Background Vitamin D deficiency compromises muscle function and is related to the etiology of several clinical conditions that can contribute to the development of disability. However, there are few epidemiological studies investigating the association between vitamin D deficiency and the incidence of disability. Objectives We aimed to assess whether vitamin D deficiency is associated with the incidence of disability in basic activities of daily living (BADL) and to verify whether there are sex differences in this association. Methods A 4-y follow-up study was conducted involving individuals aged 50 y or older who participated in ELSA (English Longitudinal Study of Ageing). The sample consisted of 4814 participants free of disability at baseline according to the modified Katz Index. Vitamin D was assessed by serum 25-hydroxyvitamin D [25(OH)D] concentrations and the participants were classified as sufficient (>50 nmol/L), insufficient (>30 to ≤50 nmol/L), or deficient (≤30 nmol/L). Sociodemographic, behavioral, and clinical characteristics were also investigated. BADL were re-evaluated after 2 and 4 y of follow-up. The report of any difficulty to perform ≥1 BADL was considered as an incident case of disability. Poisson models stratified by sex and controlled for sociodemographic, behavioral, and clinical characteristics were carried out. Results After 4-y follow-up, deficient serum 25(OH)D was a risk factor for the incidence of BADL disability in both women (IRR: 1.53; 95% CI: 1.16, 2.03) and men (IRR: 1.44; 95% CI: 1.02, 2.02). However, insufficient serum 25(OH)D was not a risk factor for the incidence of BADL disability in either men or women. Conclusions Independently of sex, deficient serum 25(OH)D concentrations were associated with increased risk of incidence of BADL disability in adults >50 y old and should be an additional target of clinical strategies to prevent disability in these populations.

ResumoUm dos maiores desafios da atualidade é gerenciar o processo de envelhecimento da população e, com isso, o consequente aumento das doenças crônico-degenerativas. O desenvolvimento de incapacidades pode estar associado ao aumento na manifestação dessas doenças e ao despreparo do sistema de saúde, podendo levar os idosos a situações de total dependência de outrem e ao isolamento social, desencadeando um processo de declínio funcional. O objetivo do presente estudo foi realizar uma revisão da literatura que abordasse a temática: o envolvimento social de idosos e sua capacidade funcional. Para isso, realizou-se um levantamento bibliográfico nas seguintes bases de dados: LILACS, Redalyc, BVS e SciELO. Foram encontrados quatro artigos que atenderam ao critério de inclusão. Os estudos indicaram que o envolvimento social de idosos e a presença de um cônjuge são fatores protetivos, ou seja, contribuem para a manutenção da sua capacidade funcional. Concluiu-se, então, que a independência funcional é um fator preditivo para o envelhecimento bem sucedido. Dessa forma, entende-se que as relações sociais devem ser desenvolvidas ao longo da vida, para que, na velhice, elas se mantenham, uma vez que uma vida social ativa pode influenciar positivamente na manutenção da capacidade funcional dos idosos. As atividades de trabalho e de lazer também devem ser valorizadas. Palavras-chave:Interação. Relacionamento. Idosos. Envelhecimento. Qualidade de vida. IntroduçãoDevido a melhores condições médico--sanitárias, ao planejamento familiar e, consequentemente, à redução do número de jovens, e ao aumento da população idosa, o Brasil está envelhecendo, e com isso deve passar por profundas transformações socioeconômicas (IBGE, 2013). Estima-se que no Brasil, nos próximos vinte anos, a população de idosos aumentará exponencialmente, e que, em 2060, a população com essa faixa etária deve

Objective to investigate whether the combination of dynapenia and abdominal obesity is worse than these two conditions separately regarding gait speed decline over time. Methods a longitudinal study was conducted involving 2,294 individuals aged 60 years or older free of mobility limitation at baseline (gait speed >0.8 m/s) who participated in the English Longitudinal Study of Ageing. Dynapenia was determined as a grip strength <26 kg for men and <16 kg for women. Abdominal obesity was determined as a waist circumference >102 cm for men and >88 cm for women. The participants were divided into four groups: non-dynapenic/non-abdominal obese (ND/NAO); only abdominal obese (AO); only dynapenic (D) and dynapenic/abdominal obese (D/AO). Generalised linear mixed models were used to analyse gait speed decline (m/s) as a function of dynapenia and abdominal obesity status over an 8-year follow-up period. Results over time, only the D/AO individuals had a greater gait speed decline (−0.013 m/s per year, 95% CI: −0.024 to −0.002; P < 0.05) compared to ND/NAO individuals. Neither dynapenia nor abdominal obesity only was associated with gait speed decline. Conclusion dynapenic abdominal obesity is associated with accelerated gait speed decline and is, therefore, an important modifiable condition that should be addressed in clinical practice through aerobic and strength training for the prevention of physical disability in older adults.

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Background There is little epidemiological evidence of sex differences in the association between dynapenic abdominal obesity and the decline in physical performance among older adults. Objective The aims of the present study were to investigate whether the decline in physical performance is worse in individuals with dynapenic abdominal obese and whether there are sex differences in this association. Methods Out of 6,183 individuals aged 60 years or older from the English Longitudinal Study of Ageing, 2,308 participants with missing data were excluded. Therefore, a longitudinal analysis was conducted with 3,875 older adults. Abdominal obesity was determined based on waist circumference (>102 cm for male and >88 cm for female) and dynapenia was based on grip strength (<26 kg for male <16 kg for female). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). Decline in physical performance in an eight-year follow-up period was analyzed using generalized linear mixed models. Results At baseline, both male (-1.11 points; 95% CI: -1.58, -0.65; p <0.001) and female (-1.39 points; 95% CI: -1.76, -1.02; p <0.001) with D/AO had worse performances on the Short Physical Performance Battery (SPPB) than their counterparts in the ND/NAO group. Over the eight-year follow-up, male with D/AO had a faster rate of decline in the SPPB performance compared to male in the ND/NAO group (-0.11 points per year; 95% CI: -0.21, -0.01; p = 0.03). Conclusion D/AO is associated with a stronger decline in physical performance in male but not female. The identification and management of dynapenic abdominal obesity may be essential to avoiding the first signs of functional impairment in older male.

Background The trajectory of incident disability that occurs simultaneously with changes in frailty status, as well as how much each frailty component contributes to this process in the different sexes, are unknown. The objective of this study is to analyse the trajectory of the incidence of disability on basic and instrumental activities of daily living (BADL and IADL) as a function of the frailty changes and their components by sex over time. Methods Longitudinal analyses of 1522 and 1548 of the English Longitudinal Study of Ageing study participants without BADL and IADL disability, respectively, and without frailty at baseline. BADL and IADL were assessed using the Katz and Lawton Scales and frailty by phenotype at 4, 8, and 12 years of follow‐up. Generalized mixed linear models were calculated for the incidence of BADL and IADL disability, as an outcome, using changes in the state of frailty and its components, as the exposure, by sex in models fully adjusted for sociodemographic, behavioural, biochemical, and clinical characteristics. Results The mean age, at baseline, of the 1522 eligible individuals free of BADL and free of frailty was 68.1 ± 6.2 years (52.1% women) and of the 1548 individuals free IADL and free frailty was 68.1 ± 6.1 years (50.6% women). Women who became pre‐frail had a higher risk of incidence of disability for BADL and IADL when compared with those who remained non‐frail (P < 0.05). Men and women who became frail had a higher risk of incidence of disability regarding BADL and IADL when compared with those who remained non‐frail (P < 0.05). Slowness was the only component capable of discriminating the incidence of disability regarding BADL and IADL when compared with those who remained without slowness (P < 0.05). Weakness and low physical activity level in men and exhaustion in women also discriminated the incidence of disability (P < 0.05). Conclusions Slowness is the main warning sign of functional decline in older adults. As its evaluation is easy, fast, and accessible, screening for this frailty component should be prioritized in different clinical contexts so that rehabilitation strategies can be developed to avoid the onset of disability.

Resumo: Analisar se idosos com dificuldade ou necessidade de ajuda para desempenhar atividades básicas ou instrumentais de vida diária estão mais distanciados socialmente em tempos de COVID-19. Participaram das entrevistas telefônicas 4.035 idosos participantes da 2ª onda do Estudo Longitudinal de Saúde dos Idosos Brasileiros (ELSI-Brasil). Classificou-se a dificuldade, necessidade e recebimento de ajuda em: (1) independentes; (2) com dificuldade e não precisa de ajuda; (3) com dificuldade, precisa e recebe ajuda de pessoa de dentro de casa; (4) com dificuldade, precisa e recebe ajuda de pessoa de fora de casa; e (5) com dificuldade, precisa, mas não recebe ajuda. O distanciamento social foi categorizado como não saiu de casa nos últimos 7 dias, saiu de casa para atividades essenciais e saiu de casa para atividades não essenciais. Modelo de regressão multinomial controlado por idade, sexo, escolaridade e região do Brasil foi utilizado. Permaneceram mais distanciados socialmente os idosos que apresentavam dificuldade, necessitavam e recebiam ajuda de pessoa de dentro (odds ratio - OR = 2,34; IC95%: 1,25-4,39) ou de fora de casa (OR = 3,94; IC95%: 2,24-6,92). A idade aumentou a chance de não sair de casa (OR = 1,06; IC95%: 1,03-1,09) e ser homem a diminuiu (OR = 0,48; IC95%: 0,33-0,70). Viver na Região Sul aumentou a chance dos idosos saírem para atividades essenciais (OR = 1,77; IC95%: 1,01-3,10). Idosos com dificuldade, que precisam e recebiam ajuda de pessoas de dentro ou de fora de casa não saíram de casa nos últimos 7 dias. Mesmo com o distanciamento social, esses idosos podem não ter sua exposição ao COVID-19 reduzida, enfraquecendo a teoria do distanciamento social seletivo.

This study analyzed the association between physical activity, health status and life quality among women with fibromyalgia. Cross-sectional study based on the clinical information of 177 women (42.1 ± 8.6 years old) diagnosed with fibromyalgia and assisted in rheumatology clinics of the private sector of the Unified Health System (UHS) in the city of Maringá-PR, Brazil. The instruments were the International Physical Activity Questionnaire (IPAQ), the Fibromyalgia Impact Questionnaire (FIQ) and the WHOQOL-Bref. Data analysis was conducted through Mann-Whitney test, Spearman correlation and Structural Equation Analysis (p<0.05). Results showed positive correlations between physical activity and life quality domain. Health status showed negative correlation life quality domains. Structural Equation Analysis revealed days of walking per week showed positive association with life quality domains. Model 3 showed that the impact of fibromyalgia on the health status showed a moderate negative association with life quality domains. Based on the results obtained, the conclusion is that light physical activity, characterized as walking, represents a positive factor in the domains of quality of life in women with fibromyalgia and also, the impact of this disease on the health status of the patients is associated negatively areas of quality of life RESUMO Este estudo analisou a associação entre atividade física, estado de saúde e qualidade de vida de mulheres com fibromialgia. Estudo transversal baseado na informação clínica de 177 mulheres (42,1 ± 8,6 anos) diagnosticadas com fibromialgia e auxiliadas em clínicas de reumatologia do setor privado do Sistema Único de Saúde (SUS) na cidade de Maringá-PR, Brasil. Os instrumentos utilizados foram o Questionário Internacional de Atividade Física (IPAQ), o Questionário de Impacto da Fibromialgia (FIQ) e o WHOQOL-Bref. A análise dos dados foi realizada através do teste de Mann-Whitney, correlação de Spearman e Análise de Equações Estruturais (p <0,05). Os resultados mostraram correlações positivas entre a atividade física e o domínio da qualidade de vida. O estado de saúde apresentou correlações negativas com a qualidade de vida. A Análise de Equação Estrutural revelou que os dias de caminhada por semana se associou positivamente com domínios de qualidade de vida. O modelo 3 mostrou que o impacto da fibromialgia no estado de saúde apresentou associação negativa e moderada com os domínios de qualidade de vida. Com base nos resultados obtidos, conclui-se que a atividade física leve, caracterizada pela caminhada, representa um fator positivo nos domínios da qualidade de vida em mulheres com fibromialgia e também, o impacto desta doença sobre o estado de saúde dos pacientes está associado negativamente domínios da qualidade de vida. Palavras chave: Atividade motora. Exercício. Reumatologia.