Is the combination of depression symptoms and multimorbidity associated with the increase of the prevalence of functional disabilities in Brazilian older adults? A cross-sectional study.

Introduction: Functional disabilities are more prevalent in older adults with multimorbidity and depression. However, few studies have investigated the combination of multimorbidity and depression with functional disability. This study aims to verify whether symptoms of depression and multimorbidity combined increase the prevalence of functional disability in Brazilian older adults. Material and methods: This is a cross-sectional study conducted with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline examination in 2015-2016 in adults aged 50 years and older. The variables included were basic (BADL) and instrumental activities of daily living (IADL), depressive symptoms, multimorbidity (≥2 chronic diseases), sociodemographic variables, and lifestyle. Logistic regression was performed to estimate crude and adjusted odds ratios. Results: A total of 7,842 participants over 50 years of age were included. Of these, 53.5% were women and 50.5% were between 50 and 59 years old, 33.5% reported ≥4 depressive symptoms, 51.4% had multimorbidity, 13.5% reported difficulty in performing at least one BADL, and 45.1% reported difficulty in performing the IADL. In the adjusted analysis, the prevalence of difficulty on BADL was 6.52 (95% CI: 5.14; 8.27) and on IADL was 2.34 (95% CI: 2.15; 2.55), higher for those with depression and multimorbidity combined when compared with those without these conditions. Conclusion: The combination of symptoms of depression and multimorbidity may increase functional impairments in the BADL and IADL of Brazilian older adults, impairing self-efficacy, independence, and autonomy. Early detection of these factors benefits the person, their family, and the healthcare system for health promotion and disease prevention.

Multimorbidity prevalence and patterns at the baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Background: To identify multimorbidity patterns, by sex, according to sociodemographic and lifestyle in ELSA-Brasil. Methods: Cross-sectional study with 14,516 participants from ELSA-Brasil (2008-2010). Fuzzy c-means was used to identify multimorbidity patterns of 2+ chronic morbidities, where the consequent morbidity had to occur in at least 5% of all cases. Association rule (O/E≥1.5) was used to identify co-occurrence of morbidities, in each cluster, by sociodemographic and lifestyle factors. Results: The prevalence of multimorbidity was higher in women (73.7%) compared to men (65.3%). Among women, cluster 1 was characterized by hypertension/diabetes (13.2%); cluster 2 had no overrepresented morbidity; and cluster 3 all participants had kidney disease. Among men, cluster 1 was characterized by cirrhosis/hepatitis/obesity; cluster 2, most combinations included kidney disease/migraine (6.6%); cluster 3, no pattern reached association ratio; cluster 4 predominated co-occurrence of hypertension/rheumatic fever, and hypertension/dyslipidemia; cluster 5 predominated diabetes and obesity, and combinations with hypertension (8.8%); and cluster 6 presented combinations of diabetes/hypertension/heart attack/angina/heart failure. Clusters were characterized by higher prevalence of adults, married and participants with university degrees. Conclusion: Hypertension/diabetes/obesity were highly co-occurred, in both sexes. Yet, for men, morbidities like cirrhosis/hepatitis were commonly clustered with obesity and diabetes; and kidney disease was commonly clustered with migraine and common mental disorders. The study advances in understanding multimorbidity patterns, benefiting simultaneously or gradually prevention of diseases and multidisciplinary care responses.

Cognitive function and blood pressure control in elderly hypertensive individuals. / Função cognitiva e controle da pressão arterial em idosos hipertensos.

This article aims to estimate the prevalence of cognitive impairment and analyze its association with blood pressure control in elderly hypertensive individuals. Cross-sectional study of 383 elderly hypertensive individuals in the state of Piauí, Brazil. The authors collected sociodemographic and clinical data, performed blood pressure measurement, and assessed cognitive function using the Montreal Cognitive Assessment (MoCA) test. Poisson regression with robust variance was used. Overall prevalence of cognitive impairment was 74.4%, higher in the age group 80 years and over and among older persons with less schooling. Prevalence of uncontrolled blood pressure was 61.6%, with a higher proportion in the elderly with cognitive impairment. An association was observed between cognitive impairment and uncontrolled blood pressure (aPR: 3.98; 95%CI = 2.51-6.33). The significant association between cognitive function and blood pressure control suggest that cognitive impairment is an important risk factor for uncontrolled blood pressure in older persons. The inclusion of screening measures for possible cognitive deficits may be useful for better monitoring blood pressure levels among elderly hypertensive individuals.

O objetivo deste artigo é estimar a prevalência de comprometimento cognitivo e analisar sua associação com o controle da pressão arterial em idosos hipertensos. Trata-se de um estudo transversal realizado com 383 idosos hipertensos no estado do Piauí, Brasil. Foram coletados dados sociodemográficos, clínicos, realizada aferição da pressão arterial e avaliação da função cognitiva utilizando o teste Montreal Cognitive Assessment (MoCA). Utilizou-se regressão de Poisson com variância robusta. A prevalência de comprometimento cognitivo foi de 74,4%, sendo maior na faixa etária entre 80 anos ou mais de idade e naqueles com menor escolaridade. A prevalência de pressão arterial não controlada foi de 61,6%, com maior proporção entre os idosos com comprometimento cognitivo. Observou-se associação entre o comprometimento cognitivo e pressão arterial não controlada (RPAjustada: 3,98; IC95% = 2,51-6,33). A associação significativa entre função cognitiva e controle pressórico sugere que comprometimento cognitivo é um importante fator de risco para pressão arterial não controlada em pessoas idosas. A inclusão de medidas de rastreamento para possíveis déficits cognitivos podem ser úteis para melhor monitoramento da elevação dos níveis pressóricos entre idosos hipertensos.

Função cognitiva e controle da pressão arterial em idosos hipertensos / Cognitive function and blood pressure control in elderly hypertensive individuals

Resumo O objetivo deste artigo é estimar a prevalência de comprometimento cognitivo e analisar sua associação com o controle da pressão arterial em idosos hipertensos. Trata-se de um estudo transversal realizado com 383 idosos hipertensos no estado do Piauí, Brasil. Foram coletados dados sociodemográficos, clínicos, realizada aferição da pressão arterial e avaliação da função cognitiva utilizando o teste Montreal Cognitive Assessment (MoCA). Utilizou-se regressão de Poisson com variância robusta. A prevalência de comprometimento cognitivo foi de 74,4%, sendo maior na faixa etária entre 80 anos ou mais de idade e naqueles com menor escolaridade. A prevalência de pressão arterial não controlada foi de 61,6%, com maior proporção entre os idosos com comprometimento cognitivo. Observou-se associação entre o comprometimento cognitivo e pressão arterial não controlada (RPAjustada: 3,98; IC95% = 2,51-6,33). A associação significativa entre função cognitiva e controle pressórico sugere que comprometimento cognitivo é um importante fator de risco para pressão arterial não controlada em pessoas idosas. A inclusão de medidas de rastreamento para possíveis déficits cognitivos podem ser úteis para melhor monitoramento da elevação dos níveis pressóricos entre idosos hipertensos.

Abstract This article aims to estimate the prevalence of cognitive impairment and analyze its association with blood pressure control in elderly hypertensive individuals. Cross-sectional study of 383 elderly hypertensive individuals in the state of Piauí, Brazil. The authors collected sociodemographic and clinical data, performed blood pressure measurement, and assessed cognitive function using the Montreal Cognitive Assessment (MoCA) test. Poisson regression with robust variance was used. Overall prevalence of cognitive impairment was 74.4%, higher in the age group 80 years and over and among older persons with less schooling. Prevalence of uncontrolled blood pressure was 61.6%, with a higher proportion in the elderly with cognitive impairment. An association was observed between cognitive impairment and uncontrolled blood pressure (aPR: 3.98; 95%CI = 2.51-6.33). The significant association between cognitive function and blood pressure control suggest that cognitive impairment is an important risk factor for uncontrolled blood pressure in older persons. The inclusion of screening measures for possible cognitive deficits may be useful for better monitoring blood pressure levels among elderly hypertensive individuals.

Can internet use reduce the incidence of cognitive impairment? Analysis of the EpiFloripa Aging Cohort Study (2009-2019).

This study aims to estimate the effect of internet use on the incidence of cognitive impairment in older adults. Data are from the EpiFloripa Aging Cohort Study which has been following a population-based sample of older adults (60+) residing in Florianópolis, southern Brazil, for ten years. The outcome was the incidence of cognitive decline in follow-up waves measured by the Mini-Mental State Examination using cutoff points according to education. The exposure was internet use according to wave (yes/no). We excluded individuals with cognitive impairment from Wave 1 (n = 453). We used a longitudinal analysis model (Generalized Estimating Equations) to estimate incidence rate ratios (IRR) with 95% confidence intervals. We estimated the risk of cognitive impairment in Wave 2 or Wave 3 according to internet use in the previous wave. The incidence of cognitive impairment was 13.4% in Wave 2 and 13.3% in Wave 3. Despite the aging of this cohort, the prevalence of internet users increased from 26.4% in Wave 1 to 32.8% in Wave 2 and 46.8% in Wave 3. The risk of cognitive impairment in Wave 2 or Wave 3 was 70% lower for older adults who used the internet in the previous wave, adjusted for sex, age, years of education, household income, and self-reported comorbidities (IRR = 0.30; 95% CI: 0.15-0.61; p = 0.001). Internet use was associated with a decline in the incidence of cognitive impairment among older adults living in the urban areas of southern Brazil after a period of ten years.

Sarcopenia, bone mineral density, and vitamin D: EpiFloripa aging study 2013/2014 / Sarcopenia, densidade mineral óssea e vitamina D: Estudo EpiFloripa Idoso 2013/2014

OBJECTIVE: To verify associations between osteopenia/osteoporosis and vitamin D and sarcopenia in the older adult population of Florianópolis, Brazil. METHODS: A cross-sectional population-based study, with 604 older adults (60 years and over). The appendicular muscle mass index (AMMI) was used to identify sarcopenia, with cutoffs of AMMI (Kg/m2) < 7.26 kg/m2 for men and < 5.50 kg/m2 for women indicating inadequate values (sarcopenia). The independent variable osteopenia/osteoporosis was measured using bone mineral density (BMD, g/cm2): T-Scores for whole body BMD, lumbar spine BMD, and femoral neck BMD, categorized as normal (BMD > -1 SD) or osteopenia/osteoporosis (BMD < -1 SD from the mean of the young adult reference population). Fasting serum samples were collected and assayed using the microparticle chemiluminescence (CMIA)/Liaison method. Vitamin D concentrations of < 30 ng/mL were defined as hypovitaminosis. Crude and adjusted logistic regression analyses were performed. RESULTS: Osteopenia/osteoporosis in the lumbar spine and femoral neck were associated with higher odds of sarcopenia in women and men. Osteopenia/osteoporosis in the whole body was associated with sarcopenia in women only. Vitamin D was not associated with sarcopenia in either sex. CONCLUSIONS: Having osteopenia/osteoporosis was associated with sarcopenia in this older adult population.

OBJETIVO: Verificar a associação entre osteopenia/osteoporose e vitamina D com a sarcopenia na população idosa de Florianópolis. METODOLOGIA: Estudo transversal de base populacional, com 604 idosos (60 anos ou mais). O índice de massa muscular apendicular (IMMA) foi utilizado para identificar a sarcopenia, onde o IMMA (Kg/m2) ­ < 7,26 kg/m2 para homens e < 5,50 kg/m2 para mulheres ­ indicava valores inadequados (sarcopenia). A variável independente osteopenia/ osteoporose foi medida pela densidade mineral óssea (DMO, g/cm2), foram calculados os T-escores para DMO corporal total, DMO da coluna lombar e DMO do colo femoral, categorizados como normais (DMO até -1 DP) ou osteopenia/osteoporose (DMO < -1 DP da média da população adulta jovem de referência). Amostras de soro em jejum foram coletadas pelo método de quimioluminescência de micropartículas (CMIA)/Liaison. Concentrações de vitamina D < 30 ng/mL foram definidas como hipovitaminose. Foi realizada análise de regressão logística bruta e ajustada. RESULTADOS: Osteopenia/osteoporose na coluna lombar e colo do fêmur foram associadas a maiores chances de sarcopenia em mulheres e homens. Osteopenia/ osteoporose no corpo total foi associada à sarcopenia apenas em mulheres. A vitamina D não foi associada à sarcopenia em ambos os sexos. CONCLUSÕES: A presença de osteopenia/osteoporose associou-se à sarcopenia nesta população de idosos.

Internação por queda em idosos residentes em Florianópolis, em Santa Catarina e no Brasil: tendência temporal 2006-2014 / Hospitalizations due to accidental falls in elderly living in Florianópolis, Santa Catarina, and Brazil: time trends 2006-2014

Resumo Introdução A queda pode causar graves problemas para os indivíduos, incluindo redução das atividades de vida diária e aumento do medo de andar e de sofrer outra queda, o que pode levar à hospitalização. Objetivo Analisar a tendência temporal de internações por quedas em idosos em Florianópolis, em Santa Catarina e no Brasil, no período de 2006 a 2014. Método Estudo de série temporal, com registros de internações por queda, oriundos do Sistema de Informações Hospitalares do Sistema Único de Saúde, em idosos residentes em Florianópolis, em Santa Catarina e no Brasil. Foi utilizado o programa Joinpoint para análise das tendências. Resultados Foram registradas 703.791 internações por quedas no Brasil, das quais 5% ocorreram em Santa Catarina e 0,3%, em Florianópolis. Houve tendência crescente no Brasil, de 2008 a 2014, e em Santa Catarina, de 2006 a 2014. Em Florianópolis, ocorreu aumento nas taxas, porém não significativo. Quando analisados os grupos etários, os idosos de 60 a 69 anos foram os que apresentaram as maiores taxas de internação. Conclusão Foi constatada tendência crescente de internação por quedas em idosos em Santa Catarina (2006-2014) e no Brasil (2008-2014). Idosos de 60 a 69 anos apresentaram as maiores taxas nos três territórios.

Abstract Background The fall can cause serious problems for individuals, including reduced activities of daily living, increased fear of walking, and suffering another fall, which can have an impact on hospitalization. Objective To analyze the temporal trend of hospitalizations due to falls in the elderly, in Florianópolis, Santa Catarina, and Brazil, from 2006 to 2014. Method This is a time-series study with records of hospitalizations from the Hospital Information System of the Unified Health System, due to falls in the elderly of Florianópolis, Santa Catarina, and Brazil. Joinpoint program was used to analyze trends. Results A total of 703,791 hospitalizations were due to falls in Brazil, of which 5.0% occurred in Santa Catarina and 0.3% in Florianópolis. There was a growing trend in Brazil, from 2008 to 2014, and in Santa Catarina, from 2006 to 2014. In Florianópolis, there was an increase in rates, however, it was not significant. When the age groups were analyzed, the group from 60 to 69 years old was the one with the highest admission rates. Conclusion There was a growing trend of hospitalization for falls in the elderly in Santa Catarina (2006-2014) and Brazil (2008-2014). People aged 60 to 69 years old had the highest rates in the three territories.

Estudo Longitudinal EpiFloripa Idoso - Rotinas de organização e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional / EpiFloripa Ageing Longitudinal Study - Organizational routines and protocols related to the collection, analysis and storage of biological material, image exams and physical-functional capacity

Resumo Introdução Exames complementares podem contribuir para a compreensão da etiologia de agravos à saúde de idosos. Objetivo Descrever os aspectos operacionais e protocolos referentes à coleta, análise e armazenamento de material biológico, exames de imagem e capacidade físico-funcional. Método Estudo longitudinal, de base populacional, com 604 idosos (≥ 60 anos) do estudo EpiFloripa Idoso, em 2014. Foram coletados dados de material biológico, composição corporal, densitometria óssea, ultrassonografia da espessura íntima média das artérias carótidas, força de preensão manual e a atividade física. Resultados A taxa de resposta foi de 50,4%. Houve perda de seguimento em relação à faixa etária, estado cognitivo e atividades de vida diária. Os indivíduos que realizaram os exames eram mais novos, trabalhavam no momento da entrevista, ingeriam álcool, eram fisicamente ativos. Além de apresentarem menor grau de dependência, ausência de déficit cognitivo, ausência de sintomas depressivos e ausência de dificuldade na mobilidade. Conclusão Espera-se que a descrição das rotinas aplicadas possa auxiliar no desenvolvimento de novas pesquisas semelhantes em grupos de idosos. Assim, poderá ser acompanhado o processo de envelhecimento da população, seus fatores de risco e proteção.

Abstract Background Complementary exams may contribute to the understanding of the etiology of health problems in older adults. Objective To describe the operational aspects and protocols used to collect, analyze and storage biological materials, image exams and physical-functional capacity tests. Method This is a longitudinal and population-based study with 604 older adults (≥ 60 years) from EpiFloripa Ageing Study, in 2014. Data of biological material, body composition, bone densitometry, ultrasonography of the carotid artery intima average thickness, hand grip strength and physical activity were collected. Results The response rate was 50.4%. There was loss of follow-up in relation to age, cognitive status, and activities of daily living. The individuals who performed the tests were younger, worked by the time of the interview, ingested alcohol and were physically active. Also, they were less dependent, absence of cognitive impairment, absence of depressive symptoms and absence of difficulty in mobility. Conclusion It is expected that the description of the applied routines may help in the development of new similar research in the older adult population. Thus, the aging process of the population, its risk and protection factors can be followed.

Quality of life associated with handgrip strength and sarcopenia: EpiFloripa Aging Study.

BACKGROUND: Quality of life (QoL) is an important measure, and it can be defined as the presence of control, autonomy, self-realization and pleasure. This study aims to verify the association between handgrip strength (HGS), sarcopenia and sarcopenic obesity with quality of life (QoL) among community-dwelling older adults in southern Brazil. METHODS: Cross-sectional analyses data of the "EpiFloripa Aging" cohort study were carried out. The participants were community-dwelling older adults (60 years and over). QoL was evaluated by CASP-16 Brazil instrument, with a score of zero, representing no QoL, to 48, total satisfaction. The TAKEI hand dynamometer verified the HGS. Sarcopenia was defined as appendicular skeletal muscle mass/body weight <2 standard deviations below gender-specific means for young adults. Sarcopenic obesity was identified as the concomitant presence of obesity and sarcopenia. Multiple linear regression was performed to estimate the associations. RESULTS: The analytical sample consisted of 584 older adults (652% females). In the adjusted analysis, at each increase of one kgf in HGS there was a 0.24 and 0.18 increase in the QoL score, for females and males, respectively. Sarcopenia was negatively associated with QoL in males, and sarcopenic obesity wasn't associated with QoL. CONCLUSION: QoL was positively associated with HGS for both sexes, and negatively associated with sarcopenia for males. Low HGS, as well as sarcopenia, lead to critical health losses. Interventions that minimize phenotypes related to these conditions are fundamental, but mainly, conditions as severe as these need to be early identified to reduce the impact on QoL.

EpiFloripa Aging cohort study: methods, operational aspects, and follow-up strategies.

OBJECTIVE: To describe the sample plan, operational aspects, and strategies used in the 2009/2010 and 2013/2014 EpiFloripa Aging Study. METHODS: The EpiFloripa Aging is a population-based longitudinal study with 1,705 older adults (60 years or more) living in the municipality of Florianópolis, State of Santa Catarina, Brazil, in 2009/2010 (baseline). The research was conducted with a face-to-face interviews, organized into blocks of identification, socioeconomic, mental health, health and life habits, global functionality, falls, physical activity, morbidities, use of health services, use of medications, food, oral health, and violence, evaluated in the first (2009/2010) and in the second wave (2013/2014). Additionally, in the second wave, we investigated the issue of discrimination and quality of life. RESULTS: The response rate of the first wave was 89.2% (n = 1,705). The baseline sample, with predominance of women (63.9%), was similar to the 2010 Census regarding age for women and slightly different for younger men. In the second wave, 1,197 participants were interviewed (response rate of 70.3%). Follow-up losses were only observed for the variable age group (p = 0.003), and predominantly for those aged 80 years or more. Mortality data linkage and active search for participants were used as a follow-up strategies. CONCLUSIONS: This study used strategies that were able to help locate the participants and maintain adherence, which ensured a good response rate during investigations.

Condições de vida e saúde de idosos: resultados do estudo de coorte EpiFloripa Idoso / Condiciones vida y salud de adultos mayores: resultados del estudio de cohortes EpiFloripa Idoso / Life and health conditions among elderly: results of the EpiFloripa Idoso cohort study

OBJETIVO: identificar as mudanças sociodemográficas, comportamentais e de saúde ocorridas ao longo do tempo nos participantes do estudo de coorte EpiFloripa Idoso. MÉTODOS: estudo longitudinal de base populacional com idosos de Florianópolis-SC, Brasil. RESULTADOS: entrevistou-se 1.702 idosos em 2009-2010 e 1.197 em 2013-2014 (proporções de resposta: 89,1% e 70,2%, respectivamente); após aproximadamente 4 anos, a maioria manteve-se com companheiro (53,4%), morando acompanhado (76,0%), sem trabalhar (78,0%), com percepção positiva de saúde (44,0%), sem usar internet (67,5%), sem fumar (57,5%), sem consumir bebida alcoólica (53,3%), insuficientemente ativo (56,3%), consumindo <5 porções diárias de frutas/hortaliças (57,3%), sem dependência (60,5%), com excesso de peso (47,0%) e rastreamento negativo para deficit cognitivo (69,4%), sem sintomas depressivos (72,0%) e sem sofrer quedas (60,6%). CONCLUSÕES: a maioria dos idosos não apresentou mudanças importantes em suas características sociodemográficas, comportamentais e de saúde; ressalta-se a necessidade de repensar ações mais efetivas para a melhoria da saúde dos idosos.

OBJETIVO: Identificar los cambios en el comportamiento, la demografía y las condiciones de salud en un seguimiento de los participantes de la encuesta de salud, EpiFloripa Idoso. MÉTODOS: Estudio poblacional longitudinal con adultos mayores de Florianópolis-SC, Brasil. RESULTADOS: Fueron entrevistados 1.702 ancianos en 2009-2010 y 1.197 en 2013-2014 (tasas de respuesta: 89,1% y 70,2%, respectivamente); entre los acompañados, la mayoría, se mantuvo con una pareja (54,4%), viviendo juntos (76,0%), sin trabajar (78,6%), mostraron una percepción positivo de salud (45,0%), sin utilizar Internet (67,3%), sin fumar (57,2%), sin consumir alcohol (52,6%), insuficientemente activos (55,9%), comiendo <5 porciones de frutas/verduras (49,0%), sin dependencia (60,8%), sobrepeso (46,0%), detección negativa para el deterioro cognitivo (68,8%), síntomas depresivos (76,9%) y sin sufrir caídas (60,6%). CONCLUSIONES: la mayoría de las personas mayores no mostraron cambios significativos en sus características analizadas; se hace hincapié en la necesidad de replantear la acción más efectiva para mejorar la salud de los adultos mayores.

OBJECTIVE: to identify sociodemographic, behavioral and health changes in a follow-up of participants in the health survey EpiFloripa Idoso. METHODS: this is a population-based longitudinal study with elderly individuals in Florianópolis-SC, Brazil. RESULTS: 1,702 elderly individuals were interviewed in 2009-2010 and 1,197 in 2013-2014 (response rate: 89.1% and 70.2%, respectively); among followed-up individuals, most of them remained with a partner (53.4%), living with other people (76.0%), not working (78.0%), with positive health perception (44.0%), not using the Internet (67.5%), not smoking (57.5%), not consuming alcohol (53.3%), not physically active (56.3%), consuming <5 servings of fruits/vegetables (57.3%), independent (60.5%), overweight (47.0%), with negative screening for cognitive impairment (69.4%), with no depressive symptoms (72.0%) and not having suffered falls (60.6%). CONCLUSION: most elderly did not show significant changes in their sociodemographic, behavioral and health characteristics; the need to rethink more effective actions to improve the elderly health stands out.

Life and health conditions among elderly: results of the EpiFloripa Idoso cohort study. / Condições de vida e saúde de idosos: resultados do estudo de coorte EpiFloripa Idoso.

OBJECTIVE: to identify sociodemographic, behavioral and health changes in a follow-up of participants in the health survey EpiFloripa Idoso. METHODS: this is a population-based longitudinal study with elderly individuals in Florianópolis-SC, Brazil. RESULTS: 1,702 elderly individuals were interviewed in 2009-2010 and 1,197 in 2013-2014 (response rate: 89.1% and 70.2%, respectively); among followed-up individuals, most of them remained with a partner (53.4%), living with other people (76.0%), not working (78.0%), with positive health perception (44.0%), not using the Internet (67.5%), not smoking (57.5%), not consuming alcohol (53.3%), not physically active (56.3%), consuming <5 servings of fruits/vegetables (57.3%), independent (60.5%), overweight (47.0%), with negative screening for cognitive impairment (69.4%), with no depressive symptoms (72.0%) and not having suffered falls (60.6%). CONCLUSION: most elderly did not show significant changes in their sociodemographic, behavioral and health characteristics; the need to rethink more effective actions to improve the elderly health stands out.

EpiFloripa Aging cohort study: methods, operational aspects, and follow-up strategies / Estudo de coorte EpiFloripa Idoso: métodos, aspectos operacionais e estratégias de seguimento

ABSTRACT OBJECTIVE To describe the sample plan, operational aspects, and strategies used in the 2009/2010 and 2013/2014 EpiFloripa Aging Study. METHODS The EpiFloripa Aging is a population-based longitudinal study with 1,705 older adults (60 years or more) living in the municipality of Florianópolis, State of Santa Catarina, Brazil, in 2009/2010 (baseline). The research was conducted with a face-to-face interviews, organized into blocks of identification, socioeconomic, mental health, health and life habits, global functionality, falls, physical activity, morbidities, use of health services, use of medications, food, oral health, and violence, evaluated in the first (2009/2010) and in the second wave (2013/2014). Additionally, in the second wave, we investigated the issue of discrimination and quality of life. RESULTS The response rate of the first wave was 89.2% (n = 1,705). The baseline sample, with predominance of women (63.9%), was similar to the 2010 Census regarding age for women and slightly different for younger men. In the second wave, 1,197 participants were interviewed (response rate of 70.3%). Follow-up losses were only observed for the variable age group (p = 0.003), and predominantly for those aged 80 years or more. Mortality data linkage and active search for participants were used as a follow-up strategies. CONCLUSIONS This study used strategies that were able to help locate the participants and maintain adherence, which ensured a good response rate during investigations.

RESUMO OBJETIVO Descrever o plano amostral, aspectos operacionais e estratégias utilizadas no Estudo EpiFloripa Idoso 2009/2010 e 2013/2014. MÉTODOS O EpiFloripa Idoso é um estudo de base populacional com 1.705 idosos (60 anos ou mais) residentes no município de Florianópolis, SC, em 2009/2010 (linha de base). A investigação foi realizada por meio de entrevista face a face, organizada nos blocos de identificação, geral (características socioeconômicas), saúde mental, saúde e hábitos de vida, funcionalidade global, quedas, atividade física, morbidades, uso de serviços de saúde, uso de medicamentos, alimentação, saúde bucal e violência, avaliados na primeira (2009/2010) e na segunda onda (2013/2014). Adicionalmente, na segunda onda, investigou-se a temática de discriminação e qualidade de vida. RESULTADOS A taxa de resposta na primeira onda foi de 89,2% (n = 1.705). A amostra da linha de base, com predomínio de mulheres (63,9%), foi semelhante ao Censo 2010 em relação à idade nas mulheres e ligeiramente diferente nos homens mais jovens. Na segunda onda, 1.197 participantes foram entrevistados (taxa de resposta de 70,3%). Houve perda de seguimento somente para a variável faixa etária (p=0,003), principalmente naqueles com 80 anos ou mais. Utilizou-se como estratégias de seguimento o relacionamento de dados e a busca ativa. CONCLUSÕES O presente estudo utilizou estratégias que conseguiram auxiliar na localização dos participantes e manutenção da aderência, o que garantiu boa taxa de resposta durante as investigações.

Quality of life and its association with work, the Internet, participation in groups and physical activity among the elderly from the EpiFloripa survey, Florianópolis, Santa Catarina State, Brazil.

The study aimed to investigate the association between changes in social relations and physical activity on the quality of life of the elderly in the city of Florianópolis, Santa Catarina state, Brazil. Data on 1,197 elderly from two waves of the population and household survey, EpiFloripa Idoso, were analyzed. Multiple linear regression was performed to estimate association of social change variables and lifestyle on quality of life score (QoL; measured by CASP-16 Brazil, score can range from 0, which represents no QoL to 48, total satisfaction in all domains of CASP). The average QoL score in the sample was 37.6 (95%CI: 37.2; 38.1). The social relations that were associated with positive QoL score were to start to work, to continue to use the Internet, to start participating in religious or lifestyle groups, to remain and to become physically active, and for those who were physically active, but became inactive in the second wave. To remain living with family had a negative effect on QoL score for the elderly. Some changes in social relations had a positive effect on QoL, and results reaffirmed the importance of physical activity to healthy aging, since to pursue it in some of the waves was better than to remain inactive.

Quality of life and its association with work, the Internet, participation in groups and physical activity among the elderly from the EpiFloripa survey, Florianópolis, Santa Catarina State, Brazil / Qualidade de vida e a associação com trabalho, Internet, participação em grupos e atividade física em idosos do Estudo EpiFloripa, Florianópolis, Santa Catarina, Brasil / Calidad de vida y asociación con el trabajo, Internet, participación en grupos y actividad física en ancianos del Estudio EpiFloripa, Florianópolis, Santa Catarina, Brasil

Abstract: The study aimed to investigate the association between changes in social relations and physical activity on the quality of life of the elderly in the city of Florianópolis, Santa Catarina state, Brazil. Data on 1,197 elderly from two waves of the population and household survey, EpiFloripa Idoso, were analyzed. Multiple linear regression was performed to estimate association of social change variables and lifestyle on quality of life score (QoL; measured by CASP-16 Brazil, score can range from 0, which represents no QoL to 48, total satisfaction in all domains of CASP). The average QoL score in the sample was 37.6 (95%CI: 37.2; 38.1). The social relations that were associated with positive QoL score were to start to work, to continue to use the Internet, to start participating in religious or lifestyle groups, to remain and to become physically active, and for those who were physically active, but became inactive in the second wave. To remain living with family had a negative effect on QoL score for the elderly. Some changes in social relations had a positive effect on QoL, and results reaffirmed the importance of physical activity to healthy aging, since to pursue it in some of the waves was better than to remain inactive.

Resumo: O estudo teve como objetivo investigar a associação entre mudanças nas relações sociais e na atividade física sobre qualidade de vida entre idosos na cidade de Florianópolis, Santa Catarina, Brasil. Foram analisados dados sobre 1.197 idosos de duas ondas do inquérito populacional e domiciliar, EpiFloripa Idoso. A regressão linear múltipla foi usada para estimar a associação entre variáveis de mudança social e de estilo de vida sobre qualidade de vida, medida pelo instrumento CASP-16 Brasil, com uma pontuação de zero até 48, que representa satisfação completa em todos os domínios de qualidade de vida no CASP. A média de qualidade de vida foi 37,6 (IC95%: 37,2; 38,1). As relações sociais associadas com pontuação alta em qualidade de vida foram iniciar um trabalho, continuação do uso da Internet, iniciar a participação em grupo religioso ou de convivência e permanecer e se tornar fisicamente ativo, e para aqueles fisicamente ativos, mas que se tornaram inativos na segunda onda. Para os idosos, continuar vivendo com familiares teve um efeito negativo sobre qualidade de vida. Algumas mudanças nas relações sociais tiveram um efeito positivo sobre qualidade de vida, e os resultados reafirmaram a importância da atividade física para o envelhecimento saudável, uma vez que a procura da vida ativa foi mais importante do que permanecer inativo.

Resumen: El estudio tuvo como objetivo investigar la asociación entre cambios en las relaciones sociales y en la actividad física sobre la calidad de vida entre ancianos en la ciudad de Florianópolis, Santa Catarina, Brasil. Se analizaron datos de 1.197 ancianos de dos olas de la encuesta poblacional y domiciliaria, EpiFloripa Idoso. La regresión lineal múltiple se usó para estimar la asociación entre variables de cambio social y de estilo de vida sobre la calidad de vida, medida por el instrumento CASP-16 Brasil, con una puntuación de cero a 48, que representa satisfacción completa en todos los dominios de calidad de vida en el CASP. La media de calidad de vida fue 37,6 (IC95%: 37,2; 38,1). Las relaciones sociales, asociadas con una puntuación alta en calidad de vida fueron: comenzar un trabajo, continuación en el uso de Internet, iniciar la participación en un grupo religioso o de convivencia y permanecer y convertirse en alguien físicamente activo, y para aquellos que son físicamente activos, pero que se hicieron inactivos en la segunda ola. Para los ancianos, continuar viviendo con familiares tuvo un efecto negativo sobre calidad de vida. Algunos cambios en las relaciones sociales tuvieron un efecto positivo sobre la calidad de vida, y los resultados reafirmaron la importancia de la actividad física para el envejecimiento saludable, puesto que la búsqueda de una vida activa fue más importante que permanecer inactivo.

Demographic, health conditions, and lifestyle factors associated with urinary incontinence in elderly from Florianópolis, Santa Catarina, Brazil / Fatores demográficos, condições de saúde e hábitos de vida associados à incontinência urinária em idosos de Florianópolis, Santa Catarina

To determine the prevalence and factors associated with urinary incontinence in the elderly population of Florianópolis, in the State of Santa Catarina, Brazil.

Determinar a prevalência e os fatores associados à incontinência urinária na população idosa de Florianópolis, no Estado de Santa Catarina.

Demographic, health conditions, and lifestyle factors associated with urinary incontinence in elderly from Florianópolis, Santa Catarina, Brazil.

OBJECTIVE: To determine the prevalence and factors associated with urinary incontinence in the elderly population of Florianópolis, in the State of Santa Catarina, Brazil. METHODS: We used data from EpiFloripa Idoso 2009/2010 survey, a cross-sectional population-based study including 1,705 elderly of both the sexes. Poisson's regression (crude and adjusted analysis) was applied to verify the association between the urinary incontinence outcome and exploratory variables (sociodemographic, lifestyle, and health conditions). RESULTS: Among the elderly, 29.4% reported urinary incontinence; 36.3% were women and 17.0% men. The factors associated with greater prevalence of urinary incontinence were being female, aged more than 70 years old, having 0 to 4 schooling years, being insufficiently active, having bronchitis or asthma, stroke or cerebral ischemia, presenting mild or moderate/severe dependence, and polypharmacy. CONCLUSION: The prevalence of urinary incontinence was high among the investigated elderly. Sociodemographic variables and those related to lifestyle and health conditions were associated with higher prevalence of urinary incontinence. Knowledge of the factors associated with urinary incontinence in aged individuals can guide actions to reduce and prevent this important issue, which affects the elderly.

Doenças do Aparelho Circulatório: Principal Causa de Internações de Idosos no Brasil entre 2003 e 2012 / Circulatory Diseases: Leading Cause of Hospitalization of Elderlies in Brazil between 2003 and 2012

Descrever as internações de idosos por doençasdo aparelho circulatório (DAC), no Brasil e regiões, de 2003a 2012. Material e métodos: Trata-se de um estudo ecológicoreferente às internações hospitalares de idosos por DAC,por local de residência. Os dados são originados do Sistemade Informações Hospitalares do Sistema Único de Saúde(SIH/SUS). Resultados: No Brasil, as DAC constituíram aprimeira causa de internações em idosos, em todos os anosanalisados. Seguida das DAC, as principais causas foramas doenças do aparelho respiratório, digestivo e neoplasias,com exceção para o ano de 2008, no qual as doençasinfecciosas e parasitárias ocuparam o quarto lugar.Observou-se que a região sul apresentou maior taxa deinternações pela doença em questão quando comparada asdemais regiões do Brasil, em toda série histórica. Porém, astaxas reduziram gradualmente ao longo do período, da mesmaforma em todas as regiões, em destaque na região centrooeste,a qual sofreu o maior declínio, de 49,4%. Os homensapresentaram maiores taxas, tanto na forma bruta, quantona forma padronizada, em todas as regiões e Brasil, quandocomparados às mulheres, em 2003. Entretanto, o quadroreverteu em 2012, em relação a forma padronizada, na qualas mulheres apresentaram taxas mais elevadas deinternações por DAC. Conclusão: As DAC representam aprincipal causa de internação entre os idosos, e tem reduzidoao longo do período estudado. Assim precisam sercontinuamente avaliadas e os programas que visam suaprevenção e promoção da saúde devem ser mantidos eaprimorados...

To describe the hospitalization of elderly bycirculatory system diseases (CD) in Brazil and Brazilianregions from 2003 to 2012. Material and Methods: This wasan ecological study evaluating hospital admissions of elderlydue to CD by place of residence. The data was collectedfrom the Hospital Information System of the Unified HealthSystem (SIH/SUS). Results: In Brazil, CD were the leadingcause of hospitalization of elderlies over the ten-year periodanalyzed. The main causes followed by CD were diseasesof the respiratory system, digestive system and neoplasms;except in 2008, where the third cause was infectious andparasitic diseases. The Southern region showed the highestrate of admissions for CD, compared to other regions ofBrazil throughout the years. However, the rates graduallyreduced over the period in all regions, in particular theMidwest, which suffered the biggest decline, 49.4%. In 2003,men had higher hospitalization rates in all regions of Brazilthan women according to the crude and standard analysis.However, this scenario reversed in 2012, in which womenpresented higher hospitalization rates due to CD accordingto the standard analysis. Conclusion: CD are the leadingcause of hospitalization among the elderly, although it reducedover the studied period. Thus, CD should continually bemonitored, and the programs aimed at its prevention andhealth promotion should be maintained and enhanced...