Systematic review and meta-analysis on population attributable fraction for physical inactivity to dementia.

INTRODUCTION: The number of cases of dementia attributable to physical inactivity remains unclear due to heterogeneity in physical inactivity definitions and statistical approaches used. METHODS: Studies that used population-based samples to estimate the population attributable fraction (PAF) of physical inactivity for dementia were included in this review. Weighted PAFs were adjusted for communality among the risk factors (i.e., inactive persons may also share other risk factors) analyzed. Values were reported as percentage (%) of cases of dementia attributable to physical inactivity. RESULTS: We included 22 studies. The overall impact of physical inactivity, defined by any criteria, on dementia ranged from 6.6% (95% CI: 3.6%, 9.6%; weighted) to 16.6% (95% CI: 14.4%, 18.9%; unweighted). Studies using the WHO criterion for physical inactivity estimated a higher unweighted impact (ß = 7.3%; 95% CI: 2.0%, 12.6%) than studies using other criteria. DISCUSSION: Conservatively, one in 15 cases of dementia may be attributable to physical inactivity, defined by any criteria.

Effects of an exercise program on health of people with epilepsy: A randomized clinical trial.

To evaluate the effects of an exercise program on the health of people with epilepsy (PWE) and seizure frequency. A randomized clinical trial was carried out in Pelotas/Brazil. Recruitment was conducted through social media, in local press, and Public Health System facilities. The intervention program was performed at the gym of the Physical Education School/Federal University of Pelotas. A total of 21 people, aged 18-60 years, diagnosed with epilepsy and who were not engaged in systematic physical exercise in the last three months were divided into two groups: (1) exercise (EG) - 12 weeks of a structured physical exercise program; (2) control (CG) - no exercise and maintenance of usual activities. The allocation rate 1:1 was used. The exercise program consisted of two 60-min weekly sessions including warm-up (5-min), aerobic training (15-25 min at 14-17 on Borg scale), resistance training (2-3 sets, 10-15 repetitions), and stretching. Sociodemographic, clinical and health variables (frequency and number of seizures, quality of life, depression, anxiety, and side effects), anthropometrics (weight, height, hip and waist circumferences), cardiorespiratory fitness (VO2max), and strength (dynamometry) were measured at baseline and after the 12-week intervention. Generalized Estimating Equations (GEE) and Bonferroni posthoc tests were used for the comparison between moments and groups. Eleven participants were randomized to EG and 10 to CG. One EG participant did not complete the study. There was a reduction in frequency of epileptic seizures during the 3-month intervention period in EG (p = 0.010) with no improvement in CG. Improvement in quality of life (p = 0.004), stress levels (p = 0.017) and physical fitness (p = 0.017) were also observed in the EG compared to CG. A structured physical exercise program improved overall health of PWE and decreased seizure frequency.

Intradialytic exercise with blood flow restriction is more effective than conventional exercise in improving walking endurance in hemodialysis patients: a randomized controlled trial.

OBJECTIVE: This study aims to compare the effect of intradialytic aerobic exercise with blood flow restriction, without blood flow restriction (conventional) and no exercise (control) on muscle strength and walking endurance among chronic kidney disease patients. DESIGN: Open label and parallel group randomized controlled trial. SUBJECTS: Adult patients with chronic kidney disease on hemodialysis. INTERVENTION: A 12-week intradialytic training with or without blood flow restriction compared with a control group. MAIN MEASURES: Strength and walking endurance were measured using thoracolumbar dynamometry and a 6-minute walk test, respectively, before and after training. RESULTS: A total of 66 patients were randomized into three groups: blood flow restriction group (n = 22), conventional exercise group (n = 22) and control group (n = 22). There were seven dropouts, and 59 patients were included in the analysis. There was a significant increase in the 6-minute walking distance in the blood flow restriction group (from 412.7 (115.9) to 483.0 (131.0) m, P = 0.007) in comparison with the conventional exercise group (from 426.79 (115.00) to 433.2 (120.42) m, not significant) and the control group (from 428.4 (108.1) to 417.3 (100.2) m, not significant). The change in the walking distance over time was significantly different among groups (intervention group/time, P = 0.02). The simple effects test found a significant time effect only in the blood flow restriction group. There was no significant difference in strength change between the groups. CONCLUSION: Among chronic kidney disease patients, intradialytic exercise of low/moderate intensity with blood flow restriction was more effective in improving walking endurance than conventional exercise or no exercise.

Who are the individuals diagnosed with epilepsy using the Public Health System in the city of Pelotas, southern Brazil?

The aim of this study was to describe sociodemographic, clinical, behavioral, nutritional, and health-related variables from people with epilepsy. A descriptive observational study was carried out in the city of Pelotas, southern Brazil. Sociodemographic, clinical, behavioral, nutritional, and health-related variables were collected. A univariate analysis was performed, calculating the measures of central tendency for continuous variables and proportions for categorical ones. The sample consisted of 101 people, age ranging from 12 to 75years, mostly male (50.5%) and white (59.4%). Only 37.2% from the sample was employed, and the average income was R$ 788.00 Brazilian Reais (US$ 245.90 at the moment of the interview). From all the subjects, 65.6% was in treatment with monotherapy, 62.9% presented more than 15 seizures during the life, 67.3% showed active epilepsy, 64.6% were physically inactive, 52.5% presented normal body mass index, and 50% showed generalized seizures. The most used antiepileptic drug was the carbamazepine. The average score of depression was 12.6±4.1 points and 34.6% showed severe depressive symptoms (equal or higher than 15 points). The mean score of trait and state anxiety was 12.2±3.6 and 15.1±3.4 points, respectively (ranging from 6 to 24 points). The mean score of quality of life and stress was 63.2±18.2 (ranging from 0 to 100 points) and 21.2±7.1 points (ranging from 0 to 40 points), respectively. Considering the medication side effects, the mean score was 42.4±8.9 points, 38.5% showing high rates (higher than 45 points), and only 16% showing good sleep quality. In conclusion, these results are important to improve understanding of these individuals' disease and to subsidize the specific public policies in countries of low and middle income.

Are physical activity levels associated with better health outcomes in people with epilepsy?

The aim of the study was to investigate the association of physical activity in three categories (inactive, insufficiently active and active) with health outcomes in people with epilepsy. The dependent variables and the instruments used in the study were: a) quality of life - measured by Quality of Life in Epilepsy-31 for adults and Quality of Life in Epilepsy for Adolescents, b) side effects of medication - measured by Adverse Events Profile, c) depression - measured by Neurological Disorders Depression Inventory for Epilepsy, and d) state and trait anxiety - measured by State-Trait Anxiety Inventory. Physical activity levels were analyzed using the International Physical Activity Questionnaire (IPAQ) for adults in the commuting and leisure domains and Physical Activity Questionnaire for Adolescents (PAQ-A). Simple and multiple linear regression was used in the statistical analysis. The cross-sectional study with one hundred and one individuals was conducted in Pelotas/RS, Brazil, at the Neurology Clinic of the Faculty of Medicine of the Federal University of Pelotas. In the crude analysis, physical activity was positively associated with quality of life (p<0.001) and negatively associated with depression (p=0.046), state of anxiety (p=0.014), trait of anxiety (p=0.015) and side effect of medication (p=0.01). In addition, physical activity levels explained 10% of the quality of life (R2=0.10). In the adjusted analysis, physical activity remained associated with side effect of medication (p=0.014) and was not associated with trait anxiety (p=0.066). However, quality of life showed a positive linear trend (p=0.001) while depression (p=0.033) and anxiety state (p=0.004) showed a negative trend according to physical activity levels. Physical activity was associated with health outcomes, and can be a nonpharmacological treatment in people with epilepsy for improving health and life conditions.

Caffeine Supplementation Effects on Concurrent Training Performance in Resistance-Trained Men: A Double-Blind Placebo-Controlled Crossover Study.

Purpose: The aim of the present study was to investigate the effects of acute caffeine supplementation on the performance during a session of resistance training alone (RT) or in combination with aerobic training (i.e. concurrent training; CT). Method: Fourteen resistance-trained men (23.1 ± 4.2 years) were recruited and performed both RT and CT under three different conditions: control (CONT), placebo (PLA), and caffeine (CAF; 6 mg.kg-1) for a total of six experimental conditions. Results: Both total and per set number of repetitions, and total volume load were lower during CT as compared to RT, irrespective of the supplementation condition (all p < .001), whereas a supplementation main effect was observed for the total number of repetitions (p = .001), the number of repetitions in the first (p = .002) and second sets (p = .001), and total volume load (p = .001). RPE values were higher after the CT sessions than after the RT sessions (p < .001), whereas no differences were observed between supplementation conditions (p = .865). Conclusions: Caffeine supplementation was not sufficient to minimize the acute interference effect on strength performance in a CT session when compared to RT alone. In contrast, caffeine improved strength performance during the first set of both CT and RT, while maintaining a similar RPE between the supplementation conditions. However, the overall effect was small.

Exercise as medicine! Physical activity mitigated the impact of the COVID-19 pandemic on depressive symptoms in adults with depression.

We investigated the longitudinal association between physical activity (PA) and symptoms of depression and anxiety in people with depression during the COVID-19 pandemic. We used data from baseline (June 2020) to wave 3 (June 2021) of the PAMPA Cohort, an ambispective cohort with adults in south Brazil. The Hospital Anxiety and Depression Scale assessed depressive and anxiety symptoms in all waves. Participants reported frequency (minutes), type (aerobic, strength, combined), and place (out of home, at home) of physical activity at baseline. Generalized linear models were used to investigate the interaction between time and PA, adjusting for possible confounding variables. Subjective memory decline was assessed using multivariate Cox proportional hazard regression models to obtain adjusted hazard ratio (HR) and respective 95% confidence interval (CI). Participants (n = 424) with self-reported clinically diagnosed depression were included. We observed a non-linear increase trajectory of depression during the first year of the COVID-19 pandemic. PA was associated with a slower trajectory of depressive (slope: -1.89; 95%CI: -3.34, -0.43 points) but not anxiety (slope: -1.33; 95%CI: -2.93, 0.25 points) symptoms during the COVID-19 pandemic. Participants who continued physically active from pre-pandemic in wave 1 showed a lower risk of subjective memory decline during follow-up than those who persisted inactive in the same period (HR: 0.52; 95%CI: 0.30, 0.89). PA attenuated the impact of the COVID-19 pandemic on depressive symptoms in adults living with depression in south Brazil. Regularity of physical activity was associated with fewer depression and anxiety symptoms and a lower risk of subjective memory decline.

Association of Sleep Duration and Use of Sleeping Medication with Multimorbidity in Adults: Results from the PAMPA (Brazil) Cohort Study.

Objective To analyze the association of sleep duration and use of sleeping medication with multimorbidity. Materials and Methods We conducted a cross-sectional study using data from the Prospective Study about Mental and Physical Health (PAMPA) cohort. Multimorbidity was defined as the presence of two or more conditions from a list of twelve health problems. Descriptive analyses were performed considering proportion and its 95% confidence interval (95%CI). We performed logistic regression (to obtain odds ratios, ORs) to estimate the associations, including models adjusted for confounding factors. Results In total, 2,936 participants were included, 79,1% of them women, 54.2% aged between 18 and 39 years, and 88.9% with white skin color. Compared with regular sleep (seven to eight hours a day), five hours or less of sleep increased the odds of multimorbidity by 145% (95%CI: 1.90-3.14), and 9 hours or more of sleep increased the odds by 49% (95%CI: 1.14-1.95) for the crude model; the results remained significant even in the adjusted models. Discussion Consumption of sleeping medication was associated with multimorbidity. Short and prolonged sleep duration increased the odds of multimorbidity, regardless of the sociodemographic and behavior characteristics. The regular use of sleeping medication was also associated with multimorbidity. The results of the present study are important but require caution due to reverse causality, and longitudinal studies are needed to confirm the findings.

Incidence of memory complaints during the COVID-19 pandemic in Southern Brazil: findings from PAMPA cohort.

Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio ­ HR 1,49; intervalo de confiança ­ IC 95% 1,16­1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06­2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49­2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57­0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

Prevalence and factors associated with long COVID in adults from Southern Brazil: findings from the PAMPA cohort.

Most COVID-19 survivors have reported experiencing persistent symptoms after the infection - these types of cases are known as long COVID. Since Brazil was an epicenter of the COVID-19 pandemic, a high burden of long COVID is expected. This study aimed to identify the prevalence and factors associated with long COVID in adults in Southern Brazil, analyzing data from the PAMPA cohort. Participants filled out a self-reported online questionnaire in June 2022. This study only included subjects who tested positive for COVID-19. Long COVID was defined by any symptoms that persisted for at least three months after the SARS-CoV-2 infection. Poisson's regression models with robust variance were used to identify factors associated with long COVID; and results were reported as prevalence ratios (PR) and respective 95% confidence intervals (95%CI). A total of 1,001 participants (77.4% women, mean age [SD] = 38.3 [11.9] years) were analyzed. The prevalence of long COVID among these patients was 77.4% (95%CI: 74.7; 79.9). The likelihood of long COVID was higher in unvaccinated participants (PR = 1.23, 95%CI: 1.06; 1.42), in those with chronic conditions (PR = 1.13, 95%CI: 1.04; 1.24), and in those who were hospitalized due to the COVID-19 infection (PR = 1.24, 95%CI: 1.16; 1.32). This prevalence was also higher in women (PR = 1.21, 95%CI: 1.09; 1.33) than in men. Physical activity was associated with a reduced likelihood of fatigue, neurological complications, coughing, and headaches as persistent symptoms after a COVID-19 infection. It was found that three out of four adults in Southern Brazil experienced long COVID. Public policies aiming to reduce the burden of long COVID must be prioritized, especially in groups that are at higher risk of developing this harmful condition.

Acute low back pain in high school adolescents in Southern Brazil: prevalence and associated factors.

PURPOSE: The aim of this study was to investigate the prevalence of acute low back pain (ALBP) and associated factors in high school students from a Southern Brazilian city. METHODS: The study was cross-sectional and interviewed 1,233 students 13- to 19-year-olds, attending high schools. A total of 25 schools were included in the sample (15 state institutions, 7 private, 2 federal and 1 municipal). The ALBP was evaluated using two questions. The outcome was LBP in the previous 30 days. RESULTS: The prevalence of ALBP was 13.7%. Non-white students, who commuted to school walking, showed a higher prevalence of ALBP. The prevalence of ALBP is relatively high. CONCLUSIONS: Further studies with follow-ups to adulthood are needed to investigate whether physical cumulative loads on the lumbar spine (for example, duration/transport, school bags and inadequate school furniture) during adolescence, may influence the development of ALBP later in life.

Is It Safe for Hemodialysis Patients to Seek Gains with Less Pain? Acute Hemodynamic Response to Intradialytic Blood Flow Restriction Training.

Considering that the hemodynamic safety is a major concern about intradialytic exercise with blood flow restriction, this analysis was performed to compare the blood pressure (BP) behavior during the first two hours of hemodialysis (HD) between sessions with no exercise (control group, CG), low/moderate intensity aerobic exercise with blood flow restriction (BFRE) and conventional aerobic exercise (AE). Adult patients with chronic kidney disease on HD at a university hospital were randomly assigned and submitted to a 12-week intradialytic training with BFRE or AE compared with the CG group. The main outcomes of this report were the change in systolic (SBP) and diastolic (DBP) BP during HD and the frequency of low BP (LBP) and high BP (HBP) episodes. A total of 6,074 BP measurements of 58 patients were analyzed. There was a larger decrease in BP in the exercise sessions compared with the control sessions, but with a similar magnitude in the BFRE and AE groups (effect size 0.49). There was a higher number of LBP in the BFRE group. The frequency of HBP was similar between the BFRE and the CG groups and lower in the AE group. Despite a greater number of mild LBP in BFRE patients, the BP change during the first two hours of HD was similar to that of patients in AE. Intradialytic aerobic exercise with blood flow restriction does not seem to be associated with a higher hemodynamic burden than conventional aerobic exercise.

Incidence of multimorbidity and associated factors during the COVID-19 pandemic in Brazil: a cohort study.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, access to healthcare services may have become difficult, which may have led to an increase in chronic diseases and multimorbidity. OBJECTIVES: To assess the incidence of multimorbidity and its associated factors among adults living in the state of Rio Grande do Sul, Brazil. DESIGN AND SETTING: Cohort study conducted in Rio Grande do Sul, Brazil. METHODS: We included data from the two waves of the Prospective Study About Mental and Physical Health (PAMPA). Data were collected via online questionnaires between June and July 2020 (wave 1) and between December 2020 and January 2021 (wave 2). Multimorbidity was defined as the presence of two or more diagnosed medical conditions. RESULTS: In total, 516 individuals were included, among whom 27.1% (95% confidence interval, CI: 23.5-31.1) developed multimorbidity from wave 1 to 2. In adjusted regression models, female sex (hazard ratio, HR: 1.97; 95% CI: 1.19-3.24), middle-aged adults (31-59 years) (HR: 1.78; 95% CI: 1.18-2.70) and older adults (60 or over) (HR: 2.41; 95% CI: 1.25-4.61) showed higher risk of multimorbidity. Back pain (19.4%), high cholesterol (13.3%) and depression (12.2%) were the medical conditions with the highest proportions reported by the participants during wave 2. CONCLUSION: The incidence of multimorbidity during a six-month period during the COVID-19 pandemic was 27.1% in the state of Rio Grande do Sul, Brazil.

Ethnoracial disparity among patients with dementia during COVID-19 pandemic.

We aim to examine the effect of the COVID-19 pandemic on the ethnoracial disparities in hospitalizations due to dementia and its related outcomes, in Brazil. A longitudinal panel study was carried out with data extracted from the Hospital Information Systems of the Brazilian Unified National Health System (SIH/SUS). We assessed the number of hospital admission per 100,000 inhabitants, mean inpatient spending, and inpatient mortality rate due to dementia during the first semester of 2019 and 2020. Data were stratified by geographic region and ethnoracial groups (black, mixed, and white) based on skin color. We observed an overall reduction in hospital admissions, mean inpatient spending, and mortality rate between the first semester of 2019 and 2020. However, the reduction of hospitalization rates among black and mixed people was 105.3% and 121.1% greater than in whites, respectively. Mortality rate was decreased by 9% in whites and was increased by 65% and 43% in the black and mixed population, respectively. In the first semester of 2020, black and mixed patients had a higher risk of losing their lives due to dementia than white people. This disparity was not observed in the same period of 2019. In 2020, the inpatient mortality ratio reached the highest values among black individuals in all regions but the North (no data available). Since the beginning of the COVID-19 epidemic in Brazil, ethnoracial disparity in hospital admissions and mortality rates due to dementia has been heightened. Governmental actions and policies to mitigate this indirect effect of the pandemic on the Brazilian population are urgent.

Ten-year trends in hospitalizations due to Alzheimer's disease in Brazil: a national-based study.

Brazil has the second highest age-standardized prevalence of Alzheimer's disease worldwide. However, information about Alzheimer's disease-related hospitalizations in Brazil is scarce despite its economic and social impact. We described temporal trends in hospitalizations related to Alzheimer's disease in Brazil from 2010 to 2019. We conducted a time-series, retrospective, descriptive, national-based study using data from the DATASUS database of the Brazilian Ministry of Health. Hospitalizations, mean days hospitalized, and economic costs from those hospitalizations were extracted from 2010 to 2019. Hospitalizations by Alzheimer's disease increased 87.7% from 2010 to 2019, with greater increase among men (97.4%), mixed ethnicity (224%), 80 years or older (115.1%), and in the Northeast (172.1%) and Central West (144.2%) regions. Although mean days hospitalized decreased in all subgroups, an increasing time trend in hospital admission was observed in the Central West Region. Costs per hospitalization increased for patients aged 50 years or younger and in admissions related to emergency services. Compared with other non-communicable chronic diseases, Alzheimer's disease had the highest increase in absolute number and rate of hospitalizations in Brazil from 2010 to 2019. AD is a public health problem in Brazil. Strategies to reduce its burden are necessary but only if accompanied by greater equality and awareness of this disease.

Economic burden of physical inactivity in hospitalizations due to dementia: a Brazilian nationwide study.

Our study aimed at determining the economic burden of leisure-time physical inactivity in hospitalizations due to dementia in Brazil. In this national-wide descriptive study, we used secondary data from the Brazilian Health Informatics Department and from the latest Brazilian National Health Survey (2013). Rate of hospitalization and economic cost were extracted from 2013. Leisure-time physical inactivity prevalence was used to estimate its population attributable fraction for dementia. Outcomes were stratified into sex (man/woman), age groups (< 50, 50-59, 60-69, 70-79, 80+), ethnicity (white, black, mixed race, other), and region (South, Southeast, North, Northeast, and Central). In 2013, 3,724 people were hospitalized due to dementia in Brazil resulting in a total cost of BRL 17,971,833.85 (USD 7,673,973.05). More than half of cost among men was spent with individuals younger than 59 years, white and mixed-race, and from Southeast region. Proportion of cost was higher in women older than 60 years and white. In 2013, 37% of all hospitalization from dementia in Brazil were attributable to physical inactivity, with values reaching 42.9% and 43.8% for men and women aged 80 or older, respectively. Physical inactivity cost BRL 6,994,254.75 (USD 2,986,546.78) in 2013 on hospitalizations due to dementia in Brazil. Higher attributable-cost was found for patients younger than 50 years and women older than 80. Strategies to preserve the quality of life of these patients are needed to reduce the burden for the patients, their family, and on the healthcare system.

Who are the people with Alzheimer's disease in Brazil? Findings from the Brazilian Longitudinal Study of Aging.

OBJECTIVE: To describe the socioeconomic, behavioral, clinical, and health-related characteristics of Brazilian older adults with Alzheimer's disease (AD). METHODS: Baseline data from the Brazilian Longitudinal Study of Aging were analyzed. This nationwide survey interviewed 9,412 adults aged at least 50 years. Self-reported medical diagnosis of AD and exposure variables (sociodemographic, clinical, behavioral, and health-related) were assessed by face-to-face questionnaire-based interview. Multivariate analyses accounted for possible confounding factors, and values were reported in prevalence ratio (PR) and 95% confidence interval (95%CI). RESULTS: Participants with AD have important demographic differences compared with older non-AD participants such as low education level and retirement. Clinically, these patients reported more medical appointments, falls, and higher frequency and duration of hospitalizations compared with non-AD participants. These characteristics may be related to worse physical and mental health observed in this population. Indeed, two out of five older adults with AD in Brazil reported always feeling lonely, while two out of three said they felt depressed or sad much of the time. Adjusted analyses showed that patients with AD were 95% (95%CI 1.08 - 3.50) more likely to be hospitalized in a year compared with non-AD older adults. People with AD in Brazil were more likely to be diagnosed with diabetes (PR = 1.83 [95%CI 1.08 - 3.12]), depression (PR = 3.07% [95%CI 1.63 - 5.79]), Parkinson's disease (PR = 17.63 [95%CI 6.99 - 44.51]), and stroke (PR = 3.55 [95%CI 1.90 - 6.67]) compared with non-AD participants. CONCLUSION: Older adults with AD in Brazil reported impaired physical and mental health compared with the non-AD population.

Managing noncommunicable diseases during the COVID-19 pandemic in Brazil: findings from the PAMPA cohort.

The objective was to identify the impact of social distance in the management of noncommunicable diseases (NCD) in the adult population from the state of Rio Grande do Sul, southern Brazil. This is an ambispective, population-based cohort study. Descriptive analysis and Poisson regression models were used and the results were reported as prevalence ratio and 95% confidence intervals. From a total of 1,288 participants, 43.1% needed medical care and 28.5% reported impaired management of NCDs during social distance. Female sex, age between 18 and 30 years old, living in the Serra region (central region of the state), people with depression and multimorbidity were more likely to have impaired management of NCDs. Being physically active reduced the probability of having impaired management of NCD by 15%. Reduced monthly income was associated with the difficulty in accessing prescription medicine and avoidance of seeking in-person medical assistance. Depression was associated with difficulties in accessing medications, while avoidance of seeking in-person medical assistance was more likely for people with multimorbidity, arthritis/arthrosis/fibromyalgia, heart disease, and high cholesterol.

Aging male's symptoms in a Southern Brazil population: lifestyle effects after the age of 40.

BACKGROUND: The interest of epidemiological research about male's aging increased in recent years along with the need to evaluate health-related quality of life. We conducted a population-based cross-sectional study to identify the prevalence of aging male's symptoms (AMS) and factors associated to this condition. METHODS: The study included 421 men aged 40 years or older, living in the urban area of Pelotas, Southern Brazil. The questionnaire covered sociodemographic, behavioral, and health variables, and to verify the aging male's symptoms, the AMS Scale was used. RESULTS: Moderate/severe male's symptoms was considered positive (AMS scores equal or above 37 points) in 20% of men (95% CI 16.1; 24.3). After controlling for confounders, the AMS was significantly associated with aging, self-perceived health status and smoking. The symptoms were more severe among physically inactive men. CONCLUSIONS: Our findings support the necessity to maintain healthy behaviors like not smoking and regular physical activity since such changeable behaviors could reduce the AMS acceleration and increase life quality and expectancy.