Risk of sarcopenia and mobility of older adults during the COVID-19 pandemic: the longitudinal data from the REMOBILIZE study.

BACKGROUND: We assessed whether clinical, functional and behavioral factors were associated with the decrease in mobility trajectories reported in older people at risk of sarcopenia (RS) and without risk of sarcopenia (NRS) during COVID-19 pandemic. METHODS: We prospectively analyzed mobility trajectories reported in older adults with RS and NRS over 16-month follow-up (Remobilize study). The self-perceived risk of sarcopenia and mobility were assessed using the SARC-F and the Life-Space Assessment (LSA) tools, respectively. Gender, age, comorbidities, pain, functional limitation, physical activity (time spent in walking; min/week), and sitting time (ST; hours/day) were assessed. We used a multilevel model to determine changes in mobility between groups and over time. RESULTS: Mobility was lower in RS than in NRS. Older people at RS, who were women, aged 70-79 years and 80 years or older, inactive, and with moderate to severe functional limitation experienced reduced mobility trajectories reported over the pandemic. For older people at NRS, trajectories with reduce mobility reported were experienced by women with comorbidities, for those with insufficient walking time and aged 70-79 years; aged 70-79 years and with ST between 5 and 7 hours/day; for those with insufficient walking time and increased ST; and for those with pain and increased ST. CONCLUSION: Mobility trajectories reported in older people at risk of sarcopenia were negatively influenced by insufficient level of physical inactivity and pre-existing moderate to severe functional limitation. Health and social interventions should be target to avoid mobility limitation during and after the COVID-19 pandemic.

Investigation of the involvement of platelet-activating factor in the control of hypertension by aerobic training. A randomized controlled trial.

Although studies have demonstrated the effectiveness of exercise in controlling systemic arterial hypertension (SAH), the mechanisms involved in this effect are still poorly understood. Thus, this study investigated the impact of aerobic training on the relationship between platelet-activating factor (PAF) circulating levels and blood pressure in hypertensives. Seventy-seven hypertensive subjects were enrolled in this randomized controlled trial (age 66.51 ± 7.53 years, body mass 76.17 ± 14.19 kg). Participants were randomized to two groups: the intervention group (IG, n = 36), composed of hypertensive individuals submitted to an aerobic training protocol, and the control group (CG, n = 41), composed of non-exercised hypertensives. Body mass index, arterial blood pressure, quality of life, respiratory muscle strength, and functional capacity were assessed before and after 12 weeks. PAF and plasma cytokine levels were also evaluated respectively by liquid chromatography coupled with mass spectrometry and enzyme-linked immunosorbent assay. Aerobic training promoted a significant reduction in blood pressure while functional capacity, expiratory muscle strength, and quality of life, PAFC16:0 and PAFC18:1 plasma levels were increased in comparison to the CG (p < 0.05). In addition, multiple correlation analysis indicated a positive correlation [F (3.19) = 6.322; p = 0.001; R2adjusted = 0.499] between PAFC16:0 levels and expiratory muscle strength after aerobic training. Taken together, our findings indicate that PAF may be involved in the indirect mechanisms that control SAH, being mainly associated with increased respiratory muscle strength in hypertensive subjects undergoing aerobic training.

Association Between the Length of Leukocyte Telomeres and Functional Performance of Older Adults: Observational Study.

Despite current literature pointing to a link between shortened telomeres and aging, chronic diseases, and geriatric syndromes, the precise implications of this connection remain unclear. The aim of this exploratory, cross-sectional, observational study was to investigate the association between the relative telomere length (RTL) of peripheral blood leukocyte subtypes (mononuclear cells and granulocytes) and physical performance using the Short Physical Performance Battery (SPPB) in older adults. A cohort of 95 participants was recruited, which included men and women aged over 60 years (70.48 ± 5.5 years). It was found that mononuclear cell RTL was significantly lower than that of granulocytes (p < 0.0001). Moreover, individuals with good SPPB performance exhibited lower mononuclear cell RTL compared with those with moderate or poor performance. However, no significant differences were observed in granulocyte RTL between different SPPB performance groups. The global SPPB score showed an inverse correlation with mononuclear cell RTL, but this correlation was not present with granulocyte RTL. Similarly, the SPPB sit-to-stand domain correlated with mononuclear cell RTL, but no such correlation was found with granulocyte RTL. Our findings challenge conventional expectations, suggesting that shorter mononuclear cell RTL may be associated with favorable functional capacity. The variations in RTL between mononuclear cells and granulocytes highlight their distinct biological roles and turnover rates. A history of immune responses may influence mononuclear cell RTL dynamics, while telomerase activity may protect granulocyte RTL from significant shortening. The unexpected associations observed in mononuclear cell RTL emphasize the complex interplay between immune responses, cellular aging, and functional capacity in older adults.

Are assessment measures for components of the International Classification of Functioning, Disability and Health reproducible for use on pre-frail and frail older adults? A systematic review.

OBJECTIVE: To analyze the internal consistency, reliability and measurement error of assessment measures for body structure and function (postural balance, muscle strength, cardiorespiratory function and physical fitness), activity (walking and mobility) and participation (quality of life and social reintegration) outcomes for use on pre-frail and frail older adults. METHODS: Searches were performed in six databases (Medline, Embase, ScienceDirect, Web of Science, The Cochrane Library and Lilacs) and reproducibility studies were included. Cronbach's alpha and the classification proposed by Terwee et al. (2007) were used for the interpretation of internal consistency. The intraclass correlation coefficient (ICC) and the Munro classification were used for the determination of reliability. The standard error of measurement (SEM), minimal detectable change (MDC) as well as percentages of error (SEM%) and change (MDC%) were calculated. Methodological quality of the studies was appraised using Boxes 4, 6 and 7 of the COSMIN Risk of Bias checklist. RESULTS: Six studies were included in the present systematic review, with a total of 835 (82.4 years; 582 women and 253 men) pre-frail and frail older adults analyzed. Seven measures were identified for the assessment of body structure and function, activity and participation outcomes (Hierarchical Assessment of Balance and Mobility, Self-Assessment of Physical Fitness, Sarcopenia Quality of Life, Reintegration to Normal Living Index, Two-Minute Walking test, Six-Minute Walking test and Ten-Meter Walking test). The following measurement properties were identified: internal consistency = 0.84 (mean Cronbach's alpha); reliability = 0.87 (mean ICC); SEM range = 0.06 to 10.10; MDC range = 0.13 to 28.10; SEM% range = 5.2 % to 9.5 %; and MDC% range = 10.7 % to 28.5 %. CONCLUSION: The present systematic review found adequate internal consistency, high reliability and an acceptable measurement error for assessment measures of body structure and function, activity and participation outcomes for use on pre-frail and frail older adults.

A dual-role for IL-10: From leukemogenesis to the tumor progression in acute lymphoblastic leukemia.

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer in the world, and accounts for 25% of all childhood cancers among children under 15 years of age. Longitudinal studies have shown that children with ALL are born with a deregulated immune response that, together with postnatal environmental exposures, favor the onset of the disease. In this context, IL-10, a key cytokine in the regulation of the immune response, presents itself as a paradoxical mediator, initially influencing the development of ALL through the regulation of inflammatory processes and later on the progression of malignancy, with the increase of this molecule in the leukemia microenvironment. According to the literature, this cytokine plays a critical role in the natural history of the disease and plays an important role in two different though complex scenarios. Thus, in this review, we explore the dual role of IL-10 in ALL, and describe its biological characteristics, immunological mechanisms and genetics, as well as its impact on the leukemia microenvironment and its clinical implications.

Insights Regarding the Role of Inflammasomes in Leukemia: What Do We Know?

Inflammation is a physiological mechanism of the immune response and has an important role in maintaining the hematopoietic cell niche in the bone marrow. During this process, the participation of molecules produced by innate immunity cells in response to a variety of pathogen-associated molecular patterns and damage-associated molecular patterns is observed. However, chronic inflammation is intrinsically associated with leukemogenesis, as it induces DNA damage in hematopoietic stem cells and contributes to the creation of the preleukemic clone. Several factors influence the malignant transformation within the hematopoietic microenvironment, with inflammasomes having a crucial role in this process, in addition to acting in the regulation of hematopoiesis and its homeostasis. Inflammasomes are intracellular multimeric complexes responsible for the maturation and secretion of the proinflammatory cytokines interleukin-1ß and interleukin-18 and the cell death process via pyroptosis. Therefore, dysregulation of the activation of these complexes may be a factor in triggering several diseases, including leukemias, and this has been the subject of several studies in the area. In this review, we summarized the current knowledge on the relationship between inflammation and leukemogenesis, in particular, the role of inflammasomes in different types of leukemias, and we describe the potential therapeutic targets directed at inflammasomes in the leukemic context.

Validity and reliability of the short form brief pain inventory in older adults with nociceptive, neuropathic and nociplastic pain.

OBJECTIVE: The aim of this study was to evaluate the validity and reliability of the Short Form Brief Pain Inventory (SF-BPI) for community-dwelling Brazilian older adults with chronic neuropathic, nociceptive and nociplastic pain. METHODS: Cross-sectional psychometric testing was conducted in a convenience sample, n=114 (66.5 ± 4.9 years). RESULTS: The 2-factor structure of the SF-BPI was ratified by confirmatory factor analysis. Convergent validity was found between the SF-BPI and the Present Pain Intensity (PPI). There was good overall internal consistency (Cronbach's α: 0.87). Test-retest reliability was excellent for pain intensity and interference scores of the SF-BPI (ICC: 0.90 and 0.96, respectively), as well as inter-rater reliability for both dimensions (ICC: 0.77). CONCLUSION: The findings support the validity and reliability of the SF-BPI for community-dwelling older adults with chronic pain and may contribute to health professionals having a brief multidimensional assessment for more effective therapeutic approaches in this population.

Effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus: a systematic review and meta-analysis.

Purpose: To assess the effects of exercise training parameters on cardiorespiratory fitness of individuals with type 2 diabetes mellitus (T2DM). Methods: This systematic review was registered on PROSPERO (CRD42020210470). Searches were performed on PubMed, PEDro EMBASE, MEDLINE (Ovid), LILACS, PsycINFO, SCIELO, CINAHL, and Cochrane Library. The primary outcome was cardiorespiratory fitness, defined as maximal oxygen uptake (VO2max) during a maximal or submaximal exercise test. Two independent reviewers extracted data and assessed the risk of bias. Data were pooled using a random effects model and expressed as mean difference (MD) and 95% confidence interval (95%CI). Heterogeneity (I2) was assessed using Cochran's Q test. The risk of bias and quality of evidence was assessed using the Cochrane risk of bias tool and GRADE. Results: Twenty-two studies comparing exercise and control groups were included. The risk of bias indicated some concerns in most studies, and the quality of evidence was rated very low. Interventions with moderate (MD = 1.91, 95%CI = .58 to 3.34) and progressive exercise intensity (MD = 2.70, 95%CI = 2.43 to 2.96) and volume (MD = 1.72, 95%CI = .59 to 2.85) showed greater improvements in VO2max. Conclusions: Protocols that progressively increased exercise training parameters improved the cardiorespiratory fitness response. Progressive exercise might be more suitable for individuals with T2DM. Our conclusion may be limited due to the very low quality of evidence. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01205-5.

Combined Training Improves Executive Functions Without Changing Brain-Derived Neurotrophic Factor Levels of Middle-Aged and Older Adults with Type 2 Diabetes.

BACKGROUND: Type 2 diabetes mellitus (T2DM) provokes executive function and long-term memory decrements, and aerobic plus resistance training (combined training) may alleviate this T2DM-related cognitive impairment. Brain-derived neurotrophic factor (BDNF) levels have been found to be related to cognitive performance. AIM: To analyze the effects of 8-week combined training on executive functions and circulating BDNF levels of subjects with T2DM and verify the association between BDNF levels and combined training-induced changes in executive functions and long-term memory. METHODS: Thirty-five (63±8 years old) subjects of both sexes were allocated to combined training (n=17, thrice weekly for 8 weeks) or the control group (n=18). Executive functions (evaluated through Trail making test, Stroop color task, and Digit Span), long-term memory (evaluated through the Taylor Complex Figure Test simplified), and plasma samples were compared pre- and post-intervention. RESULTS: Combined training improved executive function z-score compared to control (d=1.31). Otherwise, BDNF levels were not statistically altered (combined training group: 179±88 pg/mL vs. 148±108 pg/mL; control group: 163±71 pg/mL vs. 141±84 pg/mL, p>0.05). However, pre-training BDNF levels explained 50.4% of the longitudinal improvements in composite executive function z-score (r=0.71, p<0.01), 33.6% of inhibitory control (r=0.58; p=0.02), and 31.4% of cognitive flexibility (r=0.56, p=0.04) in the combined training group. CONCLUSION: Combined training improved executive functions independently of alterations in resting BDNF levels after 8 weeks. Furthermore, pre-training BDNF levels explained one-half of the variance in combined training-induced improvements in executive functions.

Allostatic load and physical performance in older adults: Findings from the International Mobility in Aging Study (IMIAS).

OBJECTIVE: This study aimed to evaluate the association between Allostatic Load (AL) and physical performance scores in older adults from four cities in North and South America. METHODS: In this cross-sectional study, data from 1101 volunteers from three countries (Canada, Brazil, and Colombia) from the International Mobility in Aging Study (IMIAS) were used to evaluate the association between AL index and Short Physical Performance Battery (SPPB) scores. Three multiple linear regression models adjusted by age, Socioeconomic Status (SES), chronic conditions, depression symptoms, and Leganés Cognitive Test (LCT) were developed to estimate the independent association between SPPB and AL. Mediation analysis with 2012 LA data and covariates was performed to access the total, direct, and indirect effects of mediation on SPPB scores from 2016. RESULTS: AL and SPPB were inversely associated, with older adults with high allostatic load scoring lower on SPPB (ß: -0.234, Std: 0.033, p-value: <0.001).  Indirect effects were evidenced between age, SES and chronic conditions with AL and SPPB scores. Chronic conditions also had a total effect on SPPB scores and were also mediated by AL. However, indirect effects of depressive symptoms and LCT on SPPB scores mediated by AL were not observed. CONCLUSIONS: Findings from this study support that increased AL index determines worse physical performance states after full adjustments. AL has a mediator role between the number of chronic diseases, depressive symptoms, cognitive status and physical performance. Socioeconomic status also influenced physical scores mediated by the AL index.

Como direcionar a formação do fisioterapeuta em Gerontologia no Brasil diante do envelhecimento populacional? / How to direct the training of physiotherapists in Gerontology in Brazil in the face of population aging?

O rápido envelhecimento populacional brasileiro mudou nosso cenário de saúde, o que exige que o profissional fisioterapeuta esteja preparado para lidar com as especificidades desta população. A Associação Brasileira de Fisioterapia em Gerontologia (ABRAFIGE), que tem a missão de fortalecer a especialidade e promover assistência qualificada em Fisioterapia em Gerontologia, propõe uma relação das competências fundamentais para formação no ensino nos cursos de graduação em Fisioterapia e de pósgraduação lato sensu em Fisioterapia em Gerontologia. Essa iniciativa visa auxiliar os gestores das Instituições de Ensino Superior das diversas regiões brasileiras no planejamento de tais cursos de forma a melhorar a qualidade da formação dos fisioterapeutas nessa área.

The rapid aging of the Brazilian population has changed the health scenario. Such a change requires physiotherapists to be prepared to deal with the specificities of this population. The Associação Brasileira de Fisioterapia em Gerontologia - ABRAFIGE (Brazilian Association of Physical Therapy in Gerontology), which has the mission of strengthening the specialty and the purpose of promoting qualified assistance in physical therapy in gerontology, proposes fundamental skills for training in teaching in undergraduate and graduate courses in physical therapy in gerontology. This initiative aims to assist administrators at higher education institutions in different regions of Brazil in the planning of such courses to improve the quality of the education of physiotherapists in this field.

The impact of low back pain and disability on frailty levels in older women: longitudinal data from the BACE-Brazil cohort.

METHODS: This is a longitudinal observational study with a convenience subsample from the international Back Complaints in the Elders (BACE)-Brazil. Frailty was assessed by researchers at baseline, 6 and 12 months according to the Frailty Phenotype. Pain was assessed using a Numerical Pain Scale (NPS). Disability was assessed using the Roland Morris Disability Questionnaire. RESULTS: A total of 155 older women (70.4 ± 5.4 years) participated. Follow-up for 6 and 12 months in this study was associated with a change of older women to worse frailty levels (OR = 2.83, 95% CI 1.98-4.67; p < 0.01). A significant association was observed between greater pain intensity and the transition of the older women through the frailty levels (ß = - 0.73; p < 0.01) when inserting the pain variable at baseline of the statistical model. Older women who reported greater pain intensity worsened their frailty level. The same happened when the disability variable was inserted in the model (ß = - 0.74; p < 0.01). The criteria proposed by Fried et al. were able to identify frailty throughout the follow-up and no prevalence of any item. CONCLUSIONS: In older women, relevant factors such as pain and disability are closely linked to the frailty phenomenon. Thus, the frailty syndrome must be assessed, monitored and treated in relation to the individualities of older adults, as those with back pain and greater disabilities are more susceptible to frailty.

Uso de medicamentos potencialmente inapropriados em pessoas idosas na Atenção Primária à Saúde: estudo transversal / Use of potentially inappropriate medications by older adults in Primary Health Care: cross-sectional study

Resumo Objetivo Verificar a prevalência e fatores associados ao uso de medicamentos potencialmente inapropriados (MPI) pela população idosa e a concordância entre duas metodologias de avaliação no contexto da Atenção Primária à Saúde (APS). Método Estudo observacional transversal. Foi estimada a prevalência de pessoas idosas que utilizam MPI e fatores associados. Inicialmente foi calculada a frequência de medicamentos, entre os utilizados, considerados MPI. A classificação como MPI foi pelos Critérios de Beers 2019 e Consenso Brasileiro de Medicamentos Potencialmente Inapropriados para idosos (CBMPI) 2016. Também avaliou-se a concordância entre as duas classificações. Foram construídos modelos de regressão logística multivariada para avaliação da associação pelo Odds Ratio (OR), e calculado Kappa para concordância entre os dois critérios de classificações. Resultados A prevalência de pessoas idosas que usavam MPI foi 32,9% pelos Critérios de Beers e 27,6% pelo CBMPI. Associações estatisticamente significativas (p<0,001) ao uso de medicamentos inapropriados, pelos Critérios de Beers foram: relato de diabetes (OR=1,96), depressão (OR=2,25) e polifarmácia (OR=4,11). Pessoas idosas satisfeitas com a própria saúde tiveram menor chance de usarem MP, em ambas classificações, Critérios Beers (OR=0,02) e CBMPI (OR=0,09). A concordância entre as classificações foi muito boa (k=0,75, p<0,001). Conclusão Foram associados ao uso de MPI relato de diabetes e depressão, polifarmácia e satisfação negativa com a saúde. As associações foram semelhantes entre as duas classificações, indicando que ambas são pertinentes na identificação do uso de MPI em pessoas idosas usuárias da APS.

Abstract Objective To verify the prevalence of potentially inappropriate medications (PIM) in use and possible associated factors in older adults and the agreement between two assessment tool in Primary Health Care (PHC) contex Methods Cross-sectional study. The prevalence of older adults in use of PIM and associated factors were estimated. First of all was calculated the frequency of drugs, among those used, considered PIM. Classification as PIM was based on the 2019 Beers Criteria and the 2016 Brazilian Consensus on Potentially Inappropriate Medications 2016 (BCPIM) for the older adults. The agreement between the two classifications was also evaluated. Multivariate logistic regression models were estimated. Association was evaluated by Odds Ratio (OR). Kappa was calculated for agreement between both classifications. Results The prevalence of older adults using MPI was 32.9%, according to Beers Criteria and 27.6% according to the BCPIM. The reports of diabetes (OR=1.96), depression (OR=2.25) and polypharmacy (OR=4.11) were associated (p<0.001) with the use of inappropriate medication, according to the Beers Criteria. Older adults who were very satisfied with their own health were less likely to use inappropriate medication both according to the Beers Criteria (OR=0.02) and the BCPIM (OR=0.09). Agreement between classifications was considered good (k=0.75, p<0.001). Conclusion Reports of diabetes and depression, polypharmacy and negative self-rated health and satisfaction were associated with PIM's use. The associations were similar between the two classifications, indicating that both are relevant in identifying PIM use in older adults in the context of PHC.

Prevalence risk of sarcopenia in older Brazilian adults during the pandemic: A cross-sectional analysis of the Remobilize Study

ABSTRACT BACKGROUND: Social distancing has led to lifestyle changes among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: This study aimed to estimate the prevalence risk of sarcopenia (RS) and investigate its associated factors during the COVID-19 pandemic in older Brazilian adults. DESIGN AND SETTING: Cross-sectional observational analysis of baseline data as part of the Remobilize Study. METHODS: Participants in the study were older adults (≥ 60 years), excluding those who were bedridden or institutionalized. The data collected consisted of answers about the RS (SARC-F), functional status, walking, sedentary behavior (SB), pain, comorbidity, and life space mobility. RESULTS: A total of 1,482 older adults (70 ± 8.14 years, 74% women) participated in the study, and an RS prevalence of 17.1% was found. (95% confidence interval [CI] 15.25-19.15%). The adjusted multivariate model showed a significant association between RS and functional limitation (odds ratio [OR]: 19.05; CI 13.00-28.32), comorbidity (OR: 5.11; CI 3.44-7.81), pain (OR: 4.56; CI 3.33-6.28), total walking (OR: 0.99; CI 0.99-1.00), SB of 8-10 hours (OR: 1.85; CI 1.15-2.93), and SB of > 10 hours (OR: 3.93; CI 2.48-6.22). RS was associated with mobility during the pandemic (OR: 0.97; CI 0.96-0.98). P < 0.05. CONCLUSIONS: During the pandemic, the prevalence of RS in older Brazilians was estimated at 17.1%. Moderate to severe functional limitation, comorbidities, presence of pain, walking, longer SB period, and reduced life space mobility significantly contributed to RS in older adults during the pandemic.

Feasibility of Remote Delivering an Exercise and Lifestyle Education Program for Individuals Living with Prediabetes and Diabetes in Brazil.

This study aimed to test the feasibility of remote delivering a 12-week exercise and lifestyle education program (ExLE) or a 12-week exercise program (Ex) for individuals with prediabetes and diabetes in terms of acceptability, implementation, practicality, and limited efficacy. The programs were internet- or telephone-based delivered, depending on the participants' internet access and technology literacy. Of the 196 individuals screened, 15 were included in the study (internet-based delivery (n = 13); telephone-based delivery (n = 2)). Twelve participants completed the program they were randomized to, and most reported being satisfied with the study interventions (acceptability). Data collection procedures, weekly follow-up, study website visits, and educational materials were proper (implementation), and the adherence rate to study interventions ranged from 24% to 58% (practicality). Additionally, both programs (ExLE and Ex) seemed to promote beneficial changes in functional capacity (limited efficacy). The internet-based remote delivery of the interventions showed feasibility. Therefore, in future trials, exercise and educational interventions can be internet-based remote delivered to individuals with prediabetes and diabetes with internet access and technology literacy. In addition, some adjustments to eligibility criteria, study websites, more accessible ways of recording exercise sessions and using educational materials, and an initial supervised exercise session are recommended.

Prevalence risk of sarcopenia in older Brazilian adults during the pandemic: A cross-sectional analysis of the Remobilize Study.

BACKGROUND: Social distancing has led to lifestyle changes among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: This study aimed to estimate the prevalence risk of sarcopenia (RS) and investigate its associated factors during the COVID-19 pandemic in older Brazilian adults. DESIGN AND SETTING: Cross-sectional observational analysis of baseline data as part of the Remobilize Study. METHODS: Participants in the study were older adults (≥ 60 years), excluding those who were bedridden or institutionalized. The data collected consisted of answers about the RS (SARC-F), functional status, walking, sedentary behavior (SB), pain, comorbidity, and life space mobility. RESULTS: A total of 1,482 older adults (70 ± 8.14 years, 74% women) participated in the study, and an RS prevalence of 17.1% was found. (95% confidence interval [CI] 15.25-19.15%). The adjusted multivariate model showed a significant association between RS and functional limitation (odds ratio [OR]: 19.05; CI 13.00-28.32), comorbidity (OR: 5.11; CI 3.44-7.81), pain (OR: 4.56; CI 3.33-6.28), total walking (OR: 0.99; CI 0.99-1.00), SB of 8-10 hours (OR: 1.85; CI 1.15-2.93), and SB of > 10 hours (OR: 3.93; CI 2.48-6.22). RS was associated with mobility during the pandemic (OR: 0.97; CI 0.96-0.98). P < 0.05. CONCLUSIONS: During the pandemic, the prevalence of RS in older Brazilians was estimated at 17.1%. Moderate to severe functional limitation, comorbidities, presence of pain, walking, longer SB period, and reduced life space mobility significantly contributed to RS in older adults during the pandemic.

Associação entre desempenho funcional e hospitalização de idosos adscritos à estratégia de saúde da família no município de Alfenas, Minas Gerais / Association between functional performance and hospitalization of elderly enrolled to family health strategy in the city of Alfenas, Minas Gerais

Resumo Introdução A queda no desempenho funcional de idosos pode relacionar-se a desfechos adversos pelos quais eles passam, entre os quais a hospitalização. Testes de desempenho, realizados na Atenção Primária à Saúde, podem ajudar a identificar idosos com maiores chances de hospitalização e que demandam maior atenção da equipe de saúde. Objetivo Identificar se o pior desempenho de idosos em testes funcionais pode estar associado a hospitalizações entre idosos. Método Estudo transversal observacional com amostra de 473 idosos comunitários adscritos à Estratégia de Saúde da Família. O desempenho funcional foi avaliado pelos quesitos equilíbrio estático, mobilidade funcional, marcha, força muscular, equilíbrio dinâmico, força de membros inferiores, e pela avaliação do risco de quedas. Dados sobre hospitalização dos participantes foram obtidos pelo Sistema de Informações Hospitalares Descentralizado (SIHD2/SUS). A análise da associação entre desempenho funcional e hospitalização foi realizada por modelos de Regressão Logística. Resultados No estudo, 32,1% dos idosos participantes foram hospitalizados pelo menos uma vez. A ocorrência de hospitalização foi associada com equilíbrio, desempenho na marcha, mobilidade funcional e risco de quedas. Conclusão Através dos testes funcionais, foi possível observar que o pior desempenho está associado às hospitalizações e a identificação destes fatores permite criar intervenções e estratégias capazes de evitar hospitalizações e seus efeitos adversos.

ABSTRACT Background The decline in the functional performance of the elderly may be related to adverse outcomes, including hospitalization. Performance tests, carried out in Primary Health Care, can help to identify older people who are more likely to be hospitalized and who require more attention from the health team. Objective To identify if the worse performance of the elderly in functional tests may be associated with hospitalizations. Method A cross-sectional observational study was conducted with 473 community-dwelling elderly enrolled by Family Health Strategy.. Functional performance was evaluated according to the following criteria: static balance, functional mobility, gait, muscle strength, dynamic balance, lower limb strength, and by assessing the risk of falls. Data on hospitalization of participants were obtained from the Decentralized Hospital Information System (SIHD2 / SUS). The analysis of association between functional performance and hospitalization was performed by Logistic Regression models. Results In the study, 32.1% of the elderly participants were hospitalized at least once. Hospitalization was associated with balance, gait performance, functional mobility, and risk of falls. Conclusion Through functional tests it was possible to observe that the worst performance is associated with hospitalizations and the identification of these factors allows the creation of interventions and strategies capable of avoiding hospitalizations and their adverse effect.

Association of Toll-like receptors polymorphisms with the risk of acute lymphoblastic leukemia in the Brazilian Amazon.

Acute lymphoblastic leukemia (ALL) is the most common hematologic malignancy in children in childhood. Single-nucleotide polymorphism (SNPs) in key molecules of the immune system, such as Toll-like receptors (TLRs) and CD14 molecules, are associated with the development of several diseases. However, their role in ALL is unknown. A case-control study was performed with 152 ALL patients and 187 healthy individuals to investigate the role of SNPs in TLRs and the CD14 gene in ALL. In this study, TLR6 C > T rs5743810 [OR: 3.20, 95% CI: 1.11-9.17, p = 0.003) and TLR9 C > T rs187084 (OR: 2.29, 95% CI: 1.23-4.26, p = 0.000) seems to be a risk for development of ALL. In addition, the TLR1 T > G rs5743618 and TLR6 C > T rs5743810 polymorphisms with protection against death (OR: 0.17, 95% IC: 0.04-0.79, p = 0.008; OR: 0.48, 95% IC: 0.24-0.94, p = 0.031, respectively). Our results show that SNPs in TLRs genes may be involved in the pathogenesis of ALL and may influence clinical prognosis; however, further studies are necessary to elucidate the role of TLR1, TLR4, TLR5, TLR6, TLR9 and CD14 polymorphisms in this disease.

Association of Social Support Network with Telomere Length: A Cross-Sectional Study with Community-Dwelling Older Adults.

Considering that telomere length can be determined not only by issues related to cell biology but also by aspects related to social factors and environmental exposures, studies on the relationship between social aspects and telomere length can help to better understand the still scarcely known aspects of the human aging process. Thus, this research seeks to verify whether social support networks are associated with telomere length in older adults. This is a cross-sectional study conducted with 448 individuals aged at least 60 years living in the urban area of an inland Brazilian municipality. Relative quantification of telomere length was obtained through real-time qPCR. Social support was assessed through the Medical Outcomes Study Social Support Scale. Descriptive statistics and multiple logistic regression were used in data analysis. The evaluated social support networks for older adults consist in a mean of 16.4 people, and the percentage of older adults who reported up to five members in their network was 27.75%. Shorter telomere length was identified in 25% of the participants, and the older adults who reported having up to five members in their support network were more likely to have a shorter telomere length than those who reported more numerous networks (odds ratio: 1.89, p = 0.011) regardless of gender, age, household arrangement, cognitive decline, and dependence for basic and instrumental activities of daily living, which suggests that measures that stimulate the creation and maintenance of social support networks should be implemented to improve older adults' health.

Discontinuation of Health Interventions Among Brazilian Older Adults During the Covid-19 Pandemic: REMOBILIZE Study.

The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60 + years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions.