Uso da modelagem de equações estruturais na compreensão da incapacidade funcional de idosos com catarata autorreferida / Use of structural equation modeling to understand the functional disability of elderly people with self-reported cataract

Objetivo: Verificar as associações diretas e indiretas entre variáveis demográficas, econômicas, biopsicossociais e comportamentais com a incapacidade funcional de idosos com catarata autorreferida. Método: Estudo transversal entre 260 idosos com catarata autorreferida e residentes na área urbana de uma microrregião de saúde de Minas Gerais. A coleta dos dados foi realizada nos domicílios mediante a aplicação de instrumentos validados no Brasil. Procederam-se as análises descritiva e de trajetórias (p<0,05). Resultados: O declínio funcional ocorreu de forma hierárquica. O pior desempenho físico associou-se diretamente à maior incapacidade funcional para as atividades básicas (p= 0,003), instrumentais (p<0,001) e avançadas (p= 0,003) da vida diária. A inatividade física esteve associada diretamente à maior incapacidade funcional para as atividades instrumentais (p<0,001) e avançadas (p<0,001). A menor escolaridade (p= 0,020), o maior número de sintomas depressivos (p<0,001) e o menor escore de apoio social (p<0,001) associaram-se diretamente à maior incapacidade funcional para as atividades avançadas, tal como a maior idade (p= 0,001) para as instrumentais. Observaram-se associações indiretas, mediadas pelo pior desempenho físico, entre o sexo feminino e o maior número de morbidades com a incapacidade funcional para as três atividades da vida diária. Conclusão: Idosos com catarata autorreferida apresentaram comprometimento da capacidade funcional relacionado à idade mais avançada, à baixa escolaridade, ao pior desempenho físico, à inatividade física, à presença de sintomas depressivos e ao menor nível de apoio social.

Objective: To verify the direct and indirect associations between demographic, economic, biopsychosocial and behavioral variables with the functional disability of the elderly with self-reported cataract. Method: Cross-sectional study among 260 elderly people with self- reported cataract and residents in the urban area of ​​a health micro-region in Minas Gerais. Data collection was carried out in the households through the application of instruments validated in Brazil. Descriptive and trajectory analyzes were carried out (p<0.05). Results: The functional decline occurred in a hierarchical manner. The worst physical performance was directly associated with greater functional incapacity for basic (p= 0.003), instrumental (p<0.001) and advanced (p= 0.003) activities of daily living. Physical inactivity was directly associated with greater functional disability for instrumental (p<0.001) and advanced (p<0.001) activities. Lower schooling (p= 0.020), higher number of depressive symptoms (p<0.001) and lower social support score (p<0.001) were directly associated with greater functional incapacity for advanced activities, such as older age (p= 0.001) for the instruments. Indirect associations, mediated by worse physical performance, were observed between females and the highest number of morbidities with functional incapacity for the three activities of daily living. Conclusion: Elderly people with self-reported cataract showed impairment of functional capacity related to older age, low education, worse physical performance, physical inactivity, presence of depressive symptoms and lower level of social support.

Use of structural models to elucidate the occurrence of falls among older adults according to abdominal obesity: a cross-sectional study

Abstract BACKGROUND: Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES: To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING: A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS: Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS: The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION: Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

Use of structural models to elucidate the occurrence of falls among older adults according to abdominal obesity: a cross-sectional study.

BACKGROUND: Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES: To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING: A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS: Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS: The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (ß = 0.25, P < 0.001; ß = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (ß = -0.16; P = 0.04), a higher number of depressive symptoms (ß = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (ß = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (ß = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION: Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

Panorama das internações por covid-19 entre pessoas idosas residentes em Minas Gerais, Brasil / Overview of hospitalizations for covid-19 among aged individuals residing in Minas Gerais, Brazil

Resumo Objetivo caracterizar as internações por covid-19, no período de março de 2020 a março de 2022, entre pessoas idosas residentes em Minas Gerais, Brasil, segundo distribuição geográfica, dados sociodemográficos, clínicos e epidemiológicos e de atendimento. Método estudo quantitativo e descritivo realizado com dados sociodemográficos, clínicos, epidemiológicos e de atendimento, do Banco de Dados de Síndrome Respiratória Aguda Grave - incluindo dados da covid-19. Foram consideradas 102.029 internações por covid-19 em pessoas idosas Resultados em 196 dos 853 municípios de Minas Gerais, a incidência foi elevada (3.098 a 8.916 casos por 100.000 habitantes). Houve predomínio de internações em pessoas idosas do sexo masculino (50,7%), entre 60├70 anos (39,0%), pardas (41,6%), com 1ª a 5ª série (17,6%) e que apresentavam fatores de risco/comorbidade (54,0%), dispneia e saturação de oxigênio <95% (72,8%, cada). Referente aos dados de atendimento, uma parcela necessitou de internação em UTI (34,0%), suporte ventilatório não invasivo (54,1%) e apresentou Raio-X com infiltrado intersticial (20,4%). Embora a cura tenha sido o desfecho mais frequente (55,6%), destaca-se que 41,8% das pessoas idosas foram a óbito. Conclusão o estudo mostrou que existem áreas de Minas Gerais com maior número de casos, que precisam ser monitoradas, fornecendo ênfase na atenção aos subgrupos de pessoas idosas do sexo masculino, mais jovens, pardas, com menor escolaridade e fatores de risco/comorbidades, além daqueles com sinais e sintomas indicativos de gravidade clínica.

Abstract Objective To characterize hospitalizations for covid-19 among aged individuals residing in Minas Gerais, Brazil, from March 2020 to March 2022, with a focus on geographical distribution, sociodemographic, clinical, epidemiological, and care data. Method This quantitative and descriptive study used sociodemographic, clinical, epidemiological, and care data from the Severe Acute Respiratory Syndrome Database, including covid-19-related data. A total of 102,029 hospitalizations of aged individuals for covid-19 were analyzed for descriptive purposes and mapping the incidence by municipality and macro-region. Results High incidence was observed in 196 of the 853 municipalities in Minas Gerais, ranging from 3,098 to 8,916 cases per 100,000 inhabitants. Hospitalizations were predominantly male (50.7%), aged 60-70 years (39.0%), of mixed race (41.6%), with 1st to 5th grade education (17.6%), and presenting risk factors or comorbidities (54.0%). Common symptoms included dyspnea and oxygen saturation below 95% (72.8% each). Regarding care data, a portion of patients required intensive care unit admission (34.0%), non-invasive ventilatory support (54.1%), and presented interstitial infiltrates in chest X-rays (20.4%). Although most cases resulted in recovery (55.6%), it is noteworthy that 41.8% of hospitalized aged individuals died. Conclusion This study highlights the existence of areas in Minas Gerais with a higher incidence of covid-19 cases that require ongoing monitoring, with a focus on the care of subgroups of aged individuals who are male, younger, of mixed race, have lower educational attainment, and have risk factors or comorbidities. Additionally, special attention is needed for aged individuals with signs and symptoms indicative of clinical severity.

Desempenho físico de membros inferiores, força de preensão manual e qualidade de vida de idosos / Lower limb physical performance, handgrip strength and quality of life of elderly

Este estudo teve o objetivo de verificar a associação entre o desempenho físico de membros inferiores e a força de preensão manual (FPM) com a qualidade de vida (QV) de idosos. Estudo transversal realizado com 608 idosos. Foi utilizado o Short Physical Performance Battery (SPPB); o teste de força de preensão manual, o World Health Organization Quality of Life-Bref (WHOQOL-BREF) e o World Health Organization Quality of Life Olders (WHOQOL-OLD). Realizou-se análise descritiva e regressão linear (p<0,05). Menores escores no SPPB e na FPM associaram-se a pior QV nos domínios físico (p<0,001; p=0,003), psicológico (p<0,001; p=0,001) e meio ambiente (p<0,001; p=0,028) e nas facetas de funcionamento dos sentidos (p=0,001; p<0,001) e atividades passadas, presentes e futuras (p=0,001; p=0,010). Verificou-se que existem domínios e facetas de QV em comum e específicos que se associaram ao desempenho físico de membros inferiores e a FPM.

This study aimed to verify the association between physical performance of lower limbs and handgrip strength (HGS) with the quality of life (QOL) of the elderly. Cross-sectional study carried out with 608 elderly people. The following were used: Short Physical Performance Battery (SPPB); handgrip strength test; World Health Organization Quality of Life-Bref (WHOQOL-BREF) and World Health Organization Quality of Life Olders (WHOQOL-OLD). Descriptive analysis and linear regression (p<0.05) were performed. Lower SPPB and HGS scores were associated with worse QOL in the physical (p<0.001; p= 0.003), psychological (p<0.001; p= 0.001) and environment (p<0.001; p= 0.028) domains and in the facets functioning of the senses (p= 0.001; p<0.001) and past, present and future activities (p= 0.001; p= 0.010). It was found that there are common and specific QOL domains and facets associated with physical performance of lower limbs and HGS.

Factors associated with the occurrence of falls among older people with and without cataracts: Structural equation modelling analysis.

AIMS AND OBJECTIVES: To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community-dwelling older adults according to self-reported cataracts. BACKGROUND: Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis. DESIGN AND METHOD: This is a cross-sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed. RESULTS: The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls. CONCLUSION: The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts. RELEVANCE TO CLINICAL PRACTICE: The expanded understanding of the factors associated with falls among community-dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events.

Fatores associados à incapacidade funcional de idosos com catarata: revisão integrativa / Factors associated with functional disability in older adults with cataract: integrative review

Resumo Objetivo identificar as evidências científicas disponíveis na literatura sobre os fatores associados à incapacidade funcional de idosos com catarata. Métodos revisão integrativa da literatura realizada nas bases de dados PubMed, Web of Science, LILACS e CINAHL. Incluíram-se os artigos originais que responderam à questão norteadora: quais as evidências científicas sobre os fatores associados à incapacidade funcional de idosos com catarata? Resultados foram incluídos seis artigos, a maioria foi publicada a partir do ano 2000 (n=4) e realizada na América (n=3). Predominaram os estudos do tipo longitudinal (n=3) com nível de evidência IV, e transversal (n=3) com nível de evidência VI, e que realizaram análise de caminhos (n=3). Com base nos achados, emergiram três categorias temáticas: características demográficas; relacionadas à saúde ocular, física e mental, e comportamentais. Conclusão a incapacidade funcional de idosos com catarata pode ser resultante de características demográficas, relacionadas à saúde ocular, física e mental, e comportamentais.

Abstract Objective to identify the scientific evidence available in the literature on factors associated with functional disability in older people with cataract. Methods integrative literature review carried out in PubMed, Web of Science, LILACS and CINAHL databases. Original articles that answered the guiding question were included: what is the scientific evidence on the factors associated with the functional disability of older people with cataract? Results six articles were included, most were published from the year 2000 (n=4) and carried out in America (n=3). Longitudinal (n=3) with level of evidence IV, and cross-sectional (n=3) with level of evidence VI predominated, and that performed path analysis (n=3). Based on the findings, three thematic categories emerged: demographic characteristics; related to eye, physical and mental health, and behavioral. Conclusion the functional disability of older people with cataract may be the result of demographic, related to eye, physical and mental health, and behavioral characteristics.

Functional capacity and physical performance of community-dwelling elderly: a longitudinal study. / Capacidade funcional e desempenho físico de idosos comunitários: um estudo longitudinal.

This study aimed to verify the occurrence of changes in the functional capacity and physical performance of community-dwelling elderly and its determining factors over a two-year period. This is a quantitative, observational and longitudinal household survey conducted in 2014 and 2016, with the participation of 380 elderly from Uberaba, Minas Gerais. The following instruments were used: The Mini-Mental State Examination and questionnaires with sociodemographic/economic, clinical and life habits data. The functional capacity was evaluated through the Katz Index and Lawton-Brody's scale. Physical performance was verified through the Short Physical Performance Battery. A descriptive, bivariate and linear multiple regression analysis was conducted, with a significance level of α < 0.05. The results showed reduced functional capacity for the instrumental activities of daily living and physical performance in a two-year period. The determining factors for both outcomes were age group, occupational activity, and physical activity. Schooling was a specific factor only for the instrumental activities of daily living, and gender and the number of medicines used, for physical performance.

O objetivo do estudo foi verificar a ocorrência de mudanças na capacidade funcional e no desempenho físico de idosos comunitários e seus fatores determinantes, em um período de dois anos. Foi realizado estudo quantitativo, do tipo inquérito domiciliar, observacional e longitudinal, em 2014 e 2016, com 380 idosos residentes em Uberaba, Minas Gerais. Foram utilizados os instrumentos: Mini Exame do Estado Mental e questionários com dados sociodemográficos/econômicos, clínicos e de hábito de vida. A capacidade funcional foi avaliada por meio do Índice de Katz e da escala de Lawton e Brody. O desempenho físico foi verificado através da Short Physical Performance Battery. Procedeu-se a análise descritiva, bivariada e de regressão linear múltipla, com nível de significância de α < 0,05. Os resultados mostraram que no período de dois anos ocorreu redução da capacidade funcional para as atividades instrumentais da vida diária e do desempenho físico. Os fatores determinantes comuns aos desfechos foram: faixa etária, atividade profissional e prática de atividade física. A escolaridade foi específica somente para as atividades instrumentais da vida diária, e o sexo e o número de medicamentos para o desempenho físico.

Capacidade funcional e desempenho físico de idosos comunitários: um estudo longitudinal / Functional capacity and physical performance of community-dwelling elderly: a longitudinal study

Resumo O objetivo do estudo foi verificar a ocorrência de mudanças na capacidade funcional e no desempenho físico de idosos comunitários e seus fatores determinantes, em um período de dois anos. Foi realizado estudo quantitativo, do tipo inquérito domiciliar, observacional e longitudinal, em 2014 e 2016, com 380 idosos residentes em Uberaba, Minas Gerais. Foram utilizados os instrumentos: Mini Exame do Estado Mental e questionários com dados sociodemográficos/econômicos, clínicos e de hábito de vida. A capacidade funcional foi avaliada por meio do Índice de Katz e da escala de Lawton e Brody. O desempenho físico foi verificado através da Short Physical Performance Battery. Procedeu-se a análise descritiva, bivariada e de regressão linear múltipla, com nível de significância de α < 0,05. Os resultados mostraram que no período de dois anos ocorreu redução da capacidade funcional para as atividades instrumentais da vida diária e do desempenho físico. Os fatores determinantes comuns aos desfechos foram: faixa etária, atividade profissional e prática de atividade física. A escolaridade foi específica somente para as atividades instrumentais da vida diária, e o sexo e o número de medicamentos para o desempenho físico.

Abstract This study aimed to verify the occurrence of changes in the functional capacity and physical performance of community-dwelling elderly and its determining factors over a two-year period. This is a quantitative, observational and longitudinal household survey conducted in 2014 and 2016, with the participation of 380 elderly from Uberaba, Minas Gerais. The following instruments were used: The Mini-Mental State Examination and questionnaires with sociodemographic/economic, clinical and life habits data. The functional capacity was evaluated through the Katz Index and Lawton-Brody's scale. Physical performance was verified through the Short Physical Performance Battery. A descriptive, bivariate and linear multiple regression analysis was conducted, with a significance level of α < 0.05. The results showed reduced functional capacity for the instrumental activities of daily living and physical performance in a two-year period. The determining factors for both outcomes were age group, occupational activity, and physical activity. Schooling was a specific factor only for the instrumental activities of daily living, and gender and the number of medicines used, for physical performance.

Qualidade de vida e morbidade entre idosos com e sem indicativo de depressão / Quality of life and moribidities among elderly with and without indicative of depression / Calidad de vida y morbilidad en personas mayores con y sin la indicación de la depresión

Objetivo: comparar a qualidade de vida (QV) e as morbidades autorreferidas entre idosos com e sem indicativo de depressão. Método: Estudo transversal, realizado entre junho e dezembro de 2012. Instrumentos: Mini-exame do Estado Mental (MEEM), Questionário Brasileiro de Avaliação Funcional Multidimensional (BOMFAQ), Geriatric Depression Scale (GDS-15), World Health Organization Quality of Life Group ­ Bref (WHOQOL-BREF) e World of Health Organization Quality of Life Assessment for Olders Adults (WHOQOL-OLD). Aplicaram-se testes t de Student e qui-quadrado com p<0,05. Resultados: Predominou sexo feminino, faixa etária 70├ 80 anos, 1├ 5 anos de estudo e renda de até um salário mínimo. Aqueles com indicativo apresentaram escores inferiores em todos domínios e facetas da QV, e maior proporção de: artrite/artrose (p<0,001), osteoporose (p<0,001), incontinência urinária (p<0,001), catarata (p<0,001), coluna (p<0,001), sono (p<0,001), dentre outras. Conclusão: A depressão impacta a QV e sua complexa relação com morbidades exige abordagens mais específicas, visando melhorar a QV (AU).

Objective: To compare quality of life (QOL) and self-reported morbidities among elderly with and without indicative of depression. Method: Cross-sectional study, conducted between June and December 2012. Instruments: Mental State Mini-Exam (MMSE), Brazilian Multidimensional Functional Assessment Questionnaire (BOMFAQ), Geriatric Depression Scale (GDS-15), World Health Organization Quality of Life Group - Bref (WHOQOL-BREF) and World of Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Student t and chi-square tests were applied with p<0.05. Results: Predominated female, age group 70├ 80 years, 1├ 5 years of study and income of up to one minimum wage. The elderly with indicative of depression presented inferior scores in all domains and facets; and increased proportion of: arthritis/arthrosis (p<0.001), osteoporosis (p<0.001), urinary incontinence (p<0.001), cataract (p<0.001), spine (p<0.001), sleeping (p<0.001), among others. Conclusion: Depression impacts QOL and its complex relationship with morbidity requires more specific approaches to improve QoL (AU).

Objetivo: Comparar la calidad de vida (CV) y las morbilidades autoinformadas entre los ancianos con y sin indicación de depresión. Método: Estudio transversal, realizado entre junio y diciembre de 2012. Instrumentos: Mini-Examen del estado mental (MMSE), Cuestionario de evaluación funcional multidimensional brasileño (BOMFAQ), Escala de depresión geriátrica (GDS-15), Grupo de calidad de vida de la Organización Mundial de la Salud - Bref (WHOQOL-BREF) y Evaluación de la calidad de vida de la Organización Mundial de la Salud para Adultos Mayores (WHOQOL-OLD). Las pruebas de t de Student y chi-cuadrado se aplicaron con p <0.05. Resultados: Mujeres con predominio, grupo de edad 70├ 80 años, 1├ 5 años de estudio e ingresos de hasta un salario mínimo. Los ancianos con indicación de depresión presentaron puntajes inferiores en todos los dominios y facetas; y una mayor proporción de: artritis/artrosis (p<0.001), osteoporosis (p<0.001), incontinencia urinaria (p<0.001), catarata (p<0.001), columna vertebral (p<0.001), dormir (p<0.001), entre otros. Conclusión: la depresión afecta la calidad de vida y su compleja relación con la morbilidad requiere enfoques más específicos para mejorar la calidad de vida (AU).

Physical exercise and functional capacity in elderly from the south triangle health regional ­ Minas Gerais state, Brazil: evaluation by gender / Exercício físico e capacidade funcional em idosos na regional de saúde triângulo do sul ­ Minas Gerais: avaliação por gênero

The aim of this study was to verify the functional capacity between genders as well as the practice of physical exercises in accordance with procedures among elderly people from municipalities in the South Triangle, Minas Gerais, Brazil. Data relating to the practice of physical exercise and functional capacity were obtained by means of a structured questionnaire and the Katz scale, respectively. It was found that most of the elderly was independent to carry out the activities of daily life, even if they were not adept at exercising. Women showed a higher dependency level compared to men. As regards the modalities of exercise and those who practice them, men prefer to walk and swim, while women prefer aerobics and weight training. These results allow concluding that elderly respondents do not practice the modalities under study (walking, aqua aerobics, weight training and swimming), although they are independent to daily life activities. Regular and supervised exercise programs are recommended for elderly of all age groups, with a view to promoting a better quality of life and preventing functional incapacity.

O objetivo desse estudo foi verificar a capacidade funcional entre os gêneros, bem como a prática de exercícios físicos segundo modalidades em idosos de municípios do Triângulo do Sul, Minas Gerais. Os dados referentes à prática de exercício físico e capacidade funcional foram obtidos através de um questionário estruturado e pela Escala de Katz, respectivamente. Verificou-se que grande parte dos idosos era independente para a realização das atividades de vida diária, mesmo não sendo adeptos a prática de exercício físico. As mulheres apresentaram nível de dependência maior em comparação aos homens. No que se refere às modalidades de exercícios, e daqueles que a realizam, os homens tem preferência pela caminhada e natação, enquanto as mulheres por hidroginástica e musculação. Estes resultados permitem concluir que os idosos respondentes não são adeptos das modalidades em estudo (caminhada, hidroginástica, musculação e natação), apesar de serem independentes para atividades de vida diária. Programas de exercícios orientados são recomendados para que o idoso alcance maior qualidade de vida e previna a incapacidade funcional.