Prevalence and incidence of Parkinson's disease and other forms of parkinsonism in a cohort of elderly individuals in Southern Brazil : protocol for a population-based study

Introduction Parkinsonism is one of the most common neurological disorders affecting the elderly. Several population-based studies have determined the epidemiology of parkinsonism, mainly Parkinson’s disease (PD), but there is still little evidence in the Brazilian population. This protocol study aims to assess the prevalence and incidence of cases of PD and other parkinsonian syndromes in a 5-year cohort in a population-based study in the southern region of Brazil. Methods and analysis A prospective population-based longitudinal study, with a cohort of development of cases of parkinsonism, divided into two phases: in phase I, two questionnaires to screen for parkinsonism (Tanner’s questionnaire), Rapid Eyes Movement (REM) sleep behaviour disorder (REM Sleep Behavior Disorder Single-Question Screen) and a short interview will be conducted with all elderly residents of Veranópolis (the first longevity Brazilian county located in the Rio Grande do Sul, Brazil) aged 60 or over. The positive screened cases will be examined independently by at least two movement disorder-trained physicians and prevalence will be determined. A comprehensive evaluation of prodromic symptoms, risk factors and clinical characteristics will be carried out. Subjects with subtle parkinsonism and a sample of healthy subjects will be followed for 5 years in a developmental cohort of parkinsonism cases. For crude incidence, all individuals admitted at the beginning of the study will be re-evaluated

Calcificação coronária e sua associação com fatores de risco cardiovascular e hábitos dietéticos em homens assintomáticos vivendo em comunidade

Introdução: As doenças cardiovasculares (DCV) são a principal causa de morte no mundo, sendo a doença arterial coronária (DAC) a mais comum das DCV, juntamente com acidente vascular cerebral. O cálcio das artérias coronárias é um marcador da DAC subclínica (assintomática) e é preditivo de eventos coronários futuros. Vários fatores de risco cardiovascular contribuem para o desenvolvimento da calcificação da artéria coronária (CAC). Adicionalmente, os fatores dietéticos podem influenciar no processo de aterosclerose e CAC. Objetivo: Avaliar a CAC e sua associação com fatores de risco cardiovascular e ingestão dietética em homens assintomáticos vivendo em comunidade. Métodos: Estudo transversal. A amostra consistiu de 150 homens assintomáticos com idades entre 50 e 70 anos (idade média 58,2 ± 5,3 anos), que foram submetidos à tomografia computadorizada multidetectores (TCMD). A aterosclerose subclínica foi avaliada pela CAC de acordo com o método de Agatston, sendo os escores de cálcio classificados como ≤10 (sem evidência e CAC mínima) e >10 (CAC moderada e aumentada). A ingestão dietética foi avaliada através do Registro de Consumo Alimentar (RCA). O modelo multivariado de Regressão de Modified Poisson foi utilizado para avaliar os fatores de risco cardiovascular independentemente associados com a CAC moderada/aumentada, sendo estimados os efeitos do consumo de diversos nutrientes na prevalência de CAC moderada/aumentada ajustado para ingestão calórica e fatores de risco para CAC, através da razão de prevalências e intervalo de 95% de confiança. Resultados: A presença de CAC (escore de cálcio >0) foi identificada em 59,3% dos participantes. Na análise multivariada, os fatores independentemente associados com a CAC moderada/aumentada foram a história familiar (HF) de DAC prematura (RP=1,39; IC95% 1,03-1,88, p=0,029) e a atividade física (AF) 10 (moderate and severe CAC). Dietary intake was assessed according to the Food consumption Register (RCA) method. The multivariate Modified Poisson regression model was used to assess cardiovascular risk associated with moderate/severe CAC and the effects of the intake of different nutrients were estimated for the prevalence of moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals. Results: CAC (calcium score >0) was present in 59.3% of the subjects. In the multivariate analysis, factors independently associated with moderate/severe CAC included family history (FH) of early CAD (PR=1.39; 95%CI 1.03-1.88, p=0.029) and physical activity (PA) <150 minutes/week (PR=1.40; 95%CI 1.01-1.93; p=0.045). The intake of some nutrients was also associated with moderate/severe CAC, such as lower carbohydrate intake (p=0.021) and higher lipid intake (p=0.006), after model adjustment for the amount of calories. Once the cardiovascular risk factors and schooling were included in the model, the nutrients associated with the prevalence of moderate/severe CAC were: percentage of carbohydrates (PR=0.98; 95%CI 0.96-0.99; p=0.040), percentage of lipids (PR=1.04; 95%CI 1.01-1.07; p=0.005), and percentage of saturated fatty acids (SFA) (PR=1.08; 95%CI 1.02-1.14; p=0.013). Conclusions: In the sample of community-dwelling asymptomatic adults and older persons, cardiovascular risk factors such as FH of early CAD, and low-intensity PA were independently associated with moderate to severe coronary calcification. Analysis of dietary factors showed that higher intake of total lipids and saturated fats were associated with higher CAC scores, whereas higher intake of carbohydrates over lipids was associated with lower CAC scores. Our results indicate that these risk factors should be considered in the cardiovascular assessment of the patient

Active aging is associated with low prevalence of depressive symptoms among Brazilian older adults

ABSTRACT: Introduction: Active aging is the process of optimizing opportunities for health, participation and security, aiming to improve quality of life as people age. A series of studies had demonstrated that a lower prevalence of depression is found among more active elderly. Objective: To evaluate the association between indicators of active aging and depressive symptoms among the elderly (aged 60 years or more). Method: A population-based cross-sectional study was conducted with 1,006 elderly people (aged 60 years or over) from a small-sized Brazilian municipality. Depressive symptoms were assessed using the Geriatric Depression Scale - 15, with cutoff point ≥ 6 symptoms. Active aging was evaluated using indicators such as: active occupational situation, manual work, reading and physical activities. Data analyses used modified Poisson regression to obtain crude and adjusted prevalence ratios (PR). Results: Most of the elderly people were: white, women and aged between 60 and 74 years. All the indicators of active aging were associated with the outcome. After controlling for socioeconomic, demographic and health variables, elderly people who worked, participated in groups, did manual work and maintained interests such as reading and talking to friends had lower prevalence of depressive symptoms compared to those not doing these activities. Conclusions: Active aging approaches may serve as a valuable mental health promotion strategy aimed at the elderly