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The aim of this study was to investigate the longitudinal association of sleep with physical performance in a representative sample of non-institutionalised older adults residing in the municipality of São Paulo, Brazil. Prospective cohort study. The current longitudinal study used data extracted from the Health, Well-being, and Aging Study (Estudo Saúde Bem-Estar e Envelhecimento [SABE]). The study population consisted of individuals aged ≥60 years who participated in the study in 2010 or 2015. Dependent variables included the Short Physical Performance Battery (SPPB) and gait speed. Independent variables of interest were self-reported sleep difficulty, daytime sleepiness and sleep quality. The longitudinal association between sleep variables and the outcomes was evaluated using Generalised Estimating Equations (GEE) Models adjusted for covariates. All the variables, except age, sex and schooling, were assessed at baseline and follow-up visits (2010 and 2015). The analyses included 2205 observations from 1559 individuals. The population mean age was 72 years in 2010 and 71 years in 2015, with a higher prevalence of women in both years. Between 2010 and 2015, there was a decline in the SPPB score and gait speed. Daytime sleepiness was negatively associated with the SPPB score [Coef.: −0.38 (95% confidence interval {CI}: −0.56, −0.21)] and gait speed [Coef.: −0.03 (95% CI: −0.05, −0.01)]. Poor sleep quality was negatively associated with the SPPB score [Coef.: −0.29 (95% CI: −0.57, −0.01)] and gait speed [Coef.: −0.03 (95% CI: −0.06, −0.00)]. Daytime sleepiness and poor sleep quality are associated with compromised physical performance in non-institutionalised older adults, and this association remained consistent over time. [ABSTRACT FROM AUTHOR]

Objective: To investigate the factors associated with diabesity in older women. Methods: This epidemiological study used a cross‐sectional design and included 196 older women (72.70 ± 7.20 years) from Jequié, Bahia, Brazil. Diabesity was defined as having both an elevated abdominal circumference (≥88 cm) and diabetes mellitus. For the inferential analyses, we constructed crude models followed by a multiple hierarchical explanatory model, with the following levels: Level 1 (socioeconomic variables), Level 2 (behavioral aspects), and Level 3 (health conditions). Poisson regression with a robust estimator was employed, and we calculated Prevalence Ratios (PR) with 95% Confidence Intervals (CI). Results: The prevalence of abdominal obesity, diabetes mellitus, and diabesity were 79.60%, 27.80%, and 22.40%, respectively. Women who were insufficiently active had a higher likelihood of diabesity (PR: 2.04; 95% CI: 1.22–3.41), as did those who spent more time in sedentary behavior (PR: 1.81; 95% CI: 1.04–3.16), used three or more continuous medications (PR: 2.51; 95% CI: 1.29–4.89), or reported a negative self‐perception of health (PR: 2.57; 95% CI: 1.03–5.80). Conclusion: The study identified several factors associated with diabesity in older women: insufficient physical activity, prolonged sedentary behavior, polypharmacy, and negative self‐perception of health. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the prevalence of dementia among older adults from Florianópolis, in the Southern Region of Brazil. Methods: Data were originally drawn from the Epifloripa Aging Cohort Study, a representative and community‐based survey designed to evaluate older people's health. This cross‐sectional study was conducted in two phases: the community‐screening phase, in which the Mini‐Mental State Examination and a multifunctional scale were administered to older subjects and close informants, respectively; and the hospital‐diagnosis phase, when the Cambridge Examination and the National Institute on Aging criteria were used. Adjustment for screening accuracy was made in order to estimate dementia prevalence. Results: Of 1184 subjects evaluated in the community, 243 were screened for the diagnosis phase, in which 47 were identified with dementia, resulting in a crude prevalence of 4.5% (95% CI: 3.241–5.758) and an estimated prevalence of 9.2% (95% CI: 7.446–10.954). Dementia was associated with older ages, lower education levels, and the presence of stroke. Mild alcohol use (in comparison with no alcohol use), community‐group practice, internet use and a higher level of physical activity, rather than education, decreased the odds ratio for dementia. Education was directly associated with these lifestyle habits. Conclusions: Prevalence was lower than that in previous studies in the country, and multivariate analysis reinforced the importance of lifestyle in preventing cognitive disorders in the older population. [ABSTRACT FROM AUTHOR]

Introduction. Despite all the improvements in surgical and anesthetic techniques, this procedure is still associated with pulmonary and cardiovascular complications in the postoperative period, and early rehabilitation, done through the use of cycloergometer, can minimize such complications, besides reducing the length of hospital stay. Objective. Therefore, the aim of the study was to assess the impact of cardiovascular exercise on lung function, respiratory muscle strength, and functional capacity in elderly patients after heart bypass surgery. Methods. To this purpose, a randomized and controlled clinical trial was conducted. Research participants were randomized to the cycle ergometer group (CEG) or to the control group (CG). The CG was managed based on the institution's protocol. The CEG also carried out all the activities of the control group, but there was the inclusion of cycle ergometry through a device built by the researchers. Pulmonary function (vital capacity (VC) and peak expiratory flow (PEF)), ventilatory muscle strength (maximum inspiratory pressure (MIP) and maximal expiratory pressure (MEP)), and functional capacity (six‐minute walk test) were evaluated before surgery, at ICU, and hospital discharge. Results. During the research period, 122 patients were evaluated, 61 in each group. The MIP of the cycle ergometry group was higher at discharge from the ICU 95% CI 8 (5.46 to 10.54) and at hospital discharge 95% CI 14 (16.89 to 11.11). MEP was higher in the cycle ergometry group at discharge from the ICU with 95% CI 6 (8.18 to 3.82) and at hospital discharge with 95% CI 9 (11.69 a 6.31). Vital capacity at ICU discharge with 95% CI 6 (7.98 to 4.02) and at hospital discharge with 95% CI 7 (8.98 to 5.02), as well as peak flow at ICU discharge with 95% CI 43 (75.27 to 10.73), showed relevance, being higher in the group that used the cycle ergometer. The CEG showed improvement in functional capacity at the time of hospital discharge with a 95% CI 56 (30.37 to 81.63). Conclusion. We conclude that application of cycloergometry after CABG decreases the loss of pulmonary function, muscle strength, and functional capacity. This trial is registered with RBR-39yrht6. [ABSTRACT FROM AUTHOR]

Despite exploring factors, little is known about sleep quality and room sharing in older adults. To examine differences in sleep quality among older adults as a function of bed/room sharing during the first wave of the COVID-19 pandemic. This cross-sectional study was conducted in Brazil and enrolled 1,123 older adults aged 60 years and older. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality and sleep duration. Bed or room sharing was assessed using a single question ("do you have a bed partner or a roommate?" "no bed partner or roommate"; "partner/roommate in other room"; "partner in the same room, but not same bed"; "partner in same bed"). Between group comparisons were performed with ANCOVA adjusting for confounders. The group "partner in the same bed" reported significant lower global PSQI scores compared to the "no bed or roommate partner" group (6.00 ± 0.27 versus 7.22 ± 0.23, respectively; p = 0.029). Furthermore, the group "partner in same bed" reported superior (p < 0.001) sleep duration (7.42 ± 0.09 hours) compared with older adults in the "no bed or roommate partner" (6.82 ± 0.08 hours), "partner or roommate in another room" (6.77 ± 0.14 hours; p < 0.001), and "partner in the same room but not in same bed" (6.82 ± 0.11 hours; p < 0.001) groups. The findings suggest that sharing a bed with a partner seems to be associated with significant better quality and duration of sleep among older adults. [ABSTRACT FROM AUTHOR]

The aging population, often burdened with multimorbidity and polypharmacy complexities, requires comprehensive care during healthcare transitions. These transitions contribute to increased prescriptions, exacerbating polypharmacy and frailty in older individuals. Medication reconciliation, a preventive strategy, optimizes medication lists through systematic analysis, particularly benefiting older patients grappling with polypharmacy. This practice holds substantial potential in enhancing patient safety during care transitions. Therefore, the aim of this study is to evaluate the discrepancies detected during the practice of medication reconciliation at the admission, discharge, or transfer of older individuals in a ward in Brazil. This is a single-cohort study of patients admitted to an older adult care ward in Brazil, monitored from September 2021 to April 2022. Older individuals hospitalized in the ward, exhibiting the characteristic clinical profile of multimorbidity and polypharmacy, were observed to identify discrepancies in the practice of medication reconciliation conducted as part of pharmaceutical care services. Medication reconciliation was carried out upon admission, discharge from the ward for older adult care, or transfer to other healthcare units. Sixty older individuals were monitored during the study period in the ward. The use of polypharmacy at home was evident in more than 70% of patients, and multimorbidity was present in over 90% of patients. On average, 8.6 discrepancies were identified per patient (± 4.7). Upon admission to the older adult care ward, 501 discrepancies were identified and assessed, decreasing to 200 at the time of hospital discharge or transfer to other units. In total, 48 medication errors were identified in the evaluated prescriptions and ongoing pharmacotherapy. The use of polypharmacy proved to be a contributing factor that increased the identification of discrepancies in medication reconciliation (p < 0.001). Analyzing medication reconciliation discrepancies uncovers intentional and unintentional aspects in prescriptions, with medication quantity, especially in polypharmacy, linked to potential harm. Continuous monitoring proved crucial, significantly enhancing patient safety in the older adult care ward. [ABSTRACT FROM AUTHOR]

Objectives: Depression is a prevalent mental health condition that also often affects older adults. The PROACTIVE psychosocial intervention was developed to reduce depressive symptomatology among older adults within primary care settings in Brazil. An important psychological marker that affects individuals' aging experience relates to how old people feel. Known as subjective age, this marker has been shown to be a risk factor for experiencing greater depressive symptoms if individuals report feeling older than their (chronological) age. In this study, we perform secondary analyses of the PROACTIVE cluster-randomized controlled trial to examine the role of subjective age. Method: The sample included 715 Brazilian older adults (74% female, Mage 68.6, SD = 6.9, age range: 60–94 years) randomized to intervention (n = 360, 74% female, Mage 68.4, SD = 6.6, age range: 60–89 years) or control (n = 355, 74% female, Mage 68.9, SD = 7.2, age range: 60–94 years) arms. Here our primary outcome was depressive symptoms at the 8-month follow-up assessed with the 9-item Patient Health Questionnaire (PHQ-9) as a continuous variable. Our previous analyses demonstrated improved recovery from depression at follow-up in the intervention compared with the control arm. Results: Relevant main effects and interactions in regression models for PHQ-9 presented here found that those reporting older subjective age had worse depressive symptoms at follow-up but that they benefitted more from the intervention when initial levels of depression were high. For participants who reported younger subjective ages the intervention showed positive effects that were independent of initial levels of depression. Conclusion: Our findings emphasize the importance of investigating possible underlying mechanisms that can help clarify the impact of mental health interventions. [ABSTRACT FROM AUTHOR]

The 180° turn phase of the test may better differentiate the oldest-old regarding their history of falls. This is a case-control study designed to detect the ability of the 180° turn timed up and go (TUG) phase to detect a history of falls in the oldest-old. Sixty people aged 85 years and older were assessed in their homes. The single-task and dual-task TUG tests were performed using an inertial sensor (G-Walk). Sociodemographic data, physical activity levels, mental status, depressive symptoms, concern for falls occurrence, number of medicines in use, self-perception of balance, and the functional reach test were also assessed. The logistic regressions revealed the 180° turn phase of both the single-task and dual-task TUG was almost three times better than the full TUG test to detect a history of falls, thus providing insights that can be used to better assess functional mobility in the oldest-old. [ABSTRACT FROM AUTHOR]

Background: Longevity increases pose public health challenges, especially in managing falls and their psychological impacts on older adults. Limited evidence exists on the relationship between a fear of falling (FOF), previous falls, and depressive symptoms among community-dwelling older adults. Objective: To evaluate the association between falls, FOF, and depressive symptoms in community-dwelling older adults. Methods: This cross-sectional study, conducted in 2018, included 400 older adults from a Basic Health Unit in São Paulo, Brazil. The Geriatric Depression Scale (GDS-15) and the International Falls Efficacy Scale (FES-I) were used, along with self-report questionnaires on fall history. Linear and logistic regression were used to analyze the relationships between variables. Results: The mean age was 75.2 (SD = 8.53) years, with 63.2% being female. Depressive symptoms were observed in 18.3% of the participants, while 90.5% reported a fear of falling (FOF). More than half (63.0%) experienced falls, with 49.5% occurring in the last year. Factors such as the female gender, negative health perceptions, and functional dependence were associated with depressive symptoms. Adjusted analyses indicated that both a fear of falling (FOF) (B = 0.043; p = 0.012) and a history of falls (B = 0.725; p = 0.015) were associated with depressive symptoms. Conclusions: Falls, FOF, and depressive symptoms are interlinked among older adults, underscoring the need for targeted interventions to improve their mental and physical health. [ABSTRACT FROM AUTHOR]

Falls are among the top 10 causes of years lived with disability in people aged 75 and over. Preventive programs like case management (CM) are crucial. Objectives: To evaluate the effects of a multifactorial fall prevention program based on CM on physical performance, the presence of pain, and the risk of falls and fractures in older people who have suffered falls. Methods: This randomized, single-blind clinical trial with parallel groups, Intervention Group (IG) and Control Group (CG), was composed of 55 older people with a history of falling, living in the community. All participants underwent an initial assessment via video call (containing anamnesis, timed up-and-go test, falls risk score, short physical performance battery, and clinical frax). The IG underwent CM, the physical exercise protocol, and the cognitive stimulation protocol. The CG was monitored through telephone calls and received general health and fall guidance. Results: No significant results were found in the physical capacity, the presence of pain, the risk of falls, or the fractures between the Intervention and Control Groups and between assessments. Conclusion: This program was not effective in improving functional performance, but it was important for characterizing pain and the probability of fracture in the next 10 years in this population. [ABSTRACT FROM AUTHOR]

Objectives: To identify the prevalence and associated factors of cognitive dysfunction, 1 year after ICU discharge, among adult patients, and it´s relation with quality of life. Methods: Multicenter, prospective cohort study including ICUs of 10 tertiary hospitals in Brazil, between May 2014 and December 2018. The patients included were 452 adult ICU survivors (median age 60; 47.6% women) with an ICU stay greater than 72 h. Results: At 12 months after ICU discharge, a Montreal Cognitive Assessment (tMOCA) telephone score of less than 12 was defined as cognitive dysfunction. At 12 months, of the 452 ICU survivors who completed the cognitive evaluation 216 (47.8%) had cognitive dysfunction. In multivariable analyses, the factors associated with long-term (1-year) cognitive dysfunction were older age (Prevalence Ratio–PR = 1.44, P < 0.001), absence of higher education (PR = 2.81, P = 0.005), higher comorbidities on admission (PR = 1.089; P = 0.004) and delirium (PR = 1.13, P < 0.001). Health-related Quality of life (HRQoL), assessed by the mental and physical dimensions of the SF-12v2, was significantly better in patients without cognitive dysfunction (Mental SF-12v2 Mean difference = 2.54; CI 95%, − 4.80/− 0.28; p = 0.028 and Physical SF-12v2 Mean difference = − 2.85; CI 95%, − 5.20/− 0.50; P = 0.018). Conclusions: Delirium was found to be the main modifiable predictor of long-term cognitive dysfunction in ICU survivors. Higher education consistently reduced the probability of having long-term cognitive dysfunction. Cognitive dysfunction significantly influenced patients' quality of life, leading us to emphasize the importance of cognitive reserve for long-term prognosis after ICU discharge. [ABSTRACT FROM AUTHOR]

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18–<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose–response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period. [ABSTRACT FROM AUTHOR]

Evidence has suggested that a history of falls and fear of falling (FOF) are associated with reduced mobility among older adults. Although many studies have explored the association between the history of falls and FOF in the context of decreased mobility, most have had small sample sizes, limiting the generalizability of the results. Therefore, this study sought to contribute to the body of knowledge around these constructs to further support the previous findings. To investigate the association between a history of falls and FOF with low mobility in community-dwelling older adults. This cross-sectional study included 308 older adults (69.9 ± 7.1 years, 57.8% female). The Timed Up and Go (TUG) test was used to classify mobility limitations in participants and the Falls Efficacy Scale–International - Brazil was used to quantify FOF. Participants were also asked if they had fallen in the previous 12 months. Multivariable logistic regression was used. The prevalence rates of a history of falls and FOF were 32.7 and 48.4%, respectively. Older adults with a history of falls and FOF had 2.20 (95%CI: 1.20; 4.02) and 3.80 (95%CI: 1.90; 7.58) greater odds of presenting low mobility than older adults without these health problems, respectively. History of falls and FOF are associated with higher odds of low mobility in community-dwelling older adults. Therefore, it is of the utmost importance to introduce public health programs aimed at preventing falls in older adults to reduce possible adverse health outcomes, including low mobility. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to explore and externally validate the Carpenter instrument's efficacy in predicting postdischarge fall risk among older adults admitted to the emergency department (ED) for reasons other than falls or related injuries. Methods: A prospective cohort study was conducted on 779 patients aged ≥ 65 years from a tertiary hospital in São Paulo, Brazil, who were monitored for up to 6 months post‐ED hospitalization. The Carpenter instrument, which evaluates the four risk factors nonhealing foot sores, self‐reported depression, inability to self‐clip toenails, and prior falls, was utilized to assess fall risk. Follow‐up by telephone occurred at 30, 90, and 180 days to identify falls and mortality. Fine–Gray models estimated the predictive power of Carpenter instrument for future falls, considering death as a competing event and sociodemographic factors, frail status, and clinical measures as confounders. Results: Among 779 patients, 68 (9%) experienced a fall within 180 days post‐ED admission, and 88 (11%) died. The majority were male (54%), with a mean age of 79 years. Upon utilizing the Carpenter score, those with a higher fall risk (≥2 points) displayed more comorbidities, greater frailty, and increased clinical severity at baseline. Regression analyses showed that every additional point on the Carpenter score increased the hazard of falls by 73%. Two primary contributors to its predictive potential were identified: a history of falls in the preceding year and an inability to self‐clip toenails. However, the instrument's discriminative accuracy was suboptimal, with an area under the curve of 0.62. Conclusions: While the Carpenter instrument associated with a higher 6‐month postadmission fall risk among older adults post‐ED visit, its accuracy for individual patient decision making was limited. Given the significant impact of falls on health outcomes and health care costs, refining risk assessment tools remains essential. Future research should focus on enhancing these assessments and devising targeted proactive strategies. [ABSTRACT FROM AUTHOR]

To compare the effect of an intensity‐controlled exercise program (ICEP) and a nonintensity‐controlled exercise program (non‐ICEP) on the variables responsible for blood pressure regulation in hypertensive older adults. 95 hypertensive older adults (65.40 ± 7.48 years/22 males and 73 females) performed hemodynamic, functional fitness, and biochemical evaluations before and after 12 weeks of the multicomponent exercises which included walking, muscle strength, hydrogymnastics, Pilates, dynamic balance, agility, flexibility, and others. A significant improvement was observed in general functional fitness index (GFFI: p ≤ 0.000, d = 0.35), nitrite (NO2−: p ≤ 0.000, d = 0.49), systolic blood pressure (SBP: p ≤ 0.000, d = 0.65), diastolic blood pressure (DBP: p ≤ 0.013, d = 0.40), thiobarbituric acid reactive substances (TBARS: p ≤ 0.007, d = 0.78), activity of the endothelial superoxide dismutase enzyme (ecSOD: p ≤ 0.032, d = 0.41), double product (DP: p ≤ 0.015, d = 0.43), and waist‐hip ratio (WHR: p ≤ 0.000, d = 0.44) for ICEP. Only GFFI (p ≤ 0.047, d = 0.12), TBARS (p ≤ 0.000, d = 0.77), SOD (p ≤ 0.025, d = 0.25), DP (p ≤ 0.046, d = 0.26), and BMI (p ≤ 0.018, d = 0.02) presented better results in non‐ICEP. When the effect of the groups (controlled by age, BMI, and sex) was evaluated, an increase was observed in the NO2−, TBARS, and SOD and a reduction in the SBP and WHR variables in the ICEP group compared to the non‐ICEP group. Twelve weeks of engagement in a controlled‐intensity exercise program was enough to improve the level of functional fitness and variables regarding blood pressure regulation in hypertensive older adults. Conversely, physical exercise performed without intensity control was related to the limited effect on such variables. [ABSTRACT FROM AUTHOR]

Background: Social Frailty is a significant public health concern affecting the elderly, particularly with the global population aging rapidly. Older adults with social frailty are at significantly higher risk of adverse outcomes such as disability, cognitive impairment, depression, and even death. In recent years, there have been more and more studies on social frailty, but no bibliometrics has been used to analyze and understand the general situation in this field. Therefore, by using CiteSpace, VOSviewer, and Bilioshiny software programs, this study aims to analyze the general situation of the research on social frailties of the older adults and determine the research trends and hot spots. Methods: A bibliometric analysis was conducted by searching relevant literature on the social frailty of the older adults from 2003 to 2022 in the Web of Science core database, using visualization software to map publication volume, country and author cooperation networks, keyword co-occurrences, and word emergence. Results: We analyzed 415 articles from 2003 to 2022. Brazil has the highest number of articles in the field of social frailty of the older adults, and the United States has the highest number of cooperative publications. Andrew MK, from Canada, is the most published and co-cited author, with primary research interests in geriatric assessment, epidemiology, and public health. "Social Vulnerability," "Health," "Frailty," "Mortality," and "Older Adult" are among the research hotspots in this field. "Dementia," "Alzheimer's disease," "Population," and "Covid-19" are emerging research trends in social frailty among the older adults. Conclusion: This scientometric study maps the research hotspots and trends for the past 20 years in social frailty among the older adults. Our findings will enable researchers to better understand trends in this field and find suitable directions and partners for future research. [ABSTRACT FROM AUTHOR]

different populations have different averages of life-space assessment scores and defining cutoff values of clinical significance by each population should take into consideration. Different cutoffs to define restricted life space have been reported. The most common is a score of 60 points. There are other cutoffs derived from receiver operating characteristic (ROC) analysis and used to classify older adults according to their ability in activities of daily living (ADLs) (52.3 points) or instrumental activities of daily living (IADLs) (56 points); other cutoffs are specialized for people with cognitive impairment (26.75 points) or people with spinal cord injury who need mobility aids (78.5 points). The aims were to identify cutoff points of Life Space Assessment (LSA) in older adults in different sites and to determine the relationship of the cutoff scores with mobility disability and depression. The study population was composed of community-dwelling adults aged 65–74 years who were not institutionalized. An ROC analysis was constructed, and the area under the curve (AUC) was calculated to identify the optimal cutoff that discriminates life-space restriction for each city. Logistic regressions were executed by site to comprehend the association among restricted LSA and mobility disability and depression. In total, 1890 participants were included in the analyses (52.38% women, 37.19% mobility disability and 21.32% had depression). Canada cities had the highest cutoff, while Tirana and Natal had the lowest cutoff (< 50). Kingston was the site with the highest association between life-space restriction and mobility disability (OR 5.4, 95% CI 2.9–10). Saint-Hyacinthe, Tirana, and Manizales had significant associations between depression and restricted life space (OR 3.25, 95% CI 1.53–6.89, OR 3.14, 95% CI 1.88–5.24, and OR 3.99, 95% CI 2.28–6.98, respectively). Different cutoffs to define restricted life-space have been identified in elderly people at different sites. The analysis of the relationship between the restricted life space and personal characteristics like depression and mobility disability supported these findings. The groupings produced by the cutoff points for each site showed notable variations. These findings emphasize the importance of population-based cutoffs to improve the general applicability of LSM criteria and take into consideration the importance of site-specific approaches. [ABSTRACT FROM AUTHOR]

To verify the factor structure of the LIFE-H 3.1-Brasil in a sample of independent older adults, and to analyze their responses to the instrument. Cross-sectional study with175 older adults assisted by the Family Health Strategy in the interior of the State of São Paulo/Brazil. We used Cronbach's alpha to assess internal consistency, Pearson's correlation coefficient for retained dimensions, and exploratory factor analysis to examine the factor structure. Among participants, 62.3 per cent were women, 49.2 per cent were aged between 60–69 years, 54.3 per cent had 0–3 years of schooling and 67.4 per cent were retired. Based on our factor analysis, four factors were identified that explained 43.5 per cent of the variance: personal care, community, recreation, and communication. Cronbach's alphas ranged from.76 to.93. We demonstrated that a 4-dimensional model for the LIFE-H 3.1-Brasil was valid and reliable to measure the quality of social participation of independents older adults living in the community. Findings support its use in clinical practice and research. Nonetheless, future research is warranted to confirm the proposed factorial structure. This study supports the importance of identifying older adults' social participation through a valid instrument such as the LIFE-H, which has been widely used internationally. [ABSTRACT FROM AUTHOR]

To understand and discuss the perceptions about fear of falling (FOF) in older adults without a history of falls. A qualitative study with a convenience sample consisting of 51 older adults. Data collection was out through semi-structured interviews during the Covid-19 pandemic. Data were analyzed using thematic analysis. Three themes were grouped: FOF and its repercussions; Reactions to FOF in the daily life of the pandemic; and No fear, but aware of aging. The older adults reported a fear of dependence, difficulties and cautious behaviors in activities of daily living and mobility in the community. Understanding FOF can contribute for your approach and building multidisciplinary and intersectoral strategies aimed at maintaining independence and strengthening the identity of older adults without a history of falls in the community. [ABSTRACT FROM AUTHOR]

Objective: To analyze the factors associated with low functional mobility in older adults residing in Alcobaça, BA. Methods: This is an epidemiological survey with a cross‐sectional design, conducted in 2015 with 473 older adults (62.4% women; mean age 70.2 ± 8.2 years) from Alcobaça, BA. The interview script addressed sociodemographic characteristics, health, and behavioral aspects. Functional mobility was assessed using the Short Physical Performance Battery (≤6 points). Inferential analyses were conducted using the Mann–Whitney U test and Poisson regression (with robust variance and estimation of prevalence ratios and their respective 95.0% confidence intervals). Results: The prevalence of low functional mobility was 9.6%, with associated factors including the use of alcoholic beverages (PR = 1.7, 95% CI: 1.01–1.13) and the number of repetitions in elbow flexion (PR = 1.01, 95% CI: 1.01–1.05). Additionally, older adults with low mobility had lower height, thigh circumference, and lower performance in handgrip strength tests, elbow flexion, and flexibility. They also spent more time in sedentary behavior and less time in physical activity compared to older adults with preserved mobility (p < 0.05). Conclusion: Older adults with low mobility exhibit poorer values in anthropometric parameters, lower performance in motor tests, spend less time engaged in physical activities, and more time in sedentary behavior. [ABSTRACT FROM AUTHOR]

This study evaluated prospective associations between self-reported and objectively measured physical activity (PA) and risk of falls among older adults. A cohort study started in 2014 with 1,451 community-dwelling older adults living in Pelotas, Brazil. Leisure-time PA was obtained by the International Physical Activity Questionnaire and 7-day raw accelerometer data evaluated for total, light PA, and moderate to vigorous PA. In 2016–2017, participants recorded their falls in the previous 12 months. Around 23% of the 1,161 participants followed-up in 2016–2017 experienced a fall in the last 12 months. Participants who did not spend any time in self-reported leisure-time PA at baseline had on average 34% higher risk of falls, and individuals in the lowest tertile for moderate to vigorous PA had on average 51% higher risk of falls compared to those in the highest tertile. Low levels of self-reported and objectively measured moderate to vigorous PA were related to higher risk of falling among Brazilian older adults. [ABSTRACT FROM AUTHOR]

Introduction: Femoral fractures in elderly individuals present significant health challenges, often leading to increased morbidity and mortality. Acute kidney injury (AKI) during hospitalization further complicates outcomes, yet the interaction between AKI severity and comorbidities, as quantified by the Charlson Comorbidity Index (CCI), remains poorly understood in this population. This study aimed to assess the associations between AKI severity and the CCI and between AKI severity and one-year mortality postfemoral fracture in elderly patients. Methodology: This study utilized data from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC-IV) database and focused on elderly patients (> 65 years) admitted with hip fractures. Patients were categorized based on AKI stage according to the KDIGO criteria and CCI scores. The primary outcome assessed was all-cause mortality one year after hospital discharge. The statistical analyses included logistic regression, Cox proportional hazards regression and moderation analysis with the Johnson–Neyman technique to evaluate associations between AKI and long-term mortality and between the CCI and long-term mortality. Results: The analysis included 1,955 patients and revealed that severe AKI (stages 2 and 3) was independently associated with increased one-year mortality. Notably, the CCI moderated these associations significantly. A lower CCI score was significantly correlated with greater mortality in patients with severe AKI. The impact of severe AKI was greater for those with a CCI as low as 3, more than doubling the observed one-year mortality rate. In contrast, higher CCI scores (≥8) did not significantly impact mortality. Sensitivity analyses supported these findings, underscoring the robustness of the observed associations. Conclusion: This study elucidates the complex interplay between AKI severity and comorbidities and long-term mortality in elderly hip fracture patients. These findings underscore the importance of considering both AKI severity and comorbidity burden in prognostic assessments and intervention strategies for this vulnerable population. Targeted interventions tailored to individual risk profiles may help mitigate the impact of AKI on mortality outcomes, ultimately improving patient care and outcomes. Further research is warranted to explore the underlying mechanisms involved and refine risk stratification approaches in this population. [ABSTRACT FROM AUTHOR]

Introduction: Low educational attainment is a potential risk factor for Alzheimer's disease (AD) development. Alpha-secretase ADAM10 plays a central role in AD pathology, attenuating the formation of beta-amyloid peptides and, therefore, their aggregation into senile plaques. This study seeks to investigate ADAM10 as a blood-based biomarker in mild cognitive impairment (MCI) and AD in a diverse group of community-dwelling older adults, focusing on those with limited educational attainment. Methods: Participants were recruited from public health services. Cognition was evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination – Revised (ACE-R) batteries. Blood samples were collected to analyze plasma ADAM10 levels. A logistic regression was conducted to verify the influence of plasma ADAM10 on the AD diagnosis. Results: Significant differences in age, years of education, prescribed medications, and cognitive test scores were found between the MCI and AD groups. Regarding cognitive performance, both ACE-R and MMSE scores displayed significant differences between groups, with post hoc analyses highlighting these distinctions, particularly between AD and cognitively unimpaired individuals. Elevated plasma ADAM10 levels were associated with a 4.5-fold increase in the likelihood of a diagnosis of MCI and a 5.9-fold increase in the likelihood of a diagnosis of AD. These findings suggest ADAM10 levels in plasma as a valuable biomarker for assessing cognitive status in older individuals with low education attainment. Conclusion: This study underscores the potential utility of plasma ADAM10 levels as a blood-based biomarker for cognitive status, especially in individuals with low educational backgrounds, shedding light on their relevance in AD development and diagnosis. [ABSTRACT FROM AUTHOR]

The objective of this study was to investigate factors related to recurrent falls among older adults attending primary health care, considering the biopsychosocial perspective. A representative sample of 201 older adults were interviewed in three Primary Health Care units randomly selected in a city in southeastern Brazil. Outcome included self-report of two or more falls in the past 12 months. Exposures included personal and environmental aspects, according to domains of International Classification of Functioning of the World Health Organization (ICF-WHO). Recurrent falls were reported by 24.4% of the participants. Associations with depressive symptoms (p =.003), having osteoporosis (p =.031), chronic musculoskeletal pain (p =.020), frailty (p =.013), sleep satisfaction (p <.001), and functional status (p <.001) were found. In logistic regression models, cognitive status, musculoskeletal pain, and functional status were predictors of recurrent falls; however, only sleep satisfaction remained significant in the final model. Strategies aimed at preventing recurrent falls in primary health care should consider assessments and interventions targeting sleep aspects among older adults. [ABSTRACT FROM AUTHOR]

Given the aging global population, identifying heart failure (HF) phenotypes has become crucial, as distinct disease characteristics can influence treatment and prognosis in older adults. This study aimed to analyze the association between clustering of cardiovascular risk factors and HF in older adults. A cross-sectional epidemiological study was conducted with 1322 older adults (55% women, mean age 70.4) seen in primary health care. Diagnosis of HF was performed by a cardiologist based on diagnostic tests and medical history. Cardiovascular risk factors included hypertension, diabetes, hypercholesterolemia, and smoking. Using logistic regression, potential associations were tested. Individual risk factor analysis showed that older adults with hypertension, diabetes, or hypercholesterolemia had up to 7.6 times higher odds to have HF. The cluster where older adults had only one risk factor instead of none increased the odds of HF by 53.0%. Additionally, the odds of older patients having HF ranged from 3.59 times for the two-risk factor cluster to 20.61 times for the simultaneous presence of all four factors. The analysis of clusters substantially increasing HF risk in older adults revealed the importance of individualizing subgroups with distinct HF pathophysiologies. The clinical significance of these clusters can be beneficial in guiding a more personalized therapeutic approach. [ABSTRACT FROM AUTHOR]

The study focused on examining the relationship between well-being and various psychological factors such as loneliness, anxiety, depression, and stress, whilst also considering changes in lifestyle. A total of 108 elderly participants, with an average age of 70.38 years, were enrolled in this quantitative cross-sectional study. The research employed a battery of assessment tools including a Sociodemographic Data Questionnaire, Mini-Mental State Examination, Positive Mental Health Scale, Stress Perception Scale, Geriatric Anxiety Inventory, Geriatric Depression Scale (reduced version), Loneliness Scale, and International Physical Activity Questionnaire. Descriptive analysis was conducted in order to understand the distribution of scores across these variables, followed by the categorization of participants based on the reported alterations in eating and physical activity behaviors. Correlations between variables were assessed using Spearman correlation and an EBIC-LASSO network analysis. The findings indicated a potential detriment to the well-being of elderly individuals practicing social distancing, evidenced by heightened symptoms of loneliness, depression, anxiety, and stress, alongside the reported changes in dietary patterns and physical activity. The study underscores the importance of understanding the pandemic's impact on the well-being of older adults and advocates for longitudinal investigations to delineate the evolving effects of social distancing measures across different phases of the pandemic. [ABSTRACT FROM AUTHOR]

Background. Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment. Aims. This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment. Methods. Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups. Results. Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4–66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (p = 0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group (p < 0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens (p < 0.05) and Fazekas (p < 0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale (p < 0.05). Conclusions. The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions. [ABSTRACT FROM AUTHOR]

Background: The use of potentially inappropriate medications (PIM) by the elderly is commonly studied, but studies evaluating the use of PIM by frail elderly covered by prepaid health plans are still lacking. Objective: To identify the prevalence of use and the factors associated with the use of PIM by the elderly patients with high and moderate risk of clinical-functional vulnerability, according to the Beers criteria 2019. Methods: A cross-sectional study was developed with elderly people from a private health plan in Vitória-ES, Brazil. Socioeconomic, demographic and clinical data were collected through a digital platform and a structured questionnaire through an interview, from October 2018 to June 2019. The association between the use of PIM and independent variables was verified by univariate logistic regression with their respective confidence intervals (CI) 95%. The Multiple Model included the variables with P ≤.20. Results: 332 elderly patients were interviewed (mean age 81.5 years, gender 237 female, 95 male). A 65% prevalence of PIM use was identified. In the multiple logistic regression model, the variables associated with the use of PIM were self-medication (P =.004), high risk of clinical-functional vulnerability (P =.022), use of psychotropic medications (P =.000001), musculoskeletal medications (P =.04) and alimentary tract medications (P =.03). Physical exercises were considered a protection factor (P =.02). Conclusion: The high prevalence of PIM use indicates the need for improvement in elderly private health care, to increase pharmacotherapy safety for this population. [ABSTRACT FROM AUTHOR]

Introduction: Neuromodulation is a non-invasive technique that allows for the modulation of cortical excitability and can produce changes in neuronal plasticity. Its application has recently been associated with the improvement of the motor pattern in older adults individuals with sequelae from neurological conditions. Objective: To highlight the effects of non-invasive neuromodulation on the risk of falls and fear of falling in community-dwelling older adults. Methods: Systematic review conducted in accordance with the items of the Cochrane Handbook for Systematic Reviews of Interventions. Searches were carried out in electronic databases: CENTRAL, Clinical Trials, LILACS, PEDro, PubMed, Web of Science, between 13/06/2020 and 20/09/2023, including all indexed texts without language and publication date restrictions, randomized controlled clinical trials, which presented as their main outcome non-invasive neuromodulation for reducing the fear of falling and risk of falls in the older adults, regardless of gender. Results: An extensive search identified 9 eligible studies for qualitative synthesis from 8,168 potential articles. Rigorous filtering through automated tools, title/ abstract screening, and full-text evaluation ensured a focused and relevant selection for further analysis. Most studies (80%) used transcranial direct current electrical stimulation as an intervention, over the motor cortex or cerebellum area, with anodal current and monopolar electrode placement. The intensity ranged from 1.2 mA to 2 mA, with a duration of 20 min (80%). The profile of the research participants was predominantly individuals over 65 years old (80%), with a high risk of falls (60%) and a minority reporting a fear of falling (40%). The outcomes were favorable for the use of neuromodulation for the risk of falls in the older adults, through improvements in static and dynamic balance. Conclusion: The results may have limited applicability to direct outcomes related to the risk of falls, in addition to evidence regarding the difference or lack thereof in applicability between genders, fallers and non-fallers, as well as older adults individuals with low and high fear of falling. Systematic review registration: The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) to obtain the identification of ongoing research (ID: 222429). [ABSTRACT FROM AUTHOR]

This study aimed to compare the prevalence and socio-economic determinants of frailty in older adults in Brazil and Chile using nationally representative survey data. Analytical research using data from the Brazilian Longitudinal Study of Aging (ELSI) and the Chilean National Health Survey (ENS) conducted in Brazil and Chile between 2015 and 2017. The study included 5484 older adults aged 60 years or older in Brazil and 2031 in Chile. Frailty was measured using the FRAIL index, and logistic regression models were used to identify the determinants of frailty. The prevalence of frailty is 15.6% and 12.6% in Brazil and Chile, respectively. Frailty is associated with several factors, including age, sex, living alone, residing in urban areas, and decreased life satisfaction. However, the analysis revealed notable differences between countries. A greater number of significant variables were associated with frailty in Brazil, whereas Chile displayed fewer categories with significant odds. Health insurance had no significant effect in either of the two countries. The limitations in data sources and methodologies make it challenging to compare frailty determinants in Latin America. This study overcomes these barriers and shows that, even within the same region, significant differences exist. Levels and characteristics that are important in one country may not be so in another. The results emphasize the need to consider contextual factors in the implementation of emerging social and healthcare policies, such as home-based long-term care. [ABSTRACT FROM AUTHOR]

Objectives To examine the rate of self-reported coronavirus disease-2019 (COVID-19) and its association with mental and cognitive health during the post-infection phase among middle-aged and older indigenous adults. Methods A cross-sectional study was conducted, including 141 individuals ≥50 and over from an urban indigenous community in Amazonas, Brazil. COVID-19 was deduced from self-reported infections. Cognitive function was evaluated using the Mini-Mental State Exam, Brief Cognitive Screening Battery (BCSB), and language fluency tests. Meanwhile, mental health was assessed through validated scales examining happiness, stress, and depression symptoms. The association between the rate of COVID-19 and cognitive and mental well-being was analyzed using logistic and linear regressions, adjusted for covariates. Results From March 2020 to February 2022, 65.2% of the urban indigenous group tested positive for COVID-19. Lower functional capacity decreased the odds of contracting COVID-19 (p  = .03). Adjusted linear regression models showed that COVID-19 was associated with higher BCSB learning (p  = .017) and delayed recall (p  = .028). Women, higher age, lower functional capacity, and hospitalization were associated with worse cognitive performance (p  < .05). No impact of mental health indicators on past COVID-19 infection was noted. Discussion COVID-19 was prevalent among urban Indigenous Brazilians. Unexpectedly, it was linked to enhanced learning and memory, not mental health issues. Cognitive performance was lower for men, older individuals, those with less functional ability, and hospitalized patients, indicating that participant characteristics and disease severity affect the COVID-19 and cognition relationship. Longitudinal studies across diverse Indigenous communities are necessary to understand COVID-19's impact on their cognitive and mental health. [ABSTRACT FROM AUTHOR]

Background We investigated the effects of a 12-week home-based exercise program delivered with virtual or minimal supervision on the physical and cognitive function of community-dwelling older adults in the context of the COVID-19 pandemic in Brazil. Methods The study was registered on the Brazilian Registry of Clinical Trials platform (code: RBR-8qby2wt). Thirty-eight older adults (81% female and 68±7 years old), non-disabled, and without cognitive impairment or dementia, were randomly assigned to a 12-week home-based exercise program: 1) virtual supervision (classes remotely delivered through video conference by trained staff), or 2) minimal supervision (once-weekly contact to touch base through standardized text messages). The participants initially performed two sets of 10 repetitions three times a week, with a 60-second interval. The volume and complexity of the exercises were progressively increased. (e.g., the number of sets increased to 3 and later to 4). At baseline and follow-up, we collected remote measurements of physical function (muscle strength and power, functional muscular fitness) and cognition (processing speed, inhibitory control, verbal fluency). Results Participants in the minimal supervision home-based exercise group significantly improved the Stroop test (-1.6 sec, 95% CI = -3.20; -0.09). No significant between-group differences were observed for physical and cognitive outcomes. Conclusion A home-based exercise program delivered with virtual or minimal supervision can produce similar effects, and may help to maintain physical and cognitive capabilities among healthy, high-functioning older adults who experienced mobility restrictions due to the COVID-19 pandemic in Brazil. [ABSTRACT FROM AUTHOR]

This study examined isolated and combined associations of physical activity (PA) and sitting time (ST) with body mass index (BMI) among older Brazilian adults. We have analyzed baseline data of 8,177 participants aged 50 years and older from the Brazilian Longitudinal Study of Aging. Respondents were categorized into sufficient PA/low ST, sufficient PA/high ST, insufficient PA/low ST, or insufficient PA/high ST using the Short Version of International Physical Activity Questionnaire. Multinomial logistic regression analysis examined the associations of being underweight (BMI, <18 kg/m2), overweight (BMI, 25–29.9 kg/m2), and obese (BMI, ≥30 kg/m2) with PA and ST categories. High ST (≥165 min/day) was associated with overweight (odds ratio, 1.26; 95% confidence interval [1.11, 1.44]) and obesity (odds ratio, 1.43; 95% confidence interval [1.21, 1.70]). However, no association was observed between PA and BMI. Participants in the insufficient and sufficient PA/high ST categories were more likely to be obese after adjusting for sociodemographic and health condition. Our findings call for public health initiatives that consider reducing ST in older adults. [ABSTRACT FROM AUTHOR]

This study described the clustering patterns of moderate to vigorous physical activity and sedentary time (ST) according to handgrip strength and investigated the association between identified clusters of fat and lean mass in older adults from southern Brazil. Objective measures were used for moderate to vigorous physical activity, ST, and body composition outcomes. Two-step cluster and linear regression analyses were conducted according to handgrip strength. Three clusters were identified: all-day sitters, sitters, and active sitters. The prevalence of clusters in the low-strength group was 58.2%, 22.8%, and 19.0%, respectively, while the prevalence of clusters in the high-strength group was 42.1%, 34.8%, and 23.1%, respectively. All-day sitters had 2.6% more fat mass than active sitters with low strength. High levels of ST characterized all cluster profiles; low strength, lack of moderate to vigorous physical activity, and high ST levels among older adults may indicate a subpopulation at a greater risk of overweight and obesity-related diseases. [ABSTRACT FROM AUTHOR]

Background: Blindness and vision loss (BVL) is a major global health issue affecting older adults, but its burden in transition countries has received limited attention. Therefore, we aimed to assess the trends in the burden of BVL among older adults between 1990 and 2019 across Brazil, Russia, India, China, and South Africa (BRICS), and predict the burden by 2040. Methods: Data on BVL and its related causes were obtained from the Global Burden of Disease 2019 study. We investigated the temporal trends by calculating the average annual percentage change using joinpoint regression analysis. Subsequently, we performed Bayesian age‐period‐cohort modeling to estimate the burden of BVL and its related causes by 2040. Results: Most BRICS countries experienced a significant decline (p < 0.05) in age‐standardized prevalence rates, and the decreasing trends tend to continue. However, by 2040, the number of BVL cases is expected to increase by approximately 50% across BRICS, with an estimated approximately 192, 170, 25, 17, and 7 million cases in China, India, Russia, Brazil, and South Africa, respectively. The related ranks of BVL causes are also estimated to change in the future, particularly in India. Conclusions: The different burdens and trends of BVL across BRICS reflected the different stages of population health transition. Effective eye disease prevention requires appropriate public health interventions. Developing effective health policies and services for older adults is urgently needed in BRICS countries. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to evaluate the feasibility of a randomized controlled trial investigating the effectiveness of a multimodal program (PAT-Back) compared to best practice advice on pain and disability in older adults with chronic low back pain (LBP) in primary care. Methods This feasibility study took place in Fortaleza, Northeast Brazil. The PAT-Back intervention consisted of a program including exercises, pain education, and motivational text messages for the in-home component. The control group received an evidence-based educational booklet. Feasibility outcomes were recruitment, adherence and retention rates, level of difficulty of the education and intervention content, perception of utility of mobile technology, and adverse events. The feasibility criteria were previously defined. Results A total of 248 people were screened, of which 46 older adults were eligible. The retention rate was high (100% in the PAT-Back group and 95% in the control group). The adherence rate to intervention was partially met (60%), whereas the adherence rate to unsupervised exercises was adequate (75%), and perception about safety to perform home exercise was partially acceptable (70%) in the PAT-Back group. In addition, 100% of older adults reported which text messages motivated them to perform the exercises in the PAT-Back group. Difficulty reported by participants in understanding and performing the intervention was small in both groups. Six participants reported transient adverse events in both groups. Conclusion Older adults accepted both interventions. Results demonstrated that the program is feasible, although minor changes targeting adherence and safety in home exercise are needed. Impact This feasibility study supports progression to a full trial investigating the effectiveness of a multimodal program (PAT-Back) on pain and disability in older adults with chronic LBP within a primary health care setting in low to middle income countries where such data from the older population are scarce and the burden of LBP is increasing. [ABSTRACT FROM AUTHOR]

Objectives: Oral health conditions can be determined by a series of factors that include psychosocial aspects. Therefore, this study aimed to investigate the association between psychosocial aspects and self‐reported oral health in Brazilian older adults. Methods: The Brazilian Longitudinal Study of Ageing (ELSI‐Brazil) baseline data was analysed to develop this cross‐sectional study. The outcome was self‐reported oral health, and the psychosocial aspects included neighbourhood trust, life satisfaction and depressive symptoms. The associations were determined through Poisson regression models, controlling for socioeconomic, demographic and behavioural characteristics. Results: A total of 9365 individuals with aged 50 years or over were included in this study. Individuals with good life satisfaction had 16% (PR: 0.84; 95% CI: 0.78–0.90) lower prevalence of having poor self‐reported oral health. Individuals who have depressive symptoms and do not trust in the neighbourhood presented 17% (PR: 1.17; 95% CI: 1.09–1.25) and 12% (PR: 1.12; 95% CI: 1.04–1.21) higher prevalence of poor self‐report oral health compared to those who did not show depressive symptoms and trust the neighbourhood. Conclusion: Our findings suggest that positive psychosocial aspects are moderately associated with better self‐reported oral health. Therefore, we suggest that psychological health and social interaction should be present in public health policy actions. [ABSTRACT FROM AUTHOR]

Background: Falls are frequent in older adults and can cause trauma, injury, and death. Fall prevention with virtual reality presents good results in improving postural control. Transcranial Direct Current Stimulation (tDCS) has been used with the same aim; however, the combination of the two techniques has still been little studied. Purpose: To assess whether tDCS can enhance the effect of video game training (VGT) on improving the postural balance of healthy older women. Method: A blinded, randomized, controlled clinical trial was conducted with 57 older women who were randomized to three balance training groups: Control Group (VGT), Anodal Group (VGT combined with anodic tDCS‐atDCS), and Sham Group (VGT combined with sham tDCS‐stDCS). Balance training was performed twice a week for four weeks, totalizing eight 20‐min sessions using VGT associated with tDCS. Postural balance was assessed pre‐and post‐training and 30 days after the end of the eight sessions using the Mini‐Balance Evaluation Systems Test. Results: Compared to pre‐intervention the Mini BEST test increased similarly in the three groups in post‐intervention (control: pre 23.7 ± 2.8 to post 27.0 ± 2.2; anodal: pre 24.4 ± 1 to post 27.7 ± 0.8 and sham: pre 24.2 ± 1.9 to post 26.5 ± 1.6; p < 0.001) and follow‐up (control: pre 23.7 ± 2.8 to follow‐up 26.8 ± 2.3; anodal: pre 24.4 ± 1 to follow‐up 27.3 ± 1.4 and sham: pre 24.2 ± 1.9 to follow‐up 26.8 ± 1.5; p < 0.001). Conclusion: There was an improvement in the postural balance of the three training groups that were independent of tDCS. Discussion: Some studies have shown the positive tDCS effects associated with other tasks to improve balance. However, these results convey the effects of only anodic‐tDCS compared to sham‐tDCS. Possibly, the effect of VGT surpassed the tDCS effects, promoting a ceiling effect from the combination of these two therapies. However, studies with other therapies combined with tDCS for older adults deserve to be investigated, as well as in frail older people. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper aims to: (a) determine the personal, sociodemographic, clinical, behavioural, and social characteristics of older Brazilians with clinical evidence of long COVID; (b) evaluate perceived quality of life and determine its association with personal, sociodemographic, behavioural, clinical and social variables; and (c) assess significant predictors of high perceived QoL. Background: Given the inherent vulnerabilities of the ageing process, the older people are an at‐risk group for both contagion of SARS‐CoV‐2 and the perpetuation of residual symptoms after infection, the so‐called long COVID or post‐COVID syndrome. Design: A cross‐sectional survey design using the STROBE checklist. Methods: Brazilian older people with long COVID syndrome (n = 403) completed a phone survey measuring personal, sociodemographic, behavioural, clinical, and social characteristics, and perceived Quality of Life (QoL). Data were collected from June 2021–March 2022. A multiple linear regression model was performed to identify salient variables associated with high perceived QoL. Results: The mean age of participants was 67.7 ± 6.6 years old. The results of the multivariate regression model showed that race, home ownership, daily screen time, musculoskeletal and anxiety symptoms, and work situation were the significant predictors of QoL among COVID‐19 survivors. Conclusions: Knowledge about the persistence of physical, emotional, and social symptoms of COVID‐19 can help nurses and other healthcare providers to improve the management of survivors, bringing benefits to the whole society. Relevance to clinical practice: Given the novelty of long‐COVID and its heterogeneous trajectory, interventions focusing on the repercussions and requirements unique to more vulnerable older persons should be developed and these aspects should be included in public health recommendations and policymakers' concerns. Patient or Public Contribution: No patient or public contribution was required to design, to outcome measures or undertake this research. Patients/members of the public contributed only to the data collection. [ABSTRACT FROM AUTHOR]

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Objectives: There is little nationally representative information about factors associated with longevity among older Brazilians. Methods: Baseline survey data from the Brazilian longitudinal Study of Aging (ELSI-Brazil) were linked to vital statistics systems. Mortality rates and life expectancy estimates were calculated and compared to official sources. Cox Proportional Hazards models and Population Attributable Fractions (PAFs) identified significant predictors of mortality. Results: Calculated mortality rates and life expectancy estimates were similar to official statistics for most ages with higher risk of death among older ages, as expected. High School completion, being partnered, and female sex were negatively associated with mortality, while being underweight, previous diagnosis of a chronic condition, having any functional limitations, poor self-rated health, low grip strength, and smoking were all associated with higher mortality risk. Discussion: The ELSI-Brazil study has potential to identify factors associated with longevity and to inform programs and policies designed to enhance healthy aging among older adults in Brazil. [ABSTRACT FROM AUTHOR]

Objective: Cross-sectional study to verify the association between dynapenic abdominal obesity and the occurrence of single and recurrent falls among Brazilian adults aged 50 years and over. Methods: Baseline data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil), comprising 8374 individuals aged 50 years and over, were analyzed. Participants were categorized according to the report of falls, dynapenic abdominal obesity was determined by combining the presence of abdominal obesity (waist circumference) and dynapenia (handgrip strength). A multinomial regression adjusted for multiple variables was conducted. Results: The prevalence of a fall was 10.4% (95% CI: 9.7–11.2) and 10.8% for single and recurrent (95% CI: 9.9–11.9). Dynapenic abdominal obesity was associated with a single fall (OR: 1.3; 95% CI 1.1–1.7) and showed greater strength of association with recurrent falls (OR: 2.8; 95% CI 2.1–3.8). Conclusions: Our data showed that the coexistence of abdominal obesity and dynapenia in older adults creates additional challenges for aging. [ABSTRACT FROM AUTHOR]

Our goal was to explore older adults' views on walkability on sidewalks. An online survey was conducted based on the Active Design framework and participants and experts committee analyzed 22 photographs about the quality of sidewalks for walking. The top barriers reported by older adults were poor sidewalk condition and lack of accessibility. Safety and good accessibility were identified as facilitators for a positive walking experience. There was disagreement in seven pictures, reflecting that they might not perceive bad walking experiences. Understating how older adults perceive attributes for walking may help shape actions for aging-friendly cities. [ABSTRACT FROM AUTHOR]

Aim: To compare the physical activity pattern before and during the COVID-19 pandemic and verify the association with contextual, behavioral, and health variables related to the pandemic in adults and older adults from southern Brazil. Subject and methods: This is a panel-type, population-based study in Rio Grande-RS and Criciúma-SC, with 4290 individuals. The physical activity pattern (dependent variable) was measured using the International Physical Activity Questionnaire-IPAQ. In addition, contextual, behavioral, and health aspects related to the pandemic (independent variables) were assessed by questionnaires. Fisher's exact test was used for bivariate analyses and Poisson regression with robust variance to calculate crude and adjusted prevalence, with their respective 95% confidence intervals. Results: There was a 72% reduction in commuting physical activity and a 145% increase in physical inactivity when compared before and during the pandemic. Social distancing, excessive search for information about COVID-19, fear of the pandemic, and COVID-19 infection were all factors that contributed to the decline in physical activity during the pandemic. The home office was a protective factor for physical inactivity. Conclusion: The COVID-19 pandemic has negatively affected the pattern of physical activity in the general population, except for those who switched to working from home. [ABSTRACT FROM AUTHOR]

Although studies show that the intake of ultra-processed products (UPP) has a negative impact on health, diet quality and dietary vitamin D, its influence on serum concentrations of this vitamin remains unknown; therefore, it is essential to verify the association between the UPP consumption and vitamin D deficiency. This is a cross-sectional, household, population-based study, carried out with 229 individuals aged 20 years or older, residents of the city of Teresina, Piauí, Brazil. Socio-demographic, lifestyle, food consumption and anthropometric data were collected. Food consumption was obtained using a 24-h food recall, and foods were grouped according to the NOVA classification. Plasma concentrations of calcidiol–25 (OH) D3 were determined by HPLC. Crude and adjusted binary logistic regression was applied to estimate the association between UPP consumption and vitamin D deficiency. Most individuals aged 20–39 years were vitamin D deficient (52·1 %). UPP contributed 19·9 % to the energetic intake of the participant's diet. This contribution was higher for individuals with vitamin D deficiency (22·5 %, P = 0·04). In addition, a high intake of UPP was associated with twice the risk of vitamin D deficiency in comparison with low consumption of UPP (OR: 2·05; CI 1·06, 4·50; P : 0·04). Our results suggest that the consumption of UPP may have a negative impact on serum concentrations of vitamin D; more studies are needed. [ABSTRACT FROM AUTHOR]

Objective: To estimate prefrailty and frailty prevalence and associated factors in people living with HIV (PLHIV) from a sex perspective. Methods: Cross‐sectional study on PLHIV at specialized public health centres in Brazil. Data were obtained from individuals aged ≥50 years using antiretroviral therapy (ART) and with an undetectable viral load through personal interviews, clinical evaluations and medical records. Frailty and prefrailty were characterized using the Fried Frailty Phenotype tool. Multinomial regression models were performed, and the associated factors were selected through the backward stepwise method. Results: Among 670 patients, 373 men and 297 women were included. The prevalence of frailty and prefrailty was significantly higher for women (16.2% and 56.2%, respectively) than for men (11.5% and 46.4%, respectively). Low socioeconomic and educational level, multimorbidity, depression, subjective cognitive complaints, and low scores on the Mini‐Mental State Exam (MMSE) were associated (P < 0.05) with frailty for both sexes. However, in the sex‐specific analysis, while smoking (OR = 3.66, 95% CI: 1.58–8.48) and a history of low adherence to ART (OR = 3.10, 95% CI: 1.33–7.23) were associated with frailty in men, depression (OR = 3.39, 95% CI: 1.36– 8.44) and the absence of functional dentition (OR = 3.77, 95% CI: 1.36– 10.43) were associated with frailty in women. Conclusions: This study adds self‐reported cognitive complaints as a potential predictor of frailty in both sexes and supports the known deleterious effect of multimorbidity on frailty in adults living with HIV. Furthermore, it suggests that other possible predictors, such as depression, oral health status and adherence to ART, may be sex‐specific. [ABSTRACT FROM AUTHOR]

Depression and loneliness in older people were a global challenge during the COVID-19 pandemic. Causal mechanisms to trigger depression might vary across different life events. We aimed to apply network analysis in a sample of Brazilian older people during the first wave of the COVID-19 pandemic, to investigate if loneliness and depression symptoms were connected within a psychological network. We explored how symptoms manifested and interacted, to discuss possible interventions that could mitigate late-life depression and loneliness symptoms in face of the COVID-19 pandemic. We collected data from 384 Brazilian older people who answered an online protocol to assess sociodemographic data, loneliness symptoms (assessed by the short version of UCLA-BR), and depression symptoms (assessed by the PHQ-2). 'Lack of companionship' was the bridge symptom connecting loneliness and depression communities. 'I feel shut out and excluded by others' and 'People are around me, but not with me' were the most predictable symptoms of loneliness. Interventions aimed to promote older people's social participation and skills, combined with strategies to expand their sources of social support and combat ageism, might be relevant to mitigate symptoms of loneliness and depression in older people during a crisis like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Subjective memory complaints (SMCs) are a possible prodrome of cognitive decline but are understudied in low‐ and middle‐income countries (LMIC). We aimed to estimate the prevalence of SMCs in a large, nationally representative sample of older adults from Brazil and to identify sociodemographic and health‐related factors that are associated with SMCs independently of objective memory. Methods: Baseline data (n = 7831) from the ELSI‐Brazil study, a national representative sample of adults aged 50 and over. They were asked to rate their memory and then divided into two groups ‐ having or not having SMCs. Logistic regression models were used to estimate the association of demographic characteristics, health related factors, objective memory performance and disability in basic (b‐ADL), instrumental (i‐ADL), and advanced (a‐ADL) activities of daily living associated with SMCs. Whether sex was an effect modifier of the association between age and objective memory performance and SMCs was also tested. Results: Of the sample, 42% (95% CI; 39.9–43.9) had SMCs, and it was higher among women (46.9%) than men (35.9%). SMC prevalence decreased with age among women and increased among men, and for both it decreased with better cognitive performance. Fully adjusted logistic regression model showed that older age, higher education, higher b‐ADL scores, and better cognitive performance were associated with decreased SMCs, while being female, with higher number of chronic conditions, higher i‐ADL scores, worst self‐rated health, and an increased number of depressive symptoms were associated with increased SMCs. However, the interaction test (p < 0.001) confirmed that increased age was associated with decreased SMCs only among women, and that better objective memory performance was associated with decreased SMCs only among men. Conclusions: SMCs are common in the Brazilian older population and are associated with health and sociodemographic factors, with different patterns between men and women. There is a need for future studies looking at the cognitive trajectory and dementia risk in older adults with subjective cognitive complaints. Key Points: Subjective Memory Complaints (SMCs) are a possible prodrome of cognitive decline but are understudied in low‐ and middle‐income countries (LMIC).SMC prevalence is high among older Brazilians, being higher among women (46.9%) than men (35.9%)Higher education and a lower number of chronic conditions and depressive symptoms were independently associated with decreased SMCsIncreased age was associated with decreased SMCs only among women, and better objective memory performance was associated with decreased SMCs only among men. [ABSTRACT FROM AUTHOR]

Aim: The objective of this study was to compare the effects of virtual supervision and minimal supervision in a 12‐week home‐based physical exercise program on the mental health and quality of life of community‐dwelling older adults. Methods: This study presents a secondary analysis of a randomized clinical trial conducted during the COVID‐19 pandemic. The sample comprised 38 elderly men and women (81.6% women, mean age 68 ± 6.4 years; mean weight 69.8 ± 12.1 km) without physical and/or cognitive impairments. The volunteers were divided into two groups: one group received virtual supervision (monitored via videoconference), while the other group received minimal supervision (monitored through weekly text messages). Both groups followed the same home‐based physical exercise program, consisting of three sessions per week, differing only in the supervision strategy. Mental health was assessed using the Depression, Anxiety, and Stress Scale (DASS‐21) in conjunction with the POMS questionnaire, which evaluates mood, and quality of life was assessed using the WHOQOL‐OLD questionnaire. Results: Our findings demonstrated statistically significant superiority of virtual supervision compared with minimal supervision in relation to depression (−2.92, 95% confidence interval = −5.22 to −0.63). Conversely, minimal supervision exhibited superiority over virtual supervision regarding quality of life (−6.70, 95% confidence interval = −11.66 to −1.73). Conclusions: Virtual supervision yielded better outcomes for the depression indicator, while minimal supervision favored the quality of life of older adults at the conclusion of the 12‐week home‐based physical exercise program. Geriatr Gerontol Int 2023; 23: 864–870. [ABSTRACT FROM AUTHOR]

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