Osteosarcopenia later in life: Prevalence and associated risk factors.

BACKGROUND AND AIMS: The identification of risk factors for osteosarcopenia in older adults is important for planning preventative strategies in clinical practice. Therefore, our study aimed to investigate the prevalence and risk factors associated with osteosarcopenia in older adults using different diagnostic criteria. METHODS: The sample included 171 community-dwelling older adults with a mean age of 79.4 ± 5.9 years and mean body mass index of 25.67 ± 4.70 kg/m2. We analyzed sociodemographic, biomarkers, lifestyle, and health condition data from participants of the "Projeto Idosos - Goiânia" cohort study. The outcome osteosarcopenia was defined as the simultaneous occurrence of sarcopenia and osteopenia. Osteopenia was diagnosed by low lumbar spine bone mineral density (BMD) using dual-energy X-ray absorptiometry (DEXA). Sarcopenia was diagnosed using handgrip dynamometry and appendicular skeletal mass index assessed by DEXA following the criteria of the two European consensuses on sarcopenia (2010 and 2018). Two osteosarcopenia outcome variables were evaluated: OsteoSarc1 and OsteoSarc2 using the 2010 and 2018 European sarcopenia consensus criteria, respectively. Multivariate Poisson regression analysis was used to calculate the prevalence ratios (PRs). RESULTS: The prevalence of OsteoSarc1 and OsteoSarc2 were 12.8% and 7.2%, respectively, with no significant gender differences. OsteoSarc1 was associated with low potassium (PR: 3.39, 95% confidence interval [CI]: 1.10-10.43) and malnutrition (PR: 3.84, 95% CI: 1.78-8.30). OsteoSarc2 was associated with being ≥80 years (PR: 7.64, 95% CI: 1.57-37.07), >4 years of education (PR: 3.25, 95% CI: 1.03-10.22), alcohol consumption (PR: 2.41, 95% CI: 1.01-5.77), low potassium (PR: 2.22, 95% CI: 1.45-6.87), low serum vitamin D (PR: 4.47, 95% CI: 1.68-11.88), and malnutrition (PR: 5.00, 95% CI: 1.06-23.51). CONCLUSIONS: OsteoSarc1 had a higher prevalence. The risk factors associated with the two outcomes were malnutrition and potassium level, as well as other risk factors, such as alcohol consumption and low vitamin D level. These findings may contribute to the prevention or treatment of this health condition in older adults.

Environmental and behavioral factors associated with household transmission of SARS-CoV-2 in children and adolescents.

Objective: To analyze the association between risk behaviors and environmental factors and SARS-CoV-2 infection in children and adolescents in the family environment. Methods: Cross-sectional study. A total of 267 children and adolescents aged 5-19 years who have contact with COVID-19-positive essential workers were tested between June and October 2020. Behavioral and environmental variables associated with SARS-CoV-2 infection were investigated. Association between these variables was performed using Poisson regression. Results: SARS-CoV-2 prevalence was 25.1%. Following the confirmation of COVID-19 diagnosis of the index case, 92.1% of adults reported hand hygiene and 83.5% showed habits of respiratory etiquette. However, 12.7% wore masks in common areas of the residence before COVID-19. Sharing common objects was a risk factor for SARS-CoV-2 infection in the sample. Conclusion: Sharing objects among family members was identified as a risk factor associated with SARS-CoV-2 infection in children and adolescents who lived with infected adults. There was high frequency of hand hygiene and low prevalence of mask use.

Low Vaccine Coverage and Factors Associated with Incomplete Childhood Immunization in Racial/Ethnic Minorities and Rural Groups, Central Brazil.

Discrimination and limited access to healthcare services in remote areas can affect vaccination coverage. Therefore, this study aimed to estimate vaccination coverage for children living in quilombola communities and rural settlements in the central region of Brazil during their first year of life and to analyze the factors associated with incomplete vaccination. An analytical cross-sectional study was conducted on children born between 2015 and 2017. The percentage of children who received all vaccines recommended by the National Immunization Program in Brazil by 11 months and 29 days was used to calculate immunization coverage. Children who received the following vaccines were considered as having a complete basic vaccination schedule: one dose of BCG; three doses of Hepatitis B, of Diphtheria-Tetanus-Pertussis (DPT), of Haemophilus influenzae type b (Hib), and of Poliovirus (Polio); two doses of Rotavirus, of 10-valent pneumococcal (PCV10), and of Serogroup C meningococcal conjugate (MenC); and one dose of Yellow Fever (YF). Measles-mumps-rubella (MMR) and other doses recommended at or after 12 months were not included. Consolidated logistic regression was used to identify factors associated with incomplete vaccination coverage. Overall vaccination coverage was 52.8% (95% CI: 45.5-59.9%) and ranged from 70.4% for the Yellow Fever vaccine to 78.3% for the Rotavirus vaccine, with no significant differences between the quilombola and settler groups. Notably, the likelihood of incomplete general vaccination coverage was higher among children who did not receive a visit from a healthcare professional. Urgent strategies are required to achieve and ensure health equity for this unique and traditionally distinct group with low vaccination coverage.

Cardiovascular risk factors in the elderly: a 10-year follow-up survival analysis.

AIMS: Cardiovascular risk factors present a high prevalence and have an impact on the morbimortality of the elderly; however, studies evaluating the impact of cardiovascular risk factors in the elderly have had short follow-up times and have not allowed specific analyses of the effects of these factors in the aged population, including how they affect the survival of the elderly. This study aimed to analyse the survival of elderly individuals living in the community, considering the presence of cardiovascular risk factors. METHODS AND RESULTS: A prospective 10-year follow-up was initiated in 2008 with a cohort of 418 elderly people living in a community in Central Brazil. The Kaplan-Meier method and the Cox proportional hazards model were used to examine the association between survival and cardiovascular risk factors. The mean age of the participants was 70.6 (±7.1) years; most participants were hypertensive (81.6%) and participated in irregular physical activity (44%), and 43.3% smoked. After a mean follow-up of 8.38 (±2.82) years, 59.3% had survived and 34.1% had died; among the deaths, 14.1% were due to cardiovascular causes. Age [hazard ratio (HR) 1.067, 95% confidence interval (CI) 1.027-1.109], hypertension (HR 3.178, 95% CI 1.144-8.826), and smoking (HR 2.235, 95% CI 1.253-3.987) were confirmed as risk factors for reduced survival, whereas physical activity was a protective factor (HR 0.456, 95% CI 0.206-1.007). CONCLUSION: The results from this study highlight the need for educational policies towards hypertension and smoking prevention among elderly people, and participation in physical activity needs to be encouraged.

Temporal trend in venous thromboembolism hospitalization rates in Brazilian older adults, 2010-2020.

Aging is one of the main risk factors for venous thromboembolism (VTE). Changes in prevention, diagnosis, and treatment strategies for this condition in recent years require an analysis of its rates in health services. The objective of this study was to analyze a temporal trend of hospitalizations for VTE in Brazilian older adults. This ecological time series study used data from the Hospital Information System (HIS) on VTE hospitalizations from 2010 to 2020, selecting admissions with the main diagnosis of pulmonary thromboembolism (PTE) (I.26.0, I.26.9) and deep vein thrombosis (DVT) (I.80.0, I80.1, I80.2, I80.3, I80.8, I80.9). Hospitalization rates were calculated for each year and the Prais-Winsten. In Brazil, the trend of hospitalizations for VTE decreased, with an annual percentage change of - 40.71 (confidence interval [CI] - 50.46; - 29.04). DVT decreased, with an annual percentage change of - 43.14 (95% confidence interval [CI] - 51.36; - 33.54). All Brazilian regions showed a downward trend in hospitalizations for VTE and DVT, except for the Northeast region, which remained stable. Conversely, the trend of hospitalizations for PTE showed an upward in Brazil, with an annual percentage change of 4.33 (95% CI 1.26; 7.48). An upward trend was observed in hospitalizations for PTE in the Northeast region, and a stationary trend was observed in the other regions. The results showed a downward trend in hospitalization rates for DVT and an upward trend for PTE. The study indicates regional differences in rates and trends.

Agentes antitrombóticos utilizados por pessoas idosas: prevalência e fatores associados / Antithrombotic agents used by older people: prevalence and associated factors

Resumo Objetivo Analisar os tipos e a prevalência da utilização de medicamentos antitrombóticos por pessoas idosas, e os fatores associados. Método Estudo transversal com pessoas idosas domiciliares, na cidade de Goiânia, Centro-Oeste do Brasil. A classificação farmacológica dos medicamentos antitrombóticos foi efetuada de acordo com a classificação Anatômico Terapêutico Químico (Anatomical Therapeutic Chemical - ATC). Realizada análise bivariada e múltipla com nível de significância de 5%. Resultados Participaram do estudo 212 idosos com prevalência de uso de medicamentos antitrombóticos de 27,8%. Os tipos mais utilizados foram: ácido acetilsalicílico (AAS) (n= 49; 83%), Clopidogrel (n=6; 10,1%) e Cilostazol (n=4; 6,7%). Os fatores associados foram: faixa etária de 70-79 anos (p<0,001) e a polifarmácia (p<0,001). Conclusão A proporção do uso de antitrombóticos foi alta entre os idosos, e os fármacos mais consumidos possuem risco de complicações e de interações medicamentosas. A vigilância deve ser maior naqueles com mais de 70 anos e em polifarmácia, sendo necessário empreender esforços para o acompanhamento clínico desses idosos em terapia antitrombótica farmacológica.

Abstract Objective To analyze the types and prevalence of use of antithrombotic drugs by older people and associated factors. Method A cross-sectional study of community-dwelling older people was carried out in the city of Goiânia, Midwest Brazil. The pharmacological classification of antithrombotic drugs was performed according to the Anatomical Therapeutic Chemical (ATC) classification. Bivariate and multivariate analyses were performed with a significance level of 5%. Results 212 older people participated in the study and the prevalence of antithrombotic drug use was 27.8%. The most used types were acetylsalicylic acid (ASA) (n= 49; 83%), Clopidogrel (n=6; 10.1%) and Cilostazol (n=4; 6.7%). Associated factors were the 70-79 years age group (p<0.001) and polypharmacy (p<0.001). Conclusion The proportion of antithrombotic use by the participants was high and the most used drugs posed a risk of complications and drug-drug interactions. Attention should be heightened in individuals aged >70 years and in use of polypharmacy and efforts must be made to clinically monitor these users of antithrombotic drugs therapy.

Qualidade de vida de cuidadores familiares de pessoas idosas acamadas / Calidad de vida de cuidadores familiares de adultos mayores encamados / Quality of life of family caregivers of bedridden older adults

Resumo Objetivo Avaliar a qualidade de vida dos cuidadores familiares e sua relação com as condições socioeconômicas, de saúde e de prestação de cuidado. Métodos Estudo transversal e analítico realizado na cidade de Palmas/TO, no período de 2020-2022, com amostra de 49 cuidadores familiares de idosos acamados. A qualidade de vida foi avaliada pelo instrumento "12-Item- Short- Form Health Survey" (SF-12). Para verificar a relação entre os componentes físico e mental e variáveis independentes, utilizou-se o Teste T. Resultados Os cuidadores apresentaram valores médios do componente físico de 43,26 pontos (IC 95%: 39,87 - 46,64) e no componente mental, de 50,98 pontos (IC 95%: 47,96 - 54,00). Encontraram-se diferenças significativas entre os escores do componente mental para disfunção familiar, consumo de bebida alcóolica e sobrecarga; e, entre o componente físico para multimorbidade, polifarmácia, índice de massa corpórea e sobrecarga. Conclusão Os achados deste estudo demonstraram relação entre condições sociais, de saúde, cuidado e qualidade de vida, concedendo assim conhecimento aos profissionais de saúde para orientá-los no planejamento de ações que visem a melhoria da qualidade de vida do cuidador.

Resumen Objetivo Evaluar la calidad de vida de los cuidadores familiares y su relación con las condiciones socioeconómicas, de salud y de prestación de cuidado. Métodos Estudio transversal y analítico realizado en la ciudad de Palmas, estado de Tocantins, en el período 2020-2022, con una muestra de 49 cuidadores familiares de adultos mayores encamados. La calidad de vida fue evaluada mediante el instrumento "12-Item- Short- Form Health Survey" (SF-12). Se utilizó el test-T para verificar la relación entre los componentes físicos y mentales y las variables independientes. Resultados Los cuidadores presentaron un valor promedio del componente físico de 43,26 puntos (IC 95 %: 39,87 - 46,64) y del componente mental de 50,98 puntos (IC 95 %: 47,96 - 54,00). Se observaron diferencias significativas en la puntuación del componente mental en disfunción familiar, consumo de bebida alcohólica y sobrecarga; y en el componente físico, en multimorbilidad, polifarmacia, índice de masa corporal y sobrecarga. Conclusión Los resultados de este estudio demostraron que existe relación entre las condiciones sociales, de salud, cuidado y calidad de vida, lo que permite que los profesionales de la salud tengan conocimientos para la planificación de acciones que busquen mejorar la calidad de vida de del cuidador.

Abstract Objective To assess the quality of life of family caregivers and their relationship with socioeconomic, health and care conditions. Methods a cross-sectional and analytical study carried out in the city of Palmas/TO, in the period of 2020-2022, with a sample of 49 family caregivers of bedridden older adults. Quality of life was assessed by the instrument "12-Item- Short- Form Health Survey" (SF-12). To verify the relationship between physical and mental components and independent variables, the t-test was used. Results Caregivers presented mean values of the physical component of 43.26 points (95% CI: 39.87 - 46.64) and the mental component of 50.98 points (95% CI: 47.96 - 54.00). Significant differences were found between the scores of the mental component for family dysfunction, alcohol consumption and overload, and between the physical component for multimorbidity, polypharmacy, body mass index and overload. Conclusion The findings of this study demonstrated a relationship between social conditions, health, care and quality of life, thus granting knowledge to health professionals to guide them in planning actions aimed at improving caregivers' quality of life.

Access and Use of Health Services by People with Diabetes from the Item Response Theory.

The objective of this study was to analyze the indicators of access and use of health services in people with diabetes mellitus. This study used data from the National Health Survey, conducted in Brazil in 2013. The National Health Survey was carried out with adults aged 18 years or older residing in permanent private households in Brazil. Indicators from 492 individuals with self-reported diabetes mellitus living in the Central-West region of the country were analyzed. Item response theory was used to estimate the score for access to and use of health services. Multiple linear regression was used to analyze factors associated with scores of access and use of health services by people with diabetes mellitus. The mean score of access estimated by the item response theory and use estimated was 51.4, with the lowest score of zero (lowest access and use) and the highest 100 (highest access and use). Among the indicators analyzed, 74.6% reported having received medical care in the last 12 months and 46.4% reported that the last visit occurred in primary care. Only 18.9% had their feet examined and 29.3% underwent eye examinations. Individuals of mixed-race/skin color and those residing outside capital and metropolitan regions had lower access and use scores when compared to white individuals and residents of state capitals, respectively. The study shows several gaps in the indicators of access and use of health services by people with diabetes. People of mixed race/skin color and residents outside the capitals and metropolitan regions had lower scores for access and use, suggesting the need to increase health care in these groups.

Does Abdominal Obesity Increase All-Cause, Cardiovascular Disease, and Cancer Mortality Risks in Older Adults? A 10-Year Follow-Up Analysis.

There is insufficient evidence on the impact of abdominal obesity (AO) on mortality in older adults. Therefore, the objective to analyze the 10-year impact of AO, assessed using different diagnostic criteria, on all-cause, cardiovascular disease (CVD), and cancer mortality in older adults. In this prospective cohort study of older adults (≥60 years), sociodemographic, lifestyle, clinical history, laboratory test, and anthropometric data were analyzed. The considered were used for AO diagnostic: waist circumference (WC) of ≥88 cm for women and ≥102 cm for men; WC of ≥77.8 cm for women and ≥98.8 cm for men; and increased waist-to-hip ratio (WHR), being the highest tertile of distribution by sex. Multivariate Cox regression and Kaplan-Meier analyses were performed. A total of 418 individuals, with an average age of 70.69 ± 7.13 years, participated in the study. In the analysis adjusted for sex and age, WHR was associated with a high risk of all-cause mortality (p = 0.044). Both cutoff points used for the WC were associated with an increased CVD mortality risk. None of the AO parameters were associated with cancer mortality. An increased WHR was associated to a higher all-cause mortality risk factor, while an increased WC was a risk factor for a higher CVD mortality in older adults.

Sarcopenia and mortality risk in community-dwelling Brazilian older adults.

We estimated the impact of sarcopenia parameters on mortality risk and assessed its prevalence and associated factors in the older adults according to the European Working Group on Sarcopenia in Older People's 2010 (EWGSOP1) and 2018 (EWGSOP2) criteria. This was a 10-year follow-up cohort study. Low muscle mass (MM) was defined as low skeletal muscle mass index (SMI) using dual-energy X-ray absorptiometry (DXA), and low calf circumference (CC). Cox regression and the Kaplan-Meier method were performed. The prevalence of sarcopenia and associated factors were influenced by the MM measurement method and diagnostic criteria used [6.8% (SMI and EWGSOP2), 12.8% (CC and EWGSOP2; and SMI and EWGSOP1) and 17.4% (CC and EWGSOP1)]. While a low BMI was associated with sarcopenia regardless of the sarcopenia definitions, diabetes, and high TGs were associated with sarcopenia only when using the EWGSOP1 criteria. Low SMI increased mortality risk (EWGSOP1: HR = 2.01, 95% CI 1.03-3.92; EWGSOP2: HR = 2.07, 95% CI 1.05-4.06). The prevalence of sarcopenia was higher according to EWGSOP1 than EWGSOP2. A low BMI, diabetes, and high TGs were associated with sarcopenia. A low SMI doubled the risk of mortality in community-dwelling older adults.

Screening for common mental disorder in elderly residents in the countryside: a cross-sectional study.

OBJECTIVE: To estimate the prevalence of common mental disorders and their associated factors in the elderly in a municipality in the countryside of the Brazilian Midwest. METHODS: Quantitative, observational, cross-sectional approach research, conducted with 218 elderly people. RESULTS: The prevalence of the common mental disorder among the elderly was 25.1%; in the univariate analysis, it was higher in females (35.4%), in the age group of 80 years or older (46.1%), brown skin color (30.2%), widowed (42.6%), illiterate (47.6%), and retired (27.6%). In the multiple analysis, the variables female gender (p<0.006), age 80 years or older (p<0.036), dissatisfaction with life (p<0.009), lack of social interaction (p=0.017), and dysfunctional family (p=0.021) remained associated with CMD. CONCLUSION: The results revealed are helpful and contribute to the reinforcement of the need for mental health care in this population extract so growing worldwide.

Risk factors for potentially inappropriate medication use in older adults: a cohort study.

BACKGROUND: Much of the knowledge on the use of potentially inappropriate medications (PIM) in older adults is derived from cross-sectional studies, with little known about the risk factors over time. AIM: Longitudinal analysis was applied to estimate the occurrence and risk factors of PIM use among older adults in a 10-year follow-up. METHOD: Longitudinal study with 418 older adult residents of a capital city of Central-West Brazil. The PIM were classified according to the Beers criteria 2019. The usage rate was calculated at baseline (2008) and at the 10-year follow-up moment (2018). Analysis of predictors (sociodemographic, self-rated health, hospitalization, number of comorbidities, polypharmacy, diabetes, hypertension, hypercholesterolemia and nutritional status) was performed using Generalized Estimating Equation (GEE) models. RESULTS: Mean age at baseline was 70.6 years (SD 7.1) and 76% were women; 221 older adults took part in the follow up. The rate of PIM use was 50.4% at baseline and 57.5% at the 10-year follow-up. Multiple analysis showed that PIM use in the cohort was statistically higher in the older adults with a history of hospitalization (RRadj 1.20; 95% CI 1.01-1.40), with three or more diseases (RRadj 1.41; 95% CI 1.14-1.74), with polypharmacy (RRadj 1.81; 95% CI 1.47-2.24) and with diabetes mellitus (RRadj 1.24; 95% CI 1.05-1.47). CONCLUSION: A high level of potentially inappropriate medication use was observed, reaching 50% of the older adults, with a 7% increase in the prevalence over the 10-year follow-up period. Hospitalization, multimorbidities, polypharmacy and diabetes mellitus were associated with the use of these medications. Interventions for surveillance of the deprescribing process need to be encouraged to avoid potential harm caused by the use of medications.

Low muscle mass and mortality risk later in life: A 10-year follow-up study.

INTRODUCTION: Little is known about the impact of low muscle mass (MM) assessed by calf circumference (CC), arm circumference (AC), arm muscle circumference (AMC), and corrected arm muscle circumference (CAMC)-on mortality risk later in life. We aimed to investigate the impact of low MM assessed by CC, AC, AMC and, CAMC on all-cause, cardiovascular, and cancer mortality risk. METHODS: Data came from 418 older adults who participated in a 10-year follow-up prospective cohort study. Low MM was defined as a CC < 33 cm for women and < 34 cm for men and by the lowest tertile of AC, AMC, and CAMC stratified by sex. The log rank test, Kaplan-Meier curves, and Cox regression were used. RESULTS: There were 147 deaths: 49 related to CVD and 22 to cancer. A small CC (HR = 1.57, 95% CI, 1.12-2.20), AMC (HR = 1.61, 95% CI, 1.13-2.30) and CAMC (HR = 1.45, 95% CI, 1.03-2.04) were associated with all-cause mortality. A small CAMC was a protective factor for CVD mortality (HR = 0.46, 95% CI, 0.22-0.98). In the Kaplan-Meier analysis, older adults with LMM presented low all-cause mortality survival, with AC (p < 0.05), AMC (p < 0.005), CAMC (p < 0.002), and CC (p < 0.001). Cancer mortality was associated with low CAMC (p < 0.020). CONCLUSIONS: Low MM assessed by anthropometric measures (AC, AMC, CAMC and CC) increased the all-cause mortality risk. A small CAMC decreased the CVD mortality.

Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study.

OBJECTIVE: To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities. METHODS: Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables. RESULTS: Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community. CONCLUSION: The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.

Predictors of hospital readmission after fractures: One-year follow-up study.

OBJECTIVE: Identify the incidence and predictive factors for readmissions of elderly hospitalized with fractures. METHOD: Prospective cohort study on 376 elderly people from a trauma referral large hospital in central Brazil. Data were collected from medical records of elderly people with radiological diagnosis of fractures. Readmission that occurs up to one year after the first discharge was defined the outcome variable. Pre- and post-admission characteristics were analyzed as predictive factors. Multiple analysis was performed using robust Poisson regression. RESULTS: The main cause of hospitalization was fracture of the femur (53.2%) and the most frequent trauma mechanism was fall from standing height (72.9%). The incidence of readmission was 20.7%, of which 30.5% were related to the fracture itself, with emphasis on Surgical Site Infection. The predictors of readmissions were: age range 60 to 69 years, COPD, delirium and fracture of the femur. CONCLUSIONS: The incidence of readmissions was high, with various causes and associated conditions pre-admission (age range 60-69, presenting COPD) and post-admission (delirium). The monitoring of these factors in the hospital environment is essential for prevention of readmissions.

Negative Self-Assessment of Health in Women: Association with Sociodemographic Characteristics, Physical Inactivity and Multimorbidity.

INTRODUCTION: Women present a higher prevalence of negative self-assessment of health (NSAH) when compared to men. However, there is a gap in the literature of factors associated with NSAH in women from developing countries such as Brazil. In addition, few studies have assessed the magnitude of the association between multimorbidity and NSAH in this population. Thus, the aim of this study was to evaluate the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity in women from the Midwest region of Brazil. METHODS: A study based on data from the National Health Survey, a household survey that investigated health situation, lifestyle and risk factors for chronic diseases in the adult population of Brazil, was held. Sampling was performed in multiple stages. The selected women answered a standardized questionnaire on sociodemographic data, self-assessment of health and potential determinants. Poisson regression was used to analyze the association between NSAH and sociodemographic characteristics, lifestyle and multimorbidity. A significance level of 0.05% was established. RESULTS: The study included 4233 women. The prevalence of NSAH found was 6.0% (95% Confidence Interval [95% CI]: 5.1-7.0%). There was an association between NSAH and advancing age, low schooling, physical inactivity and multimorbidity. Furthermore, there was an association between NSAH and diseases/disorders such as chronic back pain, systemic arterial hypertension, mental disorders, depression, cardiovascular diseases, stroke, cancer, hypercholesterolemia and diabetes mellitus. CONCLUSION: The prevalence of NSAH was low. A strong association was found between this variable and multimorbidity. In addition, increased age, low schooling and physical inactivity were predictors of NSAH in women.

Risk factors for pneumonia in hospitalized older people with femoral fractures: Results from a Brazilian prospective cohort.

BACKGROUND: Pneumonia is a common complication in older people who are hospitalized to treat different fractures, which increases morbimortality in this population. OBJECTIVES: Estimating the pneumonia incidence density in older people hospitalized to treat femoral fractures and identifying risk factors for this infection. METHODS: Prospective cohort study whose data were collected from a population of older people who were being treated for femoral fractures at a hospital in the central region of Brazil between September 2016 and February 2017. The pneumonia diagnosis was based on radiography and clinical tests. Incidence density was estimated according to gender, age, Charlson comorbidity index, polypharmacy, chronic pulmonary disease, admission to the intensive care unit, surgical treatment, and nasoenteral tube feeding. Magnitude of the associations was estimated by multiple Poisson regression. RESULTS: Among the 200 patients, the pneumonia incidence density was 13.04/1,000 person-days. For men and older people 80 years old or older, the pneumonia incidence density was 15.6/1,000 person-days and 18.3/1,000 person-days, respectively. After adjusting for age, gender, chronic pulmonary disease, and admission to the intensive care unit, use of nasoenteral tubes remained associated with occurrence of pneumonia in older people, and the risk of developing the infection was eight times higher in the population who received nasoenteral feeding than that calculated for the population that did not use the devices (p ≤ 0.001). CONCLUSION: Using nasoenteral tubes during hospital stays increased the risk of developing pneumonia in hospitalized older people, which reinforces the need for continuous care monitoring regarding use of tubes to prevent complications.

Avaliação do potencial de morbimortalidade por COVID-19 em comunidades quilombolas rurais de Goiás, Brasil / Assessment of the potential for morbidity and mortality from COVID-19 in rural quilombola communities in Goiás, Brazil

Objetivo: analisar o potencial de morbimortalidade por COVID-19 em comunidades quilombolas rurais. Métodos: estudo transversal, com 26 comunidades do Estado de Goiás. Utilizou-se o método Analytic Hierarchy Process (AHP) que hierarquiza critérios para estimar o índice de prioridade de morbimortalidade por COVID-19, sendo eles: sexo masculino, idade ≥ 60 anos, diabetes, câncer, hipertensão, tabagismo, dislipidemia e obesidade. Resultados: de 1.672 entrevistados, 52,0% eram homens, 19,0% ≥ 60 anos, 5,5% autor referiram diabetes, 19,6% hipertensão, 9,2% dislipidemia, 1,3% obesidade, 0,4% câncer e 13,9% tabagismo. Houve menor índice de prioridade na Comunidade Engenho 2, e maior em Buracão; sendo: idade ≥ 60 anos em Quilombo do Magalhães; sexo masculino em Kalunga dos Morros; diabetes e hipertensão em Tomás Cardoso; dislipidemia em Almeidas; obesidade em Buracão; câncer em Água Limpa; tabagismo em José de Coleto. Conclusão: houve diferentes potenciais de morbimortalidade por COVID-19, demonstrando qual comunidade apresenta maior/menor prioridade para ações estratégicas para enfrentamento da pandemia.

Objective: to analyze the potential for morbidity and mortality from COVID-19 in rural quilombola communities. Methods:cross-sectional study, with 26 communities in the State of Goiás. The Analytic Hierarchy Process (AHP) method was used, which ranks criteria to estimate the COVID-19 morbidity and mortality priority index, namely: male gender, age ≥ 60 years, diabetes, cancer, hypertension, smoking, dyslipidemia and obesity. Results: among the 1,672 respondents, 52.0% were men, 19.0% ≥ 60 years, 5.5% self-reported diabetes, 19.6% hypertension, 9.2% dyslipidemia, 1.3% obesity, 0.4% cancer and 13.9% smoking. There was a lower priority index in the Engenho 2 community, and higher in the Buracão; where: age ≥ 60 years in the Quilombo do Magalhães; male gender in the Kalunga dos Morros; diabetes and hypertension in the Tomás Cardoso; dyslipidemia in the Almeidas; obesity in the Buracão; cancer in the Água Limpa; smoking in the José de Coleto. Conclusion: there were different potential for morbidity and mortality from COVID-19, demonstrating which community has the highest/lowest priority for strategic actions to face the pandemic.

Burden, satisfaction caregiving, and family relations in informal caregivers of older adults.

Introduction: Family caregivers of older persons devote much of their time and energy to caring for another person. This exposure may burden caregivers and compromise their health and quality of life. Objective: To investigate the relationship between burden, sociodemographic, caregiving, and health characteristics of informal caregivers of dependent older adults. Methods: Cross-sectional and analytical study carried out in Palmas, Tocantins, Brazil, with 52 informal caregivers of older persons who need full-time help for basic living activities. Caregivers' burden was assessed by Zarit Burden Interview (ZBI). Data were analyzed using a T-test, Pearson's correlation, and Multiple Linear Regression. Results: The ZBI mean score of caregivers was 26.3 points (SD = 14.6; min = 0; max = 68). Burden scores were higher among caregivers who did not receive help from other people in care (p = 0.016), reported family dysfunction (p = 0.001), and had depression symptoms (p = 0.007). A correlation was found between the scores of burdens and satisfaction with care (r = 0.76; p < 0.001) and perceived material support (r = -0.30; p = 0.40). Satisfaction with care (ß: 0.61; p < 0.001) and family dysfunction (ß: 8.07; p = 0.033) were significantly associated with the burden score. Conclusion: Caregivers with dysfunctional families and satisfaction with the care presented the highest-burden scores. The findings reveal the need for strategies to facilitate mediation and reduce caregiver burden by strengthening the family network support or providing professional assistance.

Screening for common mental disorder in elderly residents in the countryside: a cross-sectional study / Rastreo de trastorno mental común en ancianos residentes en el interior: estudio transversal / Rastreamento de transtorno mental comum em idosos residentes no interior: estudo transversal

ABSTRACT Objective: To estimate the prevalence of common mental disorders and their associated factors in the elderly in a municipality in the countryside of the Brazilian Midwest. Methods: Quantitative, observational, cross-sectional approach research, conducted with 218 elderly people. Results: The prevalence of the common mental disorder among the elderly was 25.1%; in the univariate analysis, it was higher in females (35.4%), in the age group of 80 years or older (46.1%), brown skin color (30.2%), widowed (42.6%), illiterate (47.6%), and retired (27.6%). In the multiple analysis, the variables female gender (p<0.006), age 80 years or older (p<0.036), dissatisfaction with life (p<0.009), lack of social interaction (p=0.017), and dysfunctional family (p=0.021) remained associated with CMD. Conclusion: The results revealed are helpful and contribute to the reinforcement of the need for mental health care in this population extract so growing worldwide.

RESUMEN Objetivo: Estimar la prevalencia de trastorno mental común y sus factores relacionados en ancianos de un municipio del interior del Medio Oeste brasileño. Métodos: Investigación de abordaje cuantitativo, observacional, transversal, realizada con 218 ancianos. Resultados: La prevalencia de trastorno mental común entre los ancianos fue de 25,1%; en el análisis univariado, fue superior en el sexo femenino (35,4%), en la franja etaria igual o superior a 80 años (46,1%), color de piel parda (30,2%), viudos (42,6%), analfabetos (47,6%) y jubilados (27,6%). En el análisis múltiple, se mantuvieron relacionados a la TMC las variables sexo femenino (p<0,006), edad igual o superior a 80 años (p<0,036), insatisfacción con la vida (p<0,009), falta de interacción social (p=0,017) y familia disfuncional (p=0,021). Conclusión: Los resultados revelados son útiles y contribuyen en el refuerzo de la necesidad de cuidados visando a la salud mental de ese extracto poblacional tan creciente mundialmente.

RESUMO Objetivo: Estimar a prevalência de transtorno mental comum e seus fatores associados em idosos de um município do interior do Centro-Oeste brasileiro. Métodos: Pesquisa de abordagem quantitativa, observacional, transversal, realizada com 218 idosos. Resultados: A prevalência de transtorno mental comum entre os idosos foi de 25,1%; na análise univariada, foi superior no sexo feminino (35,4%), na faixa etária igual ou superior a 80 anos (46,1%), cor da pele parda (30,2%), viúvos (42,6%), analfabetos (47,6%) e aposentados (27,6%). Na análise múltipla, mantiveram-se associadas à TMC as variáveis sexo feminino (p<0,006), idade igual ou superior a 80 anos (p<0,036), insatisfação com a vida (p<0,009), falta de interação social (p=0,017) e família disfuncional (p=0,021). Conclusão: Os resultados revelados são úteis e contribuem no reforço da necessidade de cuidados visando à saúde mental desse extrato populacional tão crescente mundialmente.