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Objective: To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. Materials and methods: The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. Results: The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Conclusion: Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction.
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Hipertensão , Tireotropina , Tiroxina , Tri-Iodotironina , Humanos , Hipertensão/epidemiologia , Hipertensão/sangue , Masculino , Feminino , Brasil/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Longitudinais , Adulto , Tireotropina/sangue , Incidência , Tiroxina/sangue , Tri-Iodotironina/sangue , Hipertireoidismo/sangue , Hipertireoidismo/epidemiologia , Hipotireoidismo/sangue , Hipotireoidismo/epidemiologia , Fatores de Risco , Testes de Função Tireóidea , IdosoRESUMO
ABSTRACT Objective: To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. Materials and methods: The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. Results: The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Conclusion: Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction.
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SUMMARY OBJECTIVE: This study investigated the association of psoriasis with cardiovascular risk factors and psychological aspects among participants of the Brazilian Longitudinal Study of Adult Health. METHODS: This is a cross-sectional study from the baseline data of the Brazilian Longitudinal Study of Adult Health cohort, collected between 2008 and 2010 in six state capitals of Brazil (i.e., Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitória). Participants were active and retired civil servants from college and research institutions, aged between 35 and 74 years. Exclusion criteria included the intention to quit working at the institution, pregnancy, severe cognitive impairment, and, if retired, residence outside of a study center's corresponding area. Psoriasis case identification was based on a previous medical diagnosis of psoriasis. Cardiovascular risk profile, psychological aspects, and sociodemographic variables were investigated. RESULTS: Data from 15,105 participants were analyzed (mean age of 52.3 years, 51.3% women). The prevalence of psoriasis was 1.6% (n=236). Psoriasis was associated with higher education (OR 1.94 [CI 1.07-3.52]), health insurance plan (OR 1.56 [CI 1.08-2.25]), central obesity (OR 1.63 [CI 1.10-2.40]), smoking status (former OR 1.40 [CI 1.03-1.88]; current OR 1.61 [CI 1.08-2.40]), and very bad self-perception of health (OR 7.22 [CI 2.41-21.64]), remaining significant even after multivariate adjustment. Self-reported Black participants were less likely to have psoriasis (OR 0.45 [CI 0.26-0.75]). CONCLUSION: In a sample of healthy workers, psoriasis was associated with central obesity, smoking, and a very bad self-perception of health, which may contribute to future cardiovascular disease.
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ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis.
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Exergame, a type of enjoyable active video game that combines physical exertion and game is a technological innovation that has generated important information for the health field. In the car-diovascular area, exergames have been used to manage blood pressure in adults with some positive results. Despite this, in primary studies, it is possible to identify that participants dropout of the exergames interventions, but no synthesis of evidence has been produced so far to explore that. The aims of this review are i) to estimate the pooled rate of dropouts in controlled trials assessing the effects of exergame-based interventions on resting blood pressure in adults and older people; ii) to compare dropout rates between exergame and controls groups, and iii) to investigate the intervention characteristics associate with dropout rates. Inclusion criteria: Randomized controlled trials (RCTs) or quasi-RCTs (≥ 4 weeks) assessing the effects of exergame-based interventions on resting blood pressure in adults aged ≥ 18 years old. Without restriction to language, date of the publication, and intervention setting. Literature searches will be conducted using PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. The quality of the RCTs will be assessed using Cochrane's risk of bias tool. A descriptive narrative synthesis and a random-effects model meta-analysis of the pooled event rate (prevalence) will be provided (p < 0.05). This protocol is registered with PROSPERO: CRD42020199547.
Exergame, um tipo de videogame ativo divertido que combina esforço físico e jogo virtual, é uma inovação tecnológica que tem gerado informações importantes para a área da saúde. Na área cardiovascular, os exer-games têm sido usados para gerenciar a pressão arterial em adultos, com alguns resultados positivos. Apesar disso, em estudos primários, é possível identificar que os participantes abandonaram (dropout) as interven-ções dos exergames, mas nenhuma síntese de evidências foi produzida até o momento para explorar isso. Os objetivos desta revisão são i) estimar a taxa combinada de dropouts em estudos controlados que avaliam os efeitos de intervenções baseadas em exergame na pressão arterial de repouso em adultos e idosos; ii) comparar as taxas de dropouts entre os grupos exergame e controles e iii) investigar as características de intervenção associadas às taxas de dropouts. Serão incluídos ensaios clínicos randomizados (ECRs) ou quase-ECRs (≥ 4 semanas) avaliando efeitos de intervenções com exergames sobre a pressão arterial em repouso em adultos (≥ 18 anos). Não haverá restrição de idioma, data de publicação e ambiente de intervenção. As buscas na lite-ratura serão conduzidas usando PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Cochrane Central Register of Controlled Trials e Scientific Electronic Library Online. O risco de viés dos ECRs será avaliado por meio da ferramenta da Cochrane. Uma síntese narrativa descritiva e uma metanálise de modelo de efeitos aleatórios da taxa de eventos combinados (pre-valência) serão fornecidas (p < 0,05). Este protocolo está registrado com PROSPERO: CRD42020199547.
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Pacientes Desistentes do Tratamento , Exercício Físico , Guias como Assunto , Pressão Arterial , Atividade MotoraRESUMO
Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.
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Objetivo: Verificar a tendência da taxa de mortalidade por suicídio em adolescentes, adultos e idosos, nas Regiões do Brasil, entre 1996 e 2016. Métodos: Estudo de séries temporais, incluindo óbitos por suicídio de adolescentes, adultos e idosos. Foram utilizados dados secundários, disponibilizados pelo Sistema de Informação de Mortalidade e pelo Instituto Brasileiro de Geografia e Estatística. A análise de regressão linear segmentada foi adotada para calcular a variação anual percentual e alterações significativas na tendência. Resultados: Entre 1996 e 2016 ocorreram 195.440 óbitos por suicídio no Brasil. Houve aumento significativo na taxa de mortalidade por suicídio na região Nordeste em adolescentes e adultos do sexo feminino. As taxas aumentaram no Nordeste e reduziram significativamente no Sudeste e Sul para as idosas. O sexo masculino apresentou aumento da taxa de mortalidade por suicídio nas regiões Norte, Nordeste e CentroOeste para os adolescentes; aumento nas regiões Norte e Nordeste e, redução significativa da taxa na região Sul para os adultos. Para os idosos, houve aumento na região Norte e redução significativa da taxa na região Sul. Conclusão: Observou-se diferentes taxas de mortalidade por suicídio entre regiões, sexos e grupos etários.
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OBJECTIVE: To analyze the effects of an exergame-based training compared to resistance training on the quality of life and symptoms of depression in older adults. METHODS: This was a two-arm, non-blinded, randomized clinical trial. Thirty-five participants (62.09 ± 7.11 years) were randomized either on the Exergame-based Training Group (n = 17) or the Resistance Training Group (n = 18). Sessions lasted 50 to 60 minutes, three times per week, for 13 weeks. For the Exergame-based Training Group, we used games that simulate sports and adventure activities through Xbox360 Kinect™. The Resistance Training Group performed ten exercises per session for upper and lower limbs using free weights and machines, following linear periodization and individualized loads. Quality of life and symptoms of depression were assessed using the World Health Organization Quality of Life assessment - an abbreviated version (WHOQOL-BREF) and the Geriatric Depression Scale, respectively. We performed a two-way analysis of variance (p < 0.05). RESULTS: Only time effects were identified for overall quality of life, general health, and symptoms of depression. After the intervention, overall quality of life score increased (3.82 ± 0.95 versus 4.18 ± 0.53, p = 0.05), whereas symptoms of depression decreased (3.35 ± 1.73 versus 2.59 ± 1.54, p = 0.02) in the Exergame-based Training Group, and the general health improved in the Resistance Training Group (3.78 ± 0.81 versus 4.11 ± 0.68, p = 0.05) compared with the baseline scores. CONCLUSION: Both training groups improved different aspects of quality of life. The Exergaming-based Training Group improved the overall perception, whereas the Resistance Training Group improved the general health-related perception. Participants in the Exergame-based Training Group also decreased the number of symptoms of depression.
OBJETIVO: Analisar os efeitos de um treinamento baseado em exergames comparado ao treinamento contra resistência na qualidade de vida e nos sintomas depressivos em adultos mais velhos. METODOLOGIA: Trata-se de um estudo clínico randomizado, com dois braços e não cego. Trinta e cinco participantes (62,09 ± 7,11 anos) foram randomizados para o Grupo de Treinamento com Exergames (n = 17) ou Treinamento de Resistência (n = 18). As sessões tiveram duração de 50 a 60 minutos, três vezes por semana, durante 13 semanas. Para o Grupo de Treinamento com Exergames, foram utilizados jogos que simulavam atividades esportivas e de aventura por meio do Xbox360 Kinect™. O Grupo de Treinamento contra Resistência realizou dez exercícios por sessão, para membros superiores e inferiores, utilizando pesos livres e máquinas, seguindo periodização linear e ajuste de carga individualizado. A qualidade de vida e os sintomas depressivos foram avaliados usando o instrumento de Qualidade de Vida da Organização Mundial da Saúde versão abreviada (WHOQOL-BREF) e a Escala de Depressão Geriátrica, respectivamente. Foram realizadas análises de variância two-way (p ≤ 0,05). RESULTADOS: Apenas efeitos no tempo foram identificados para qualidade de vida geral, saúde geral e sintomas depressivos. Após a intervenção, o escore de qualidade de vida geral aumentou (3,82 ± 0,95 versus 4,18 ± 0,53, p = 0,05) e os sintomas depressivos diminuíram (3,35 ± 1,73 versus 2,59 ± 1,54, p = 0,02) no Grupo de Treinamento com Exergames, e a saúde geral melhorou no Grupo de Treinamento contra Resistência (3,78 ± 0,81 versus 4,11 ± 0,68, p = 0,05) quando comparados com os escores da linha de base. CONCLUSÃO: Ambos os grupos de treinamento melhoraram diferentes aspectos da qualidade de vida. O Grupo de Treinamento com Exergames melhorou a percepção geral, enquanto o Grupo de Treinamento contra Resistência apresentou melhorias na percepção geral relacionada à saúde. Os participantes do Grupo de Treinamento com Exergames também diminuíram o número de sintomas depressivos.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Depressão/terapia , Terapia por Exercício , Terapia de Exposição à Realidade Virtual , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Saúde do IdosoRESUMO
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.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Doença Crônica/epidemiologia , Comportamento Sedentário , Multimorbidade , Brasil/epidemiologia , Estudos TransversaisRESUMO
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.
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Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Demência/epidemiologia , Avaliação da Deficiência , Gordura Abdominal/metabolismo , Obesidade/epidemiologia , Brasil/epidemiologia , Atividades Cotidianas , Envelhecimento , Índice de Massa Corporal , Antropometria , Estudos Transversais , Fatores de Risco , Circunferência da Cintura , Razão Cintura-Estatura , Pessoa de Meia-IdadeRESUMO
ABSTRACT Objective: To verify the variation of the premature mortality rate caused the group of the main chronic noncommunicable diseases. Method: This is a time-series ecological study, which used secondary data of the Mortality Information System, from 2006 to 2014, from the 26 federal units and from the Federal District. Deaths caused by circulatory system diseases, cancer, diabetes and chronic respiratory diseases were included. The trend of adjusted mortality rate was analyzed by segmented linear regression. Results: Premature mortality tended to be reduced in most states, except for Maranhão and Rio Grande do Norte, which presented a stable premature mortality rate. Bahia, Pernambuco, Sergipe, Roraima and all the states from the South, Southeast and Central-West Regions reached the goal of reducing 2% per year in premature mortality caused by main diseases. Conclusion: Most of the states showed a reduced mortality rate and are reaching the proposed target.
RESUMEN Objetivo: Verificar la variación de la tasa de mortalidad prematura por el conjunto de las principales enfermedades crónicas no transmisibles. Método: Estudio ecológico de series temporales, en que se utilizaron datos secundarios del Sistema de Información sobre Mortalidad, de 2006 a 2014, de las 26 Unidades Federativas y del Distrito Federal. Se incluyeron muertes con causa básica las enfermedades del aparato circulatorio, cáncer, diabetes y enfermedades respiratorias crónicas. La tendencia de la tasa ajustada de mortalidad se analizó por la regresión lineal segmentada. Resultados: Hubo tendencia de reducción de la mortalidad prematura en la mayoría de los estados, excepto Maranhão y Rio Grande do Norte que presentaron estabilidad de la tasa de mortalidad prematura. Los estados de Bahía, Pernambuco, Sergipe, Roraima y todos de la Región Sur, Sudeste y Centro-Oeste alcanzaron la meta de reducción del 2% al año en la mortalidad prematura por las principales enfermedades. Conclusión: La mayoría de los estados presentan reducción de la tasa de mortalidad y están alcanzando la meta propuesta.
RESUMO Objetivo: Verificar a variação da taxa de mortalidade prematura pelo conjunto das principais doenças crônicas não transmissíveis. Método: Estudo ecológico de séries temporais, que utilizou dados secundários do Sistema de Informações sobre Mortalidade, de 2006 a 2014, das 26 unidades federativas e do Distrito Federal. Foram incluídos óbitos que tiveram como causa básica doenças do aparelho circulatório, câncer, diabetes e doenças respiratórias crônicas. A tendência da taxa ajustada de mortalidade foi analisada pela regressão linear segmentada. Resultados: Houve tendência de redução da mortalidade prematura na maioria dos estados, exceto Maranhão e Rio Grande do Norte, que apresentaram estabilidade da taxa de mortalidade prematura. Os estados da Bahia, Pernambuco, Sergipe, Roraima e todos das regiões Sul, Sudeste e Centro-Oeste atingiram a meta de redução de 2% ao ano na mortalidade prematura pelas principais doenças. Conclusão: A maioria dos estados apresentaram redução da taxa de mortalidade e estão atingindo a meta proposta.
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Humanos , Masculino , Feminino , Adulto , Idoso , Doença Crônica/mortalidade , Mortalidade/tendências , Fatores Etários , Mapeamento Geográfico , Brasil/epidemiologia , Doença Crônica/epidemiologia , Pessoa de Meia-IdadeRESUMO
ABSTRACT Objective This cross-sectional population-based study aimed to determine the cutoff points of anthropometric indicators to screen for sarcopenia and the association between sarcopenia and these indicators. Methods The sample consisted of 601 older adults. Sarcopenia was detected by appendicular skeletal muscle index. The receiver operating characteristic curve identified the cutoff points for body mass index, waist-to-height ratio, waist circumference, and handgrip strength to screen for sarcopenia. Based on the cut-off points, principal component analysis determined which indicators had a better fit as discriminants to compose an indicator. Finally, logistic regression analysis was performed with this indicator as the main independent variable. Results The results showed that all anthropometric indicators and handgrip strength were capable of discriminating sarcopenia; however, body mass index, waist circumference, and waist-to-height ratio were the best discriminants in principal components analysis, composing the new indicator. Adjusted logistic regression analysis showed that sarcopenia was associated with the indicator in both sexes. Conclusion The concomitant presence of low body mass index, low waist circumference, and low waist-to-height ratio may help to discriminate sarcopenia.
RESUMO Objetivo Este estudo transversal, populacional, teve como objetivo determinar pontos de corte de indicadores antro-pométricos e força de preensão manual para triagem de sarcopenia e verificar a associação entre sarcopenia e estes indicadores. Métodos A amostra foi composta por 601 idosos e a sarcopenia foi identificada pelo índice de massa muscular apendicular. A curva Receiver Operating Characteristic identificou os valores de pontos de corte para: índice de massa corporal, razão cintura-estatura, perímetro de cintura e força de preensão manual para triagem da sarcopenia. A partir dos pontos de corte foi realizada análise de componentes principais para definir os que mais se adequaram como discriminantes, compondo um indicador, e realizado análise de regressão logística com este indicador como variável independente principal. Resultados Os resultados mostraram que todos os indicadores antropométricos e a força de preensão manual foram considerados discriminadores de sarcopenia, entretanto o índice de massa corporal, o perímetro da cintura e a razão cintura estatura mostram-se como os melhores discriminantes na análise de componentes principais, compondo o novo indicador. A análise de regressão logística (ajustada) mostrou que a sarcopenia foi associada com o indicador em ambos os sexos. Conclusão A presença de índice de massa corporal baixo, baixa relação cintura estatura e baixo perímetro da cintura concomitantemente podem auxiliar na discriminação da sarcopenia.
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Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/diagnóstico , Idoso , Antropometria , Curva ROC , Força da MãoRESUMO
The purpose of the program "Video games for people aged 50 years or older" is to create free opportunities for older adults to engage in motivating and enjoyable physical activity, and to stimulate their functional fitness and cognition. This program has been carried out in the Universidade Federal de Santa Catarina since March 2014 and involves undergraduate and postgraduate students in the physical education department. The program follows the school semester, with approximately 36 people from the community participating each semester. The program consists of exercises that use video games that simulate sports activities, called exergames. Participants engage in a 60-minute session two or three times a week and on alternating days. Participants are evaluated at the beginning and end of each semester for functional fitness and cognition and the findings are presented to them. We expected that this program can be expanded and spread to other communities.
O projeto "Jogos eletrônicos para pessoas com 50 anos ou mais" tem como objetivo oportunizar, de forma gratuita, a prática de uma atividade motivadora, atraente e estimuladora da aptidão funcional e da cognição. Este projeto é desenvolvido junto ao Centro de Desportos, da Universidade Federal de Santa Catarina desde março de 2014 e envolve alunos de pós-graduação e graduação em Educação Física (Bacharelado). O projeto segue o semestre letivo e consiste em programa de exercícios físicos baseados em exergames, usando-se jogos que simulam atividades esportivas, por meio do Xbox 360 Kinecttm. A duração das sessões é de 60 minutos e estas são realizadas duas ou três vezes por semana, em dias alternados. Os participantes são avaliados em relação à aptidão funcional e cognição, no início e ao final de cada semestre.
Assuntos
Aptidão Física , Terapia de Exposição à Realidade Virtual , Atividade MotoraRESUMO
Abstract The aim of this study was to analyze the association between diseases and chronic health conditions, multimorbidity and body mass index (BMI) in older adults from southern Brazil. Epidemiological cross-sectional study, with household basis was carried out with 343 older adults aged 60-79 years, selected by probability sampling and all aged 80 years or older (n=134). Hypertension, diabetes, cancer, chronic pulmonary diseases, coronary heart disease, cerebrovascular disease, arthritis, osteoporosis, depression, history of falls and dependency in activities of the daily living were assessed by self-report. Associations between independent variables and BMI (outcome) were tested using simple and multiple linear regression. Participated in the study 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years). After adjustment (age, education, living arrangement, smoking, alcohol consumption, waist circumference, cognitive status and all other disease and chronic health conditions), the associations identified were: hypertension with higher BMI values (β 3.43; 95%CI: 2.38 to 4.48), for women, and chronic pulmonary disease with lower BMI values (β -2.05; 95%CI: -3.50 to -0.60). There was a linear trend between number of diseases and BMI for both sexes. Conclusion: The results showed an independent association between specific chronic diseases and BMI. Monitoring of nutritional status in older adults is important to identify extreme BMI values, especially those with more than two diseases and chronic health conditions.
Resumo O estudo teve como objetivo analisar a associação entre doenças e condições crônicas de saúde, multimorbidade e índice de massa corporal (IMC) em idosos do sul do Brasil. Estudo epidemiológico transversal, de base domiciliar. Foram entrevistados 477 pessoas, sendo 343 de 60 a 79 anos (amostragem probabilística) e todos aqueles com 80 anos ou mais (n=134). A hipertensão, diabetes, câncer, doença crônica pulmonar, doença coronariana, doença vascular cerebral, artrite, osteoporose, depressão, o histórico de quedas e dependência nas atividades da vida diária foram avaliados por meio de autorrelato. As associações entre as variáveis independentes e o IMC (desfecho) foram testadas por meio de regressão linear simples e múltipla. Participaram da pesquisa 270 mulheres (73,2±8,8 anos) e 207 homens (73,3±9,0 anos). Após ajuste (idade, escolaridade, arranjo familiar, tabagismo, consumo de álcool, circunferência da cintura, estado cognitivo e todas as doenças e condições crônicas de saúde) as associações identificadas foram: hipertensão e maiores valores de IMC (β 3,43; IC95%: 2,38 a 4,48), para as mulheres e; doença crônica pulmonar e menores valores de IMC (β -2,05; IC95%: -3,50 a -0,60). Houve tendência linear entre o número de doenças e condições crônicas de saúde e o IMC, para ambos os sexos. Os resultados mostraram associação independente entre doenças crônicas específicas e IMC. O monitoramento do estado nutricional da população idosa é importante para identificar valores extremos de IMC, especialmente naqueles com mais de duas doenças e condições crônicas de saúde.
RESUMO
Resumo Os exergames, videogames ativos, necessitam do movimento corporal e vêm sendo utilizados como alternativa para aumentar o nível de atividade física de pessoas de diferentes faixas etárias. Este estudo qualitativo investigou a percepção de adultos mais velhos quanto à prática deexergames. O grupo focal (GF) foi conduzido após 12 semanas da realização de um programa de exercícios físicos comexergames (50 min., 3dias/semana), utilizando jogos eletrônicos que simulam atividades esportivas (Xbox 360 Kinect Sportstm). Participaram do GF 14 pessoas (55 a 77 anos). Um moderador treinado conduziu o GF, sendo as sessões gravadas em audio e transcritas, posteriormente, para análise. A técnica de análise de conteúdo foi realizada utilizando o software ATLAS.ti®. Os participantes relataram benefícios psicológicos (autoestima, concentração, humor, raciocínio, memória e bem estar), físicos (agilidade e condições físicas) e de interação social (troca de experiências, amizade e competitividade). Quanto às experiências vivenciadas pelo grupo, a inovação, a ludicidade e o estímulo visual foram citados como características dos jogos. A percepção de benefícios com a prática de exergames facilita a adesão ao exercício e aumenta a motivação dos participantes.
Abstract Exergames are active video games that monitor body movement and are being used as an alternative to increase the level of physical activity of people from different age groups. This qualitative study investigated the perceptions of the elderly regarding exergaming. The focus group (FG) was conducted after 12 weeks of performing a program ofexergaming-based exercise (50 min, 3 days/week) using electronic games that simulate sports activities (Xbox 360 Kinect Sportstm). Fourteen people (55-77 years of age) participated in the FG, and a trained moderator led each group. The sessions were videotaped and transcribed for subsequent analysis. The content analysis technique was performed using ATLAS.ti® (qualitative analysis software). Participants reported psychological benefits (self-esteem, concentration, mood, reasoning, memory and well-being), physical benefits (agility and physical conditions) and social interaction (exchange of experiences, friendship and competitiveness). Regarding the experiences of the group, innovation, playfulness and visual stimulation were cited as characteristics of the games. The perception of benefits from participation in exergames fosters adherence to exercise and increases the motivation of the participants.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Exercício Físico , Jogos de Vídeo , Motivação , Atitude Frente a Saúde , Grupos Focais , Pesquisa QualitativaAssuntos
Humanos , Brasil , Índice de Massa Corporal , Estudos Transversais , Sarcopenia , ObesidadeRESUMO
The objective of this study was to present reference values and assess the motor performance of the elderly in a community in the south of Brazil, according to sex and age group. Population-based household study, conducted with 477 elderly (≥60 years) from the municipality of Antônio Carlos, Santa Catarina state. Motor performance was verified by four tests: handgrip strength (KG), balance (four tasks), 'chair stand' and 'pick up a pen' (seconds). We use a score varying from 0 (unable) to 3 (good) in all the tests. We assessed 270 women with a mean age of 73.2 ±8.82 years, and 207 men (73.3 ± 8.96 years). The results showed that the values (means, standard deviations and percentiles) were higher in men than those of the women in handgrip strength test and lower in the tests evaluated by time. The chi-square test showed that men had the highest prevalence of 'good' performance in the 'chair stand', balance and handgrip strength tests, when compared to the women (p≤0.01). With the advance of age there is a reduction in the prevalence (p≤0.01) of men and women with good performance and an increase in the prevalence of incapacity or poor performance in all the tests. The best motor performance is specific to the test, sex and age group. The men and the youngest age groups exhibit the best motor performance in all the tests.
O estudo teve como objetivo apresentar valores de referência e avaliar o desempenho motor de idosos de uma comunidade do sul do Brasil, de acordo com sexo e grupo etário. Estudo populacional, de base domiciliar, realizado com 477 idosos (≥ 60 anos) do município de Antônio Carlos, SC. O desempenho motor foi verificado por meio de quatro testes: força de preensão manual (Kg), equilíbrio estático (quatro tarefas), "sentar e levantar" e "pegar o lápis" (segundos). Foi usado escore de classificação para todos os testes que variou de 0 (incapaz) a 3 (bom). Foram avaliadas 270 mulheres (73,2 ±8,82 anos) e 207 homens (73,3 ± 8,96 anos). Os resultados mostraram que os valores (médias, desvios padrão e percentis) dos homens, no teste de força de preensão manual, foram maiores do que os das mulheres e menores no testes avaliados por tempo. O teste qui-quadrado mostrou que os homens tiveram maior prevalência de desempenho "bom" nos testes "sentar e levantar", equilíbrio e força de preensão manual, comparados às mulheres (p≤0,01). Com avanço da idade, houve redução na prevalência (p≤0,01) de homens e mulheres com desempenho bom e aumento na prevalência de incapacidade ou desempenho fraco, em todos os testes. O melhor desempenho motor é específico ao teste, sexo e grupo etário. Os homens e os grupos etários mais jovens apresentam melhor desempenho motor, em todos os testes realizados.