Valores de referencia y factores de riesgo de la condición física en personas mayores chilenas físicamente activas / Reference values and risk factors in the deterioration of the physical fitness of physically active older chilean adults

BACKGROUND: Physical fitness assessment of older adults is essential because it is a key component of functional independence and healthy aging. AIM: To establish physical fitness reference values for physically active older Chilean adults of both sexes and identify the variables associated with the deterioration of their physical condition. MATERIAL AND METHODS: Cross-sectional study that included 342 older adults aged 60 and over. Their physical fitness was assessed with the Senior Fitness Test (SFT). The timed up and go (TUG), chair stand (CS), arm curl (AC), and aerobic resistance (2 min) tests were evaluated. RESULTS: Performance in the physical fitness tests by age group decreased in all tests as older adults advanced in age. Scores for men were more evenly distributed across the different age groups. The main risk factors for the deterioration of physical fitness were age, sex, and body mass index (BMI) (p-value < 0.05). The primary risk factor for men was age and for women age and BMI. CONCLUSIONS: Performance of both men and women in the different SFT tests decreased as older adults aged. Age, sex, and BMI were the main risk factors for the deterioration of the physical fitness of physically active older adults.

Asociación entre nivel educacional y sospecha de deterioro cognitivo en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017 / Association between educational level and suspicion of cognitive imparirment in Chilean older people

BACKGROUND: A low education level has been associated with cognitive impairment in older adults. AIM: To determine the association between educational attainment and suspicion of cognitive imparirment in older Chilean population. MATERIAL AND METHODS: Data from 2,005 adults aged ≥ 60 years assessed during 2016-2017 Chilean National Health Survey were included. Education was self-reported and categorized as primary: ≤ 8 years; secondary: 9 to 12 years and beyond secondary: > 12 years. suspicion of cognitive imparirment was assessed with the Mini-Mental questionnaire. RESULTS: Men and women with low education attainment had a higher prevalence of cognitive impairment (33% [95% confidence intervals (CI): 24; 41] and 27% [95% CI: 21; 33], respectively). Men who reported less schooling (≤ 8 years) were more likely to be at risk of suspicion of cognitive imparirment (Odds ratio (OR): 4.53 [95% CI: 1.10, 18.62]) compared to their peers. Women showed a substantially higher magnitude of association than men. The probability of suspicion of cognitive imparirment increased 9-times (OR: 9.96 [95% CI: 1.24; 79.6]) for 9-12 years and 18-times for ≤ 8 years of education (OR: 18.8 [95% CI: 2.42; 146.1]) compared to women with higher education. CONCLUSIONS: Older adults with low education attainment had an increased likelihood of developing suspicion of cognitive imparirment. However, the risk differs by sex, being higher in women than men.

Fuerza de prensión manual. Un sencillo, pero fuerte predictor de salud en población adulta y personas mayores / Handgrip strength as a predictor of adverse health outcomes

Muscle strength can be measured through different methods and handgrip strength is one of the most used techniques in epidemiological studies. Given its easy application, high reliability, and low cost, it is considered an important health biomarker. Handgrip strength is associated with adverse health outcomes such as mortality and risk of developing chronic diseases, cardiovascular, respiratory, cancer and dementia. There is a paucity of evidence in Chile about the association of handgrip strength with these health outcomes limiting its visibility and implementation in clinical settings. Therefore, this narrative review summarizes the scientific evidence about the association of grip strength with non-communicable chronic diseases and mortality in middle age and older adults.

Efectos en la capacidad funcional de un programa de ejercicio físico terapéutico basado en telesalud en personas con diagnóstico de osteoartritis de rodilla y cadera / Effects of a telehealth-based physical exercise program on functional capacity in patients with osteoarthritis

BACKGROUND: Telehealth is a novel therapeutic alternative. Aim: To determine the effects of a remote therapeutic physical exercise program (TPEP), based on telehealth, on functional physical capacity in people with knee or hip osteoarthritis. PATIENTS AND METHODS: An eight-week TPEP was undertaken by 36 participants with a mean age of 68 years. The control group received printed exercise instructions, while the experimental group received the same instructions plus TPEP using tutorial videos and voice messaging via WhatsApp. Both groups were evaluated at baseline and the end of the intervention with the Lower Extremity Functional Scale (LEFS), Barthel index (BI), Short Physical Performance Battery (SPPB), senior fitness test and with the Visual Analog Scale for pain (VAS). RESULTS: The experimental group decreased the VAS score and improved tandem balance, three-meter walk, sit and stand 5 times, sit and stand in 30 seconds, push-ups in 30 seconds, two minutes' walk, join the right hand behind the back and SPPB general score. The control group increased the BI score and improved the three meters walking test, sitting, and standing 5 times, sit and stand 30 seconds chair test, 2 minutes walking test and the SPPB general score. No differences between groups were observed for the LEFS scale, BI, VAS and functional capacity. CONCLUSIONS: A TPEP based on telehealth has similar effectiveness than a TPEP based on traditional paper-based intervention to improve functional physical capacity in patients with OA. (Rev Med Chile 2022; 150: 33-45)

Fitness cardiorrespiratorio estimado mediante ecuación y su caracterización sociodemográfica en población chilena: Resultados de la Encuesta Nacional de Salud 2016-2017

Background: Cardiorespiratory fitness is a strong predictor of mortality and chronic diseases. However, its estimation is costly and time consuming which may limit it broad use in population-based studies. Aim: To estimate the cardiorespiratory fitness of the Chilean population by using equations and to characterize fitness levels of the Chilean population by sociodemographic factors. Material and Methods: This cross-sectional study included 5,958 adults from the Chilean Health Survey conducted between 2016 and 2017. Cardiorespiratory fitness was estimated from sex-specific equations for men and women and expressed as METs (Energy Metabolic Equivalent). Fitness levels were characterized by sociodemographics factors (age, sex, education, income and area of residency). Results: Fitness levels were higher in men (9.01 METs) than in women (6.76 METs) and in average decrease by 0.59 and 0.34 METs per each year increment in age for men and women, respectively. Fitness levels were 12.7 METs and 7.8 METs for 20-year-old men and women, respectively. However, fitness levels decreased to 7.8 METs and 4.3 METs in 90-year-old men and women, respectively. Fitness levels were also higher in individuals living in urban setting, those with higher education or income levels and lean individuals. Conclusions: This study reports fitness levels in a nationally representative sample of Chile. Fitness levels were higher in men than women however, its decline with age was more pronounce in men than women.

Efectos de un programa multicomponente sobre la fragilidad y calidad de vida de adultos mayores institucionalizados / Effects a multicomponent program on the frailty and quality of life of institutionalized older adults

Introducción: El envejecimiento se relaciona con mayor prevalencia de fragilidad y deterioro en la calidad de vida. Además, existe pérdida de la autonomía, lo que aumenta la institucionalización. Objetivo: Determinar los efectos de un programa de entrenamiento físico multicomponente, sobre la fragilidad y la calidad de vida de adultos mayores institucionalizados. Metodología: Estudio preexperimental, longitudinal, que evaluó 28 adultos mayores institucionalizados (17 mujeres y 11 hombres). La muestra fue seleccionada mediante un criterio no probabilístico intencionado. Se realizó un programa de entrenamineto multicomponente (resistencia aeróbica, fuerza muscular, equilibrio y flexibilidad) durante 6 semanas. Antes y después se evaluó la fragilidad en base a la escala de fenotipo propuesta por Fried y la calidad de vida con el cuestionario World Health Organization Quality of Life - Older Adults (WHOQoL-OLD). Se aplicó la prueba t de Student para realizar las comparaciones y se calculó el tamaño del efecto. Se utilizó un nivel alfa de 0,05. Resultados: Los adultos mayores mostaron mejoras significativas en el índice de fragilidad (p = 0,007; d = 0,36). La calidad de vida mostró cambios estadísticamente significativos en las dimensiones, Actividades pasadas, presentes y futuras (p = 0,018; d = 0,53); Participación social (p = 0,003; d = 0,53) e Intimidad (p = 0,005; d = 0,36), luego de realizar un programa de ejercicios multicomponente. La calidad de vida global de los participantes también mostró cambios significativos (p = 0,007; d = 0,65). Conclusión: Un programa de entrenamiento fisico multicomponente de 6 semanas de duración mejoró la fragilidad y calidad de vida de adultos mayores institucionalizados(AU)

Introduction: Aging is related to a higher prevalence of frailty and deterioration in quality of life. There is also a loss of autonomy, which increases institutionalization. Objective: To determine the effects of a multicomponent physical training program, on frailty and quality of life in institutionalized older adults. Methodology: Pre-experimental, longitudinal study that evaluated 28 institutionalized older adults (17 women and 11 men). The sample was selected using an intentional non-probabilistic criterion. A multicomponent training program (aerobic resistance, muscular strength, balance and flexibility) was carried out for 6 weeks, before and after the fragility was evaluated based on the phenotype scale proposed by Fried and the quality of life with the World Health Organization questionnaire Quality of Life - Older Adults (WHOQoL-OLD). The Student's t-test was applied to make the comparisons and the effect size was calculated. An alpha level of 0.05 was used. Results: After participating in the multicomponent exercise program, older adults showed significant improvements in the frailty index (p = 0.007; d = 0.36). The quality of life showed statistically significant changes in the dimensions Past, present and future activities (p = 0.018; d = 0.53), Social Participation (p = 0.003; d = 0.53) and Intimacy (p = 0.005; d = 0.36) after completing a multi-component exercise program. The overall quality of life of the participants also showed significant changes (p = 0.007; d = 0.65). Conclusion: A 6-week multi-component physical training program improved the frailty and quality of life of institutionalized older adults(AU)

Prevalencia de debilidad muscular en personas mayores chilenas: resultados de la Encuesta Nacional de Salud 2016-2017

Background: Handgrip strength is an indicator of frailty in older people. Aim: To determine the prevalence of low handgrip strength in older Chilean adults. Material and Methods: A cross-sectional analysis of 244 individuals aged 60 years or more, participating in the 2016-2017 Chilean National Health Survey, was carried out. Handgrip strength was evaluated by a hand dynamometer and low grip strength was determined as a grip strength ≤ 15 kg and ≤ 27 kg for women and men, respectively. Results: Twenty nine percent of participants had low grip strength. The average grip strength among 60-year-old men and women was 34.7 and 22.1 kg, respectively. These figures decreased to 28.8 kg and 17.2 kg among 90-year-old men and women, respectively. The prevalence of low grip strength in men and women aged 60 years was 18%. In 90-year-old men and women, these figures increased to 79% and 56.3%, respectively. Conclusions: The prevalence of low grip strength increased substantially with age.

Comparación entre el auto-reporte de actividad física y la medición con acelerómetro según factores sociodemográficos / Comparison of self-reported and accelerometer-measured physical activity according to sociodemographic factors

RESUMEN Introducción: La determinación del nivel de actividad física (AF) puede realizarse a través de acelerómetro o mediante cuestionario de auto-reporte. El objetivo de este estudio fue comparar los niveles de AF entre un cuestionario de auto-reporte y la medición con acelerómetro de movimiento según factores sociodemográficos en la población chilena. Métodos: Estudio de corte transversal que incluyó a 230 adultos chilenos participantes del proyecto Genes, Ambiente, Diabetes y Obesidad (GENADIO). Niveles de AF fueron medidos mediante el cuestionario Internacional Physical Activity Questionnaire (IPAQ) y acelerómetro de movimiento (ActiGraph). Resultados: IPAQ subestimó los niveles de AF total en comparación a la medición con acelerómetro (delta [IPAQ-Acel.]= −55,7 min/día). Según nivel educacional, se evidenció que el cuestionario IPAQ sobreestimó los niveles de AF total en personas con bajo nivel educacional (delta [IPAQ-Acel.]= 70,4 min/día), pero subestimó la AF total en personas con enseñanza media o técnico universitaria (delta [IPAQ-Acel.]= −67,9 y −135,6 min/día, respectivamente). Resultados similares fueron observados para los distintos niveles de ingreso socioeconómico (NSE). Conclusión: El cuestionario de auto-reporte IPAQ subestimó los niveles de AF total en comparación a la medición por acelerómetro; sin embargo, estas diferencias variaron según factores sociodemográficos.

ABSTRACT Introduction: Determining level of physical activitY (PA) can be done with objective measurement, through accelerometer, or by subjective measurement through self-report questionnaire. The aim of this study was to compare PA measurements derived from a self-reported questionnaire and accelerometer according to sociodemographic factors in the Chilean population. Methods: This was a cross-sectional study which included 230 Chilean adults participating in the GENADIO study (Genes, Environment, Diabetes and Obesity). PA levels were measured through the International Physical Activity Questionnaire (IPAQ) and GT1M accelerometer (ActiTrainer, ActiGraph). Results: IPAQ questionnaire underestimated the total PA levels compared to the accelerometer measurement (delta[IPAQ-Acel.]= −55.7 min/day). According to educational level, IPAQ questionnaire overestimated PA level in people with low educational level (delta[IPAQ-Accel.]= 70.4 min/day), but underestimated total PA in people with secondary education or university technician (delta[IPAQ-Accel.]=-67.9 and-135.6 min/day, respectively). Similar results were observed for the different levels of socioeconomic income. Conclusion: The IPAQ questionnaire underestimated total PA levels compared to accelerometer; however, these differences varied according to sociodemographic factors.

Diagnóstico médico de depresión se asocia a sospecha de deterioro cognitivo en adultos mayores / Association between cognitive impairment and depression in Chilean older adults

Background: Depression has been previously associated with cognitive impairment in high income country populations. However, its association in the Chilean population has not been investigated. Aim: To investigate the association between depression and cognitive impairment. Material and Methods: Data from 1384 Chilean adults aged > 60 years, participating in the National Health Survey 2009-2010 was analyzed. Cognitive impairment was assessed using the Mini Mental Examination score. The medical diagnosis of depression was self-reported. The association between depression and cognitive impairment was assessed using a logistic regression. Results: Depression was positively associated with cognitive impairment. However, the magnitude of the association was higher in men (Odds ratio (OR) = 4.02 [95% confidence intervals (CI): 1.44; 6.61], p < 0.01]) than in women (OR = 2.23 [95%CI: 1.03; 3.43], p = 0.04). Older adults who were diagnosed for the first time with depression after 65 years of age, showed a stronger association with cognitive impairment (OR = 6.65 [95% CI: 2.39; 10.9], p < 0.01) than those diagnosed before 55 years. Conclusions: Our study confirms the association between depression and cognitive impairment. Further research is needed to elucidate the nature and potential mechanisms that link depression with cognitive impairment.

Personas mayores en Chile: el nuevo desafío social, económico y sanitario del Siglo XXI / Older people in Chile: the new social, economic and health challenge for the 21st century

Ageing will be one of the most significant social transformations of the 21st century worldwide. In the last 40 years, Chile has tripled its older adult population. As a result, by 2050 the country will have the highest proportion of older adults in Latin America. This remarkable growth reinforces the need to identify their current situation and to revise what is the society doing to maintain older people as active members. In this context, this narrative revision aimed to describe the sociodemographic, epidemiologic and sociocultural profile of the older Chilean adults. Besides, programs and public policies focused on the improvement of their quality of life were identified.

Caracterización de los estilos de vida en dueñas de casa chilenas: análisis de la Encuesta Nacional de Salud 2009-2010 / Lifestyles of Chilean housewives: analysis of the 2009-2010 Chilean Health Survey

Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.

Valores de referencia para la batería de pruebas Senior Fitness Test en mujeres mayores chilenas físicamente activas / Reference values for the senior fitness test in Chilean older women

Background:: The Senior Fitness Test (SFT) is frequently used to assess physical fitness and functional independence in older people. Aim: To establish reference values for the SFT in Chilean physically active older women according to age ranges. Material and Methods: Cross-sectional study that included 1048 Chilean women aged between 60 and 85 years. Chair stand (CS), arm curl (AC), two-min walk (2 min), chair sit-and-reach (CSr), back scratch (BS), and timed up-and-go test (TUG) were evaluated. The reference values are presented in percentiles (p5, p10, p25, p50, p75, p90 and p95) and are distributed age intervals (60-64, 65-69, 70-74, 75-79 and ≥ 80 years). Results: There was a decrease in strength (CS and AC), aerobic resistance (2 min) and flexibility (CSr and BS) along with age, whereas the time required to perform the timed up and go increased along with age. Conclusions: Physically active older women show a deterioration in physical fitness along with age. These women have higher reference values in CS, AC, 2 min and CSr, and lower in BS and TUG, than those reported abroad for the SFT.

Factores de riesgo asociados a bajo nivel de actividad física y exceso de peso corporal en estudiantes universitarios / Levels of physical activity and excess body weight in university students

Background: University students are considered a vulnerable group due to their adoption of unhealthy diets and lifestyles. Aim: To determine the main risk factors associated with low level of physical activity and excess body weight in university students. Material and Methods: This cross-sectional study included 358 university students from Talca, (53% female). Sociodemographic, academic, health, lifestyle, nutritional status, physical activity and sedentary behavior variables were analyzed by logistic regression. Results: Men were more likely to present excess body weight than women (Odds ratio (OR): 2.16 [95% CI: 1.17-4.01], p = 0.01). Similarly, those with low level of physical activity (OR: 2.13 [95% CI: 1.10-414], p = 0.03), musculoskeletal injuries (OR: 2.43 [95% CI: 1.09-6.34], p = 0.05) and smokers (OR: 2.09 [95% CI: 1.05-4.14], p = 0.04) were more likely to have excess body weight. Individuals with excess body weight (OR: 2.94 [95% CI: 1.31-6.61], p < 0.01), high sedentary behaviors (OR: 2.01 [95% CI: 1.04-4.55], p = 0.04), those who spent more than 7 hours per week studying (OR: 2.11 [95% CI: 1.06-4.66], p = 0.04), and those with presence of musculoskeletal injuries (OR: 1.49 [95% CI: 1.06- 3.66], p = 0.04) were more likely to be physically inactive. In addition, men were 73% less likely to have low physical activity levels compared to women (OR: 0.27 [95% CI: 0.11-0.56], p < 0.01). Conclusions: University students have several modifiable risk factors associated with low levels of physical activity and excess weight. Healthy lifestyles promotion should modify these risk behaviors.

Efectos de un programa de estimulación físico-cognitiva sobre la autopercepción de la funcionalidad en adultos mayores / Effects of a physical and cognitive stimulation program on the self-perception of the functional status in older adults

Propósito: determinar el efecto de un programa de 8 semanas de estimulación físico-cognitiva sobre la autopercepción de la funcionalidad en adultos mayores. Metodología: estudio de tipo pre-experi-mental, longitudinal y prospectivo. Participaron 59 mujeres y 15 hombres entre 65 y 80 años de edad quienes realizaron 24 sesiones de estimulación físico-cognitiva con una frecuencia de 3 veces por semana, durante 8 semanas. Se evaluó la autopercepción de la funcionalidad al inicio y al final de la intervención. Se utilizó la prueba t de Student de una cola para muestras relacionadas para comparar la autopercepción de los adultos mayores evaluados antes y después de la intervención. Se consideró un nivel alfa de 0.05. Resultados: la autopercepión de funcionalidad de los adultos mayores intervenidos mejoró luego de ser sometidos a un programa de estimulación físico-cognitiva (p < 0.001; d = 0.28) en hombres (p = 0.010; d = 0.18) y mujeres (p = 0.002; d = 0.33). Conclusiones: los resultados de este estudio señalan que los adultos mayores (mujeres y hombres), mejoran su autopercepción de funcio-nalidad luego de participar en un programa de estimulación físico-cognitiva.

Purpose: To determine the effect of an 8-week physical-cognitive stimulation program on the self-perception of the functional status in older adults. Methodology: Pre-experimental, longitudinal and prospective study. Fifty-nine women and fifteen men between 65 and 80 years old performed 24 ses-sions of physical-cognitive stimulation, 3 times a week for 8 weeks. The self-perception of the adults ́ functional status was evaluated at the beginning and at the end of the intervention. The Student's t-test was used to compare mean scores for the self-perception evaluated in older adults. An alpha level of 0.05 was considered. Results: The self-perception of the functional status in older adults improved after taking part in a physical-cognitive stimulation program (p <0.001; d = 0.28) in men (p = 0.010, d = 0.18) and women (P = 0.002, d = 0.33). Conclusions: The results of this study indicate that older adults (women and men) improve their self-perception of their functional status after participating in a physical-cognitive stimulation program.