Inflammatory markers and occurrence of falls: Bambuí Cohort Study of Aging

OBJECTIVE: Analyze whether inflammatory markers are associated with falls among older adults living in Bambuí. METHODS: Study that analyzed baseline data from a Bambuí Cohort Study of Aging, involving 1,250 participants. Data about falls were collected from previous 12 months, classified as single or multiple occurrence and severity (participant seeking health services). Information about sociodemographic characteristics, health behaviors and health condition was also collected and used as confounding factors. The exposures of interest included interleukins (IL-1β, IL-6, IL-8, IL-10, IL-12), tumor necrosis factor (TNF), ultra-sensitive C-reactive protein (us-CRP) and chemokines (CXCL9, CCL5, CCL10, MCP1). Data were processed through logistic regression, obtaining odds ratio and 95% confidence interval (95%CI). RESULTS: The prevalence of falls was 27.1%; 40.1% of the older adults reported multiple falls and 33.3% sought health services. After adjustments, the following elevated levels were associated with falls: us-CRP (OR = 1.46, 95%CI 1.04–2.03), CCL5 (OR = 1.38, 95%CI 1.01–1.90) and CXCL9 (OR = 1.43, 95%CI 1.02–2.02). An association was observed between the number of elevated markers and the occurrence of falls: two (OR = 1.47, 95%CI 1.02–2.12) and three (OR = 2.08, 95%CI 1.12–3.87) elevated biomarkers indicated fall probability of 32.0% and 39.4%, respectively. CONCLUSIONS: Elevated levels of us-CRP, CCL5 and CXCL9, which were associated with falls, may contribute to a proper understanding of the mechanism associated with the occurrence of falls among older people.OBJETIVO: Analisar se marcadores inflamatórios estão associados a quedas em idosos vivendo na comunidade. MÉTODOS: Estudo da coorte de idosos de Bambuí, envolvendo 1.250 participantes da linha de base do projeto. Foram coletadas informações sobre quedas nos últimos 12 meses, classificadas quanto à ocorrência (única ou múltipla) e gravidade (procura por serviços de saúde). O inquérito também continha informações a respeito das características sociodemográficas, comportamentais e condições de saúde, as quais foram utilizadas como fatores de confusão. As exposições pesquisadas incluíram: interleucinas (IL-1β, IL-6, IL-8, IL-10 e IL-12), fator de necrose tumoral (TNF), proteína C reativa ultrassensível (PCRus) e quimiocinas (CXCL9, CCL5, CCL10 e MCP1). O tratamento dos dados foi realizado por meio de regressão logística, obtendose odds ratio e intervalo de 95% de confiança (IC95%). RESULTADOS: A prevalência de queda foi 27,1%; 40,1% dos idosos relataram quedas múltiplas e 33,3% procuraram serviços de saúde. Após ajustes, permaneceram associados às quedas os níveis elevados de PCRus (OR = 1,46; IC95% 1,04–2,03), CCL5 (OR = 1,38; IC95% 1,01–1,90) e CXCL9 (OR = 1,43; IC95% 1,02–2,02). Houve associação entre o número de marcadores elevados e a ocorrência de quedas: dois (OR = 1,47; IC95% 1,02–2,12) e três (OR = 2,08; IC95% 1,12–3,87) biomarcadores aumentados predisseram probabilidades de quedas iguais a 32,0% e 39,4%, respectivamente. CONCLUSÕES: Os níveis elevados de PCRus, CCL5 e CXCL9, que estiveram associados a quedas, podem contribuir para o adequado entendimento do mecanismo associado à ocorrência desse evento em idosos

Discontinuation of health interventions among Brazilian older adults during the COVID-19 pandemic: REMOBILIZE Study

The objective of this study was to analyze changes in access to health interventions during the pandemic among Brazilian older adults and to investigate the factors associated with social and health inequalities. We conducted an online survey with Brazilian adults aged 60 + years between May and June 2020. A multidimensional questionnaire was used to investigate access to health interventions during the pandemic and associated factors. Of 1482 participants, 56.5% reported health care before the pandemic, and 36.4% discontinued it during the pandemic. The discontinuation rate was 64.4% (95% CI 61.1-67.6). Participants with higher educational level (nine or more years of education: OR 0.34; 95% CI 0.17-0.70) and higher income (eight or more times the minimum wage: OR 0.54; 95% CI 0.36-0.81) were associated with less probability of discontinuation. Presenting multimorbidity (OR: 1.42; 95% CI 1.06-1.90) and polypharmacy (OR: 0.61; 95% CI 0.46-0.81) were associated with discontinuity in health interventions. Our study showed that structural health inequities in access to health care shaped the rates of discontinuation in health care interventions during the COVID-19 pandemic. Strategic actions should be set up to actively monitor socially vulnerable older adults and strengthen community-based services to mitigate the discontinuation of health care interventions

Marcadores inflamatórios associados às quedas em idosos: Coorte de Base Populacional de Bambuí

Submitted by Nuzia Santos ([email protected]) on 2019-07-10T19:03:41Z No. of bitstreams: 1 T_2018_JuleimarAmorim.pdf: 1183685 bytes, checksum: c1a58afd179832682ce2bc8bf0afe7bf (MD5)Approved for entry into archive by Nuzia Santos ([email protected]) on 2019-07-10T19:25:47Z (GMT) No. of bitstreams: 1 T_2018_JuleimarAmorim.pdf: 1183685 bytes, checksum: c1a58afd179832682ce2bc8bf0afe7bf (MD5)Made available in DSpace on 2019-07-10T19:25:47Z (GMT). No. of bitstreams: 1 T_2018_JuleimarAmorim.pdf: 1183685 bytes, checksum: c1a58afd179832682ce2bc8bf0afe7bf (MD5) Previous issue date: 2018CAPES, FAPEMIGFundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Os marcadores inflamatórios como contribuintes de quedas em idosos ainda não foram detalhadamente explorados na literatura e esse conhecimento pode contribuir na compreensão do inflammaging, tratando-se de importante abordagem nas práticas de saúde pública. O objetivo deste trabalho foi explorar os marcadores inflamatórios associados às quedas gerais, recorrentes e graves, em idosos vivendo na comunidade. Estudo de delineamento transversal, utilizando dados da linha de base da Coorte de Idosos de Bambuí, um estudo de base populacional conduzido entre moradores da cidade de Bambuí (MG), com 60 anos ou mais. As informações a respeito de quedas nos últimos 12 meses, gerais, recorrentes (≥2) e graves (procura por serviços de saúde), foram consideradas variáveis dependentes. Os biomarcadores séricos foram as exposições investigadas e incluíram interleucinas (IL-1β, IL-6, IL-12 e IL- 10), receptor solúvel do fator de necrose tumoral (TNF), quimiocinas (CXCL8, CXCL9, CXCL10 e CCL5) e Proteína C-Reativa Ultra-Sensível (PCRus). Para essas dosagens foi realizada coleta de cinco mL de sangue por punção venosa por meio do sistema de coleta a vácuo e analisados por citometria de fluxo em ensaios multiplex. Foram incluídas como potenciais variáveis de confusão as características sociodemográficas (idade, sexo e escolaridade), comportamentos em saúde (consumo de álcool, tabagismo, nível de atividade física), condições de saúde (multimorbidade e incapacidade funcional) e uso de medicamentos. Foi realizada estatística descritiva da amostra total e segundo os desfechos analisados, além de análise múltipla por meio de regressão logística, estimando-se os valores de odds ratio e respectivos intervalos de confiança (95%). Todas as análises foram realizadas no software Stata 13.0, considerando-se o nível de significância de 5%. A prevalência de alguma queda nos últimos 12 meses foi de 27,1%, de queda recorrente foi igual a 10,7% e 9,0% de queda grave. Após todos os ajustes, permaneceram associados às quedas gerais os níveis elevados de PCRus (OR: 1,46; IC95%: 1,04-2,03), CCL5 (OR: 1,38; IC95%: 1,01-1,90) e CXCL9 (OR: 1,43; IC95%: 1,02-2,02), à queda recorrente níveis séricos superiores de IL-12 (OR: 1,92; IC95%: 1,09-3,37) e CXCL9 (OR:1,67; IC9 5%: 1,05-2,66), e por fim, os maiores níveis de TNF (OR: 1,58; IC95%: 1,01-2,50), IL-12 (OR: 2,04; IC95%: 1,13-3,70), CXCL10 (OR: 1,75; IC95%: 1,04-2,92) e CCL5 (OR: 1,90; IC95%: 1,18-3,07) com o relato de queda grave. Esses resultados revelam novos marcadores associados, além dos já classicamente descritos na literatura, podendo contribuir para o adequado entendimento do perfil de biomarcadores séricos associados a quedas em idosos.nflammatory markers as contributors to falls in th e older adults have not yet been explored in detail in the literature and this knowledge may con tribute to the understanding of inflammaging, being an important approach in public health practices. The objective of this study was to explore the inflammatory markers assoc iated with general, recurrent and severe falls in older adults community-dwelling. Cross-sect ional study using data from the Bambuí Elderly Cohort, a population-based study conducted am ong residents of the city of Bambuí (MG) aged 60 and over. Data on falls in the last 12 months, general, recurrent (≥2) and severe (health care demand) were considered dependent vari ables. Serum biomarkers were the investigated exposures and included interleukins (I L-1β, IL-6, IL-12 and IL-10), soluble tumor necrosis factor receptor (TNF), chemokines (CXCL8 , CXCL9, CXCL10 and CCL5) and Ultra Sensitive C-Reactive Protein (PCRus). For th ese dosages, five mL of blood was collected by venipuncture through the vacuum collec tion system and analyzed by flow cytometry in multiplex assays. Potential confoundin g variables included socio-demographic characteristics (age, sex and schooling), health be haviors (alcohol consumption, smoking, physical activity level), health conditions (multim orbity and functional disability) and medication use. Descriptive statistics of the total sample and the outcomes analyzed were performed, as well as multiple analysis using logis tic regression, estimating the odds ratio and respective confidence intervals (95%). All analyzes were performed in the Stata 13.0 software, considering the significance level of 5%. The prevalence of some fall in the last 12 months was 27.1%, recurrent fall was equal to 10.7% and 9.0% of severe fall. After all adjustments, elevated CRP levels (OR: 1.46; 95%CI: 1. 04-2.03), CCL5 (OR: 1.38; 95%CI: 1.01-1.90) and CXCL9 (OR: 1.43; 95%CI: 1.02-2.02), to the recurrent decrease in serum levels of IL-12 (OR: 1.92; 95%CI: 1.09-3.37) and CXCL9 (OR: 1.67; 95%CI: 1.05-2.66), and finally, higher levels of TNF (OR: 1.58; 95%CI: 1.01-2 .50), IL-12 (OR: 2.04; 95%CI: 1.13- 3.70), CXCL10 (OR: 1.75; 95%CI: 1.04-2.92) and CCL5 (OR: 1.90; 95%CI: 1.18-3.07) with the report of severe fall. These results reveal new associated markers, in addition to those already classically described in the literature, an d may contribute to the adequate understanding of the profile of serum biomarkers as sociated with falls in the older adults

Functional capacity associated with work ability in older university staff employed by the state

Abstract Introduction: The increase in numbers of older adults in the workplace and in the number of years they spend in work prior to retiring has challenged health professionals to provide enable health conditions such that they may undertake occupational activity. Objective: To analyze the variables for functional ability, associated with work ability, in older adults who were government employees at a university. Methods: A cross-sectional design, with older workers aged 60 years old or over, located in different university centers and departments. A structured sociodemographic questionnaire was used to characterize the sample, and the Work Ability Index was used as an outcome variable for the associations, using the Timed Up and Go test, the handgrip strength test, the walking speed test and the chair sit to stand test. The Chi-squared test and Pearson correlation coefficient were used in the statistical analysis. The association of the factors of functional capacity was based on the odds ratio and 95% confidence interval, calculated using the Logistic Regression Model, as part of the SPSS statistical package for Windows. Results: A total of 258 staff participated in the investigation, with men (57.7%) and a lower age range (60 to 62 years old) predominating. Women differed in relation to falls after the age of 60 (p = 0.007) and in the last 12 months (p = 0.017). The mean Work Ability Index was 39.70 ± 5.64 points and a statistical association was ascertained between performance in the chair sit to stand test (OR = 2.26; p = 0.043). Muscle strength (r = 0.72; p < 0.000) and the chair sit to stand test (r = 0.73; p < 0.000) showed excellent correlation with work ability. Conclusion: The variables for functional capacity were associated with work ability

Factors associated with work ability in the elderly: systematic review

OBJECTIVE: To synthesize the evidence on factors associated with the maintenance of work ability during the aging process. METHODS: SciELO, LILACS and PubMed databases were consulted, in order to find out studies in Portuguese, English and Spanish published from 2000 to 2013. Descriptors which encompassed terms related to work ability, aging and elderly were used. Quantitative observational studies were included to investigate the work ability and the effect of aging. Studies aiming at analyzing the clinical course of illnesses related to aging and/or papers and publications in the form of editorials, interviews, projects, clinical notes and preliminary or conceptual data were excluded. RESULTS: A total of 924 articles were obtained, but 27 were included in the analyses. Later on, 2 intervention and 8 repeated studies were excluded. Variables that showed negative correlations with work ability were the following: age, smoking, service time and physical demands in occupational activities. Satisfaction with life, sufficient income, physical activity, volunteerism and mental workload were considered positive associations that protect the elderly from functional loss. CONCLUSION: This study was reported as a protective mechanism against depression, disability and fragility, maintaining the well-being, good cognitive function and autonomy in daily activities. Increased investments in the health care of this population are needed regarding musculoskeletal and cardiorespiratory capacity. Physical activity must be encouraged by policies to foster health promotion

Functional capacity associated with work ability in older university staff employed by the state

<div><p>Abstract Introduction: The increase in numbers of older adults in the workplace and in the number of years they spend in work prior to retiring has challenged health professionals to provide enable health conditions such that they may undertake occupational activity. Objective: To analyze the variables for functional ability, associated with work ability, in older adults who were government employees at a university. Methods: A cross-sectional design, with older workers aged 60 years old or over, located in different university centers and departments. A structured sociodemographic questionnaire was used to characterize the sample, and the Work Ability Index was used as an outcome variable for the associations, using the Timed Up and Go test, the handgrip strength test, the walking speed test and the chair sit to stand test. The Chi-squared test and Pearson correlation coefficient were used in the statistical analysis. The association of the factors of functional capacity was based on the odds ratio and 95% confidence interval, calculated using the Logistic Regression Model, as part of the SPSS statistical package for Windows. Results: A total of 258 staff participated in the investigation, with men (57.7%) and a lower age range (60 to 62 years old) predominating. Women differed in relation to falls after the age of 60 (p = 0.007) and in the last 12 months (p = 0.017). The mean Work Ability Index was 39.70 ± 5.64 points and a statistical association was ascertained between performance in the chair sit to stand test (OR = 2.26; p = 0.043). Muscle strength (r = 0.72; p < 0.000) and the chair sit to stand test (r = 0.73; p < 0.000) showed excellent correlation with work ability. Conclusion: The variables for functional capacity were associated with work ability.</p></div

Fatores associados à ótima capacidade para o trabalho em servidores idosos de uma universidade no Sul do Brasil

Resumo Objetivo: investigar a associação entre o índice de capacidade para o trabalho e os fatores sociodemográficos, ocupacionais, estilo de vida e saúde em idosos. Métodos: estudo transversal, com amostra de servidores idosos de uma instituição de ensino superior. Foram coletadas informações sociodemográficas e dados referentes a comportamento social, saúde, e trabalho. Utilizou-se análise uni e multivariada pelo Modelo de Regressão Logística para determinar os fatores associados à ótima capacidade para o trabalho. Resultados: na amostra prevaleceram os homens (57,8%), entre 60 e 64 anos (75,6%), com ensino superior (57,8%). A maioria declarou ser sedentária (89,1%) e com exigência mental de trabalho (62,8%). Mais da metade da amostra era de idosos em sobrepeso (53%), que relataram quedas (21,3%) e uso regular de múltiplos medicamentos (25,6%). As variáveis associadas à menor chance de ótima capacidade para o trabalho foram sexo feminino (OR=0,39; IC95%=0,18-0,83); cor não branca (OR=0,37; IC95%=0,16-0,84); exigência física para o trabalho (OR=0,40; IC95%=0,17-0,97); hospitalização (OR=0,14; IC95%=0,03-0,57); dificuldades no sono (OR=0,12; IC95%=0,04-0,43); autopercepção de saúde ruim (OR=0,22; IC95%=0,09-0,54); queixas de sintomas osteomusculares nos últimos 7 dias (OR=0,29, IC95%=0,10-0,87); e sintomas que comprometem o trabalho (OR=0,25; IC95%=0,08-0,82). Conclusão: fatores sociodemográficos, ocupacionais e condição de saúde comprometeram a ótima capacidade para o trabalho em idosos

Incapacidade funcional, sintomas depressivos e dor lombar em idosos

Introdução: A dor lombar modifica e limita aspectos tanto físicos quanto psicossociais da vida do idoso, impondo muitas vezes mudanças que causam transtornos pessoais, familiares e redução da capacidade funcional. Objetivo: Verificar a prevalência de dor lombar (DL) não específica em uma amostra de idosos da comunidade e determinar a correlação existente entre as variáveis: sexo, índice de massa corpórea (IMC), incapacidade funcional e sintomas depressivos. Materiais e métodos: Participaram deste estudo 54 idosos da comunidade (72 ± 5,2 anos). As características clínicas e sociodemográficas foram avaliadas por meio de questionário semiestruturado e a DL, por meio do Questionário de McGill. Para a medida de incapacidade em indivíduos com disfunções na coluna foi usado o Questionário de Roland Morris Brasil (RMBR). Sintomas depressivos e o nível geral de atividade física foram avaliados, respectivamente, por meio da versão reduzida da Escala de Depressão Geriátrica (GDS15) e pelo Perfil de Atividade Humana. Resultados: Evidenciou-se correlação alta e positiva entre a presença de DL, incapacidade funcional (RMBR) (rs = 0,774; p = 0,00) e presença de sintomas depressivos (GDS15) (rs = 0,271; p = 0,048). Nenhuma correlação foi evidenciada entre IMC (rs = 0,178; p = 0,197), sexo (rs = -0,073; p = 0,599) e DL. Conclusão: Observou-se prevalência alta de DL não específica na amostra de idosos estudada. Incapacidade funcional e depressão são condições fortemente associadas com DL em idosos da comunidade; cabe, portanto, desenvolver outras abordagens a fim de alcançar melhor efetividade das propostas terapêutica