Avaliação do desempenho físico de acordo com a faixa etária em idosos comunitários

TCC (graduação) - Universidade Federal de Santa Catarina. Araranguá. Fisioterapia.Objetivo: Avaliar o desempenho físico de acordo com a faixa etária em idosos comunitários. Métodos: Tratou-se de um estudo transversal, com amostra não probabilística composta por 173 idosos, distribuídos por faixa etária: 60-64, 65-69, 70-74, 75-79 e 80-84 anos. Os idosos foram avaliados pelos testes de desempenho funcional: Timed Get Up and Go (TGUG); Teste de Sentar e Levantar da Cadeira de 30 segundos (TSLC30”); Teste de Alcance Funcional (TAF); Tandem Stance (TS) e Velocidade da Marcha Habitual (VMH) e Máxima (VMM). Resultados: Observaram-se diferenças significativas para as seguintes variáveis: TAF foi maior entre 65-69 anos e menor entre 80-84 anos; TGUG foi maior entre 60-64 anos e menor entre 80-84 anos; a velocidade do teste VMH foi maior nas categorias de 65 a 74 anos e menor entre 80-84 anos; e por fim, a velocidade do teste VMM foi maior entre 65-69 anos e menor entre 80-84 anos. Não houve diferença significativa para as variáveis TSLC30” e TS. Conclusão: Os resultados do presente estudo apontaram que o TGUG foi o teste que apresentou maiores diferenças conforme a idade dos idosos, sendo que o pior desempenho foi verificado naqueles de 80-84 anos. O TAF e os testes VMH e VMM se mostraram menores entre os idosos de 80-84 anos, quando comparados aos demais grupos.Objective: To evaluate the physical performance according to the age range in the community elderly. Methods: This was a cross-sectional study with a non-probabilistic sample composed of 173 elderly people, aged 60-64, 65-69, 70-74, 75-79 and 80-84 years. The elderly were evaluated by functional performance tests: Timed Get Up and Go (TGUG); 30- second Chair Sit and Rise Test (TSLC30 "); Functional Reach Test (TAF); Tandem Stance (TS) and Regular Speed (VMH) and Maximum (VMM). Results: Significant differences were observed for the following variables: TAF was higher between 65-69 years and less between 80-84 years; TGUG was greater between 60-64 years and younger between 80-84 years; the speed of the VMH test was higher in the categories from 65 to 74 years and smaller in the 80- 84 years; and finally, the speed of the VMM test was higher between 65-69 years and less between 80-84 years. There was no significant difference for TSLC30" and TS variables. Conclusion: The results of the present study showed that TGUG was the test that showed the greatest differences according to the age of the elderly, and the worst performance was verified in those 80-84 years old. The TAF and the VMH and VMM tests were lower among the elderly of 80-84 years, when compared to the other groups. Keywords: Aging; Functional performance; Old people older

Perceived characteristics of the neighborhood and depressive symptoms in community-dwelling older adults: a cross-section study

La alta prevalencia de síntomas depresivos en losancianos apunta la necesidad de investigar los factores deriesgo que pueden contribuir a esta condición y, sobre todo,que son objeto de intervenciones eficaces, como el entornode vivienda. Sin embargo, todavía no está completamenteestablecida la asociación entre las características de losentornos de vivienda y la presencia de síntomas depresivosen ancianos brasileños, especialmente en aquellos quefrecuentan unidades de Atención Primaria de Salud (APS).Este estudio tuvo como objetivo verificar la asociación entrela percepción del entorno de vivienda y la presencia desíntomas depresivos en ancianos residentes en la comunidad.Este es un estudio transversal, de carácter domiciliar y muestraprobabilística. Se incluyeron a 293 ancianos (57,3% mujeres;54,7% de edades entre 60 y 69 años) de edad ≥60 años, dela comunidad y registrados en la Atención Primaria municipalde Balneário Arroio do Silva (en Santa Catarina, Brasil).Los síntomas depresivos se evaluaron mediante laescala de depresión geriátrica, y la percepción delentorno se obtuvo mediante el instrumento adaptadoneighborhood environment walkability scale. Para probarlas asociaciones se utilizó la regresión logística multivariada.Se observaron asociaciones negativas significativas entrela presencia de síntomas depresivos y la presencia deestablecimientos de comida (OR: 0,52; IC95%: 0,28-0,98),centros de salud y centros comunitarios (OR: 0,52; IC95%:0,28-0,96), gimnasios al aire libre (OR: 0,38; IC95%: 0,20-0,72),gimnasios y/o clubes (OR: 0,42; IC95%: 0,19-0,89), mejor calidadde aceras (OR: 0,37; IC95%: 0,19-0,71), presencia de señalizaciónpeatonal (OR: 0,39; IC95%: 0,18-0,84) y caminar seguro de día(OR: 0,35; IC 95%: 0,16-0,76) y de noche (OR: 0,40; IC95%:0,19-0,83). Se concluyó que hubo asociaciones inversas entremejor percepción de las características del entorno y la presenciade síntomas depresivos en ancianos residentes en la comunidad,lo que muestra la importancia de promover estrategias paramejorar la infraestructura del barrio y la presencia de síntomasdepresivos en esta poblaciónA elevada prevalência de sintomas depressivosem idosos denota a importância de se investigar osfatores de risco que podem contribuir para esse agravoe, principalmente, que são passíveis de intervençõeseficazes, como o ambiente de moradia. No entanto,ainda não está totalmente estabelecida a associaçãoentre as características dos ambientes de moradiae a presença de sintomas depressivos em idososbrasileiros, em especial naqueles que frequentamunidades de Atenção Primária à Saúde (APS). Este estudoteve como objetivo verificar a associação entre apercepção do ambiente de moradia e a presença desintomas depressivos em idosos comunitários. Tratou-sede um estudo transversal, de base domiciliar e amostraprobabilística. Foram incluídos 293 idosos (57,3%mulheres; 54,7% com idades entre 60 e 69 anos)com idade ≥60 anos, comunitários e cadastrados naAtenção Básica municipal de Balneário Arroio do Silva(SC). Os sintomas depressivos foram avaliados pormeio da escala de depressão geriátrica e a percepçãodo ambiente foi obtida por meio do instrumentoadaptado neighborhood environment walkability scale.As associações foram testadas pela regressão logísticamultivariada. Observaram-se associações negativassignificativas entre a presença de sintomas depressivose a presença de estabelecimentos alimentícios (OR:0,52; IC95%: 0,28-0,98), postos de saúde e centroscomunitários (OR: 0,52; IC95%: 0,28-0,96), academiasao ar livre (OR: 0,38; IC95%: 0,20-0,72), academiasde ginástica e/ou clubes (OR: 0,42; IC95%: 0,19-0,89),melhor qualidade das calçadas (OR: 0,37; IC95%:0,19-0,71), presença de sinalização para pedestres (OR:0,39; IC95%: 0,18-0,84) e segurança para caminhadadurante o dia (OR: 0,35; IC95%: 0,16-0,76) e à noite(OR: 0,40; IC95%: 0,19-0,83). Concluiu-se que houveassociações inversas entre melhores característicaspercebidas do ambiente e a presença de sintomasdepressivos em idosos que residem na comunidade,demonstrando a importância de promover estratégiaspara melhorar a infraestrutura do bairro e a presença desintomas depressivos nessa população.The high prevalence of depressive symptomsin older adults highlights the importance of investigatingrisk factors that may contribute to this condition, especiallythose that are subject to effective interventions, such asthe neighborhood environment. However, the associationbetween perceived characteristics of the environment and presence of depressive symptoms in Brazilian older adults,as well as in those who attend Primary Health Care (PHC)units is not yet fully established. This study aimed to verify theassociation between the perception of the neighborhood andpresence of depressive symptoms in community-dwelling olderadults. This is a cross-sectional, household-based study with aprobabilistic sample. A total of 293 community-dwelling olderadults (57.3% women; 54.7% aged 60–69 years) and registeredin the municipal Primary Health Care System of BalneárioArroio do Silva/SC were included. Depressive symptoms wereassessed using the Geriatric Depression Scale (GDS) andthe perception of the environment was obtained using theadapted instrument Neighborhood Environment WalkabilityScale (NEWS). Associations were tested by multivariatelogistic regression. Significant negative associations wereobserved between the presence of food establishments(OR: 0.52; 95%CI: 0.28–0.98), health clinics and communitycenters (OR: 0.52; 95%CI: 0.28–0.96), outdoor gyms(OR: 0.38; 95%CI: 0.20–0.72), fitness centers and/or clubs(OR: 0.42; 95%CI: 0.19–0.89), well-maintained sidewalks(OR: 0.37; 95%CI: 0.19–0.71), pedestrian signals (OR: 0.39; 95%CI:0.18–0.84), and neighborhood safety for walking during theday (OR: 0.35; 95%CI: 0.16–0.76) and night (OR: 0.40; 95%CI:0.19–0.83) and the presence of depressive symptoms. It wasconcluded that there is inverse associations between betterperceived characteristics of the environment and the presenceof depressive symptoms in community-dwelling older adults,demonstrating the importance of promoting strategies toimprove the neighborhood infrastructure and prevent depressivesymptoms in this populatio

The loss of soil parent material: detecting and measuring the erosion of saprolite

Soil parent material is a fundamental natural resource for the generation of new soils. Through weathering processes, soil parent materials provide many of the basic building blocks for soils and have a significant bearing on the physico-chemical makeup of the soil profile. Parent materials are critical for governing the stock, quality, and functionality of the soil they form. Most research on soil parent materials to date has aimed to establish and measure the processes by which soil is generated from them. Comparatively little work has been performed to assess the rates at which soil parent materials erode if they are exposed at the land surface. This is despite the threat that the erosion of soil parent materials poses to the process of soil formation and the loss of the essential ecosystem services those soils would have provided. A salient but unanswered question is whether the erosion of soil parent materials, when exposed at the land surface, outpaces the rates at which soils form from them. This study represents one of the first to detect and measure the loss of soil parent material. We applied Uncrewed Aerial Vehicle Structure-From-Motion (UAV-SfM) photogrammetry to detect, map, and quantify the erosion rates of an exposed saprolitic (i.e., weathered bedrock) surface on an agricultural hillslope in Brazil. We then utilized a global inventory of soil formation to compare these erosion rates with the rates at which soils form in equivalent lithologies and climatic contexts. We found that the measured saprolite erosion rates were between 14 and 3766 times faster than those of soil formation in similar climatic and lithological conditions. While these findings demonstrate that saprolite erosion can inhibit soil formation, our observations of above-ground vegetation on the exposed saprolitic surface suggests that weathered bedrock has the potential to sustain some biomass production even in the absence of traditional soils. This opens up a new avenue of enquiry within soil science: to what extent can saprolite and, by extension, soil parent materials deliver soil ecosystem services?This work was funded by a Global Challenge Research Fund grant awarded to Daniel L. Evans

Telemedicine-Based Management of Oral Anticoagulation Therapy:Systematic Review and Meta-analysis

BACKGROUND: Oral anticoagulation is the cornerstone treatment of several diseases. Its management is often challenging, and different telemedicine strategies have been implemented to support it. OBJECTIVE: The aim of the study is to systematically review the evidence on the impact of telemedicine-based oral anticoagulation management compared to usual care on thromboembolic and bleeding events. METHODS: Randomized controlled trials were searched in 5 databases from inception to September 2021. Two independent reviewers performed study selection and data extraction. Total thromboembolic events, major bleeding, mortality, and time in therapeutic range were assessed. Results were pooled using random effect models. RESULTS: In total, 25 randomized controlled trials were included (n=25,746 patients) and classified as moderate to high risk of bias by the Cochrane tool. Telemedicine resulted in lower rates of thromboembolic events, though not statistically significant (n=13 studies, relative risk [RR] 0.75, 95% CI 0.53-1.07; I2=42%), comparable rates of major bleeding (n=11 studies, RR 0.94, 95% CI 0.82-1.07; I2=0%) and mortality (n=12 studies, RR 0.96, 95% CI 0.78-1.20; I2=11%), and an improved time in therapeutic range (n=16 studies, mean difference 3.38, 95% CI 1.12-5.65; I2=90%). In the subgroup of the multitasking intervention, telemedicine resulted in an important reduction of thromboembolic events (RR 0.20, 95% CI 0.08-0.48). CONCLUSIONS: Telemedicine-based oral anticoagulation management resulted in similar rates of major bleeding and mortality, a trend for fewer thromboembolic events, and better anticoagulation quality compared to standard care. Given the potential benefits of telemedicine-based care, such as greater access to remote populations or people with ambulatory restrictions, these findings may encourage further implementation of eHealth strategies for anticoagulation management, particularly as part of multifaceted interventions for integrated care of chronic diseases. Meanwhile, researchers should develop higher-quality evidence focusing on hard clinical outcomes, cost-effectiveness, and quality of life. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020159208; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=159208.</p

Incapacidade, desempenho físico-funcional e ambiente de vizinhança: avaliação de idosos comunitários com base na Classificação Internacional de Funcionalidade, Incapacidade e Saúde

La Clasificación Internacional del Funcionamiento,de la Discapacidad y de la Salud (CIF) es todavía una herramientalejana y, muchas veces, temida en el área de la salud del adultomayor. Ante esto, el objetivo de este estudio fue describirla discapacidad en las actividades de la vida diaria (AVD),las limitaciones en el desempeño físico-funcional y la percepcióndel barrio en ancianos que viven en comunidad en el extremosur de Santa Catarina (Brasil) al clasificarlos según los dominiosy calificadores propuestos por la CIF. Se trata de un estudiotransversal, en el que participaron ancianos de ambos sexos.Las variables fueron categorizadas según los dominios de la CIF:(1) funciones y estructuras corporales: pruebas de desempeñofísico-funcional; (2) actividad y participación: instrumento deautoevaluación de AVD; y (3) factores ambientales: autopercepcióndel entorno del barrio. Del total de 308 ancianos participantes,la mayoría eran mujeres (57,8%), con edades entre 60 y 69 años(54,7%). Considerando los calificadores de la CIF, hubo una mayordificultad moderada/severa para el test de sentarse y levantarsede una silla durante 5 repeticiones (TSLS5R) (66,2%) en eldominio “función y estructura corporal”, mientras que para eldominio “actividad y participación” predominó la prevalencia de discapacidad moderada/grave para la tarea de cortar las uñas de los pies (21,2%). En el dominio “factores ambientales”, hubo predominio de la ausencia de locales para practicar actividadfísica en el entorno del barrio (72,5%): International Classification of Functioning, Disability, and Health (ICF) is still a distant and often feared tool in the area of older adults health and, given that, the objective of this study was to describe a disability in activities of daily living (ADLs), limitations in the physical-functional performance and the perception of the neighborhood environment in community-dwelling older adults from the extreme south of Santa Catarina, classifying them in the domains and qualifiers proposed by the ICF. This was a cross-sectional study, with older adults of both sexes. The variables analyzed were classified and categorized according to the categories of the ICF: 1) Body Functions and Structures: physical-functional performance tests; 2) Activity and Participation: ADL self-assessment instrument; and 3) Environmental factors: self-perception of the neighborhood environment. A total of 308 older adults were evaluated, most of them women (57.8%) and aged 60 to 69 years (54.7%). There were higher prevalences of moderate/severe difficulty in the 5-Repetition Sitting and Standing Chair Test (5RSCT) (66.2%), of moderate/severe disability in the activity of cutting toenails (21.2%), and no reports of places for the practice of physical activity close to the residence (72.5%). As for the ICF qualifiers, there was greater “moderate/severe difficulty” for the 5RSCT in the “Body Function and Structure” categories and in the task of cutting like toenails in the “Activity and Participation” categories. In the category “Environmental factors”, there was a higher prevalence of lack of places for physical activity in the neighborhood.A Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) se mostra ainda uma ferramenta distante e muitas vezes temida na área da saúde do idoso e, diante disso, o objetivo deste estudo foi descrever a incapacidade nas atividades de vida diária (AVDs), limitações no desempenho físico-funcional e a percepção do ambiente de vizinhança em idosos comunitários do extremo sul de Santa Catarina, classificando-os nos domínios e qualificadores propostos pela CIF. Tratou-se de estudo transversal, com idosos de ambos os sexos. As variáveis analisadas foram classificadas e categorizadas de acordo com os domínios da a CIF: 1) Funções e Estruturas do corpo: testes de desempenho físico-funcional; 2) Atividade e Participação: instrumento de auto avaliação das AVDs; e 3) Fatores ambientais: autopercepção do ambiente de vizinhança. Foram avaliados 308 idosos, sendo a maioria mulheres (57,8%) e com 60 a 69 anos de idade (54,7%). Verificaram-se maiores prevalências de dificuldade moderada/grave no Teste de Sentar e Levantar da Cadeira de 5 Repetições (TSLC5R) (66,2%), de incapacidade moderada/grave na atividade de cortar as unhas dos pés (21,2%) e no relato de ausência de locais para a prática de atividade física próximos à residência (72,5%). Considerando os qualificadores da CIF, houve maior “dificuldade moderada/grave” para o TSLC5R no domínio “Função e Estrutura do corpo” e na tarefa de cortar as unhas dos pés no domínio “Atividade e Participação”. No domínio “Fatores ambientais”, verificou-se maior prevalência de ausência de locais para a prática de atividade física no ambiente de vizinhança. &nbsp

Comportamento sedentário e sua associação com incapacidade funcional em idosos

Atividades sedentárias são frequentes em idosos, tornando importante avançar o conhecimento sobre o comportamento sedentário (CS) e sua relação com a capacidade funcional da população idosa, a fim de contribuir para implementação de intervenções de promoção à saúde. Objetivo: Identificar pontos de corte do CS para rastreio de incapacidade funcional e verificar sua associação com a presença de incapacidade nas atividades básicas (ABVDs) e instrumentais (AIVDs) da vida diária em idosos comunitários. Métodos: Tratou-se de um estudo transversal, domiciliar, realizado com 308 idosos comunitários. As incapacidades nas ABVDs e AIVDs foram avaliadas pelo Multidimensional Functional Assessment Questionnaire. Idosos com relato de “pouca/muita dificuldade” ou “incapacidade total” para realizar ao menos uma tarefa em cada domínio foram classificados com incapacidade. O tempo despendido em CS foi avaliado pela média ponderada do tempo sentado em um dia da semana e um dia de final de semana, avaliado pelo Questionário Internacional de Atividade Física. Os pontos de corte do CS para rastrear a incapacidade foram obtidos pela análise da curva ROC. Resultados: Os idosos que permaneceram tempo ≥ 4,4h/dia em CS tiveram 1,92 (IC95%:1,03; 3,57) vezes maiores chances de incapacidade nas AIVDs e aqueles que ficavam ≥ 4,3h/dia em CS tiveram 2,36 (IC95%:1,37;4,05) vezes maiores chances de incapacidade nas ABVDs, comparados aos que ficavam tempo inferior em CS. Conclusão: Estes dados sugerem que os idosos residentes na comunidade limitem o tempo em CS, evitando tempo superior a 4,3 horas diárias, a fim de prevenir a ocorrência de incapacidades funcionais.Sedentary activities are frequent in the elderly, making it important to advance knowledge about sedentary behavior (SB) and its relationship with the functional capacity of the elderly population, in order to contribute to the implementation of health promotion interventions. Objective: Identify SB cutoff points for screening for functional disability and to verify its association with the presence of disability in basic activities (BADLs) and instrumental activities (IADLs) of daily living in community-dwelling elderly. Methods: This was a cross-sectional, household study carried out with 308 community-dwelling older adults. Disabilities in BADLs and IADLs were assessed using the Multidimensional Functional Assessment Questionnaire. Elderly people with reports of “little/very difficult” or “complete inability” to perform at least one task in each domain were classified as having incapacity. Time spent in SB was assessed by the weighted average of time sitting on a weekday and a weekend day, assessed by the International Physical Activity Questionnaire. SB cutoff points to track disability were obtained by ROC curve analysis. Results:  Elderly people who spent ≥ 4.4h/day in SB had 1.92 (95%CI: 1.03; 3.57) times greater chances of incapacity in IADLs, and those who stayed ≥ 4.3h/day in CS had 2 .36 (95%CI:1.37;4.05) times greater chances of disability in BADLs, compared to those who spent less time in SB. Conclusion: These data suggest that community-dwelling elderly people limit their time in SB, avoiding times longer than 4.3 hours a day, in order to prevent the occurrence of functional disabilities