No abstract

ObjectivesSelf-rated health (SRH) is a predictor of objective health measures, including mortality and morbidity. The link between resilience and SRH among the elderly is unclear. We aim to examine whether resilience aligns with SRH and, secondarily, whether resilience can override the negative health consequences of adverse childhood experiences (ACE).Design and settingWe use 2012, 2014 and 2016 data from the International Mobility in Aging Study, a longitudinal cohort study that collects survey and biophysical data from Albania, Brazil, Colombia and Canada. The main independent variables were resilience and ACE (social and economic).ParticipantsCommunity-dwelling 65–74 year olds (in 2012) were recruited through primary care registers. The sample size of the study was 1506.Primary outcomeThe outcome measure was SRH.ResultsWe found that sex, site, economic ACE, current income sufficiency, current depressive symptoms, current physical function and current resilience were associated with current SRH. In regression analyses, we showed that the association between ACE and SRH disappeared once factors such as sex, site, income, depression, physical health and resilience were considered.ConclusionsThe association between resilience and health poses a compelling argument for building resilience throughout life.

Background and Purpose Dyspnea, fatigue, and reduced exercise tolerance are common in post‐COVID‐19 patients. In these patients, rehabilitation can improve functional capacity, reduce deconditioning after a prolonged stay in the intensive care unit, and facilitate the return to work. Thus, the present study verified the effects of cardiopulmonary rehabilitation consisting of continuous aerobic and resistance training of moderate‐intensity on pulmonary function, respiratory muscle strength, maximum and submaximal tolerance to exercise, fatigue, and quality of life in post‐COVID‐19 patients. Methods Quasi‐experimental study with a protocol of 12 sessions of an outpatient intervention. Adults over 18 years of age ( N = 26) with a diagnosis of COVID‐19 and hospital discharge at least 15 days before the first evaluation were included. Participants performed moderate‐intensity continuous aerobic and resistance training twice a week. Maximal and submaximal exercise tolerance, lung function, respiratory muscle strength, fatigue and quality of life were evaluated before and after the intervention protocol. Results Cardiopulmonary rehabilitation improved maximal exercise tolerance, with 18.62% increase in peak oxygen consumption (VO2peak) and 29.05% in time to reach VO 2 peak. VE/VCO 2 slope reduced 5.21% after intervention. We also observed increased submaximal exercise tolerance (increase of 70.57 m in the 6‐min walk test, p = 0.001), improved quality of life, and reduced perceived fatigue after intervention. Discussion Patients recovered from COVID‐19 can develop persistent dysfunctions in almost all organ systems and present different signs and symptoms. The complexity and variability of the damage caused by this disease can make it difficult to target rehabilitation programs, making it necessary to establish specific protocols. In this work, cardiopulmonary rehabilitation improved lung function, respiratory muscle strength, maximal and submaximal exercise tolerance, fatigue and quality of life. Continuous aerobic and resistance training of moderate intensity proved to be effective in the recovery of post‐COVID‐19 patients.

The aims of this study were to compare cut points for weakness proposed by Foundation for the National Institutes of Health (FNIH) Sarcopenia Project with cut points estimated with our own data; to assess the prevalence of clinically relevant handgrip strength (HGS) weakness according to published criteria across distinct populations of older adults; to estimate the ability of HGS weakness to identify slowness. This is a cross-sectional analysis of International Mobility in Aging Study (IMIAS) involving 1935 community-dwelling older adults, between 65 and 74 years, who completed HGS and gait speed assessment. We used baseline data from Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). Weakness was defined according to sex-specific HGS cut points associated with slowness proposed by FNIH Sarcopenia Project. Slowness was defined as gait speed <0.8 m/s. IMIAS cut points for clinical weakness had good agreement with those proposed by FNIH. Weakness prevalence across the research sites ranged from 1.1 % (Saint-Hyacinthe) to 19.2 % (Manizales) among men. Women from Manizales (13.5 %) and Natal (19.3 %) had higher prevalence of weakness than their counterparts. FNIH cut points had a strong association with slowness, for both sexes. The IMIAS population generated cut points which were close to those proposed by FNIH. There was large variability in prevalence of weakness across our research sites. The HGS cut points for weakness proposed by FNIH performed well in IMIAS populations, providing a useful tool for screening older adults at risk for functional problems.

No abstract

BackgroundFrailty, a state of vulnerability to poor resolution of homoeostasis after a health stressor, may be a result of cumulative decline in many physiological systems across the life course and its prevalence and incidence rates vary widely depending on the place and population subgroup.ObjectiveThis study aims to examine social and economic factors as predictors of worse frailty status over 2 years of follow-up in a sample of community-dwelling older adults from the International Mobility in Aging Study.MethodsWe analyzed 2012 baseline and 2014 follow-up (n = 1,724) data on participants from a populational-based, longitudinal study conducted in 4 countries (e.g., Brazil, Colombia, Albania, and Canada). Frailty was defined according to the Fried’s phenotype and Poisson regression models with robust standard errors were performed to estimate the relative risks of becoming frail.ResultsIn our study, 366 (21.2%) participants migrated to a worse stage of frailty. After statistical adjustment (e.g., participant age, sex, and study site), insufficient income (RR = 1.40; 95% CI = 1.00–1.96) and having partner support (RR = 0.80; 95% CI = 0.64–1.01) were predictors of incident frailty status.ConclusionNotably, transitions in frailty status were observed even in a short range of time, with sociodemographic factors predicting incident frailty.

OBJECTIVE: To compare sleepiness scores of the Epworth scale in patients with different levels of arterial pressure when undergoing outpatient monitoring within the context of clinical evaluation. METHODS: A total of 157 patients selected for outpatient monitoring of arterial pressure during hypertension evaluation were divided into 3 groups: group 1 - normotensive; group 2 - hypertensive; group 3 - resistant hypertensive. For analysis, values > or = 11 were considered as associated with respiratory disturbances during sleep. RESULTS: Seventeen (10.8%) patients in group 1, 112 (71.3%) in group 2, and 28 (17.8%) in group 3, which was composed of aged, more severely hypertensive individuals, were analyzed. Groups were similar relative to sex and body mass index, but different in relation to systolic and diastolic pressure levels and age. Despite an absolute difference, no statistically significant difference occurred between Epworth scores and in the proportion of patients with values > or = 11 (5.9% vs. 18.8% vs. 212.4%; P=0.37). Despite the positive association between degree of sleepiness measured with the scale and the severity of the hypertension, no statistical significance occurred following control by age (p=0.18). CONCLUSION: A positive correlation exists between degree of sleepiness and hypertension severity. The absence of a statistical significance shown in the present study could be due to a beta type of error. Instruments that render this complaint into an objective finding could help in the pursuit of an investigation of respiratory disturbances during sleep in more severely hypertensive patients, and should therefore be studied better

Background: Type 2 Diabetes Mellitus (T2DM) is common in older adults, who also present a high level of risk factors for cardiovascular disease (CVD), such as dyslipidemia. However, the role of depression in T2DM patients and its relationship with CVD risk factors are understudied. Objective: The present study aimed to investigate the relationship between depressive symptoms (DS) and known cardiovascular risk factors in community dwelling older adults with T2DM. Methods: This is a cross sectional study, in which 85 community-dwelling older adults with T2DM were assessed. DS was assessed using the Yesavage Geriatric Depression Scale-short version (GDS-15). The following cardiovascular risk factors were evaluated: systolic (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), lipid profile (serum triglycerides-TG, serum total cholesterol-TC, serum low-density lipoprotein cholesterol-LDL-C, and serum high-density lipoprotein cholesterol-HDL-C) and body mass index (BMI). Poisson multiple regression was performed to test the association between DS and each cardiovascular risk factor adjusted by sex, age, time spent in moderate physical activity, and functional status. The significance level adopted for the analysis was 5%. Results: Among all the analyzed risk factors, only high levels of LDL-C were related to high DS (PR=1.005, CI 95% 1.002-1.008). A significant association was observed between HDL-C levels (PR=0.99, CI 95% 0.98-0.99) and SBP (PR=1.009, CI 95% 1.004-1.014). Conclusion: In older adults with T2DM, the presence of DS was associated with LDL-C, HDL-C levels and SBP, even after adjusting for sex, age, physical activity level and functional capacity.