Isotemporal substitution analysis of time between sleep, sedentary behavior, and physical activity on depressive symptoms in older adults: a cross-sectional study.

BACKGROUND: Compared to young individuals, older adults participate more in sedentary behavior (SB) and less in physical activity (PA). These behaviors are associated with numerous adverse health factors. OBJECTIVE: The purpose of the study was to examine the hypothetical effects of substituting time spent sleeping, performing SB, and performing moderate-to-vigorous physical activity (MVPA) on depressive symptomatology in older adults. DESIGN AND SETTING: An analytical cross-sectional study employing exploratory survey methods was conducted in the city of Alcobaça in the state of Bahia, Brazil. METHODS: The study included 473 older adults who answered a structured questionnaire during an interview. Exposure time to SB and PA level were assessed using the International Physical Activity Questionnaire, and depressive symptoms were analyzed using the short version of the Geriatric Depression Scale. An isotemporal replacement model was used to evaluate the effects of different SB sessions on depressive symptomatology. RESULTS: An increase in the risk of depressive symptoms was observed when MVPA and sleep time were substituted for the same SB time at all times tested, with maximum values of 40% and 20%, respectively. Opposite substitution of MVPA and sleep time increments reduced the risk of depressive symptomatology by 28% and 17%, respectively. CONCLUSIONS: The results of the present study indicate that replacing SB with the same amount of sleep or MVPA may reduce depressive symptoms. The longer the reallocation time, the greater are the benefits.

Isotemporal substitution analysis of time between sleep, sedentary behavior, and physical activity on depressive symptoms in older adults: a cross-sectional study

ABSTRACT BACKGROUND: Compared to young individuals, older adults participate more in sedentary behavior (SB) and less in physical activity (PA). These behaviors are associated with numerous adverse health factors. OBJECTIVE: The purpose of the study was to examine the hypothetical effects of substituting time spent sleeping, performing SB, and performing moderate-to-vigorous physical activity (MVPA) on depressive symptomatology in older adults. DESIGN AND SETTING: An analytical cross-sectional study employing exploratory survey methods was conducted in the city of Alcobaça in the state of Bahia, Brazil METHODS: The study included 473 older adults who answered a structured questionnaire during an interview. Exposure time to SB and PA level were assessed using the International Physical Activity Questionnaire, and depressive symptoms were analyzed using the short version of the Geriatric Depression Scale. An isotemporal replacement model was used to evaluate the effects of different SB sessions on depressive symptomatology. RESULTS: An increase in the risk of depressive symptoms was observed when MVPA and sleep time were substituted for the same SB time at all times tested, with maximum values of 40% and 20%, respectively. Opposite substitution of MVPA and sleep time increments reduced the risk of depressive symptomatology by 28% and 17%, respectively. CONCLUSIONS: The results of the present study indicate that replacing SB with the same amount of sleep or MVPA may reduce depressive symptoms. The longer the reallocation time, the greater are the benefits.

Body mass index and sex differences for mortality in hospitalized COVID-19 patients: a path analysis using a brazilian national database.

Previous studies have shown that associations between obesity and other comorbidities favor worse outcomes in COVID-19. However, it is not clear how these factors interrelate and whether effects on men and women differ. We conducted an observational, cross-sectional study using a national COVID-19 inpatient database. We studied differences in direct and indirect effects of obesity and comorbidities according to sex and body mass index (BMI) categories in hospitalized COVID-19 patients in Brazil using path analysis models and logistic regression. For men, path analysis showed a direct association between BMI and death and a negative correlation of death and chronic cardiovascular disease (CCD). For women, the association of BMI and death was indirect, mediated by admission to the ICU and comorbidities and association with CCD was non-significant. In the logistic regression analyses, there was a positive association between death and BMI, age, diabetes mellitus, kidney and lung diseases and ICU admission. We highlight the need to consider the distinct impact of obesity and sex on COVID-19, of monitoring of BMI and of the design for specific male-targeted approaches to manage obesity.

Associations of Physical Activity and Sedentary Behavior With Survival Time in Older Adults: Path Analysis.

This study investigated the direct and indirect associations of physical activity and sedentary behavior with survival time in older adults. Prospective population-based cohort study used exploratory survey-type methods and physical performance tests in 319 adults aged ≥60 years. Trajectory diagrams were used to represent the initial hypothetical and final models with the relationships of independent, mediating, and dependent variables. Physical activity was indirectly associated with survival time and was mediated by instrumental activities of daily living and functional performance. In contrast, instrumental activities of daily living, functional performance, the number of hospitalizations, and medications mediated the association between duration of sedentary behavior and survival time. The explanatory power of the final model was 19%. Future efforts should focus on increasing the participation and adherence of older adults to exercise programs to improve their physical functions and general health, which may increase their health period and, consequently, their survival time.

Isotemporal substitution of sleep or sedentary behavior with physical activity in the context of frailty among older adults: a cross-sectional study

ABSTRACT BACKGROUND: Frailty syndrome is associated with various physical, cognitive, social, economic, and environmental factors. Although frailty syndrome occurs progressively with age, prevention and treatment are possible. Reducing or eliminating risks and increasing protective factors may be potential strategies for reducing the prevalence of injuries related to frailty. One of the most effective actions is to decrease the time spent in sedentary behavior (SB) by increasing regular physical activity (PA). OBJECTIVE: To examine the hypothetical effect of substitution of the time spent in sleep or SB with an equivalent time spent performing moderate or vigorous PA on frailty syndrome in the older population. DESIGN AND SETTING: An analytical cross-sectional study conducted using exploratory methods of survey, carried out in Alcobaça city, Bahia, Brazil. METHODS: A total of 456 older adults of both sexes, aged ≥ 60 years, participated in this study. Frailty syndrome was identified according to the criteria of the Study of Osteoporotic Fractures. PA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. The effects of time substitution on these behaviors were verified using Poisson regression. RESULTS: The replacement of 60 min/day of SB (prevalence ratio, PR = 0.52; 95% confidence interval, CI: 0.28-0.96) or sleep (PR = 0.52; 95% CI: 0.27-0.98) with 60 min/day of moderate PA (MPA) was associated with a 48% reduction in the prevalence of frailty syndrome. CONCLUSIONS: Replacing the time spent sitting or sleeping with the same amount of MPA time may reduce frailty; the longer the duration of time spent in the substitution of sleep or SB with MPA, the greater the benefits.

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

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

Isotemporal substitution of sleep or sedentary behavior with physical activity in the context of frailty among older adults: a cross-sectional study.

BACKGROUND: Frailty syndrome is associated with various physical, cognitive, social, economic, and environmental factors. Although frailty syndrome occurs progressively with age, prevention and treatment are possible. Reducing or eliminating risks and increasing protective factors may be potential strategies for reducing the prevalence of injuries related to frailty. One of the most effective actions is to decrease the time spent in sedentary behavior (SB) by increasing regular physical activity (PA). OBJECTIVE: To examine the hypothetical effect of substitution of the time spent in sleep or SB with an equivalent time spent performing moderate or vigorous PA on frailty syndrome in the older population. DESIGN AND SETTING: An analytical cross-sectional study conducted using exploratory methods of survey, carried out in Alcobaça city, Bahia, Brazil. METHODS: A total of 456 older adults of both sexes, aged ≥ 60 years, participated in this study. Frailty syndrome was identified according to the criteria of the Study of Osteoporotic Fractures. PA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. The effects of time substitution on these behaviors were verified using Poisson regression. RESULTS: The replacement of 60 min/day of SB (prevalence ratio, PR = 0.52; 95% confidence interval, CI: 0.28-0.96) or sleep (PR = 0.52; 95% CI: 0.27-0.98) with 60 min/day of moderate PA (MPA) was associated with a 48% reduction in the prevalence of frailty syndrome. CONCLUSIONS: Replacing the time spent sitting or sleeping with the same amount of MPA time may reduce frailty; the longer the duration of time spent in the substitution of sleep or SB with MPA, the greater the benefits.

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

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

Reallocation of time spent on sedentary behavior by time spent on physical activity reduces dynapenia in older adults: a prospective cohort study

ABSTRACT BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85-0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01-2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40-0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults.

[Depressive symptoms and mortality in older people in Latin America: systematic review and meta-analysisSíntomas de depresión y mortalidad en personas mayores en América Latina: revisión sistemática con metanálisis]. / Sintomatologia depressiva e mortalidade em idosos da América Latina: uma revisão sistemática com metanálise.

Objective: To determine the existence of association between depressive symptoms and mortality in older individuals in Latin America. Method: A systematic review with meta-analysis was performed based on published studies indexed in PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus, and LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), and structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was performed using random effects models, and the data analyzed included crude relative risk (RR) and heterogeneity, with poin estimates and 95% confidence intervals (95%CI). Results: Five studies, performed in Brazil and Mexico, were included in the meta-analysis, for a total of 8 954 older individuals. RR for mortality in the presence of depressive symptoms was 1.44 (95%CI: 1.16; 1.78). Heterogeneity was 80.87%. Meta-regression showed that the higher the proportion of women in the sample, the higher the mortality risk associated with depressive symptoms; and that the longer the study follow-up, the lower the risk of mortality associated with depressive symptoms. Conclusion: The presence of depressive symptoms was positively associated with mortality in older Latin American individuals. The RR for death was 44.0% higher in individuals with depressive symptoms as compared to those without depressive symptoms. The main study limitations were the lower number of studies retrieved through systematic review and the variety of scales used to determine the presence of depressive symptoms.

Objetivo: Investigar la relación entre un cuadro sintomático de depresión y la mortalidad en personas mayores en América Latina. Métodos: Se realizó una revisión sistemática con metanálisis de los estudios indexados en las bases de datos PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). El estudio se registró en la base de datos PROSPERO (Registro Prospectivo Internacional de Revisiones Sistemáticas) y se estructuró según la referencia metodológica PRISMA (Elementos preferidos de notificación para revisiones sistemáticas y metanálisis). El metanálisis se realizó con modelos de efectos aleatorios, y los datos analizados incluyeron los valores de riesgo relativo (RR) bruto y de heterogeneidad, con estimaciones puntuales e intervalos de confianza de 95% (IC 95%). Resultados: En el metanálisis se incluyeron cinco estudios realizados en Brasil y México con 8 954 personas mayores. El RR de mortalidad en presencia de un cuadro sintomático de depresión fue de 1,44 (IC 95%: 1,16; 1,78). La heterogeneidad fue de 80,87%. Las metarregresiones mostraron que cuanto mayor era la proporción de mujeres en las muestras de los estudios, mayor era el riesgo de mortalidad relacionada con el cuadro sintomático de depresión, y que cuanto mayor era el tiempo de seguimiento del estudio, menor era el riesgo de mortalidad relacionada con dicho cuadro sintomático. Conclusión: La presencia de un cuadro sintomático de depresión guardó una relación positiva con la mortalidad de personas mayores en América Latina, con un RR de muerte 44% mayor en comparación con las personas sin síntomas. Las principales limitaciones del estudio fueron el reducido número de estudios encontrados en la revisión sistemática y la variación entre las escalas utilizadas para determinar la presencia de un cuadro sintomático de depresión.

Reallocation of time spent on sedentary behavior by time spent on physical activity reduces dynapenia in older adults: a prospective cohort study.

BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85-0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01-2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40-0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults.

Risk of hospitalization and mortality due to COVID-19 in people with obesity: An analysis of data from a Brazilian state.

The aim of this article is to assess the odds ratio of hospitalization and mortality due to COVID-19 in people with obesity using data from residents of Espírito Santo, Brazil. An observational, quantitative, cross-sectional study was carried out from the database available on the official channel of the State Health Secretariat of Espírito Santo. Crude odds ratio estimates (ORs) referring to the association between variables were calculated, as well as adjusted odds ratios (adjusted odds ratios-OR adj.) and their respective 95% confidence intervals (CI 95%). The results indicate that men, non-white, no education or with lower education level and age over 40 years old were more likely to be hospitalized and died of COVID-19. People with obesity are at risk of hospitalization and death due to COVID-19 54% and 113% higher than people who do not have obesity. People with obesity had a higher chance of hospitalization when they were over 40 years old, had breathing difficulty, and the comorbidities diabetes (2.18 higher) and kidney disease (4.10 higher). The odds ratio of death for people with obesity over 60 years old was 12.51 higher, and those who were hospitalized was 17.9 higher compared to those who were not hospitalized.

Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults.

The aim of the present study was to investigate the relationship of dynapenia combined with sedentary behavior (SB) on the risk of mortality in older adults living in a Brazilian community. A total of 322 participants aged ≥ 60 years from the ELSIA (Longitudinal Study of Elderly Health in Alcobaça) prospective cohort were included. Dynapenia was diagnosed when the handgrip strength was < 27 â€‹kg for men and < 16 â€‹kg for women. The exposure time to SB was assessed considering the total time spent sitting during one day in the week and one day on the weekend. When combined with dynapenia, we derived the construction of four groups: best behavior (absence of dynapenia and low SB), intermediate behavior (absence of dynapenia and high SB; presence of dynapenia and low SB) and worst behavior (presence of dynapenia and high SB). Mortality was assessed by the follow-up time until death and/or censorship. During the 5-year follow-up of the study, 55 participants progressed to death. In the adjusted models, the dynapenia and the time spent exposed to SB were analyzed in a combined way, the older adults with worse behavior (high SB and dynapenia) had higher risk ratios for mortality (hazard ratio 2.46; 95% confidence interval 1.01-5.97) than the best behavior group. Older adults with dynapenia are at greater risk for all-cause mortality, which is aggravated by the addition of longer exposure to SB.

Validation of the Trackhealth physical activity monitor / Validação do monitor de atividade física Trackhealth

ABSTRACT This is a quantitative methodological study for the validation of a research instrument. It aimed to validate the data from the TrackHealth accelerometry device. The sample consisted of 30 adult individuals of both sexes selected by convenience who met the inclusion and exclusion criteria. The physical activity monitors used for the research protocol were the ActiGraph® wGT3X-BT triaxial accelerometer and the TrackHealth accelerometer (TH). The activity protocol consisted of 4 (four) activities (walking at 4.8 and 6.4 km h1 and running at 9.7 and 12 km h1) performed in the laboratory, on an Ibramed treadmill, lasting 5 (five) minutes at each stage. A difference was found between the raw acceleration data of the two devices, however the TrackHealth device showed higher sensitivity at speeds of 4.8 and 6.4 km/h, and a high level of agreement (2.7-2.8%) at the initial speeds of the magnitude vectors. However, there is still a need for improvement in the functioning of the device, so that TrackHealth can be commercialized.

RESUMO Trata-se de um estudo metodológico quantitativo para validação de um instrumento de pesquisa. O objetivo era validar os dados do dispositivo de acelerometria TrackHealth. A amostra foi composta por 30 indivíduos adultos de ambos os sexos selecionados por conveniência que atenderam aos critérios de inclusão e exclusão. Os monitores de atividade física utilizados para o protocolo de pesquisa foram o acelerômetro triaxial ActiGraph® wGT3X-BT e o acelerômetro TrackHealth (TH). O protocolo de atividades consistiu em 4 (quatro) atividades (caminhada a 4,8 e 6,4 km h1 e corrida a 9,7 e 12 km h1) realizadas em laboratório, em esteira Ibramed, com duração de 5 (cinco) minutos em cada etapa. Foi encontrada uma diferença entre os dados brutos de aceleração dos dois dispositivos, no entanto, o dispositivo TrackHealth apresentou maior sensibilidade nas velocidades de 4,8 e 6,4 km / h, e um alto nível de concordância (2,7-2,8%) nas velocidades iniciais da magnitude vetores. Porém, ainda há necessidade de melhorias no funcionamento do aparelho, para que o TrackHealth possa ser comercializado.

Sintomatologia depressiva e mortalidade em idosos da América Latina: uma revisão sistemática com metanálise / Depressive symptoms and mortality in older people in Latin America: systematic review and meta-analysis / Síntomas de depresión y mortalidad en personas mayores en América Latina: revisión sistemática con metanálisis

RESUMO Objetivo. Averiguar a associação entre sintomatologia depressiva e mortalidade em idosos da América Latina. Métodos. Realizou-se uma revisão sistemática com metanálise de estudos indexados nas bases PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). O estudo foi registrado na base PROSPERO (International Prospective Register of Systematic Reviews) e estruturado de acordo com o referencial metodológico PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A metanálise foi realizada usando modelos de efeitos aleatórios, e os dados analisados incluíram as medidas de risco relativo (RR) bruto e heterogeneidade, com estimativas pontuais e intervalos de confiança de 95% (IC95%). Resultados. Cinco estudos, realizados no Brasil e no México, foram incluídos na metanálise, abrangendo 8 954 idosos. O RR para mortalidade na presença de sintomatologia depressiva foi de 1,44 (IC95%: 1,16; 1,78). A heterogeneidade encontrada foi de 80,87%. As metarregressões mostraram que quanto maior a proporção de mulheres nas amostras dos estudos, maior o risco de mortalidade associada à sintomatologia depressiva, e quanto maior o tempo de acompanhamento do estudo, menor o risco de mortalidade associada à sintomatologia depressiva. Conclusão. A presença de sintomatologia depressiva associou-se positivamente à mortalidade em idosos latino-americanos, com RR de óbito 44% maior em relação aos idosos sem sintomatologia depressiva. As principais limitações do estudo foram o pequeno número de trabalhos encontrados na revisão sistemática e a variação entre as escalas utilizadas para determinar a presença de sintomatologia depressiva.

ABSTRACT Objective. To determine the existence of association between depressive symptoms and mortality in older individuals in Latin America. Method. A systematic review with meta-analysis was performed based on published studies indexed in PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus, and LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), and structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was performed using random effects models, and the data analyzed included crude relative risk (RR) and heterogeneity, with poin estimates and 95% confidence intervals (95%CI). Results. Five studies, performed in Brazil and Mexico, were included in the meta-analysis, for a total of 8 954 older individuals. RR for mortality in the presence of depressive symptoms was 1.44 (95%CI: 1.16; 1.78). Heterogeneity was 80.87%. Meta-regression showed that the higher the proportion of women in the sample, the higher the mortality risk associated with depressive symptoms; and that the longer the study follow-up, the lower the risk of mortality associated with depressive symptoms. Conclusion. The presence of depressive symptoms was positively associated with mortality in older Latin American individuals. The RR for death was 44.0% higher in individuals with depressive symptoms as compared to those without depressive symptoms. The main study limitations were the lower number of studies retrieved through systematic review and the variety of scales used to determine the presence of depressive symptoms.

RESUMEN Objetivo. Investigar la relación entre un cuadro sintomático de depresión y la mortalidad en personas mayores en América Latina. Métodos. Se realizó una revisión sistemática con metanálisis de los estudios indexados en las bases de datos PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). El estudio se registró en la base de datos PROSPERO (Registro Prospectivo Internacional de Revisiones Sistemáticas) y se estructuró según la referencia metodológica PRISMA (Elementos preferidos de notificación para revisiones sistemáticas y metanálisis). El metanálisis se realizó con modelos de efectos aleatorios, y los datos analizados incluyeron los valores de riesgo relativo (RR) bruto y de heterogeneidad, con estimaciones puntuales e intervalos de confianza de 95% (IC 95%). Resultados. En el metanálisis se incluyeron cinco estudios realizados en Brasil y México con 8 954 personas mayores. El RR de mortalidad en presencia de un cuadro sintomático de depresión fue de 1,44 (IC 95%: 1,16; 1,78). La heterogeneidad fue de 80,87%. Las metarregresiones mostraron que cuanto mayor era la proporción de mujeres en las muestras de los estudios, mayor era el riesgo de mortalidad relacionada con el cuadro sintomático de depresión, y que cuanto mayor era el tiempo de seguimiento del estudio, menor era el riesgo de mortalidad relacionada con dicho cuadro sintomático. Conclusión. La presencia de un cuadro sintomático de depresión guardó una relación positiva con la mortalidad de personas mayores en América Latina, con un RR de muerte 44% mayor en comparación con las personas sin síntomas. Las principales limitaciones del estudio fueron el reducido número de estudios encontrados en la revisión sistemática y la variación entre las escalas utilizadas para determinar la presencia de un cuadro sintomático de depresión.

Physical activity combined with sedentary behaviour in the risk of mortality in older adults.

OBJECTIVE: To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults. METHODS: Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB. RESULTS: Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time. CONCLUSION: Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

Effects of Reallocating Time Spent Engaging in Sedentary Behavior and Physical Activity on Mortality in Older Adults: ELSIA Study.

BACKGROUND: The objective of the study is to investigate the effects of reallocating time spent engaging in sedentary behavior (SB) and physical activity on the risk of mortality. METHODS: In all, 332 older adult low-income and low-education populations participated in the study. At the end of the study, 273 of the participants were alive and 59 had died. Time spent undertaking moderate to vigorous physical activity (MVPA) and SB was assessed using the international physical activity questionnaire. The Cox proportional hazards regression model was used. RESULTS: The replacement of time spent engaging in SB with MVPA reduced the risk of mortality from all causes in the older adults, resulting in reductions in mortality risk of between 10% and 46%. CONCLUSION: A reduction in the risk of mortality in older adults was observed when time spent in SB was replaced with the same amount of time in MVPA for all times tested.

Validade das medidas do tempo sentado do questionário IPAQ-versão curta em universitários brasileiros / Validity of measure of sitting time of IPAQ Questionnaire short version in undergraduate from Brazil

Os objetivos deste estudo foram estimar o nível de reprodutibilidade das medidas do tempo sen-tado do questionário International Physical Activity Questionnaire (IPAQ-versão curta) e analisar a validade concorrente dessas medidas em relação ao tempo sedentário mensurado pelo acelerômetro em universitários. Realizou-se um estudo correlacional com amostra de 61 universitários de uma instituição do ensino superior de Minas Gerais, Brasil, que autopreencheram as medidas do tempo sentado do IPAQ, intercalados por dois momentos diferentes para fins da análise de reprodutibili-dade, e usaram o acelerômetro para estimativa do tempo sedentário e emprego como padrão ouro na análise de validade concorrente. Empregou-se as análises de correlação, via coeficiente de correlação intraclasse (CCI) e gráfico de dispersão de Bland-Altman, para analisar a concordância. O nível de significância adotado foi de 5%. A média de idade foi de 21,54 anos e 62,3% foram do sexo feminino. A reprodutibilidade do tempo sentado durante um dia de semana foi moderada (CCI = 0,51; p < 0,01), enquanto em um dia do final de semana foi baixa (CCI = 0,30; p = 0,01). As diferenças médias entre o tempo sentado pelo IPAQ e o tempo sedentário pelo acelerômetro, em um dia da semana foi de -51 minutos e em um dia do final de semana foi de -64,7 minutos. Conclui-se que houve correlações e concordâncias satisfatórias tanto na reprodutibilidade quanto na comparação com a medida critério (acelerômetro) das medidas do tempo sentado mensurado pelo IPAQ para aplicação em universitários

The objectives of this study were to estimate the level of reproducibility of the sitting time measurements of the International Physical Activity Questionnaire (IPAQ-short version), and to analyze the concurrent validity of these measurements in relation the sedentary time measured by the accelerometer, in university students. A correlational study was carried out with a sample of 61 university students of a higher educa-tion institution from Minas Gerais, Brazil, who self-completed the IPAQ sitting time measurements, with interval of seven days for the purposes of the reproducibility analysis and used the accelerometer to estimate sedentary time and employment as the gold standard in the analysis of concurrent validity. The correlation analyzes via intraclass correlation coefficient (ICC) and Bland-Altman scatter plot were used to analyze the agreement. The significance level adopted was 5%. The average age was 21.54 years and 62.3% were female. The reproducibility of sitting time on a weekday was moderate (ICC = 0.51; p < 0.01), while on a weekend day it was low (ICC = 0.30; p = 0.01). The mean differences between sitting time using the IPAQ and sedentary time using the accelerometer on a weekday was -51 minutes and on a weekend was -64.7 minutes. Concluded that there were satisfactory correlations and agreements both in reproducibility and in comparison, with the criterion measure (accelerometer) of the sitting time measures measured by the IPAQ for application in university students

Smartphone e folder podem ser uma alternativa para reduzir o comportamento sedentário? Estudo piloto / Can smartphone and folder be an alternative to reduce sedentary behavior? Pilot study

O objetivo do estudo foi investigar se a exposição a informações sobre vida saudável, via aplicativo de mensagem de smartphone ou folder impresso, reduz o comportamento sedentário (CS) de universitários. Este estudo é um piloto prospectivo quase experimental, constituído por 69 participantes, randomizados por turma, em dois grupos de intervenção via mensagem de texto Whatsapp (grupo MSG)e folder impresso (grupo FOLDER). As intervenções apresentaram orientações semelhantes com foco geral de promover um perfil de vida saudável, reduzindo o CS. As mensagens foram encaminhadas às segundas-feiras por um período de quatro semanas consecutivas. O tempo exposto ao CS foi avaliado a partir do Questionário Internacional de Atividade Física na Baseline e após quatro semanas de intervenção. Para avaliar o efeito do tempo, da intervenção e a interação (tempo*intervenção) no CS, foram utilizados modelos mistos generalizados para medidas repetidas, utilizando uma matriz de covariância autorregressiva de primeira ordem (AR1) e foi utilizado o teste post hoc de Bonferroni. Foi adotado o nível de significância de 5%. Foram observados efeitos significantes das intervenções (F = 5,30; p = 0,024), FOLDER (519,71 ± 28,01) e MSG (430,37 ± 26,82), e dos tempos (F = 19,05; p < 0,001) baseline (522,07 ± 22,18) e após 4 semanas (428,00 ± 22,18) mas não foi observado interação entre o tempo e a intervenção (F = 0,430; p = 0,514). Foram observadas diferenças significantes entre os grupos no momento pós intervenção (p = 0,022). Ambas as intervenções parecem ser úteis para a redução do tempo exposto ao CS em uma população de adultos jovens durante o período de quatro semanas

The objective of the study was investigate whether exposure to information about healthy living, via smart-phone message application or printed folder, reduces the sedentary behavior (SB) of university students. This study is an almost experimental prospective pilot, consisting of 69 participants, randomized by class, in two intervention groups via Whatsapp text message (MSG group) and printed folder (FOLDER group). The interventions presented similar guidelines with a general focus on promoting a healthy life profile, reducing SB. The messages were forwarded on Mondays for a period of four consecutive weeks. The time exposed to the SB was evaluated using the International Physical Activity Questionnaire on the baseline and after four weeks of intervention. To evaluate the effect of time, intervention and interaction (time * intervention) in the SB, generalized mixed models for repeated measures were used, using a first order autoregressive covariance matrix (AR1) and Bonferroni post hoc test was used. The significance level of 5% was adopted. Significant effects of the interventions (F = 5.30; p = 0.024), FOLDER (519.71 ± 28.01) and MSG (430.37 ± 26.82), and of the times (F = 19.05; p < 0.001) baseline (522.07 ± 22.18) and after 4 weeks (428.00 ± 22.18) but no interaction was observed between time and intervention (F = 0.430; p = 0.514). Significant differences were observed between the groups at the time after the intervention (p = 0.022). Both interventions appear to useful for reducing the time exposed to SC in a population of young adults over the four-week period

Physical activity combined with sedentary behaviour in the risk of mortality in older adults

ABSTRACT OBJECTIVE To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults. METHODS Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB. RESULTS Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time. CONCLUSION Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.