Longitudinal Associations Between Cognition and Grip Strength, Differentiated by Sex and Physical Activity: A Population-Based Study in Older Adults From 17 European Countries.

Objectives (1) To investigate longitudinal associations between grip strength (GS) and cognition over 4 years in European older adults, (2) to examine differences in temporal associations between men and women and between levels of physical activity, (3) to explore in each year 2015 and 2019 associations between GS quartiles and cognitive performance, and (4) to explore longitudinal associations between GS quartiles (year 2015) and cognitive performance (year 2019). Methods: 25,281 individuals (14,200 women) from 17 European countries aged ≥50 years responded to waves 6th and 8th of the SHARE project. We analyzed GS, a general cognition index, and physical activity level. Results: Panel analyses revealed a bidirectional relationship over 4 years between GS and cognition, with differences between sex, as well as between participants with moderate-to-vigorous and low physical activity levels. Conclusion: Women and participants with low physical activity were more likely to experience cognitive performance deficits 4 years later.

The Longitudinal Association between Multiple Frailty Criteria and Depressive Symptomatology Five Years Later in Older Adults: A Decision Tree Modelling Approach.

Background: To examine the longitudinal association between frailty criteria and depression (DEP) in a large sample of older Europeans using decision tree models, and to examine complex relationships between frailty criteria and DEP symptomatology. Methods: Data come from waves six and eight of the Population Survey of Health, Ageing and Retirement in Europe. DEP was assessed using the EURO-D scale (wave 8) and frailty (wave 6). We included 27,122 people (56.9% women), aged 50 or over. Results: Women indicated a higher rate of DEP (29.0%), as well as a higher prevalence of pre-frailty (21.6%) and frailty (10.8%) than men. For both sexes, fatigue, weight loss, and slowness indicated an increased chance of DEP 5 years later. MPA (moderate physical activity) and grip strength were considered longitudinally protective factors for DEP. The highest prevalence of DEP symptomatology 5 years later was 50.3%, pointing to those with fatigue and slowness. Among women, the highest incidence of DEP was 66.8%, identified through fatigue, slowness, and low MPA. Conclusions: Strategies to reduce frailty and DEP in older European adults may include the creation of policies that encourage the promotion of physical capacity to reach MPA levels, as well as an improvement in muscular strength.

A Comparison of Cognitive Performance, Depressive Symptoms, and Incidence of Falls in Brazilian Older Women with and without a Confirmed History of COVID-19.

The study aimed to compare cognitive performance, depressive symptoms, and the incidence of falls in Brazilian older women with and without a confirmed history of COVID-19. This cross-sectional study included 188 women (60-89 years), divided into two groups: one with a history of COVID-19 (n = 139), and one without any history of COVID-19 (n = 49). The instruments used were the Cognitive Telephone Screening Instrument (COGTEL) test battery, the Trail Making Test (TMT), the Geriatric Depression Scale (GDS-15), and the self-reported history of falls since the beginning of mandatory confinement. The higher the age, the higher the incidence of falls. The highest prevalence of falls (57.1%) occurred in the COVID-19 group (p = 0.001), the members of which also indicated a better cognitive performance in the COGTEL test (p = 0.017), TMT-B (p = 0.004), and ∆TMT (B-A) (p = 0.004). In turn, the depressive symptoms were more severe in the COVID-19 group (p < 0.001). We observed that COVID-19 infection without hospitalization did not affect the cognitive performance of older adult women. Future studies should be carried out to monitor the mental health of older adult Brazilian women. Moreover, regardless of their history of COVID-19, older adults should participate in a physical training program focused on preventing falls.

Effects of two different dual-task training protocols on gait, balance, and cognitive function in community-dwelling older adults: a 24-week randomized controlled trial.

Background: Although alternating dual-task (ADT) training is functionally easier for older adults, a large part of the motor and cognitive tasks is simultaneously performed, especially during activities of daily living that require maintaining body balance. Objective: To evaluate the effects of mixed dual-task training on mobility, cognitive function, and balance in community-dwelling older adults. Methods: Sixty participants were randomly allocated at a 1:1 ratio into the experimental group-single motor task (SMT) and simultaneous dual task (SDT) interchangeably in stage 1 (for 12 weeks) and after strictly with SDT in stage 2 (the last 12 weeks)-or into the control group-only SMT and SDT interchangeably in stages 1 and 2. Gait parameters were acquired by two inertial sensors. Physical and cognitive performance were acquired by specific questionnaires. Generalized linear mixed models were used for analyzing interaction and main effects. Results: No between-group difference was observed for gait performance. Both protocols improved mobility (mean change ((MC) = 0.74)), dual-task effect (MC = -13.50), lower limb function (MC = 4.44), static (MC = -0.61), and dynamic balance (MC = -0.23), body sway (MC = 4.80), and cognitive function (MC = 41.69). Conclusion: Both dual-task training protocols improved these outcomes.

The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study.

This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.

Is foot clearance influenced by different types of dual task in once-only faller community-dwelling older adults?

BACKGROUND: Tripping is one of the main causes of falls in older adults and has an important association with minimum toe clearance (MTC). MTC variability while performing alternating (ADT) or concurrent (CDT) dual-task activities may be a useful gait parameter to differentiate once-only fallers from non-faller older adults. RESEARCH QUESTION: Is the MTC variability influenced by ADT and CDT in once-only faller community-dwelling older adults? METHODS: Twenty-two community-dwelling older adults with a self-report of up to one fall in the last 12 months were allocated to the fallers group and 38 to the non-fallers group. Gait data were collected by two foot-worn inertial sensors (Physilog® 5, GaitUp, Lausanne, Switzerland). MTC mean magnitude and variability, as well as the stride-to-stride variability, stride time and length, lower limb peak angular velocity, and foot forward linear speed at the MTC instant, were calculated across approximately 50 gait cycles for each participant and condition using the GaitUp Analyzer software (GaitUp, Lausanne, Switzerland). The statistical analyzes were performed in the Statistical Package for the Social Sciences (SPSS), v.22.0, using generalized mixed linear models, adopting an alpha of 5%. RESULTS AND SIGNIFICANCE: No interaction effect was observed; however, faller participants reduced the MTC variability (standard deviation) [(mean difference, MD = -0.099 cm; confidence interval, 95%CI = -0.183 to -0.015)], regardless of the condition. CDT compared to a single task (only gait) reduced the mean magnitude of the foot forward linear speed (MD=-0.264 m/s; 95%CI=-0.462 to -0.067), peak angular velocity (MD = -25.205 degrees/s; 95%CI = -45.507 to -4.904), and gait speed (MD = -0.104 m/s; 95%CI = -0.179 to -0.029), regardless of the group. These results suggest that MTC variability, regardless of condition, may be a promising gait parameter to differentiate once-only faller community-dwelling older adults from non-fallers.

The Association of Obesity and Overweight with Executive Functions in Community-Dwelling Older Women.

Among the risk factors reported for cognitive decline, the literature highlights changes in body composition. Thus, the aim of the present study was to examine the relationship between obesity/overweight and executive functions in cognitively normal older adult women. This cross-sectional study included 224 individuals (60-80 years), stratified into normal weight (n = 45), overweight (n = 98), and obesity (n = 81). As outcomes, body mass index (BMI), waist circumference (WC), and Trail Making Test Parts A and B were assessed. We found positive correlations of BMI and WC with completion times of TMT-A and TMT-B, and a negative correlation of BMI and WC with education. ANCOVA showed an association between higher BMI and slower completion time of TMT-A, TMT-B, and ΔTMT (B-A). Impairment of executive functions of cognitively normal older women may be positively associated with obesity and negatively associated with years of education. The findings may contribute to designing strategies that make it possible to prevent cognitive decline in women during aging.

Sex Differences in Falls: The Mediating Role of Gait Stability Ratio and Body Balance in Vulnerable Older Adults.

This study, conducted on a large sample of older adults at elevated fall risk (1), aimed to verify statistical differences in gait stability ratio (GSR) and body balance (BB) according to sex, (2) to examine and compare GSR and BB performance between older adult fallers and non-fallers, (3) to determine an association between GSR and BB according to the history of falls, and (4) to explore whether GSR and BB mediate the association between sex and falls. We included 619 individuals (69.8 ± 5.6 years) living in the Autonomous Region of Madeira, Portugal. The frequency of falls was obtained by self-report. BB was determined by the Fullerton Advanced Balance scale, while GSR was established by dividing cadence by gait speed and data collected during the 50-foot walk test. Males indicated a lower prevalence of falls in the last 12 months (23.6%), while females had a higher score (48.7%), as well as a lower balance performance (p < 0.001) and higher GSR scores (p < 0.001). Lower BB control (p < 0.001), as well as higher GSR, were more expressive for fallers (p < 0.001). We found a large, negative and significant correlation between GSR and BB for historical falls (r = −0.560; p < 0.001), and between male and female cohorts (r = −0.507; p < 0.001). The total effect of sex on falls mediated by GSR and BB was 16.4%. Consequently, GSR and BB mediated this association by approximately 74.0% and 22.5%, respectively.

The Mediating Role of Physical Activity and Physical Function in the Association between Body Mass Index and Health-Related Quality of Life: A Population-Based Study with Older Adults.

This study aimed (1) to investigate the association between body mass index (BMI), physical activity (PA), and physical function (PF) with health-related quality of life (HRQoL), and (2) to examine in-depth whether PA and PF mediate the relationship between BMI and HRQoL in older adults. We investigated 802 individuals (mean age 69.8 ± 5.6 years), residents of the Autonomous Region of Madeira, Portugal. Harmol and PA were assessed using the SF-36 and Baecke questionnaires, respectively, and PF by the Senior Fitness Test. The prevalence of overweight was 71.3%, 26.5% for normal weight, and 2.1% for underweight. We verified a small correlation between age and sex with BMI, PA, PF, and medium borderline with HRQoL. After adjusting for covariates (i.e., sex, age, comorbidities), the multivariate regression analysis indicated a 93.1% chance of improvement in HRQoL for low BMI, while PA and PF revealed a chance of increasing HRQoL by 91.8% and 60.0%, respectively. According to the serial mediation pathway, PA and PF partially mediated the association between BMI and HRQoL by 32.3% and 81.5%, respectively. The total variance of the model was 90%. It was concluded that BMI can negatively affect HRQoL. On the other hand, PA and PF are able to increase HRQoL levels during the aging process.

Associations of Gait Speed, Cadence, Gait Stability Ratio, and Body Balance with Falls in Older Adults.

To investigate the association between gait speed (GS), cadence (CAD), gait stability ratio (GSR), and body balance (BB) with falls in a large sample of older adults. The analysis included 619 individuals-305 men and 314 women (69.50 ± 5.62 years)-residing in the Autonomous Region of Madeira, Portugal. Mobility in GS, CAD, and GSR was assessed using the 50-foot walk test and BB by the Fullerton Advanced Balance scale. The frequency of falls was obtained by self-report. Linear regression analysis showed that higher performance in GS and BB was able to reduce the risk of falling by up to 0.34 and 0.44 times, respectively. An increase in the GSR value enhanced the risk of falling by up to 0.10 times. Multinomial analysis indicated that, in relation to the highest tertile (reference), older adults classified with GS and BB performance in the lowest tertile (lowest) had an increased chance (OR) of falling by up to 149.3% and 48.8%, respectively. Moreover, in relation to the highest tertile, the performance of the GSR classified in the lowest and medium tercile showed an increase in the chance of falling by up to 57.4% and 56.4%, respectively.

Exploring Mediation Effects of Gait Speed, Body Balance, and Falls in the Relationship between Physical Activity and Health-Related Quality of Life in Vulnerable Older Adults.

The present study aimed to examine whether gait speed (GS), body balance (BB), and falls mediated the relationship between physical activity (PA) and health-related quality of life (HRQoL) in community-dwelling older adults. This is a cross-sectional study that included 305 men and 314 women (69.5 ± 5.6 years), residing in the Autonomous Region of Madeira, Portugal. HRQoL and PA were assessed using the SF-36 and Baecke Questionnaires, respectively. While BB was obtained by the Fullerton Advance Balance (FAB) scale, GS by the 50-foot (15 m) walk test, and the frequency of falls was obtained by self-report. According to the analyses, when GS and BB were placed concomitantly as mediators, the direct effect revealed by the model revealed a non-significant relationship between PA and falls. Thus, in the context of falls, GS and BB partially mediated the association between PA and HRQoL in approximately 29.7%, 56%, and 49.2%, respectively. The total HRQoL model explained a variance of 36.4%. The results can help to understand the role that GS, BB, and falls play in the relationship between PA and HRQoL of the vulnerable older adult population.

The Role of Physical Function in the Association between Physical Activity and Gait Speed in Older Adults: A Mediation Analysis.

Adequate levels of physical function (PF) are essential for vulnerable older adults to perform their daily tasks safely and remain autonomous. Our objective was to explore the mediating role of PF in the relationship between physical activity (PA) and gait speed (GS) in a large sample of older adults from the north of Brazil. This is a cross-sectional study that analyzed 697 older adults (mean age 70.35 ± 6.86 years) who participated in the project "Health, Lifestyle, and Physical Fitness in Older Adults in Amazonas" (SEVAAI). PA was assessed using the Baecke Questionnaire, PF using the Senior Fitness Test, and GS using the 50-foot Walk Test. Mediation pathways were analyzed to test the possible mediating role of PF between specific PA domains (PA-total score, PA-housework, PA-sport, PA-leisure) and GS. Regarding PA-total, the analysis showed that high-performance GS was partially mediated in approximately 19% by better PF performance. Moreover, the PF could partially mediate the association between PA-sport and PA-leisure with GS, at levels of approximately 9% and 46%, respectively. An inverse relationship was observed between PA-housework (sedentary lifestyle) and GS. This association was partially mediated to an extent of approximately 9% by better PF performance. We conclude that PF plays a crucial role in mediating the association between PA and GS among vulnerable older adults.

The Role of Cognitive Performance and Physical Functions in the Association between Age and Gait Speed: A Mediation Study.

INTRODUCTION: With vulnerable aging, gait speed (GS) undergoes progressive changes, becoming slower. In this process, cognitive performance (CP) and physical function (PF) both play an important role. This study aims (1) to investigate the association between CP and PF with GS and (2) to examine whether CP and PF mediate the association between age and GS in a large sample of Brazilian older adults. METHODS: A cross-sectional study analyzed 697 individuals (mean age 70.35 ± 6.86 years) from the state of Amazonas. The CP was evaluated by the COGTEL test battery, PF by the Senior Fitness Test battery, and GS with the 50-foot Walk Test. RESULTS: Older adults with a lower CP and PF had a 70% and 86% chance of slow GS, respectively. When CP and PF were placed simultaneously as mediators, the direct effect estimated by the model revealed a non-significant relationship between age and GS. Specifically, CP and PF mediated the association between age and GS, at approximately 12% and 98%, respectively. CONCLUSIONS: CP and PF show the potential to estimate GS performance among older adults. Moreover, CP and PF indicated a negative and direct association between age and slow GS, especially PF.

Concern About Falling, Confidence in Balance, Quality of Life, and Depression Symptoms in Community-Dwelling Older Adults After a 24-week Dual-Task Training With Variable and Fixed Priority: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the effect of a 24-week dual-task training with progression from variable to fixed priority on the concern about falling, confidence in balance, quality of life, and depression symptoms in community-dwelling older adults. METHODS: A total of 60 participants (60-80 y.o.) were randomly allocated into a dual-task training group with progression from variable to fixed priority (experimental group) or into a dual-task training group with variable priority (control group). RESULTS: No between-group difference was observed after the intervention. A significant time effect showed a reduction in concern about falling [mean difference (MD) = -2.91)] and depression symptoms (MD = -1.66), an increase in the physical function (MD = 7.86), overall mental health (MD = 5.82), perception of vitality, energy, and less fatigue (MD = 10.45), general perception of overall health (MD = 6.81), and their health compared to the last year (MD = 11.89). CONCLUSION: The experimental protocol was not superior to the control one. However, both protocols improved these outcomes.

Dança na escola: a formação do conhecimento corporificado / School dance: the formation of corporate knowledge / Danza escolar: la formación del conocimiento corporativo

A dança é conteúdo oficial do ensino regular da disciplina de Educação Física. Com ela, professores podem desenvolver capacidades motoras, intelectuais, expressivas e sociais do aluno, e ampliar seu entendimento sobre fatos da cultura. Este ensaio se propõe a discutir a formação e o ganho do conhecimento por meio do ensino e aprendizagem da dança. A base foi a obra The Phenomenology of Dance, de Maxin Sheets-Johnstone, e a Fenomenologia da Percepção, de Merleau-Ponty. Nesse contexto, o conhecimento sobrevem ao conjunto de experiências vividas corporalmente pelo aluno durante a resolução das atividades, nisso, a relação corpo-movimento-cinestesia-cognição incide no principal mecanismo para o firmamento do conhecimento "corporificado" (AU).

Dance is the official content of regular teaching in the discipline of Physical Education. With it, teachers can develop motor, intellectual, expressive and social skills of the student, and expand their understanding of cultural facts. This essay proposes to discuss the formation and the gain of knowledge through the teaching and learning of dance. The basis was Maxin Sheets-Johnstone's The Phenomenology of Dance, and Merleau-Ponty's Phenomenology of Perception. In this context, knowledge comes from the set of experiences lived bodily by the student during the resolution of activities, in this, the body-movement-kinesthesia-cognition relationship focuses on the main mechanism for the firmament of "embodied" knowledge

La danza es el contenido oficial de la enseñanza regular en la disciplina de Educación Física. Con él, los profesores pueden desarrollar las habilidades motoras, intelectuales, expresivas y sociales del alumno y ampliar su comprensión de los hechos culturales. Este ensayo se propone discutir la formación y la adquisición de conocimientos a través de la enseñanza y el aprendizaje de la danza. La base fue La fenomenología de la danza, de Maxin Sheets-Johnstone y la Fenomenología de la percepción, de Merleau-Ponty. En este contexto, el conocimiento proviene del conjunto de experiencias vividas corporalmente por el alumno durante la resolución de actividades, en este, la relación cuerpo-movimiento-cinestesia-cognición se centra en el mecanismo principal para el firmamento del conocimiento "encarnado" (AU).

DANÇA NA ESCOLA: A FORMAÇÃO DO CONHECIMENTO CORPORIFICADO / School dance: the formation of corporate knowledge / Danza escolar: la formación del conocimiento corporativo

A dança é conteúdo oficial do ensino regular da disciplina de Educação Física. Com ela, professores podem desenvolver capacidades motoras, intelectuais, expressivas e sociais do aluno, e ampliar seu entendimento sobre fatos da cultura. Este ensaio se propõe a discutir a formação e o ganho do conhecimento por meio do ensino e aprendizagem da dança. A base foi a obra The Phenomenology of Dance, de Maxin Sheets-Johnstone, e a Fenomenologia da Percepção, de Merleau-Ponty. Nesse contexto, o conhecimento sobrevem ao conjunto de experiências vividas corporalmente pelo aluno durante a resolução das atividades, nisso, a relação corpo-movimento-cinestesia-cognição incide no principal mecanismo para o firmamento do conhecimento "corporificado".

Dance is the official content of regular teaching in the discipline of Physical Education. With it, teachers can develop motor, intellectual, expressive and social skills of the student, and expand their understanding of cultural facts. This essay proposes to discuss the formation and the gain of knowledge through the teaching and learning of dance. The basis was Maxin Sheets-Johnstone's The Phenomenology of Dance, and Merleau-Ponty's Phenomenology of Perception. In this context, knowledge comes from the set of experiences lived bodily by the student during the resolution of activities, in this, the body-movement-kinesthesia-cognition relationship focuses on the main mechanism for the firmament of "embodied" knowledge.

La danza es el contenido oficial de la enseñanza regular en la disciplina de Educación Física. Con él, los profesores pueden desarrollar las habilidades motoras, intelectuales, expresivas y sociales del alumno y ampliar su comprensión de los hechos culturales. Este ensayo se propone discutir la formación y la adquisición de conocimientos a través de la enseñanza y el aprendizaje de la danza. La base fue La fenomenología de la danza, de Maxin Sheets-Johnstone y la Fenomenología de la percepción, de Merleau-Ponty. En este contexto, el conocimiento proviene del conjunto de experiencias vividas corporalmente por el alumno durante la resolución de actividades, en este, la relación cuerpo-movimiento-cinestesia-cognición se centra en el mecanismo principal para el firmamento del conocimiento "encarnado".

COVID-19 and death of older adults in the Northeast region of Brazil: a survival analysis / COVID-19 y muerte de ancianos en la región Nordeste de Brasil: un análisis de supervivencia / COVID-19 e óbito de pessoas idosas na região Nordeste do Brasil: uma análise da sobrevivência

ABSTRACT Objective: to analyze survival and factors associated with increased risk of death for older adults diagnosed with COVID-19, living in the Northeast region of Brazil. Method: retrospective observational study developed with secondary data provided by the Brazilian Ministry of Health, between June 14 and December 26, 2020. The Kaplan-Meyer method, the time-dependent cox regression model was used, including covariates (age, sex, skin color, comorbidities, admission to the ICU, ventilatory support). Results: out of 9,306 individuals analyzed, 55.9% died and 44.1% survived. The highest risk of death was observed for those aged 80-89 (HR=1.95), brown-skinned (HR=1.99), with immunodeficiency (HR=1.259) or kidney disease (HR=1.147), admitted to the ICU (HR=1,795) and in use of ventilatory support (HR=1606). Conclusion: among older adults residing in the Northeast region of Brazil, there was a higher risk of death from COVID-19 for octogenarians, brown-skinned, with comorbidities, hospitalization in the ICU, followed by the use of ventilatory support. The creation of health prevention strategies that identify older adults with these profiles is suggested to prevent deaths in future pandemic situations.

RESUMENObjetivo: analizar la supervivencia y los factores asociados con un mayor riesgo de muerte en ancianos diagnosticados con COVID-19, residentes en la región Nordeste de Brasil. Método: estudio observacional retrospectivo desarrollado con datos secundarios proporcionados por el Ministerio de Salud de Brasil, entre el 14 de junio y el 26 de diciembre de 2020. Se utilizó el método de Kaplan-Meyer, modelo de regresión de Cox-tempo-dependiente, incluyendo covariables (edad, sexo, color de piel, comorbilidades, ingreso en UCI, soporte ventilatorio). Resultados: 9.306 personas analizadas, el 55,9% falleció y el 44,1% sobrevivió. El mayor riesgo de muerte se observó en las personas de 80 a 89 años (HR=1,95), color de piel morena (HR=1,99), inmunodeficiencia (HR=1,259), enfermedad renal (HR=1,147), con ingreso en UCI (HR=1.795) y uso de soporte ventilatorio (HR=1606). Conclusión: entre los ancianos residentes en la región Nordeste de Brasil, hubo mayor riesgo de muerte por COVID-19 para los octogenarios, color de piel morena, que tenían comorbilidades, hospitalización en la UCI, seguido del uso de soporte ventilatorio. Se sugiere la creación de estrategias de prevención en salud que identifiquen a las personas mayores con estos perfiles para prevenir muertes en futuras situaciones pandémicas.

RESUMOObjetivo: analisar a sobrevida e os fatores associados ao maior risco de morte para idosos com diagnóstico de COVID-19, residentes na região Nordeste do Brasil. Método: estudo observacional retrospectivo desenvolvido com dados secundários fornecidos pelo Ministério da Saúde do Brasil, entre 14 dejunho a 26 de dezembro de 2020. Utilizou-se o método de Kaplan-Meyer, o modelo de regressão de cox tempo-dependente, incluindo covariáveis (idade, sexo, cor da pele, comorbidades, admissão na UTI, suporte ventilatório). Resultados: 9.306 indivíduos foram analisados; 55,9% morreram e 44,1% sobreviveram. O maior risco de ocorrência de óbitos foi observado para aqueles entre 80-89 anos (HR=1,95), cor da pele parda (HR=1,99), imunodeficiência (HR=1,259), doença renal (HR=1,147), com admissão em UTI (HR=1,795) e uso de suporte ventilatório (HR=1.606). Conclusão: entre idosos residentes na região Nordeste do Brasil, constatou-se maior risco de óbitos por COVID-19 para octogenários, cor parda, que apresentaram comorbidades, internação em UTI, seguido do uso de suporte ventilatório. Sugere-se a criação de estratégias de prevenção em saúde que identifiquem idosos com esses perfis para prevenir óbitos em futuras situações de pandemia.

Influence of Drugs of Continuous Use on the Sensory Regulation of the Static Balance of Elderly Regular Practitioners of the Pilates Method / Influência de Fármacos de Uso Contínuo Sobre a Regulação Sensorial do Equilíbrio Estático de Idosas Praticantes Regulares do Método Pilates

The combination of types of medications can compromise the regulation of body balance in older adults. This study evaluated the effect of continuous use drugs on the sensory regulation of static balance in elderly women who regularly practice the Pilates method with and without a history of falls and estimate the risk of falls in this population. Cross-sectional study, carried out with 94 women (67.12±4.74 years) practicing Pilates, divided into: non fallers (n = 74) and fallers (n = 18). Sociodemographic data, comorbidities, medications, and Mini Mental State Examination (MMSE), Falls Efficacy Scale (FES), Confidence in Balance Scale (ABC) were applied. The examination of static balance was performed by the Clinical Test of Sensory Interaction and Balance (CTSIB). The risk of falling was analyzed using an adjusted multiple logistic regression model, while the effect of drugs on falls was estimated by binary regression, results were presented using the odds ratio (OR). The CTSIB test revealed Condition 4 (OR = 3.038; 95% CI = 1.321­15.674) and Condition 5 (OR = 5.542; 95% CI = 1.678­18.303) as predictors of falls. Drugs showing an effect on fall were ß2 agonist associated with glucocorticoid (OR = 0.245; 95% CI = 1,233­2,400), thiazide diuretic (OR = 0.344; 95% CI = 1.122­2.234), statin (OR = 0.245; 95 % CI = 1,237­2,338), angiotensin II receptor antagonist (OR = 0,245; 95% CI = 1,236­2,339), beta blocker (OR = 0,245; 95% CI = 1,238­2,402) and anti-vertigo (OR = 0,245; 95 % CI = 1.230­2.399). Regardless of the history of falls, the risk of falling was present in older adult regular Pilates practitioners. Six different drugs for continuous use showed an effect on falls. (AU)

A combinação de tipos de medicamentos pode comprometer a regulação do equilíbrio corporal de idosos. Este estudo avaliou o efeito de fármacos de uso contínuo sobre a regulação sensorial do equilíbrio estático de mulheres idosas praticantes regulares do método Pilates com e sem histórico de queda e estimar o risco de queda dessa população. Estudo transversal, realizado com 94 mulheres (67,12±4,74 anos) praticantes de Pilates, divididas em: não-caidoras (n=74) e caidoras (n=18). Foram coletados dados sociodemográfico, comorbidades, medicamentos, e aplicado Mini Exame do Estado Mental (MEEM), Falls Efficacy Scale (FES), Escala de Confiança no Equilíbrio (ABC). O exame do equilíbrio estático foi realizado pelo Clinical Test of Sensory Interaction and Balance (CTSIB). O risco de queda foi analisado pelo modelo de regressão logística múltipla ajustado, enquanto, que o efeito dos fármacos sobre queda foi estimado pela regressão binária, resultados foram apresentados pelo odds ratio (OR). O teste CTSIB revelou a Condição 4 (OR= 3,038; 95% IC= 1,321­15,674) e Condição 5 (OR= 5,542; 95% IC= 1,678­18,303) como previsora de quedas. As drogas que mostram efeito sobre queda foram agonista ß2 associada com glicocorticóide (OR=0,245; 95% IC= 1,233­2,400), diurético tiazídico (OR=0,344; 95% IC=1,122­2,234), estatina (OR=0,245; 95% IC=1,237 2,338), antagonista do receptor de angiotensina II (OR=0,245; 95% IC=1,236­2,339), betabloqueador (OR=0,245; 95% IC=1,238­2,402) e antivertiginoso (OR=0,245; 95% IC=1,230­2,399). Independente do histórico de quedas, o risco de cair esteve presente em idosas praticantes regulares do Pilates. Seis diferentes medicamentos de uso contínuo mostraram efeito sobre queda. (AU)

Clinical characteristics of 1544 Brazilians aged 60 years and over with laboratory evidence for SARS-CoV-2.

INTRODUCTION: Infection with the new coronavirus responsible for Severe Acute Respiratory Syndrome (SARS-CoV-2) continues to spread worldwide. In Brazil, there are already more than 230 thousand dead, many of these older adults. OBJECTIVE: To present the clinical characteristics of older Brazilian adults infected by COVID-19, in the epidemiological weeks (EW) 34-52, and to verify factors responsible for the increased risk of death. METHODS: Retrospective and observational study conducted with secondary publicly available data, provided by the Brazilian Ministry of Health. 1,544 confirmed cases of registered COVID-19 infection were included between August 16 and December 26, 2020, aged 60 or older. OUTCOMES: Demographic data, comorbidity, symptoms for disease, clinical information: days of hospitalization, chest X-ray, type of RT-PCR. RESULTS: 48% of patients admitted to the ICU with evidence for SARS-CoV-2 died. Symptoms and comorbidities related to increased chance of death (OR) were immunodeficiency (188%), kidney disease (166%), neurological disease (103%), dyspnea (86%), pneumopathy (55%), O2 saturation <95% (53%), respiratory discomfort (49%), age (36%), sore throat (31%), and sex (0.5%). There was a 5% increase in the chance of death for each year of life. CONCLUSION: Heart disease and Diabetes mellitus were the most frequent comorbidities, but did not indicate an increased risk of death from SARS-CoV-2 infection. Age, sex, sore throat, dyspnea, respiratory discomfort, O2 saturation <95%, neurological disease, pneumopathy, immunodeficiency, and kidney disease were significantly associated with risk of death from COVID-19.

Sensory assessment of balance regulation of physically active women, 60-79 years old / Avaliação sensorial da regulação do equilíbrio de mulheres fisicamente ativas, 60-79 anos

OBJECTIVE: To evaluate the performance of sensory regulation of static and dynamic balance in older women, and to verify the sensitivity and specificity levels of the Body Balance Test (Teste de Equilíbrio Corporal, TEC) in relation to its reference standard, determining the best cutoff point for identifying risk of falling. METHODS: 74 women (age 67.59 ± 5.26 years) participated in the study, divided into fallers (n = 18) and non-fallers (n = 56). RESULTS: Comparatively, non-fallers had higher performance scores on static balance exteroceptive regulation (SBER), dynamic balance exteroceptive regulation (DBER), and dynamic balance interoceptive regulation (DBIR). Statistically significant differences were found in DBER (p = ≤0.001) and DBIR (p = 0.031). The area under the ROC curve was 0.73 (95%CI 0.58 ­ 0.88; p = 0.003), with a sensitivity level of 42.30% and specificity of 84.80%. CONCLUSIONS: The greatest chance of falling was found for dynamic balance in situations of exteroceptive and interoceptive regulation for older women with and without a history of falls. Deficits in sensory regulation of body balance are common in older women, both fallers and non-fallers

OBJETIVO: Avaliar o desempenho da regulação sensorial do equilíbrio estático e dinâmico de mulheres idosas e verificar os níveis de sensibilidade e especificidade do Teste de Equilíbrio Corporal (TEC) em relação ao seu padrão de referência, determinando o melhor ponto de corte para a identificação do risco de queda. METODOLOGIA: participaram do estudo 74 mulheres (67,59 ± 5,26 anos), divididas em caidoras (n = 18) e não-caidoras (n = 56). RESULTADOS: Comparativamente, não-caidoras indicaram escores de desempenho mais elevados para equilíbrio estático regulação exteroceptiva (EERE), equilíbrio dinâmico regulação exteroceptiva (EDRE) e equilíbrio dinâmico regulação interoceptiva (EDRI). Diferenças estatisticamente significativas foram encontradas na regulação EDRE (p = ≤0,001) e EDRI (p = 0,031). A área verificada sob a curva ROC foi de 0,73 (IC95% 0,58 ­ 0,88; p = 0,003) e nível de sensibilidade de 42,30% e especificidade de 84,80%. CONCLUSÕES: A maior chance de queda foi encontrada para o equilíbrio dinâmico em situação de regulação exteroceptivo e interoceptivo para mulheres idosas com e sem histórico de queda. Déficits na regulação sensorial do equilíbrio corporal são comuns em mulheres idosas caidoras e não-caidoras