Sarcopenia, chronic pain, and perceived health of older: a cross-sectional study / Sarcopenia, dor crônica e percepção de saúde do idoso: um estudo transversal

Abstract Introduction Aging is a dynamic and progressive process that can be associated with the presence of morbidities, such as chronic diseases, and functional decline, characteristic of sarcopenia, which directly affects the self-perceived health of the older. Objective To test the hypothesis that there is an association between sarcopenia, chronic pain, and perceived health in the older. Methods The study used a quantitative approach and enrolled 43 sarcopenic elderly individuals registered in the University of The Third Age Program (UATI) at Universidade do Estado da Bahia, in Brazil, between November and December 2019. Data included patients' sociodemographic and anthropometric characteristics, self-reported morbidities, multimorbidity, history of chronic pain and perceived health. The data were subjected to descriptive statistical analyses. Crossing of data was performed using Pearson's chi-square test, and the correlation coefficient was assessed using Cramer's Phi and V tests. Results There was an association of sarcopenia with chronic pain (p = 0.027) and with age group (p = 0.016), however not with perceived health (p = 0.09). There was also no association between age range and chronic pain (p > 0.05). Conclusion According to the findings of this study, it can be concluded that sarcopenia is associated with the presence of chronic pain and the age of the elderly, not being associated with the perception of health. However, the age of the elderly was not associated with the presence of chronic pain.

Resumo Introdução O envelhecimento é um processo dinâmico e progressivo que pode estar associado à presença de morbidades, como doenças crônicas, e ao declínio funcional, característico da sarcopenia, que afeta diretamente a autopercepção de saúde do idoso. Objetivo Testar a hipótese de que existe associação entre sarcopenia, dor crônica e percepção de saúde em idosos. Métodos O estudo utilizou uma abordagem quantitativa e envolveu 43 idosos sarcopênicos cadastrados na Universidade Aberta da Terceira Idade (UATI) da Universidade do Estado da Bahia, no Brasil, entre novembro e dezembro de 2019. Dados incluíram características sociodemográficas e antropométricas dos pacientes, morbidades autorreferidas, multimorbidade, história de dor crônica e percepção de saúde. Os dados foram submetidos a análises estatísticas descritivas. O cruzamento dos dados foi feito pelo teste de qui-quadrado de Pearson e o coeficiente de correlação foi avaliado pelos testes Phi e V de Cramer. Resultados Houve associação da sarcopenia com dor crônica (p = 0,027) e com faixa etária (p = 0,016), porém não houve associação com a percepção de saúde (p = 0,09). Também não houve associação entre faixa etária e dor crônica (p > 0,05). Conclusão De acordo com os achados deste estudo, pode-se concluir que a sarcopenia está associada à presença de dor crônica e à idade do idoso, não estando associada à percepção de saúde. No entanto, a idade dos idosos não foi associada à presença de dor crônica.

Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORT-prospective, randomised controlled clinical trial.

AIMS: To test the hypothesis of a semi-supervised home physical exercise programme that is likely to improve the functional mobility and quality of life (QOL) of elderly in the community. METHODS: This trial included elderly adults (88% female) aged 60 years or older and who were sedentary and without cognitive decline. The participants were randomly assigned to an intervention group (IG, home physical exercise and sleep hygiene) and a control group (CG, sleep hygiene). The International Questionnaire on Physical Activity, mental state mini-exam, World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the Timed Up and Go (TUG) tests were conducted before and after the 12-week intervention period. RESULTS: The study was concluded with 125 elderly participants. Anthropometric data were indicative of pre-obesity, with a mean body mass index of 27.3 ± 4, a low-income socio-economic profile (78% ≤ 2 SM) and low schooling rates (76% ≤ 3 years of study). Most of the elderly (87%) were considered physically active with IPAQ > 150 min/week. The group of elderly people who performed the home physical exercise programme showed a significant improvement in functional mobility according to the time of execution of the TUG test before (9.1 ± 2) and after (7.1 ± 1) with an average reduction of 2 ± 1 s (P < .01). The difference in the QOL of the elderly who participated in the exercise protocol was also observed, verified through the WHOQOL-OLD global score, which presented an initial score of 85 ± 10, changing to 90.4 ± 9 after the intervention. CONCLUSION: Semi-supervised physical home exercise is safe and effective in improving the functional mobility and QOL of sedentary elderly people in the community.

Efeitos de um programa de treinamento funcional nas atividades da vida diária e capacidade funcional de idosos da UATI: um ensaio clínico / Effects of a functional training program in the activities of daily life and functional capacity of elderly persons of UATI: a clinical test

INTRODUÇÃO: O envelhecimento humano provoca alterações biopsicossociais que interferem nas atividades da vida diária (AVD) e o treinamento funcional pode atuar como um recurso terapêutico para prevenir, minimizar ou reverter esses quadros. OBJETIVO: testar a hipótese de que o treinamento funcional melhora a capacidade de realização das AVD e a capacidade funcional de idosos sedentários. MATERIAIS E MÉTODOS: Ensaio clínico de braço único, do tipo antes e após a intervenção no mesmo grupo. Foram incluídas idosas da Universidade Aberta da Terceira Idade, com 60 anos ou mais, a mais de três meses sem realizar exercício físico, com indicação médica e fisioterapêutica para exercícios e, como exclusão, apresentar declínio cognitivo de acordo com o Mini Exame do Estado Mental (MEEM) e frequência menor que 70%. Coletados dados sociodemográficos, antropométricos, morbidades autorreferidas, capacidade funcional e de realização das AVD. O treinamento funcional ocorreu duas vezes na semana com duração de 60 minutos por sessão, durante quatro meses. Os dados foram submetidos à estatística descritiva e teste t. O projeto foi aprovado pelo comitê de ética com CAAE: 02585813.0.0000.0057. RESULTADOS: Participaram 16 idosas, todas do sexo feminino, média da idade de 69,6 + 6,6 anos, a maioria com baixa escolaridade (52,5%) baixa renda (56,3 < um salário mínimo), viúvas (50%) e 75,1% acima do peso. Dentre as morbidades, prevaleceu dor crônica (25%). Os testes de capacidade funcional e AVD, demonstraram resultados positivos da intervenção com p < 0,05 e constatou-se que a melhora funcional foi maior nos idosos de 60 a 69 anos (p < 0,05). CONCLUSÃO: Treinamento funcional melhora a capacidade funcional e realização das AVD de idosos, independente da faixa etária, porém, essa melhora é mais pronunciada entre os idosos com menos idade.

INTRODUCTION: Human aging causes biopsychosocial changes that interfere with the activities of daily living (ADL) and functional training can act as a therapeutic resource to prevent, minimize or reverse these clinical features. OBJECTIVE: To test the hypothesis that functional training improves the ability to perform ADL and the functional capacity of sedentary elderly. METHODS: Single-arm trial with before and after intervention analysis in the same group. Elderly of the 'Universidade Aberta da Terceira Idade', aged 60 years and older, with more than three months without physical exercise, with a medical and physiotherapeutic indication for exercise, were included in the study, and were excluded the ones who presented cognitive decline according to the Mini Mental State Exam (MMSE) and frequency less than 70%. Sociodemographic and anthropometric data, self-reported morbidities, functional capacity and ADL performance were collected. Functional training occurred twice a week, 60 minutes per session for four months. Data were submitted to descriptive statistics and t test. This study was approved by the ethics committee with number 02585813.0.0000.0057. RESULTS: Participants were 16 elderlies, with mean age 69.6 ± 6.6 years, the majority with low schooling (52.5%), low income (56.3

Qualidade de vida de idosos hipertensos e diabéticos da comunidade: um estudo observacional / Quality of life of elderly hypertensive and diabetics of the community: an observational study

INTRODUÇÃO: O envelhecimento da população brasileira provocou modificações no perfil das morbidades, aumentando as doenças crônicas não transmissíveis (DCNT), principalmente hipertensão e diabetes, interferindo na qualidade de vida. OBJETIVO: Avaliar a qualidade de vida de idosos hipertensos e diabéticos da comunidade, analisar suas correlações e caracterizar o perfil desses idosos. MATERIAIS E MÉTODO: Estudo observacional, transversal, com 108 idosos da comunidade com 60 anos ou mais. Na coleta de dados, aplicaram-se questionários sociodemográficos, antropométricos, de morbidades, avaliação do comprometimento cognitivo, por meio do Mini Exame do Estado Mental, e da qualidade de vida por meio do WHOQOL-OLD. Os dados foram submetidos à estatística descritiva, análise de variância para comparação de médias entre os grupos e correlação de Pearson para testar a associação da qualidade de vida com o quantitativo de DCNT. RESULTADOS: A média de idade foi 70±6 anos, predominância do sexo feminino (85,2%); baixa escolaridade (75,8%); baixa renda (51,9%); morando com familiares (80,6%) e casados (46,3%). Em relação às DCNT, 37,0% eram hipertensos, 18,5% diabéticos e 14,8% tinham associação das duas. Os idosos sem DCNT apresentaram médias do WHOQOL-OLD maiores que os demais grupos com pelo menos uma DCNT e houve correlação negativa da quantidade de DCNT e a qualidade de vida. CONCLUSÃO: DCNT influenciam negativamente a qualidade de vida dos idosos, sendo que idosos sem DCNT apresentaram melhor qualidade de vida, comparados aos hipertensos, diabéticos ou com associação de ambas e, o medo de morrer foi a variável que apresentou maior interferência na qualidade de vida dos idosos.

INTRODUCTION: With the aging of the Brazilian population, there was a change in the morbidity profile, with a consequent increase in chronic noncommunicable diseases (CNCD) OBJECTIVE: To evaluate the quality of life of elderly diabetic and hypertensive in the community and characterize the profile of these elderly people. MATERIALS AND METHODS: 108 elderly subjects were investigated in a cross-sectional observational study. Data collection included questionnaires containing sociodemographic, anthropometric and self-reported morbidity data, as well as the evaluation of cognitive impairment through the Mini Mental State Examination and quality of life through the WHOQOL-OLD. Data were submitted to descriptive statistics, analysis of variance for comparison of means between groups and Pearson correlation to test the association of quality of life with the quantitative of CNCD. RESULTS: Mean age 70 ± 6, predominantly female (85.2%); low schooling (75.8%); low income (51.9%); living with relatives (80.6%) and married (46.3%). They were hypertensive (37.0%), diabetics (18.5%) and both (14.8%). Elderly non-CNCD had WHOQOL-OLD averages higher than the other groups with at least one CNCD, and there was a moderate and statistically significant negative association of the amount of CNCD and quality of life. CONCLUSION: CNCD negatively influence the quality of life of the elderly, and the elderly without chronic disease presented better quality of life when compared to the elderly with the presence of hypertension, diabetes or both, and the fear of dying was the variable that presented greater interference in the quality of life of the elderly.

Effect of a home-based exercise program on functional mobility and quality of life in elderly people: protocol of a single-blind, randomized controlled trial.

BACKGROUND: Elderly people have high rates of functional decline, which compromises independence, self-confidence, and quality of life (QoL). Physical exercise leads to significant improvements in strength, balance, functional mobility, and QoL, but there is still reduced access to this therapeutic strategy due to difficulties in locomotion to training centers or lack of adaptation to the exercise environment. METHODS/DESIGN: The purpose of this clinical trial will be to verify the effect of a progressive and semi-supervised, home-based exercise program on the functional mobility, and in the QoL of sedentary elderly people. This is a protocol of a consecutive, single-center, single-blind, and randomized controlled trial. The design, conduct, and report follows the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. Sedentary elderly people will be enrolled, and randomly allocated into two groups. The intervention group will perform exercises in their own home and the control group will not perform exercises. The evaluations will occur at study enrollment and after 3 months of intervention, and will be performed using the functional mobility Timed Up & Go (TUG) test and sociodemographic and QoL questionnaires. In the statistical analysis, comparisons of mean and correlation analyses will be performed. The primary expected outcome is the improvement in functional mobility verified through the TUG test and the secondary outcome is the improvement in QoL verified by the WHOQOL-OLD. DISCUSSION: The lack of scientific evidence demonstrating the benefits of semi-supervised home exercise on functional mobility and QoL in elderly people represents an obstacle to the development of guidelines for clinical practice and for policy-makers. The World Health Organization highlighted the importance of musculoskeletal health programs for elderly people, and the exercise program described in this protocol was designed to be viable, easy to implement, and inexpensive, and could be performed at the home of elderly subjects after receiving only guidelines and follow-up via periodic visits. Based on these facts, we hope that this study will demonstrate that a well-structured, home-based exercise program can be effective in improving functional mobility and QoL of sedentary elderly people, even without constant supervision during exercise. TRIAL REGISTRATION: Registro Brasileiro de Ensaios Clínicos (ReBEC), Identifier: RBR-3cqzfy . Registered on 2 December 2016.

Association of sleep quality with excessive daytime somnolence and quality of life of elderlies of community.

BACKGROUND: The progressive increase in the elderly population contributes to the fact that studies on human aging have important attention of health professionals and government agents, since they present a great challenge regarding public health. Our objective is to characterize the profile of older people with poor sleep quality and analyze possible associations with excessive daytime somnolence, quality of life and functional mobility. METHODS: This is a cross-sectional descriptive study, involving elderlies of the community, with the questionnaires Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, WHOQOL-OLD and application of the Timed Up and Go test - TUG. Descriptive statistics, Student's t test for paired samples and Pearson's correlation coefficient (p ≤ 0.05) were used. RESULTS: We recruited 131 elderly people, predominantly female (87%); mean age 68 ± 7 years, low per capita income (84.8% ≤ 2 minimum wage), low education (86.3% ≤ 3 years of study), and mostly staying with relatives (67.9%), married (39.7%) or amassed (35.9%). Seventy-one percent of the sample is above normal weight, 90.1% of women have an abdominal circumference ≥ 80 cm and a high prevalence of chronic and psychosocial diseases was identified in the self-report, and the risk of obstructive sleep apnea in 38.2%. The mean PSQI, Epworth Sleepiness Scale, WHOQOL-OLD and TUG were equal to, respectively, 11.2 ± 3.2; 8.32 ± 2.2; 84.8 ± 10.2 and 8.97 ± 2. An association of sleep quality with excessive daytime somnolence and quality of life, while not with functional mobility, was observed. CONCLUSION: The results of the present study allowed to identify a sleep quality associated with excessive daytime somnolence and quality of life and also to characterize the profile of elders with poor sleep quality.

Home exercise improves the quality of sleep and daytime sleepiness of elderlies: a randomized controlled trial.

BACKGROUND: Aging causes physiological changes which affect the quality of sleep. Supervised physical exercise is an important therapeutic resource to improve the sleep of the elderlies, however there is a low adherence to those type of programs, so it is necessary to implement an exercise program which is feasible and effective. The study aimed to test the hypothesis that a semi-supervised home exercise program, improves sleep quality and daytime sleepiness of elderlies of the community who present poor sleep quality. METHODS: This was a randomized controlled trial study, conducted from May to September 2017, in Northeastern Brazil, with elderlies of the community aging 60 years old or older, sedentary, with lower scores or equal to 5 at the Pittsburgh Sleep Quality Index (PSQI) and without cognitive decline. From one hundred ninety-one potential participants twenty-eight refused to participate, therefore, one hundred thirty-one (mean age 68 ± 7 years), and 88% female, were randomly assigned to an intervention group - IG (home exercise and sleep hygiene, n = 65) and a control group - CG (sleep hygiene only, n = 66). Sleep assessment tools were used: PSQI, Epworth sleepiness scale (ESS) and clinical questionnaire of Berlin. The level of physical activity has been assessed by means of International Physical Activity Questionnaire adapted for the elderly (IPAQ) and Mini-Mental State Examination for cognitive decline. All participants were assessed before and after the 12-week intervention period and, also, the assessors were blind. RESULTS: The IG showed significant improvement in quality of sleep with a mean reduction of 4.9 ± 2.7 points in the overall PSQI (p < 0.01) and in all its 7 components of evaluation (p < 0.05), and improvement of secondary endpoint, daytime sleepiness, a decline of 2.8 ± 2.2 points in the ESS (p < 0.01). CONCLUSION: Our results suggest that semi-supervised home exercise is effective in improving the quality of sleep and self-referred daytime sleepiness of sedentary elderlies of the community who presented sleep disorders. TRIAL REGISTRATION: Ensaiosclinicos.gov.br process number: RBR-3cqzfy.