Medo de cair em idosos classificados como vulneráveis de um centro de referência à atenção da saúde do idoso

Objetivo: Correlacionar o medo de cair com a vulnerabilidade em idosos. Método: A vulnerabilidade foi avaliada por meio da Pesquisa sobre Idosos Vulneráveis (VES-13) e o medo de cair pela Escala de Eficácia de Quedas - Internacional – Brasileira (FES-I-BR), participaram idosos de ambos os sexos e idade (60-85 anos), foram excluídos voluntários com limitações cognitivas e os que não participavam do grupo de convivência. Foram aplicado os testes de Kolmogorov-Smirnov, de Mann-Whitney, de Spearman, de regressão logística binária e para análise de sensibilidade e especificidade da FES-I-BR, empregou-se a curva da característica do operador receptor (ROC), a análise foi realizada em 95% nível de confiança e p<0,05 foi adotado.  Resultados: Entre os n= 123 idosos, foi observado que (33,3%) são vulneráveis, n= 120 (97,6%) apresentaram alguma preocupação em cair. Entre as atividades analisadas na FES-I-BR, 21,1% estão extremamente preocupados em cair ao andar em superfícies escorregadias e foi observada uma correlação positiva e significativa entre a pontuação do VES-13 com a pontuação da FES-I-BR, a FES-I-BR foi um previsor significativo para a vulnerabilidade.  A FES-I-BR de forma aceitável mostrou-se capaz de discriminar o medo de cair de vulneráveis de não vulneráveis em uma área de 0,656 (p<0,005), sensibilidade de 53,7% e especificidade de 69,5%.  Conclusão: O medo de cair está correlacionado com a vulnerabilidade, os idosos vulneráveis apresentaram mais medo de cair, o medo de cair é fator preditor de vulnerabilidade e a FES-I-BR foi capaz de discriminar o medo de cair de idosos vulneráveis e não vulneráveis.Objective: Was to correlate the fear of falling with vulnerability in the elderly. Method: Vulnerability was assessed using the Vulnerable Elderly Survey (VES-13) and the fear of falling using the Falls Efficacy Scale - International - Brazilian (FES-I-BR), elderly people of both sexes and age (60- 85 years old), volunteers with cognitive limitations and those who did not participate in the coexistence group were excluded. The Kolmogorov-Smirnov, Mann-Whitney, Spearman, binary logistic regression tests were applied and for the sensitivity and specificity analysis of the FES-I-BR, the Receiver Operator Characteristic Curve (ROC) was used, analysis was performed at 95% confidence level and p <0.05 was adopted. Results: Among the n = 123 elderly, it was observed that (33.3%) are vulnerable, n = 120 (97.6%) had some concern about falling. Among the activities analyzed at FES-I-BR, 21.1% are extremely concerned about falling when walking on slippery surfaces and a positive and significant correlation was observed between the VES-13 score and the FES-I-BR score, FES-I-BR was a significant predictor for the vulnerability. In the present study, the FES-I-BR in an acceptable way proved to be able to discriminate the fear of falling from vulnerable to non-vulnerable in an area of 0.656 (p <0.005), sensitivity of 53.7% and specificity of 69, 5%. Conclusion: Fear of falling is correlated with vulnerability, vulnerable elderly people were more afraid of falling, fear of falling is a predictor of vulnerability and FES-I-BR was able to discriminate between the fear of falling of vulnerable and non-vulnerable elderly people

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background: Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods: We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5-19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school-aged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings: From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation: The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity. Funding: UK Medical Research Council, UK Research and Innovation (Research England), UK Research and Innovation (Innovate UK), and European Union