Gláucia Regina Falsarella

Impact of rheumatic diseases and chronic joint symptoms on quality of life in the elderly

Musculoskeletal disorders are the major causes of the pain in the elderly population. Rheumatic conditions restrict participation in activities and mobility, as well as cause difficulties in the execution of self-care tasks. The assessment of health related quality of life (HRQOL) is an important indicator of the impact of rheumatic diseases on the physical, mental and social aspects. This study aims to analyze the influence of rheumatic diseases and chronic joint symptoms on the quality of life of the elderly (n=2209) aged 60 years or over. The effects of rheumatism and joint symptoms on quality of life were investigated by the Outcome Study Short-Form Health Survey (SF-36), and this analysis was adjusted for age and sex. The univariate analysis of variance and analysis of covariance (ANOVA and ANCOVAS) were used for statistical procedures, p≤0.05. Rheumatic diseases affected: functional capacity (F(1, 2012))=10.9 and pain (F(1, 2012))=34.77. Joint symptoms affected all components of the SF-36: physical functioning (F(1, 2012))=10.9; physical problems (F(1, 2012))=72.61; pain (F(1, 2012))=164.29; general health (F(1, 2012))=71.95; vitality (F(1, 2012))=55.78; social aspect (F(1, 2012))=73.14; emotional aspect (F(1, 2012))=49.09 and mental health (F(1, 2012))=44.72. There was a significant impact of rheumatic diseases on physical health, and that joint symptoms affected self-evaluations of physical and mental health. These results will contribute to a better understanding of this systemic disease and will be used for planning effective interventions.

Body composition as a frailty marker for the elderly community

Background Body composition (BC) in the elderly has been associated with diseases and mortality; however, there is a shortage of data on frailty in the elderly. Objective To investigate the association between BC and frailty, and identify BC profiles in nonfrail, prefrail, and frail elderly people. Methods A cross-sectional study comprising 235 elderly (142 females and 93 males) aged ≥65 years, from the city of Amparo, State of São Paulo, Brazil, was undertaken. Sociodemographic and cognitive features, comorbidities, medication, frailty, body mass index (BMI), muscle mass, fat mass, bone mass, and fat percent (%) data were evaluated. Aiming to examine the relationship between BC and frailty, the Mann–Whitney and Kruskal–Wallis nonparametric tests were applied. The statistical significance level was P<0.05. Results The nonfrail elderly showed greater muscle mass and greater bone mass compared with the prefrail and frail ones. The frail elderly had greater fat % than the nonfrail elderly. There was a positive association between grip strength and muscle mass with bone mass (P<0.001), and a negative association between grip strength and fat % (P<0.001). Gait speed was positively associated with fat mass (P=0.038) and fat % (P=0.002). The physical activity level was negatively associated with fat % (P=0.022). The weight loss criterion was positively related to muscle mass (P<0.001), bone mass (P=0.009), fat mass (P=0.018), and BMI (P=0.003). There was a negative association between fatigue and bone mass (P=0.008). Discussion: Frailty in the elderly was characterized by a BC profile/phenotype with lower muscle mass and lower bone mass and with a higher fat %. The BMI was not effective in evaluating the relationship between BC and frailty. The importance of evaluating the fat % was verified when considering the tissue distribution in the elderly BC.

Influence of muscle mass and bone mass on the mobility of elderly women: an observational study

BackgroundThe purpose of this study was to investigate the influence of muscle mass and bone mineral density on markers of mobility in dwelling elderly women.MethodsThis cross-sectional study included 99 elderly women, who were 65 years old or above, in Campinas-SP, Brazil. To collect data, we used sociodemographic data, the body mass index (BMI), health status, comorbidities, use of medications, mobility tests (TUG and gait speed) and examinations of the body composition (densitometry with dual-emission X-ray absorptiometry “DXA”). In order to examine the relationship between muscle and bone mass with mobility (gait speed and TUG), we applied the Spearman correlation coefficient.Also was applied the analysis of covariance (ANCOVA) adjusted for age and comorbidities. To identify the factors associated with mobility, we used the univariate and multivariate logistic regression analysis. The level of significance for statistical tests was P < 0.05.ResultsThe correlation between sarcopenia and bone mineral density with mobility tests showed a significant relationship only between sarcopenia and TUG (r = 0.277, P = 0.006) in Spearman correlation coefficient. The result of the correlation analysis (ANCOVA) showed that sarcopenia was associated with gait speed (r2 = 0.0636, P = 0.0018) and TUG (r2 = 0.0898, P = 0.0027). The results of the multivariate analysis showed that age (P = 0.034, OR = 1.081) was associated with worse performance on gait speed. By highlighting the TUG test, the results of the multivariate analysis showed that the age (P = 0.004, OR = 1.111) and BMI in overweight (P = 0.011, OR = 7.83) and obese (P < 0.001, OR = 7.84) women were associated with lower performance of the functionality of the lower limbs.ConclusionThe findings with regard to mobility tests which were analyzed in this study indicate the association of variables related to the aging process that contribute to the decline in physical performance, for example, age, BMI and sarcopenia.

Prevalence and factors associated with rheumatic diseases and chronic joint symptoms in the elderly.

In the elderly population, rheumatic conditions are major causes of pain that restrict participation in activities and mobility, and cause difficulties in the execution of self‐care tasks. The present study aimed to analyze the prevalence and factors associated with the self‐reported rheumatic diseases and chronic joint symptoms of the elderly.

As quedas no cenário da velhice: conceitos básicos e atualidades da pesquisa em saúde

Quedas tem sido referidas como importante fator de risco para reducao da capacidade funcional em individuos idosos. Por sua alta prevalencia nesta populacao, um dos objetivos das pesquisas foi delinear a queda sob seus aspectos causais e respectivas consequencias. Com base nessas definicoes, e possivel apontar perspectivas para a atuacao da saude na mitigacao dos efeitos deste evento, bem como reduzir o alto gasto hospitalar destes idosos para a saude publica. Dentro da logica citada, este trabalho traz algumas das principais consideracoes e consensos da atualidade sobre queda, a partir da analise de pesquisas recentes. Tem como objetivo propor uma visao ampliada, capaz de divulgar os aspectos ligados a queda que sao de interesse comum a todos os profissionais de saude que lidam com essa populacao. Metodologia: utilizaram-se as bases Cochrane, Pubmed e Medline para busca das informacoes pretendidas atraves de descritores correspondentes as palavras Envelhecimento e Quedas e tendo como limite os anos 2009 a 2013. Resultados: Definiu-se para esta discussao os artigos ligados a aspectos epidemiologicos, fatores associados, consequencias da queda, prevencao e intervencao nas quedas. Conclusao: Em resumo, o suporte multiprofissional esta alicercado nas praticas preventivas de quedas e necessita, portanto, de uma postura compartilhada de informacoes entre os profissionais da saude que trabalham com este publico.

Quedas: conceitos, frequências e aplicações à assistência ao idoso. Revisão da literatura

A review of the literature on falls in community-dwelling elderly was conducted, identifying prevalence, risk factors and consequences associated to falls, as well as screening, assessment and preventive measures to falls in old age. We selected publications indexed in the following data bases: Medical Literature Analysis and Retrieval System Online (MEDLINE), both consulted through PubMed; (Lilacs) Latin-American and Caribean Science of Health) and Scientific Electronic Library Online (SciELO), from 2008 to 2012; 41 references were analyzed. The evidences surveyed in this study highlight falls as a condition of great complexity that imposes great challenge for elderly and health professionals. We emphasize the importance of identification and management of determinant factors and consequences associated with falls, coupled with the design of multifactorial preventive strategies for elderly vulnerable to falls and among those with history of recurrent falls.

Mortality in Brazilian community-dwelling older adults: 7 years of follow up in primary care.

To describe the main causes and factors associated with mortality in community‐dwelling older adults in a county where the public health system covers most of the population.

Lumbar spine angular measures in older people: comparison between two radiographic analysis strategies

A literatura sobre postura em idosos tem apresentado artigos que medem os ângulos da coluna por diferentes estrategias. Isso pode interferir no diagnostico postural e impactar na resolucao das comorbidades que afetam a coluna desses individuos. O objetivo deste estudo foi comparar dois metodos de medida da coluna lombar comumente utilizados em pesquisa. A associacao dessas medidas com o ângulo da cifose foi utilizada como base para comparacao. Participaram da pesquisa 160 idosos, submetidos a raio-X anteroposterior da coluna lombar. Foram realizadas duas medidas de Cobb para cada radiografia: uma com base em T12-S1 e outra em L1-L5. Somente a medida com base em L1-L5 apresentou associacao significativa com o ângulo da cifose. Nao houve associacao da medida T12-S1 com o ângulo da curva toracica. Nossos achados indicam que o metodo de Cobb mais adequado para analisar radiografias de coluna lombar em idosos e o do tracado de linhas entre L1-L5.

Medidas angulares de la columna lumbar en adultos mayores: comparación entre dos estrategias de análisis radiográfico

A literatura sobre postura em idosos tem apresentado artigos que medem os ângulos da coluna por diferentes estrategias. Isso pode interferir no diagnostico postural e impactar na resolucao das comorbidades que afetam a coluna desses individuos. O objetivo deste estudo foi comparar dois metodos de medida da coluna lombar comumente utilizados em pesquisa. A associacao dessas medidas com o ângulo da cifose foi utilizada como base para comparacao. Participaram da pesquisa 160 idosos, submetidos a raio-X anteroposterior da coluna lombar. Foram realizadas duas medidas de Cobb para cada radiografia: uma com base em T12-S1 e outra em L1-L5. Somente a medida com base em L1-L5 apresentou associacao significativa com o ângulo da cifose. Nao houve associacao da medida T12-S1 com o ângulo da curva toracica. Nossos achados indicam que o metodo de Cobb mais adequado para analisar radiografias de coluna lombar em idosos e o do tracado de linhas entre L1-L5.

Medidas angulares da coluna lombar em idosos: comparação entre duas estratégias de análise radiográfica

A literatura sobre postura em idosos tem apresentado artigos que medem os ângulos da coluna por diferentes estrategias. Isso pode interferir no diagnostico postural e impactar na resolucao das comorbidades que afetam a coluna desses individuos. O objetivo deste estudo foi comparar dois metodos de medida da coluna lombar comumente utilizados em pesquisa. A associacao dessas medidas com o ângulo da cifose foi utilizada como base para comparacao. Participaram da pesquisa 160 idosos, submetidos a raio-X anteroposterior da coluna lombar. Foram realizadas duas medidas de Cobb para cada radiografia: uma com base em T12-S1 e outra em L1-L5. Somente a medida com base em L1-L5 apresentou associacao significativa com o ângulo da cifose. Nao houve associacao da medida T12-S1 com o ângulo da curva toracica. Nossos achados indicam que o metodo de Cobb mais adequado para analisar radiografias de coluna lombar em idosos e o do tracado de linhas entre L1-L5.