Temporal patterns of food consumption and their association with cardiovascular risk in rotating shift workers.

OBJECTIVE: We aimed to evaluate the association of temporal patterns of food consumption with cardiovascular disease (CVD) risk. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Data on food consumption was collected using a 24 h recall, applied by trained interviewers. The variables for temporal patterns of food consumption were: eating window, eating at night, number of meals and omission of breakfast. CVD-risk was measured by calculating the Framingham coronary heart disease risk score (FCRS), and classified as low risk or intermediate to high risk. Descriptive, univariate and multivariate logistic regression analyses examined the association between variables related to temporal patterns of food consumption and CVD-risk. RESULTS: The study assessed 208 workers, the majority with 20-34 years (45.1%), non-white (77.2%), and 5 years or more in shift work (76.0%). Most participants had a feeding window exceeding 12 h (63.9%), consumed meals until 10 p.m. (68.1%), had five or more meals per day (54.8%), and did not skip breakfast (86.5%). Regarding CVD-risk, 43.8% of the participants were classified with intermediate to high risk for CVD. In the multivariate model, a feeding window (OR: 2.32; 95%CI: 1.01-5.35), eating after 10 p.m. (OR: 3.31; 95%CI: 1.01-11.0), and skipping breakfast (OR: 2.58; 95%CI: 1.07-6.19) increased the likelihood of intermediate to high CVD-risk. Conversely, having five or more meals per day decreased the odds (OR: 0.27; 95%CI: 0.08-0.92). CONCLUSION: Eating window longer than 12 h, eating after 10 p.m., less than four meals a day and omission of breakfast, are associated with cardiovascular risk in shift workers.

Rotating shift work time is directly associated with excess body adiposity.

OBJECTIVE: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

Arterial hypertension in rotating shift workers: The role of hypertriglyceridemic waist and hypertriglyceridemic waist-to-height ratio phenotypes.

OBJECTIVE: To examine the association of arterial hypertension and the hypertriglyceridemic waist phenotype (HWP) and hypertriglyceridemic waist-to-height phenotype (HWHP). METHODOLOGY: This cross-sectional study was conducted with 1422 male rotating shift workers in Brazil. The HWP was defined as having a waist circumference ≥94 cm and serum triglycerides ≥150 mg/dL, whereas the HWHP was determined by having a waist-to-height ratio ≥0.5 and serum triglycerides ≥150 mg/dL. To provide a characterization of the sample, data were presented in both absolute and relative values, and Pearson's chi-square test was employed. To investigate the potential association between arterial hypertension and the presence of HWP or HWHP, multivariate logistic regression was conducted, accounting for sociodemographic, behavioral, and clinical variables. Furthermore, we conducted a stratified multivariate logistic regression analysis, considering the duration of shift work, to assess whether the results remained consistent depending on the length of work experience in shifts. RESULTS: A noteworthy association was observed between arterial hypertension and both HWP and HWHP, with HWHP exhibiting a stronger association with the disease. Furthermore, a positive association between arterial hypertension and these phenotypes was identified in workers with five or more years of shift work. CONCLUSION: We recommend the utilization of HWHP as a screening tool, as it indicates a stronger association with arterial hypertension compared to HWP. Additionally, the duration of time spent working in shifts emerged as a significant factor influencing the presence of these phenotypes.

Vitamin D deficiency and hyperglycemia in male rotating shift workers: A disturbed circadian rhythms influence.

BACKGROUND: Shift work is related to several negative impacts on the health of workers. This study aimed to evaluate the association between vitamin D deficiency (VDD) and hyperglycemia in shift workers. METHODOLOGY: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Hyperglycemia was classified when fasting glucose ≥100 mg/dL or HbA1c ≥ 5.7%. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression, from a model of determination, was performed to investigate whether VDD was associated with hyperglycemia. RESULTS: The study evaluated 1411 workers, most workers were aged 30-39 years (53.2%), and 77.5% self-declared as black, brown, with up to complete high school (71.4%) and working alternate shifts for more than 5 years (76.1%). Regarding glucose and vitamin D, 32.0% and 29.1% of the workers had hyperglycemia and VDD, respectively. In multivariate analysis, controlled for confounding factors, workers with VDD had a 119% increased chance of hyperglycemia (OR: 2.19; IC95%: 1.56-3.08). Furthermore, vitamin D levels in distribution quintiles showed a dose-response gradient in relation to hyperglycemia, where increased vitamin D values were associated with a reduction in the occurrence of hyperglycemia. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have hyperglycemia.

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers.

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers. Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated. Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706). Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA.

Association of Hypovitaminosis D with Sleep Parameters in Rotating Shift Worker Drivers.

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers. Material and Methods We conducted a cross-sectional study on 82 male rotating shift workers (24-57 years old) with at least one cardiovascular risk factor (such as hyperglycemia, dyslipidemia, abdominal obesity, physical inactivity, hypertension, and smoking). Polysomnography was used to evaluate sleep parameters. Logistic regression was used to model the association between hypovitaminosis D and sleep parameters after adjustment for relevant covariates. Results Hypovitaminosis D (< 20 ng/mL) was seen in 30.5% of the workers. Shift workers with hypovitaminosis D had lower sleep efficiency (odds ratio [OR]: 3.68; 95% confidence interval [CI]: 1.95-5.53), lower arterial oxygen saturation (OR: 5.35; 95% CI: 3.37-6.12), and increased microarousal index (OR: 3.85; 95% CI: 1.26-5.63) after adjusting. Conclusion We suggest that hypovitaminosis D is associated with greater sleep disturbances in rotating shift workers.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

BACKGROUND: Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS: This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS: Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION: In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

Body fat indicators for cardiometabolic risk screening among shift workers.

BACKGROUND: In view of the costly methods currently available for the assessment of body adiposity, anthropometric obesity indicators have proven effective in predicting cardiovascular risk. OBJECTIVE: To investigate the discriminatory power of body fat indicators for cardiovascular risk screening among shift workers. METHODS: Cross-sectional study with male employees of an iron ore extraction company. The predictive power of body fat indicators relative to cardiovascular risk was analyzed based on the Framingham risk score and metabolic syndrome by means of receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve and Youden's index. RESULTS: The prevalence of cardiovascular risk was 14.2% in the metabolic syndrome risk model. According to the Framingham score, 95.0%, 4.1% and 0.9% of the participants exhibited low, moderate and high risk, respectively. All the analyzed body fat indicators exhibited satisfactory discriminatory power for the tested cardiovascular risk models. CONCLUSION: Waist-height ratio exhibited the highest ability to predict cardiometabolic risk in both risk models.

Hipovitaminose D e índices glicêmicos em trabalhadores de turno alternante de empresa de mineração / Hypovitaminosis D and glycemic index in individuals working in rotate shifts of a mining company

Objetivo: Demonstrar a prevalência da hipovitaminose D em trabalhadores de turno de uma empresa de mineração e verificar se, nesta população, há correlação entre as variáveis glicêmicas (hemoglobina glicada e glicemia de jejum) e os níveis séricos de vitamina D. Métodos: Estudo transversal observacional realizado por 2 anos consecutivos com trabalhadores de turno. No primeiro ano, foram analisados os níveis séricos de vitamina D (25(OH)D) e glicemia de jejum, excluindo indivíduos que realizavam tratamento para controle glicêmico, suplementação de vitamina D e/ou participantes do sexo feminino, totalizando 548 trabalhadores. No ano seguinte, foram selecionados da amostra anterior apenas os indivíduos que apresentaram hipovitaminose D (25(OH) D<30ng/mL). Nestes, foram analisados os níveis de 25(OH)D, glicemia de jejum e hemoglobina glicada. Foram aplicados o teste de normalidade Kolmogorov-Smirnov e a correlação de Spearman. Resultados: A idade média dos participantes foi de 38,2 anos. No primeiro ano, 80,8% dos trabalhadores apresentaram hipovitaminose D e 10,8% apresentavam glicemia de jejum fora dos níveis de normalidade. Dentre a amostra do ano seguinte, 81,1% permaneceram com hipovitaminose D, 18,2% apresentaram glicemia de jejum fora dos níveis de normalidade e 15,8% apresentaramhemoglobina glicada alterada. Não foram encontradas correlações significativas entre a 25(OH)D e a glicemia de jejum e hemoglobina glicada. Conclusão: Foi observada alta prevalência de hipovitaminose nos trabalhadores de turno. Diferentemente de outros estudos, não foram encontradas correlações significativas entre as variáveis glicêmicas e a concentração sérica da vitamina D. (AU)

Objective: To demonstrate the prevalence of hypovitaminosis D in shift workers of a mining company, and to check whether, in this population, there is a correlation between glycemic variables (glycosylated hemoglobin and fasting plasma glucose)- and serum levels of vitamin D. Methods: These are cross-sectional observational studies performed in two consecutive years with shift workers. In the first year, the serum levels of vitamin D (25(OH)D) and fasting plasma glucose were analyzed, with people who underwent treatment for glycemic control, vitamin D supplementation, and/or female participants being excluded, totalizing 548 workers. In the following year, only those individuals who presented hypovitaminosis D (25 (OH) D <30 ng/dL) were selected from the previous sample. The levels of 25 (OH) D, fasting plasma glucose, and HbA1C of these individuals were analyzed. The Kolmorogov-Smirnov normality test and the Spearman correlation were applied. Results: Th e m ean a ge o f participants was 38.2 years. In the first year, 80.8% (n=442) of the workers presented hypovitaminosis D, and 10.8% had fasting plasma glucose out of normal levels. Among the sample of the following year, 81.1% remained with hypovitaminosis D, 18.2% (n=51) had fasting glycemia out of normal levels, and 15.8% (n=44) had altered glycosylated hemoglobin. Conclusion: A high prevalence of hypovitaminosis in shift workers was observed. Differently from other studies, no significant correlations were found between glycemic variables and serum vitamin D concentration. (AU)

Qualidade de vida e excesso de peso em trabalhadores em turnos alternantes / Quality of life and overweight in alternating shift workers

Resumo Objetivo: identificar a percepção dos trabalhadores de turnos alternantes de uma mineradora da região dos Inconfidentes, Minas Gerais, sobre sua qualidade de vida (QV) e analisar sua associação com indicadores de excesso de adiposidade corporal. Métodos: estudo transversal com 437 trabalhadores em turnos alternantes com um ou mais fatores de risco cardiovascular. Dados sociodemográficos e clínicos foram analisados. A QV foi avaliada com o questionário SF-36 e a adiposidade corporal estimada a partir das medidas antropométricas e de composição corporal. Resultados: a pontuação para os domínios da QV variou de 67 a 100, no entanto, o aumento de gordura corporal apresentou correlação negativa com os domínios saúde geral, vitalidade e capacidade funcional. Foi observada, por análise de cluster, a formação de dois agrupamentos, um composto pelos domínios da QV e o outro constituído pelos indicadores de composição corporal. Não foi identificada associação entre os escores estimados de QV dos trabalhadores de turno e o tempo de trabalho. Conclusão: o declínio da QV apresentou associação com o excesso de adiposidade corporal. Recomenda-se a adoção de medidas visando reduzir o excesso de adiposidade corporal e melhorar a qualidade de vida dos trabalhadores em turno alternante da mineração.

Abstract Objective: to identify the perception that alternating shift workers from a mining company in the region of Inconfidentes, Minas Gerais, Brazil, have about their quality of life (QoL) and to analyse its association with indicators of excess body adiposity. Methods: cross-sectional study involving 437 alternating shift workers with one or more cardiovascular risk factors. Sociodemographic and clinical data were analyzed. QoL was evaluated by the SF-36 questionnaire. Body adiposity was estimated through anthropometric and body composition measurements. Results: the scores for QoL domains ranged from 67 to 100, however, body fat increasing showed a negative correlation with general health, vitality and functional capacity domains. Through cluster analysis, the authors observed the formation of two groups, one comprising the QoL domains, and a second made up of body composition indicators. No association was found between the shift workers estimated QoL scores and their shift working lifetime. Conclusion: the QoL decline was associated with body adiposity excess. The recommendation is the adoption of measures aimed at reducing excess body adiposity and improving mining alternating shift workers' quality of life.

Indicadores de adiposidade como método de rastreamento para polissonografia em trabalhadores de turno / Adiposity indicators as a screening method for polysomnography in shift workers

Resumo Objetivo: verificar o potencial discriminatório dos indicadores de adiposidade na predição da apneia obstrutiva do sono (AOS) em trabalhadores de turnos. Métodos: estudo transversal realizado em uma empresa de extração de minério de ferro, em Minas Gerais, Brasil. Dados antropométricos foram coletados e polissonografia (PSG) foi realizada em 118 trabalhadores de turno do sexo masculino que possuíam ao menos um fator de risco global para doença cardiovascular. Resultados: a prevalência de AOS na amostra foi de 84,7%. Entre os indicadores de adiposidade usados para predizerem a AOS (≥ 5 eventos/hora), o índice de massa corporal (IMC), a circunferência da cintura (CC), a relação cintura/estatura (RCE) e a gordura corporal total (GCT), revelaram valores de sensibilidade acima de 70%. Gordura visceral (GV), circunferência do pescoço (CP) e relação pescoço-estatura (RPE) foram as mais efetivas em identificar corretamente trabalhadores sem AOS (valores de especificidade acima de 70%). As áreas sob a curva de Característica de Operação do Receptor (COR) para CC e RPE foram maiores que 0,7, o que indicou que o teste foi eficaz na discriminação de indivíduos com AOS. Conclusões: alterações nos indicadores de adiposidade abdominal e cervical têm relação significativa com a presença de AOS e demostraram eficácia como método de rastreamento para PSG. CC e RPE são considerados bons indicadores para predizerem a AOS.

Abstract Objective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a cross-sectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (≥ 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.

Doenças crônicas, cognição, declínio funcional e Índice de Charlson em idosos com demência / Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia

OBJETIVO: Este estudo avaliou a associação entre as doenças crônico-degenerativas e o declínio funcional, a cognição e a predição da mortalidade. MÉTODOS: Um estudo transversal foi realizado em um Serviço de Geriatria em Belo Horizonte, Brasil, envolvendo 424 pacientes subdivididos em dois grupos: controle e com demência. Foram analisados dados sociodemográficos e ambientais, doenças crônicas degenerativas, o Índice de Charlson, dados sobre a demência, funcionais e de cognição. RESULTADOS: Após análise univariada, houve maior frequência de acidente vascular encefálico (AVE), incontinência urinária, constipação intestinal e distúrbio do sono no grupo demência, enquanto na análise multivariada houve maior número de fatores ambientais e distúrbio do sono. Quanto ao Mini Exame do Estado Mental (MEEM), pacientes com doença pulmonar obstrutiva crônica (DPOC), AVE e insuficiência cardíaca apresentaram escores mais baixos. Em relação ao Índice de Charlson, houve maior pontuação no grupo com demência. CONCLUSÃO: As comorbidades foram associadas ao declínio funcional nos idosos com demência.

OBJECTIVE: To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction. METHODS: A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia. RESULTS: After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index. CONCLUSION: These comorbidities were associated with the functional decline in elderly people with dementia.

Chronic diseases, cognition, functional decline, and the Charlson index in elderly people with dementia.

OBJECTIVE: To assess the association between chronic degenerative diseases and functional decline, cognition, and mortality prediction. METHODS: A cross-sectional study was conducted in a geriatrics service in Belo Horizonte, Brazil, involving 424 patients subdivided into two groups: control and dementia. The study analyzed socio-demographic and environmental data, chronic degenerative diseases, the Charlson index, and data on functional and cognitive dementia. RESULTS: After a univariate analysis, there was a greater frequency of cerebrovascular accident (CVA), urinary incontinence, constipation, and sleep disorder in the dementia group, while the multivariate analysis showed a greater number of environmental factors and sleep disorder. Regarding the Mini Mental State Examination (MMSE), patients with chronic obstructive pulmonary disease (COPD), CVA, and heart failure presented lower scores. There was a greater score in the dementia group with regarding the Charlson index. CONCLUSION: These comorbidities were associated with the functional decline in elderly people with dementia.

Classificação internacional de funcionalidade, de doenças e prognóstico médico em pacientes idosos / International classification of functioning, disease andmedical prognosis in elderly patients

O envelhecimento populacional e o aumento das doenças crônico-degenerativas sinalizam para a necessidade de discutir como proceder a abordagem clínica atual, em que a conduta é definida pelos achados orgânicos em doenças associadas. A avaliação da Medicina moderna deve considerar como modelo a Classificação Internacional de Funcionalidade, Incapacidades e Saúde associada à Classificação Internacional de Doenças proposta pela Organização Mundial de Saúde. A abordagem médica baseada apenas na doença não representa, verdadeiramente, o real estado do paciente. É necessário, portanto, avaliar os aspectos relacionados à prática clínica atual, pautada no ?paradigma da cura?, baseada principalmente em aspectos etiológicos e dados estatísticos que não se aplicam às doenças associadas e não respeitam a singularidade dos pacientes. Dados etiológicos, epidemiológicos e capacidade funcional devem compor a abordagem que respeite a individualidade. Deve ser questionado o paradigma tradicional do diagnóstico e da cura como objetivos fundamentais. Desta forma, é importante avaliar os potenciais ganhos funcionais e psicológicos não apenas para o paciente, mas também para seus familiares. Este trabalho procura contribuir para melhor abordagem médica, em que se considera a avaliação dos conceitos de funcionalidade associados aos diagnósticos anatômicos no prognóstico de idosos com doenças associadas.

The population getting old and the increase of degenerative-chronic diseases indicate a need to discuss how to proceed with the current clinical approach, in which the conduct is defined by the findings of organic diseases. The evaluation of modern medicine should be considered as a model to the International Classification of Functioning, Disability and Health associated to International Classification of Diseases proposed by the World Health Organization The medical approach based only on the disease does not represent truly the real state of the patient. It is necessary to evaluate the aspects related to current clinical practice, based on the ?paradigm of healing?, based mainly on etiological and statistical data that are not applied to associated diseases and do not respect the characteristics of the patients. Etiological and epidemiological data and functional capacity must make possible an approach that respects individuality. Traditional paradigm of diagnosis and cure must be questioned as mainly objectives. Thus, it is important to assess the potential functional and psychological gains not only for the patient, but also for their relatives. This paper aims at contributing to better medical approach, which considers the evaluation of the functionality concepts associated with anatomical diagnosis in the prognosis of elderly patients who present associated diseases.

[Retiree quality of life assessment with SF-36 questionnaire]. / Avaliação da qualidade de vida de aposentados com a utilização do questionário SF-36.

OBJECTIVE: Increase of the elderly in the Brazilian population demands assessment of aspects that interfere with the retirees' quality of life. METHODS: The Brazilian version of SF-36 questionnaire was applied to 87 retirees at their homes. Data on quality of life was associated with demographic data, socioeconomic status, health conditions and life style. Statistical analysis of data was performed using single-variable and multivariate analysis. RESULTS: The mean age was 57.3 years (standard deviation 8.9 years) and the mean retirement time was 7.1 years. Fifty-five percent were early retirements due to disability and 23.4% of those queried were still working when research was carried out. Smokers were 11.5% and 5.7 % were diagnosed as alcohol dependent by CAGE criteria. Depression and arterial systemic hypertension were the most prevalent conditions and 56.3% of the retirees practiced regular physical activity. Multivariate analysis disclosed that regular physical activity and post-retirement occupation were the only variables associated with improved quality of life. CONCLUSION: The SF-36 questionnaire was a suitable instrument, relatively quick and easy to use. The quality of life was associated with life style, as indicated by the practice of physical activities and post-retirement occupation. Actions are needed to enable retirees to improve their life style after retirement.

Avaliação da qualidade de vida de aposentados com a utilização do questionário SF-36 / Retiree quality of life assessment with SF-36 questionnaire

OBJETIVO: O aumento da população idosa no Brasil justifica a necessidade de avaliar os aspectos que podem interferir na qualidade de vida de aposentados. MÉTODOS: A versão brasileira do questionário SF-36 foi aplicada em 87 aposentados para avaliação da qualidade de vida. Os resultados obtidos foram associados às características demográficas, socioeconômicas, condições de saúde e estilo de vida e foram estudados por meio de análise uni e multivariada. RESULTADOS: A idade média foi de 57,3 anos (desvio-padrão de 8,9 anos) e tempo médio de aposentadoria foi de 7,1 anos. A aposentadoria foi por invalidez em 55,2 por cento da amostra e 23,4 por cento dos aposentados trabalhavam no momento da pesquisa. Os fumantes somaram 11,5 por cento e 5,7 por cento eram dependentes de álcool. A depressão e hipertensão arterial sistêmica foram as doenças mais prevalentes, e 56,3 por cento dos aposentados praticavam algum tipo de atividade física regularmente. Após a análise multivariada, evidenciou-se melhor qualidade de vida apenas nos aposentados que praticavam atividade física regular ou que tinham alguma atividade de trabalho no momento da pesquisa. CONCLUSÃO: O questionário SF-36 foi um instrumento adequado, de aplicação relativamente rápida e de fácil uso para avaliação da qualidade de vida em aposentados. A qualidade de vida na amostra estudada foi associada ao estilo de vida dos pacientes e aponta para a necessidade de ações que contribuam de forma positiva para melhorar o estilo de vida nesta nova fase da vida.

OBJECTIVE: Increase of the elderly in the Brazilian population demands assessment of aspects that interfere with the retirees' quality of life. METHODS: The Brazilian version of SF-36 questionnaire was applied to 87 retirees at their homes. Data on quality of life was associated with demographic data, socioeconomic status, health conditions and life style. Statistical analysis of data was performed using single-variable and multivariate analysis. RESULTS: The mean age was 57.3 years (standard deviation 8.9 years) and the mean retirement time was 7.1 years. Fifty-five percent were early retirements due to disability and 23.4 percent of those queried were still working when research was carried out. Smokers were 11.5 percent and 5.7 percent were diagnosed as alcohol dependent by CAGE criteria. Depression and arterial systemic hypertension were the most prevalent conditions and 56.3 percent of the retirees practiced regular physical activity. Multivariate analysis disclosed that regular physical activity and post-retirement occupation were the only variables associated with improved quality of life. CONCLUSION: The SF-36 questionnaire was a suitable instrument, relatively quick and easy to use. The quality of life was associated with life style, as indicated by the practice of physical activities and post-retirement occupation. Actions are needed to enable retirees to improve their life style after retirement.