analizadas son los factores de riesgo para un envejecimiento saludable y potencialmente prevenible y/o tratable.

3.
Rev. saúde pública (Online) ; 57: 88, 2023. tab, graf
مقالة ي الانجليزية, البرتغالية | LILACS | ID: biblio-1522870

الملخص

ABSTRACT OBJECTIVE To describe the process and epidemiological implications of georeferencing in EpiFloripa Aging samples (2009-2019). METHOD The EpiFloripa Aging Cohort Study sought to investigate and monitor the living and health conditions of the older adult population (≥ 60) of Florianópolis in three study waves (2009/2010, 2013/2014, 2017/2019). With an automatic geocoding tool, the residential addresses were spatialized, allowing to investigate the effect of the georeferencing sample losses regarding 19 variables, evaluated in the three waves. The influence of different neighborhood definitions (census tracts, Euclidean buffers, and buffers across the street network) was examined in the results of seven variables: area, income, residential density, mixed land use, connectivity, health unit count, and public open space count. Pearson's correlation coefficients were calculated to evaluate the differences between neighborhood definitions according to three variables: contextual income, residential density, and land use diversity. RESULT The losses imposed by geocoding (6%, n = 240) caused no statistically significant difference between the total sample and the geocoded sample. The analysis of the study variables suggests that the geocoding process may have included a higher proportion of participants with better income, education, and living conditions. The correlation coefficients showed little correspondence between measures calculated by the three neighborhood definitions (r = 0.37-0.54). The statistical difference between the variables calculated by buffers and census tracts highlights limitations in their use in the description of geospatial attributes. CONCLUSION Despite the challenges related to geocoding, such as inconsistencies in addresses, adequate correction and verification mechanisms provided a high rate of assignment of geographic coordinates, the findings suggest that adopting buffers, favored by geocoding, represents a potential for spatial epidemiological analyses by improving the representation of environmental attributes and the understanding of health outcomes.


RESUMO OBJETIVO Descrever o processo e as implicações epidemiológicas do georreferenciamento nas amostras do EpiFloripa Idoso (2009-2019). MÉTODO O estudo de coorte EpiFloripa Idoso buscou investigar e acompanhar as condições de vida e saúde da população idosa (≥ 60) de Florianópolis em três ondas de estudo (2009/2010, 2013/2014, 2017/2019). Com uma ferramenta de geocodificação automática, os endereços residenciais foram espacializados, permitindo a investigação do efeito das perdas amostrais do georreferenciamento em relação a 19 variáveis, avaliadas nas três ondas. A influência de diferentes definições de vizinhança (setores censitários, buffers euclidianos e buffers pela rede de ruas) foi examinada nos resultados de sete variáveis: área, renda, densidade residencial, uso misto do solo, conectividade, contagem de unidades de saúde, e contagem de espaços livres públicos. Coeficientes de correlação de Pearson foram calculados para avaliar as diferenças entre as definições de vizinhança de acordo com três variáveis: renda contextual, densidade residencial e diversidade de uso do solo. RESULTADO As perdas impostas pela geocodificação (6%, n = 240) não ocasionaram diferença estatística significativa entre a amostra total e a georreferenciada. A análise das variáveis do estudo sugere que o processo de geocodificação pode ter incluído uma maior proporção de participantes com melhor nível de renda, escolaridade e condições de vida. Os coeficientes de correlação evidenciaram pouca correspondência entre medidas calculadas pelas três definições de vizinhança (r = 0,37-0,54). A diferença estatística entre as variáveis calculadas por buffers e setores censitários ressalta limitações no uso destes na descrição dos atributos geoespaciais. CONCLUSÃO Apesar dos desafios relacionados à geocodificação, como inconsistências nos endereços, adequados mecanismos de correção e verificação propiciaram elevada taxa de atribuição de coordenadas geográficas. Os achados sugerem que a adoção de buffers, favorecida pela geocodificação, representa uma potencialidade para análises epidemiológicas espaciais ao aprimorar a representação dos atributos do ambiente e a compreensão dos desfechos de saúde.


الموضوعات
Humans , Male , Female , Aged , Aged, 80 and over , Health of the Elderly , Health Surveys , Geographic Information Systems , Environment and Public Health , Geographic Mapping , Spatial Analysis , Cohort Studies
4.
مقالة ي الانجليزية, البرتغالية | LILACS | ID: biblio-1432156

الملخص

ABSTRACT OBJECTIVE To estimate the association between negative self-perception of hearing and depression in older adults in Southern Brazil. METHODS This is a cross-sectional study conducted with data from the third wave of the EpiFloripa Idoso 2017/19 study, a population-based cohort of older adults (60+). A total of 1,335 older adults participated in this wave. The dependent variable was self-reported depression, and the main exposure was self-perception of hearing (negative; positive). For both the crude (bivariate) and adjusted analysis, the odds ratio (OR) was used as a measure of association and estimated by means of binary logistic regression analysis. The exposure variable was adjusted by sociodemographic and health covariates. A p value < 0.05 was adopted as statistically significant. RESULTS The prevalence of negative self-perception of hearing and depression was 26.0% and 21.8%, respectively. In the adjusted analysis, the older adults with negative self-perception of hearing were 1.96 times more likely to report depression when compared to the ones with positive self-perception of hearing (p = 0.002). CONCLUSION The association between negative self-perception of hearing and depression reflects the importance of reviewing health care actions for older adults, incorporating hearing-related issues, to ensure comprehensive care for this growing segment of the population.


RESUMO OBJETIVO Estimar a associação entre a autopercepção negativa da audição e a depressão em idosos do sul do Brasil. MÉTODOS Trata-se de um estudo transversal realizado com dados da terceira onda do estudo EpiFloripa Idoso 2017/19, de coorte de base populacional de idosos (60+). Participaram desta onda 1.335 idosos. A variável dependente foi a depressão autorreferida e a exposição principal foi a autopercepção auditiva (negativa; positiva). Tanto para a análise bruta (bivariada) quanto para a ajustada, a odds ratio (OR) foi utilizada como medida de associação e estimada por meio da análise de Regressão Logística Binária. A variável de exposição foi ajustada pelas covariáveis sociodemográficas e de saúde. Adotou-se o valor de p < 0,05 como estatisticamente significativo. RESULTADOS A prevalência da autopercepção negativa da audição e depressão foi de 26,0% e 21,8%, respectivamente. Na análise ajustada, idosos com autopercepção negativa da audição apresentaram 1,96 vezes mais chance de referirem depressão quando comparados aos idosos com autopercepção positiva da audição (p = 0,002). CONCLUSÃO A associação encontrada entre a autopercepção negativa auditiva e a depressão reflete a importância de rever as ações de atenção à saúde do idoso, incorporando questões relacionadas à audição para a garantia da atenção integral a esta parcela crescente da população.


الموضوعات
Humans , Aged , Aged, 80 and over , Presbycusis , Self Concept , Aged , Health Surveys , Depression , Diagnostic Self Evaluation , Hearing Loss
5.
Cad. Saúde Pública (Online) ; 38(11): e00011422, 2022. tab, graf
مقالة ي الانجليزية | LILACS-Express | LILACS | ID: biblio-1404032

الملخص

This study aimed to verify the association between the consumption of omega-3-rich (n-3) fish and depressive symptoms in older adults living in Southern Brazil. This is a cross-sectional analysis with data from the second wave of the EpiFloripa Aging cohort study (2013/2014) including 1,130 individuals aged 60 years or older. The presence of depressive symptoms was measured by the 15-items Geriatric Depression Scale (GDS-15), and the consumption of n-3-rich fish by a question of weekly frequency. The minimum set of variables for adjustment was defined using directed acyclic graph (DAG). Poisson regression with robust error variance was applied (adjusted by Model 1: demographic and socioeconomic variables, Model 2: added behavioral variables, Model 3: added health variables). We identified the prevalence of depressive symptoms in 19% of older adults and 51.8% reported eating n-3-rich fish once a week. Models 1 and 3 showed an inverse association between n-3-rich fish and depressive symptoms. However, the association was reduced when behavioral factors (leisure-time physical activity) were included in Model 2. These findings suggest that n-3-rich fish intake tends to be associated with depressive symptoms in older adults. However, other factors, such as physical exercise, are as pivotal as n-3 fatty acids in preventing the development of depressive symptoms.


Este estudo buscou verificar a associação entre o consumo de peixes ricos em ômega-3 (n-3) e sintomas depressivos em idosos residindo no Sul do Brasil. Esta é uma análise transversal com dados da segunda onda do estudo de coorte EpiFloripa Idoso (2013/2014) e incluiu 1.130 indivíduos com 60 anos ou mais. A presença de sintomas depressivos foi medida pela Escala de Depressão Geriátrica de 15 itens (GDS-15) e pela frequência semanal de consumo de peixes ricos em n-3. O conjunto mínimo de variáveis para ajuste foi definido utilizando-se um gráfico acíclico dirigido (GAD). Foi aplicada a regressão de Poisson com variância robusta de erros (ajustada pelo Modelo 1: variáveis demográficas e socioeconômicas, Modelo 2: variáveis comportamentais adicionadas e Modelo 3: variáveis de saúde). Identificamos a prevalência de sintomas depressivos em 19% dos idosos e 51,8% relataram comer peixes ricos em n-3 uma vez por semana. Os Modelos 1 e 3 apresentaram uma associação inversa entre peixes ricos em n-3 e sintomas depressivos. No entanto, a associação foi reduzida quando fatores comportamentais (atividade física de lazer) foram incluídos no Modelo 2. Esses achados sugerem que a ingestão de peixes ricos em n-3 tende a estar associada a sintomas depressivos em idosos. No entanto, outros fatores como o exercício físico são tão cruciais quanto os ácidos graxos n-3 em prevenir o desenvolvimento de sintomas depressivos.


El objetivo de este estudio fue verificar la asociación entre el consumo de pescado rico en omega-3 (n-3) y los síntomas depresivos en adultos mayores que viven en el Sur de Brasil. Análisis transversal con datos de la segunda oleada del estudio de cohortes EpiFloripa Anciano (2013/2014) que incluyó a 1.130 individuos de 60 años o más. La presencia de síntomas depresivos se midió mediante la Escala de Depresión Geriátrica de 15 ítems (GDS-15), y el consumo de pescado rico en n-3 mediante una pregunta sobre la frecuencia semanal. El conjunto mínimo de variables para el ajuste se definió mediante un gráfico acíclico dirigido (GAD). Se aplicó la regresión de Poisson con varianza de error robusta (ajustada por el Modelo 1: variables demográficas y socioeconómicas, Modelo 2: variables de comportamiento añadidas, Modelo 3: variables de salud añadidas). Se identificó la prevalencia de síntomas depresivos en el 19% de los adultos mayores y el 51,8% informó de que comía pescado rico en n-3 una vez a la semana. Los Modelos 1 y 3 mostraron una asociación inversa entre el pescado rico en n-3 y los síntomas depresivos. Sin embargo, la asociación se redujo cuando se incluyeron los factores conductuales (actividad física en tiempo libre) en el Modelo 2. Estos resultados sugieren que la ingesta de pescado rico en n-3 tiende a asociarse con los síntomas depresivos en los adultos mayores. Sin embargo, otros factores como el ejercicio físico son tan fundamentales como los ácidos grasos n-3 para prevenir el desarrollo de síntomas depresivos.

6.
Cad. Saúde Pública (Online) ; 38(6): e00210321, 2022. tab, graf
مقالة ي الانجليزية | LILACS | ID: biblio-1384262

الملخص

This study aims to analyze the association between perceived characteristics of the neighborhood environment and changes in leisure-time physical activity in Brazilian older adults. Longitudinal analysis was performed considering a population-based study carried out in 2009/2010 with follow-up in 2013/2014. Changes in leisure-time physical activity, obtained with the International Physical Activity Questionnaire during both waves, were associated with data of environment perception with the Neighborhood Environment Walkability Scale - Abbreviated (baseline only) performing multinomial logistic regression. In total, 1,162 older adults (65.2% women, mean age = 73.7 years) participated. Older adults who perceived flat streets, bicycle paths, and high flow of vehicles in the neighborhood were more likely to remain active in leisure time walking. Those who noticed the presence of flat streets also had a greater chance of becoming active than those who did not notice it. Older adults who perceived bicycle paths and sports events were more likely to maintain moderate and vigorous physical activity during leisure time. Furthermore, older adults who noticed parks and squares close to their residence were 0.49 times less likely to become insufficiently active. Brazilian older adults are more active in neighborhoods with more favorable attributes regarding leisure-time physical activity.


Este estudo teve como objetivo analisar a associação entre a percepção das características do ambiente do bairro e a mudança na atividade física no lazer de idosos brasileiros. Esta análise longitudinal foi realizada a partir de um estudo de base populacional realizado em 2009/2010 com acompanhamento em 2013/2014. Alterações na atividade física durante o lazer, obtidas com o Questionário Internacional de Atividade Física durante ambas as ondas, estiveram associadas a dados de percepção ambiental da Escala Abreviada de Caminhabilidade do Ambiente de Bairro (somente na linha de base) através de uma regressão logística multinomial. Participaram do estudo 1.162 idosos (65,2% mulheres, média de 73,7 anos). Idosos que perceberam a presença de ruas planas, ciclovias e alto fluxo de veículos em seus bairros estiveram mais propensos a permanecer ativos em caminhadas de lazer. Além disso, a presença de ruas planas também esteve associada a maior chance de os idosos se tornarem ativos em comparação com aqueles que não perceberam. Idosos que perceberam a presença de ciclovias e eventos esportivos estiveram mais propensos a permanecerem ativos em atividade física moderada ou vigorosa em seu lazer. Além disso, idosos que percebem parques e praças próximas à sua residência tiveram 0,49 vezes menos chances de se tornarem insuficientemente ativos. Idosos brasileiros são mais ativos em bairros que apresentam atributos mais favoráveis à atividade física no lazer.


Este estudio tiene como objetivo analizar la asociación entre la percepción de las características del entorno del barrio y el cambio en la actividad física en tiempo libre en los adultos mayores brasileños. El análisis longitudinal se realizó considerando un estudio de base poblacional realizado en 2009/2010 con seguimiento en 2013/2014. Los cambios en la actividad física en tiempo libre, obtenidos con el Cuestionario Internacional de Actividad Física durante ambas olas, se asociaron con los datos de la percepción del entorno con la Escala Abreviada de Caminabilidad del Entorno Vecinal (sólo en la línea de base) realizando una regresión logística multinomial. Participaron 1.162 adultos mayores (65,2% mujeres, edad media de 73,7 años). Se observó que las personas mayores que percibían la presencia de calles planas, carriles para bicicletas y un alto flujo de vehículos en el barrio presentaban tiempos más probables de permanecer activos en el tiempo de ocio caminando. Además, la presencia de calles planas también se asoció a una mayor probabilidad de que los adultos mayores se mantuvieran activos en comparación con los que no lo percibieron. Las personas mayores que percibieron la presencia de carriles para bicicletas y la presencia de eventos deportivos presentaron, veces más, la probabilidad de permanecer activos en la actividad física moderada y vigorosa en el tiempo libre. Además, los adultos mayores que perciben parques y plazas cerca de su residencia tenían 0,49 veces menos probabilidades de ser insuficientemente activos. Los adultos mayores brasileños son más activos en los barrios que presentan atributos más favorables en cuanto a la actividad física en el tiempo libre.


الموضوعات
Humans , Male , Female , Aged , Residence Characteristics , Leisure Activities , Perception , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Cohort Studies , Walking , Environment Design
7.
São Paulo med. j ; São Paulo med. j;139(4): 372-379, Jul.-Aug. 2021. tab, graf
مقالة ي الانجليزية | LILACS | ID: biblio-1290249

الملخص

ABSTRACT BACKGROUND: Associations between behaviors and individual chronic diseases have been demonstrated. However, the relationship between time spent on sedentary behavior and multimorbidity remains less clear. OBJECTIVE: To identify the predictive power of various intensities of physical activity versus sedentary behavior, as discriminatory factors for cardiometabolic multimorbidity (cardiovascular diseases and diabetes) in the elderly. DESIGN AND SETTING: Cross-sectional study in different residential census tracts and residential households in Florianópolis (SC). METHODS: The participants were 425 elderly people (65% women) from the EpiFloripa Aging study in 2014. Sociodemographic variables and self-reported incidence of cardiovascular diseases and diabetes were obtained via a questionnaire. Light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) were measured using accelerometers. The analyses were stratified according to sex and included a diagnosis for interpretation. Behaviors were taken into consideration if their predictive power in terms of area under the receiver operating characteristic (ROC) curve was greater than 0.50. The time cutoff point was defined from sensitivity and specificity. RESULTS: For older adult men with diabetes, the predictive value of MVPA for absence of multi-morbidity was an area of 0.75 (95% confidence interval, CI: 0.538-0.962), and a cutoff of 17 minutes per day. Older adult women with diabetes had an area of 0.71 (95% CI: 0.524-0.866) and a cutoff of 10 minutes per day. LPA and SB did not present predictive values. CONCLUSION: The time spent on MVPA is a predictor of absence of multimorbidity in elderly people with diabetes, for both sexes.


الموضوعات
Humans , Male , Female , Aged , Sedentary Behavior , Multimorbidity , Exercise , Cross-Sectional Studies , Accelerometry
8.
Arq. bras. cardiol ; Arq. bras. cardiol;117(1): 39-48, July. 2021. tab, graf
مقالة ي الانجليزية, البرتغالية | LILACS | ID: biblio-1285237

الملخص

Resumo Fundamento O aumento significativo de doenças cardiovasculares em países em desenvolvimento alerta sobre seu impacto em populações carentes. Objetivo Identificar a relação de agrupamentos de componentes da síndrome metabólica (SM) com aterosclerose e inflamação crônica em adultos e idosos. Métodos Análise transversal usando dados de dois estudos populacionais de tipo coorte realizados em Florianópolis, sul do Brasil (EpiFloripa Adult Cohort Study, n = 862, 39,9±11,5 anos; EpiFloripa Aging Cohort Study, n = 1197, 69,7±7,1 anos). Pressão arterial (PA), circunferência da cintura (CC), e níveis plasmáticos de lipídio e glicose foram analisados como fatores individuais ou como agrupamentos de componentes da SM (como número de componentes presentes em um indivíduo ou como combinações). Os desfechos incluíram espessura intima-media carotídea (EIMC), placas ateroscleróticas, e níveis de proteína C reativa (CRP). Regressão linear múltipla e regressão logística, ajustadas quanto aos fatores de confusão, foram usadas para análise. O nível de significância adotado foi de 5%. Resultados Indivíduos com PA e CC elevadas, dislipidemia e hiperglicemia (61,5%) apresentaram maiores valores de EIMC e PCR que aqueles que não apresentaram componentes de SM. CC elevada foi um determinante comum de inflamação sistêmica, ao passo que a coexistência de PA elevada e CC elevada (agrupamentos de dois ou três fatores) associou-se com maior EIMC (β entre +3,2 e +6,1 x 10-2 mm; p < 0,05) e PCR (EXPβ entre 2,18 e 2,77; p < 0,05). Conclusão A coexistência de PA e CC elevadas associou-se com maiores valores de EIMC e níveis de PCR. A obesidade central, isolada ou em combinação com outros fatores de risco, teve efeito sobre a inflamação sistêmica.


Abstract Background The significant increase in cardiovascular diseases in developing countries alerts about their impact on underprivileged populations. Objective To identify the relationship of clusters of metabolic syndrome (MS) components with atherosclerosis and chronic inflammation among adults and elderly. Methods Cross-sectional analysis using data from two population-based cohort studies in Florianópolis, Southern Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.9±11.5 years; EpiFloripa Aging Cohort Study, n = 1197, 69.7±7.1 years). Blood pressure (BP), waist circumference (WC), and lipid and glucose levels were analyzed as individual factors or as clusters (either as the number of components present in an individual or as combinations of components). Outcomes included carotid intima-media thickness (IMT), atherosclerotic plaques, and C-reactive protein (CRP) levels. Multiple linear and logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results Individuals with high BP, elevated WC, dyslipidemia and hyperglycemia (6.1% of the sample) showed higher IMT and CRP than those negatives for all MetS components. Elevated WC was a common determinant of systemic inflammation, while the coexistence of high BP and elevated WC (clusters of two or three factors) was associated with higher IMT (β between +3.2 and +6.1 x 10-2 mm; p value < 0.05) and CRP (EXPβ between 2.18 and 2.77; p value < 0.05). Conclusion The coexistence of high BP and elevated WC was associated with increased IMT and CRP levels, but central obesity affected systemic inflammation either alone or in combination with other risk factors.


الموضوعات
Humans , Adult , Aged , Atherosclerosis/etiology , Atherosclerosis/epidemiology , Carotid Intima-Media Thickness , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Cohort Studies , Cardiometabolic Risk Factors , Inflammation
9.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; Braz. J. Psychiatry (São Paulo, 1999, Impr.);43(3): 247-253, May-June 2021. tab, graf
مقالة ي الانجليزية | LILACS | ID: biblio-1249190

الملخص

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.


الموضوعات
Humans , Aged , Depression/epidemiology , Brazil/epidemiology , Risk Factors , Cohort Studies , Longitudinal Studies
10.
São Paulo med. j ; São Paulo med. j;138(6): 545-553, Nov.-Dec. 2020. tab
مقالة ي الانجليزية | LILACS, SES-SP | ID: biblio-1145133

الملخص

ABSTRACT 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.


الموضوعات
Humans , Male , Female , Middle Aged , Aged , Chronic Disease/epidemiology , Sedentary Behavior , Multimorbidity , Brazil/epidemiology , Cross-Sectional Studies
11.
Rev. bras. epidemiol ; Rev. bras. epidemiol;23: e200091, 2020. graf
مقالة ي الانجليزية, البرتغالية | LILACS | ID: biblio-1126034

الملخص

RESUMO: Objetivo: Analisar a relação entre o potencial de propagação do SARS-CoV-2 e as tomadas de decisão do governo municipal de Florianópolis, Brasil, quanto ao distanciamento social. Métodos: Foram analisados casos novos de COVID-19 com tratamento de nowcasting identificados em residentes de Florianópolis entre 1º de fevereiro e 14 de julho de 2020. Também foram examinados os decretos relacionados à COVID-19 publicados no Diário Oficial do Município entre 1º de fevereiro e 14 de julho de 2020. Com base nas ações dispostas nos decretos, analisou-se se elas promoviam o relaxamento, o aumento ou a manutenção das restrições vigentes, criando-se o Índice de Distanciamento Social. Para o período de 14 dias anteriores a cada decreto, calcularam-se os números de reprodução dependente do tempo (Rt). Construiu-se uma matriz entre a classificação de cada decreto e os valores de Rt, verificando-se a consonância ou a dissonância entre o potencial de disseminação do SARS-CoV-2 e as ações dos decretos. Resultados: Foram analisados 5.374 casos de COVID-19 e 26 decretos. Nove decretos aumentaram as medidas de distanciamento social, nove as mantiveram e oito as flexibilizaram. Das 26 ações, nove eram consonantes e 17 dissonantes com a tendência indicada pelos Rt. Dissonâncias foram observadas com todos os decretos que mantiveram as medidas de distanciamento e os que as flexibilizaram. No segundo bimestre da análise houve a mais rápida expansão do número de casos novos e a maior quantidade de dissonâncias dos decretos. Conclusão: Observou-se importante divergência entre as medidas de distanciamento social com indicadores epidemiológicos no momento da decisão política.


ABSTRACT: Objective: To analyze the association between the transmission potential of SARS-CoV-2 and the decisions made by the municipal government of Florianópolis (Brazil) regarding social distancing. Methods: We analyzed new cases of COVID-19 identified in Florianópolis residents between February 1 and July 14, 2020, using a nowcasting approach. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, whether they loosened social distancing measures, or increased or maintained existing restrictions, was analyzed, thus creating a Social Distancing Index. Time-dependent reproduction numbers (Rt) for a period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees. Results: A total of 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased social distancing measures, nine maintained them, and eight loosened them. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonance was observed in all of the decrees that maintained the distance measures or loosened them. The fastest expansion in the number of new cases and the greatest amount of dissonant decrees was found in the last two months analyzed. Conclusion: There was an important divergence between municipal measures of social distancing with epidemiological indicators at the time of each political decision.


الموضوعات
Humans , Pneumonia, Viral/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , Decision Making , Pandemics/prevention & control , Local Government , Pneumonia, Viral/prevention & control , Psychological Distance , Brazil/epidemiology , Retrospective Studies , COVID-19
12.
Rev. saúde pública ; Rev. saúde pública;47(4): 701-710, ago. 2013. tab
مقالة ي البرتغالية | LILACS | ID: lil-695416

الملخص

OBJETIVO Analisar a prevalência e fatores associados a sintomas depressivos em idosos. MÉTODOS Estudo epidemiológico transversal e de base domiciliar (inquérito Epi Floripa Idoso) com 1.656 idosos, realizado por conglomerados em dois estágios, setores censitários e domicílios, em Florianópolis, SC. A prevalência de sintomas depressivos (desfecho) foi obtida por meio da Geriatric Depression Scale (GDS-15), e testadas associações segundo variáveis sociodemográficas, de saúde, comportamentais e sociais. Foram calculadas razões de prevalências brutas e ajustadas com intervalo de 95% de confiança por regressão de Poisson. RESULTADOS A prevalência de sintomas depressivos foi de 23,9% (IC95% 21,84;26,01). Os fatores de risco associados no modelo final foram: escolaridade de cinco a oito anos (RP = 1,50; IC95% 1,08; 2,08), um a quatro anos (RP = 1,62; IC95% 1,18; 2,23) e nenhum ano de estudo (RP = 2,11; IC95% 1,46;3,05); situação econômica pior quando comparada com a que tinha aos 50 anos (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepção de saúde regular (RP = 1,95; IC95% 1,47;2,60) e ruim (RP = 2,64; IC95% 1,82;3,83); dependência funcional (RP = 1,83; IC95% 1,43; 2,33); e dor crônica (RP = 1,35; IC95% 1,10;1,67). Grupo etário de 70 a 79 anos (RP = 0,77; IC95% 0,64;0,93); atividade física de lazer (RP = 0,75; IC95% 0,59;0,94); participação em grupos de convivência ou religiosos (RP = 0,80; IC95% 0,64;0,99); e ter relação sexual (RP = 0,70; IC95% 0,53;0,94) mostraram-se fatores protetores ao aparecimento dos sintomas depressivos. CONCLUSÕES Situação clínica adversa, desvantagem socioeconômica e pouca atividade social e sexual mostraram-se associadas aos sintomas depressivos em idosos. .


OBJETIVO Analizar la prevalencia y factores asociados a síntomas depresivos en ancianos. MÉTODOS Estudio epidemiológico transversal y de base domiciliar (pesquisa EpiFloripa Anciano ) con 1.656 ancianos, realizado por conglomerados en dos fases, sectores censitarios y domicilios, en Florianópolis, SC, Brasil. La prevalencia de síntomas depresivos (resultado) fue obtenida por medio de la Geriatric Depression Scale (GDS-15), y evaluadas asociaciones según variables sociodemográficas, de salud, comportamiento y sociales. Se calcularon tasas de prevalencia brutas y ajustadas con intervalo de 95% de confianza por regresión de Poisson. RESULTADOS La prevalencia de síntomas depresivos fue de 23,9% (IC95% 21,84;26,01). Los factores de riesgo asociados en el modelo final fueron: escolaridad de cinco a ocho años (RP = 1,50; IC95% 1,08; 2,08), uno a cuatro años (RP = 1,62; IC95% 1,18; 2,23) y ningún año de estudio (RP = 2,11; IC95% 1,46;3,05); situación económica peor al compararse con la que tenía a los 50 años (RP = 1,33; IC95% 1,02;1,74); déficit cognitivo (RP = 1,45; IC95% 1,21;1,75); percepción de salud regular (RP = 1,95; IC95% 1,47;2,60) y mala (RP = 2,64; IC95% 1,82;3,83); dependencia funcional (RP = 1,83; IC95% 1,43; 2,33) y dolor crónico (RP = 1,35; IC95% 1,10;1,67). Grupo etario de 70 a 79 años (RP = 0,77; IC95% 0,64;0,93); actividad física de placer (RP = 0,75; IC95% 0,59;0,94); participación en grupos de convivencia o religiosos (RP = 0,80; IC95% 0,64;0,99) y tener relación sexual (RP = 0,70; IC95% 0,53;0,94) se mostraron como factores protectores de la aparición de los síntomas depresivos. CONCLUSIONES Situación clínica adversa, desventaja socioeconómica y poca actividad social y sexual se mostraron asociados a los síntomas depresivos en ancianos. .


OBJECTIVE To estimate the prevalence and associated factors of depressive symptoms in the elderly. METHODS Cross-sectional population based epidemiological study (The Epi Floripa Elderly survey) was carried out in two stage clusters, census tracts and households, with1.656 elderly individuals in Florianópolis, SC. The prevalence of depressive symptoms (outcome) was obtained using Geriatric Depression Scale (GDS-15) and its associations with socio-demographic, health, behavioral and social variables were assessed. Crude and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression. RESULTS Depressive symptoms were observed in 23.9% of the elderly individuals (95%CI 21.84;26.01). In the final model, depressive symptoms were associated with: 5 to 8 years of schooling (PR = 1.50, 95%CI 1.08;2.08); one to four years of schooling (PR = 1.62, 95%CI 1.18;2.23) and no schooling (PR = 2.11, 95%CI 1.46;3.05); being in a worse financial condition than at the age of 50 (PR = 1.33, 95%CI 1.02;1.74); cognitive impairment (PR = 1.45, 95%CI 1.21;1.75); perceiving their health to be regular (PR = 1.95, 95%CI 1.47;2.60) or poor (PR = 2.64, 95%CI 1.82;3.83); functional dependence (PR =1.83, 95%CI 1.43;2.33) and chronic pain (PR = 1.35, 95%CI 1.10;1.67). Factors with protective effects were: being in the 70 to 79 year old age group (PR = 0.77, 95%CI 0.64;0.93); physical activity in leisure time (PR = 0.75, 95%CI 0.59;0.94); participation in social or religious groups (PR = 0.80, 95%CI 0.64;0.99) and having sexual relations (PR = 0.70, 95%CI 0.53;0.94). CONCLUSIONS : Adverse clinical situations, being socioeconomically disadvantaged and low social and sexual activity were associated with depressive symptoms in the elderly. .


الموضوعات
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Depression/epidemiology , Age Distribution , Brazil/epidemiology , Cross-Sectional Studies , Depression/diagnosis , Prevalence , Risk Factors , Sex Distribution , Socioeconomic Factors
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