Brazilian Adults Research Articles

Mindful eating questionnaire: Validation and reliability in Brazilian adults with type 2 diabetes mellitus

ObjectiveThe objective was to evaluate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian subjects with type 2 diabetes mellitus (T2DM) and validate a Brazilian version of the MEQ for adults with T2DM (MEQ-DM). MethodologyBaseline data from the multicentre Nutritional Strategy for Glycaemic Control in Patients with Type 2 Diabetes Mellitus (NUGLIC) trial were used. Construct validity was assessed using exploratory factor analysis (EFA). The root mean square error of approximation (RMSEA), comparative fit index (CFI) and Tucker‒Lewis index (TLI) fit indices indicated the adequacy of the model. The reliability of the questionnaire was evaluated considering the different factor loadings. Criterion validity was tested by correlating the MEQ-DM with sociodemographic variables, body mass index (BMI) and physical activity levels. ResultsA total of 370 participants were included, who were mostly female (60.8 %) and had a median age of 61 (54–67) years. The EFA results supported the two-factor structure of the 25-item MEQ-DM: disinhibition and awareness. The results of the fit indices (RMSEA = 0.04; CFI = 0.95 and TLI = 0.94) and composite reliability (disinhibition = 0.84 and awareness = 0.81) were consistent. The criterion validity analysis indicated a significant association between MEQ-DM scores and age, sex, civil status, education level, BMI and physical activity (p < 0.05). ConclusionWhen explored with Brazilian adults with T2DM, the MEQ-DM presented a factorial model with two dimensions: disinhibition and awareness. This model must be confirmed in future studies with Brazilians with T2DM.

Prevalence and association of compliance with the Canadian 24-hour movement guidelines with sociodemographic aspects in Brazilian adults: a cross-sectional epidemiological study

BackgroundThe physical inactivity is a global health concern, so that recommendations on sufficient physical activity levels are elaborated worldwide, such as in Brazil. However, the Canadian 24-Hour Movement Guidelines were first in the world to consider time-specific recommendations for physical activity, sedentary behavior and sleep, which is still not developed for Latin-American population. The present study aimed to verify the adherence to Canadian 24-hour guidelines in a Brazilian inner city and to analyze its association with sociodemographic aspects.MethodsA cross-sectional epidemiological study, with a sample composed by 250 adults (140 women), with a median age of 41.0 years. Objective measures of moderate-to-vigorous physical activity (MVPA) and sedentary behavior were collected by accelerometry. Sleep duration and sociodemographic aspects (ethnicity, gender, age, educational attainment and socioeconomic level) were obtained through a face-to-face questionnaire. Canadian 24-hour guidelines considered ≥ 150 min/week of MVPA, <8 h/day of sedentary behavior and daily sleep time between 7 and 9 h, being analyzed separately and in combination. Poisson regression with robust variance estimator was used to analyze the prevalence ratio (PR) of meeting the 24-hour guidelines according to the categories of sociodemographic variables, being performed by the software IBM SPSS version 25.0.ResultsThe complete 24-hour guidelines were met only by 24.4% of sample (n = 61). Sedentary behavior was the most met guideline (88%), followed by MVPA (56.8%) and sleep (53.2%), without significant difference according to sex. When compared to elderly participants, those participants in younger groups (18–39 years and 40–59 years) were more likely to meet MVPA guideline (PR = 2.51 [95%CI = 1.47; 4.28] and PR = 2.60 [95%CI = 1.52; 4.45], respectively), as well as the combination of MVPA and sedentary behavior (PR = 1.98 [95%CI = 1.13; 3.44] and PR = 2.17 [95%CI = 1.25; 3.79], respectively) and MVPA with the sleep guideline (PR = 2.39 [95%CI = 1.09; 5.27] only for 18–39 years group). Men were more likely to meet MVPA guideline than women (PR = 1.29 [95%CI = 1.04; 1.59]).ConclusionYounger aged and male adults were more likely to meet the Canadian 24-hour guidelines in a small Brazilian city. However, further studies with larger and representative samples of sociodemographic stratum are still needed.

Fat phobia scale-short form and beliefs about obese persons scale: cross-cultural adaptation to Brazilian Portuguese

The Fat Phobia Scale-Short Form (FPS) and the Beliefs About Obese Persons Scale (BAOP) are scales developed to investigate fatphobia and beliefs about obese persons, respectively. The aim of the study was to carry out the cross-cultural adaptation of these scales to Brazilian Portuguese. The methodology was carried out in 5 stages: 1. translation, 2. synthesis of translations, 3. evaluation by the expert committee of semantic, idiomatic, experiential and conceptual equivalences, 4. discussion with the target population (health professionals and other areas), and 5. back-translation. The results of the judgment of equivalences evaluated by the specialists were presented in absolute and relative frequency, and the agreement of the results between the specialists was verified by the Kappa de Fleiss Coefficient (₭). The results showed excellent agreement for all equivalences in both scales, except for BAOP semantics, which was good. (₭ = 0.67). Suggestions from the target population (Brazilian adults) were considered to adapt the final version of the two scales, which were back-translated and approved by the original authors. It is concluded that FPS and BAOP are duly adapted to Brazilian Portuguese and ready to be tested for their psychometric qualities.

Comparison of frailty determinants in Latin America: a national representative study in Brazil and Chile

ObjectiveThis study aimed to compare the prevalence and socio-economic determinants of frailty in older adults in Brazil and Chile using nationally representative survey data. Study designAnalytical 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. MethodsThe 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. ResultsThe 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. ConclusionsThe 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.

Evaluation of the psychometric properties and convergent validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) questionnaire in Brazilian young adults

BackgroundThis cross-sectional study aims to evaluate the psychometric properties and the convergent validity of the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Confirmatory factor analysis (CFA) and linear regression adjusted for confounding factors were performed to obtain the adjusted beta value (βadj) for sleep quality (Pittsburgh Sleep Quality Index), burnout (Copenhagen Burnout Inventory), and depressive symptoms (Patient Health Questionnaire-9).ResultsThe study population consisted of 3187 young adult university students. The CFA indicated adequate fits for the one- and two-factor structure of the ASSIST, with better indices for the two-factor model. Convergent validity results confirmed the best fit of the one-factor model (version 3.1), in which individuals classified as “suggestive of dependence” showed a greater effect on worse sleep quality (βadj 2.16, 95% confidence interval (CI) 1.48–2.84), burnout (βadj 12.25, 95% CI 8.43–16.06), and depressive symptoms (βadj 6.69, 95% CI 5.37–8.00).ConclusionsThe results and the literature review indicated that the one-factor presents an adequate factor structure and better convergent validity.

Intra- and inter-rater reliability of muscle and fat thickness measurements obtained using portable ultrasonography in older adults

Ultrasonography (US) is a promising tool for assessing body composition, offering accuracy and accessibility. However, technician skills and equipment characteristics can impact measurement reliability. We aimed to evaluate the intra- and inter-rater reliability of two evaluators using A-mode Portable Ultrasound to measure muscle and fat thickness in Brazilian older adults. Quantitative cross-sectional study carried out with 150 community-dwelling older adults of Campinas-SP-Brazil, recruited in a retirement preparation program and a geriatric outpatient care unit. Scans of nine anatomical points were performed using the portable ultrasound in A-mode (BodyMetrix Pro System BX2000; Livermore, CA), with 6 scans per location and 3 measurements taken by each evaluator. After the selection and analysis of the generated images, muscle and fat thickness were measured. Reliability estimates between measures of the same evaluator (intra-rater) and between evaluators (inter-rater) were assessed using intraclass correlation coefficients (ICC), and differences within and between technicians were assessed using one-way ANOVA. Analyses were carried out for the overall sample and stratified by sex and by nutritional status. Excellent ICC values (>0.90) were found for subcutaneous fat thickness in intra- and inter-rater reliability analyses. The lowest ICC values were observed for deep abdominal fat thickness measured by evaluator 1 (ICC=0.90) and evaluator 2 (ICC=0.87), as well as in the inter-rater analysis (ICC=0.85). Muscle thickness measurements had satisfactory ICC values for triceps, biceps, anterior thigh, and calf, ranging from moderate to good (ICC 0.50-0.90). A portable A-mode ultrasound demonstrates excellent reliability among both intra- and inter-raters for assessing fat thickness but only moderate for muscle thickness in older adults. Hence, this could prompt inquiries regarding the sole reliance on this tool for quantifying muscle mass and examining sarcopenia in older adults. To our knowledge, this study represents the first assessment of reliability for a portable A-mode ultrasound device conducted with older adults.

Prevalence of functional dependence and chronic diseases in the community-dwelling Brazilian older adults: an analysis by dependence severity and multimorbidity pattern

BackgroundDespite the advancements in knowledge about health care for older adults, essential gaps persist regarding the effects of chronic diseases as epidemiological markers of the state of functional dependence. This study aimed to identify the prevalence of moderate and severe functional dependence in Brazilian older adults and its association with chronic diseases and verify the multimorbidity patterns by dependence status.MethodsThis cross-sectional analytical study used data from 11,177 community-dwelling Brazilian older adults from the 2013 National Health Survey conducted in Brazil. The dependent variables were moderate and severe functional dependence in basic activities of daily living (BADLs) and instrumental ADLs (IADLs). The independent variables were defined based on the questions applied to measure each morbidity in a self-reported manner and asked, "Has a doctor ever diagnosed you as having (each disease)? Multimorbidity was simultaneously considered present for older adults with ≥ 2 chronic morbidities. The association between functional dependence on BADLs and IADLs separately by severity and the independent variables was verified from crude and adjusted estimates of the point prevalence ratios and their 95% confidence intervals using the regression model Poisson with robust variance. To group diseases into patterns, exploratory factor analysis was used.ResultsThe prevalences of moderate and severe BADL dependence were 10.2% (95% CI, 9.6–10.7) and 4.8% (95% CI, 4.4–5.2), respectively. Moderate and severe IADL dependence prevalences were 13.8% (95% CI, 13.1–14.4) and 15.6% (95% CI, 14.9%–16.2), respectively. When changing the condition from moderate to severe dependence in BADLs, in the presence of other mental illnesses and stroke, the probability of dependence increased more than four times in the case of other mental illnesses and more than five times for stroke. There was a linear trend for dependence severity, both moderate and severe, whereas, for severe dependence on IADLs, this same factor maintained a linear trend toward an increase in probability as the number of diseases simultaneously increased.ConclusionsChronic diseases are associated with functional dependence, with greater emphasis on mental illnesses and stroke in severe disability, considering their acute adverse effects.

Using a mobile application to reduce potentially inappropriate prescribing for older Brazilian adults in primary care: a triple-blind randomised clinical trial

BackgoundPotentially inappropriate prescribing (PIP) has been evaluated in several countries, and several strategies have been devised for deprescribing drugs in older adults. The aim of this study was to evaluate the efficacy of a mobile application in reducing PIP for older adults in primary care facilities in Brazil.MethodsThis randomised, triple-blind, parallel-group trial was conducted in 22 public primary care facilities in Brazil. During the intervention phase, the general practitioners (GPs) were randomly allocated to the intervention (MPI Brasil app provides information about PIP, therapeutic alternatives and deprescribing) or control (MedSUS app provides general information about medications) group. All GPs were trained on the Clinical Decision-Making Process and how to access an Evidence-Based Health website. The GPs received an Android tablet with an installed mobile application depending on their allocated group, which they used when caring for older patients over at least 3 months. At the end of this period, a sample of older patients aged ≥ 60 years who had been awaiting medical consultation by the participating GPs were interviewed and their prescriptions analysed. The primary outcome was the frequency of PIP in and between the groups.ResultsAmong 53 GPs who were administered the baseline survey, 14 were included in the clinical trial. At baseline, 146 prescriptions were analysed: the PIP overall was 37.7% (55/146), in the intervention group was 40.6% (28/69), and in the control group was 35.1% (27/77). After the intervention, 284 prescriptions were analysed: the PIP overall was 31.7% (90/284), in the intervention group was 32.2% (46/143), and in the control group was 31.2% (44/141) (RR: 1.16; 95% CI, 0.76–1.76). In the within-group analysis, the PIP reduced from before to after the intervention in both groups—more significantly in the intervention than in the control group (p < 0.001). In the stratified analysis of PIP frequency by GPs, there was a relative risk reduction in 86% (6/7) of GPs in the intervention group compared to 71% (5/7) in the control group.ConclusionWe found that the MPI Brasil app effectively reduced PIP, suggesting that it may be useful to incorporate this tool into clinical practice.Trial registrationThe study was registered at ClinicalTrials.gov (NCT02918643). First registration on 22/09/2016.

Kvaal’s dental age estimation method applied to Brazilian adults—a cross-sectional test of validity

BackgroundDental age estimation of adults is a challenging procedure in forensic odontology. Radiographic techniques have enabled non-invasive age estimation of adults since the 90’s. Kvaal’s method based on the deposition of secondary dentin has demonstrated broad applicability in several populations. Population-specific studies with this method, however, are scarce in South America. This study tested the validity of Kvaal’s method in a sample of radiographs of Brazilian adults. The sample consisted of 192 periapical radiographs of 106 females (55.2%) and 86 males (44.8%) with ages between 20 and 80 years old. The permanent maxillary right (n = 84, 43.8%) and left (n = 108, 56.2%) central incisors were assessed based on Kvaal’s method.ResultsLin’s coefficient of concordance between estimated (EA) and chronological (CA) ages was 0.800 (IC95% = 0.753; 0.847) (p < 0.001). The mean difference between EA and CA was − 2.84 years (p < 0.001). For females and males, separately, the mean differences between EA and CA were − 3.82 years (CI95% = − 5.38; − 2.25) (p < 0.001) and − 1.86 years (CI95% = − 3.56; − 0.17) (p = 0.031), respectively. Underestimations were predominant and increased with time.ConclusionAfter 28 years of the original publication, Kvaal’s method remains reliable for non-invasive dental age estimation of adults, especially for the analysis of the permanent maxillary central incisors of Brazilian individuals.

Age- and sex-specific normative values for muscle mass parameters in 18,625 Brazilian adults.

The present study aimed to provide age- and sex-specific normative values for muscle mass parameters in Brazilian adults. Data pertaining to Brazilian adults (18+ years) who attended a nutritional clinical between January 2018 and July 2022 were analyzed. Muscle mass parameters were assessed using a bioimpedance digital scale (InBody 230, GBC BioMed NZ). Assessments were conducted under standard conditions, with participants refraining from physical exercise for 96 h and from eating or drinking (including water) for 8 h before evaluations. A total of 18,625 Brazilian adults were analyzed. Normative values for absolute and relative (height, m2) muscle mass and appendicular muscle mass (ASM) were calculated. In addition, specific age-related changes in muscle mass parameters were observed. In women, muscle mass peaked between the ages of 40-49 before gradually declining at an average rate of 5.7% per decade from the sixth decade of life onwards. ASM reached its peak earlier, during the third decade of life, and started to decline later, from 50 to 59 years. In contrast, absolute and ASM peaked at 40-49 years and declined from the sixth decade of life in men. Both sexes displayed a slightly greater decline in ASM than in muscle mass (13 vs. 12%). The present study provides normative values for absolute and relative muscle mass and ASM in Brazilian adults. Furthermore, important specific age-related changes in muscle mass parameters were observed. These data have public health implications and might serve as a reference tool to guide health professionals.

Translation and validation of the audiovisual version of the Montreal cognitive assessment in older adults in Brazil

BackgroundThe use of a reliable remote cognitive screening test for older adults is crucial for the diagnosis of cognitive impairment. This study aimed to translate and validate the audiovisual Montreal Cognitive Assessment (MoCA)for older adults in Brazil.MethodsOne hundred and fourteen older adults were recruited from the community and demographic, functional, mood, and cognitive data were collected. Participants were classified into two groups: cognitively healthy or mild cognitive impairment (MCI). Statistical analyses were performed in order to assess the validity of the test and the cutoff score.ResultsThe psychometric properties of the audiovisual MoCA showed good convergent validity. The audiovisual MoCA was represented as a unifactorial adjusted model, the composite reliability value was acceptable and a cutoff point of ≥23 reached adequate sensitivity and specificity at 0.77 and 0.92, respectively.ConclusionsThe translated audiovisual MoCA is a valid and reliable cognitive screening test that can be administered remotely in older adults in Brazil. The test demonstrated a great ability to discriminate older adults with MCI from cognitively healthy adults. Future studies should focus on validating the audiovisual MoCA using other target population groups in order to expand the use of this remote screening test.

Validation and measurement invariance of the Compulsive Exercise Test among Brazilian and American young adults

PurposeTo evaluate compulsive exercise, researchers often rely on the widely used Compulsive Exercise Test (CET). However, the measure has shown unstable factor structure in several validation studies and is not available in Portuguese for use in Brazil. We aimed to describe the translation and cultural adaptation of the CET to Brazilian Portuguese, to test several factor structures among Brazilian and US samples of men and women, to test measurement invariance across countries, and to evaluate its internal consistency. Furthermore, we sought to evaluate convergent validity, correlating the CET with a measure of eating disorder symptoms, and to compare compulsive exercise symptoms between countries.MethodsFour models of the latent structure of the CET were tested using confirmatory factor analyses (CFAs), three-factor structure with 15 items, three-factor structure with 18 items, four-factor structure with 21 items, and the original five-factor structure with 24 items, in a sample of 1,531 young adults (601 Brazilians and 930 Americans), aged 18–35 years.ResultsA series of CFAs demonstrated that the three-factor structure with 15 items showed a better fit to the data. This model demonstrated good convergent validity and internal consistency. Results from the CET multigroup CFA showed evidence for the invariance at the configural, metric, and scalar levels across Brazilians and Americans. Furthermore, significant differences were found between Brazilians and Americans, with Brazilians demonstrating higher scores on the Avoidance and rule-driven behavior and Mood improvement subscales, whereas US participants scored higher on the Weight control exercise subscale.ConclusionsResults support the three-factor structure with 15 items to be used as a measure of compulsive exercise among Brazilians and Americans, allowing cross-cultural comparisons between these countries.Level of evidence Level V, Cross-sectional, Psychometric study.

Cooking using social media: young Brazilian adults’ interaction and practices

PurposeThis study explored how Brazilian young adults who cook interact with cooking-related content on social media and how such content fits their cooking routine.Design/methodology/approachSemi-structured interviews (n = 31) were transcribed, inductively and reflexively thematic analysed.FindingsInteractions happened both in recreational and intentional ways, which coexisted and alternated depending on participants' motives and schedules. Recreational interactions such as browsing and saving happened more for self-entertainment and to some participants, to help meal planning and food shopping. Intentional interactions such as searching and sharing happened to fulfil specific needs which arised on cooking occasions, leading to agency development. Young adults who self-identified as being less experienced in cooking reported checking and comparing many recipes, as well as relying on video features to improve skills and develop self-efficacy. Despite showing agency in cooking-related matters, participants perceived lack of time to cook as an important barrier to cooking more. Intentional interactions with cooking content were linked to more established cooking routines, indicating the importance of social media to young adults' development of self-efficacy and improvement of skills.Originality/valueThe use of social media to search for cooking-related content is recommended by Brazilian dietary guidelines to develop cooking and food skills, but research on if and how the interaction occurs, and the resulting knowledge is put into practice, is scarce. This study addressed this gap and proposed practical implications to inform the development of interventions employing social media to improve young adults' cooking skills and health.

Prevalence of multimorbidity in Brazilian individuals: A population-based study.

This study aimed to estimate the prevalence of multimorbidity in Brazilian individuals and its association with sociodemographic and lifestyle factors. This cross-sectional study used data from the National Health Survey conducted in 2019 with 88,531 Brazilian adults Multimorbidity is the presence of two or more non-communicable chronic diseases. Associated factors were assessed by calculating the prevalence ratio (PR) obtained using Poisson regression with robust variance. Multimorbidity was estimated in 29.9% (95%CI: 29.33% to 30.48%) of Brazilian individuals. In the multiple models, the prevalence was high in women (PR: 1.37; 95%CI: 1.32 to 1.42), individuals over 60 years (PR: 4.26; 95%CI: 3.87 to 4.69), non-employed (PR: 1.20; 95%CI: 1.15 to 1.26), individuals with obesity (PR: 1.49; 95%CI: 1.43 to 1.56), and smokers (PR: 1.24; 95%CI: 1.19 to 1.29). This study identified a high prevalence of multimorbidity and its association with sociodemographic and lifestyle factors. The monitoring of these outcomes may support the development of policies and services.

Association between physical activity domains and depressive symptoms among Brazilian adults: does every move count?

This study aimed to investigate the practice of physical activities in the four domains (leisure time, transportation, household, and work) and the prevalence of depressive symptoms in Brazilian adults, in general and stratified by sex, schooling level, and having or not a self-reported diagnosis of depression. This is a cross-sectional study with data from 88,531 individuals aged 18 years or older, who responded to the Brazilian National Health Survey in 2019. The depressive symptoms were evaluated by the Patient Health Questionnaire-9 (PHQ-9). Those who practice physical activities at least once a week in a given domain were considered physically active. Additionally, the calculation of physical activities duration was conducted and later divided into quartiles for each domain. For the association analyses, the crude odds ratio (crudeOR) and adjusted odds ratio (adjustedOR) were calculated for the total and stratified analyses. Individuals who are physically active during leisure time showed a lower chance of presenting depressive symptoms, in total (adjustedOR = 0.74; 95%CI: 0.64-0.86) and in all stratifications, except for individuals with self-reported depression. The associations of leisure-time physical activity were most frequent in those who practice from 121 to 360 minutes/week. The individuals who were active in the transportation, household, and work domains had a higher chance of presenting depressive symptoms in some groups, with more consistent results for household physical activities. The results showed that the relationship between physical activities and depression among Brazilians varies according to domain and duration, and that the concept that "every move counts" seemed to be correct only for the leisure-time domain.

Social inequalities in self-reported SARS-CoV-2 infection in Brazilian adults: PNAD COVID-19.

To investigate inequalities related to race/ethnicity and socioeconomic status in self-reported positive diagnosis for COVID-19 in Brazilian adults. Data available from the National Household Sample Survey COVID-19 (PNAD COVID 19) (July/September/November, 2020) were used in this retrospective investigation. The analyses considered the sampling design, primary sampling units, strata and sample weights. Poisson regression with robust variance was used to estimate prevalence ratio (PR) and the 95% confidence interval (95%CI) of the associations. In July, September and November 2020, with regard to the rapid test, indigenous people were 2.45 (95%CI 1.48-4.08), 2.53 (95%CI 1.74-4.41) and 1.23 (95%CI 1.11-1.86) times more likely to report a positive history of SARS-CoV-2 infection, respectively. With regard to the RT-PCR test in November, indigenous people were more likely to test positive for COVID-19 (PR: 1.90; 95%CI 1.07-3.38). It was observed that the indigenous group was 1.86 (95%CI 1.05-3.29) and 2.11 (95%CI 1.12-3.59) times more likely to test positive for COVID-19 in September and November (2020). Income was associated with testing positive for COVID-19: in November, individuals whose income ranged from R$0.00-R$1.044 were more likely (PR: 1.69; 95%CI 1.16-23.06) to test positive using the RT-PCR test; participants whose income was in this range were also more likely to be diagnosed with COVID-19 using blood tests (PR: 1.72; 95%CI 1.43-2.07). The data presented show an association between race/ethnicity and economic status with a positive diagnosis of COVID-19.

Prevalence of current smoking and associated factors in older adults in Brazil.

The aim of this study was to estimate the prevalence of current smoking and its associated factors in adults aged 50 years and older in Brazil. This cross-sectional study utilized data from the ELSI-Brazil study, encompassing 9,412 adults aged 50 years or over. A multivariate model using Poisson regression with a robust estimator was employed, estimating prevalence ratios and their 95% confidence intervals. The prevalence of current smoking was 17.04%. It was positively and independently associated with male gender, age up to 62 years, living without a partner, illiteracy, chronic obstructive pulmonary disease, depression, poor or very poor sleep quality, and alcohol intake more than once a month. Conversely, systemic arterial hypertension, hypercholesterolemia, diabetes mellitus, and repetitive strain injuries showed an inverse and independent association with current smoking. The prevalence of current smoking among adults over 50 years old in Brazil was approximately 17%, with associations found with certain sociodemographic conditions and self-reported comorbidities.

Factors associated with unfavorable treatment outcomes of tuberculosis in older adults in Brazil: a multinomial analysis

Resumo Objetivo identificar, dentro dos três eixos de vulnerabilidades (individuais, sociais e programáticas), os fatores associados aos desfechos desfavoráveis do tratamento de tuberculose (TB) entre os idosos no Brasil entre 2015 e 2019. Método trata-se de um estudo transversal com dados secundários provenientes do Sistema de Informação de Agravos de Notificação dos casos de TB notificados no Brasil, em pessoas com idade igual ou maior que 60 anos. As co-variáveis associadas com o desfecho de interesse (p≤0,20) foram incluídas em um modelo de regressão logística multinomial utilizando a categoria cura como referência. Resultados idosos autodeclarados pretos e pardos, em situação de rua, com transtorno de saúde mental, que vivem com o vírus da imunodeficiência humana (HIV), que utilizam drogas lícitas e ilícitas tiveram maiores chances de perda de seguimento. Enquanto idosos em situação de rua, com transtorno de saúde mental, que utilizam drogas lícitas e ilícitas, e que não realizaram baciloscopia, apresentaram maiores chances para ocorrência de óbito por TB. Para o desfecho óbito por outras causas, pessoas que vivem com diabetes mellitus e com HIV, que utilizam drogas lícitas e ilícitas, tiveram maiores chances para ocorrência desse desfecho. Conclusão os resultados destacam a influência de fatores nos desfechos do tratamento da TB em idosos, abrangendo os eixos individual, social e programático. Aspectos como idade avançada, raça, sexo feminino, comorbidades e situação de rua foram identificados como determinantes relevantes, ressaltando a necessidade de abordagens integradas para melhorar os resultados e promover um desfecho favorável no tratamento da TB em idosos.

Análise da tendência da mortalidade por causas externas em pessoas idosas no Brasil, 2000 a 2022

Abstract Objective To analyze the trend of mortality due to external causes in older adults in Brazil within the temporal interval spanning from 2000 to 2022 and to identify the sociodemographic profile of mortality. Method Ecological time-series study utilizing secondary data, encompassing mortality in older adults due to external causes in Brazil, spanning the period from 2000 to 2022. The data were collected from the databases of the Department of Informatics of the Unified Health System, population estimates, and census population data provided by the Brazilian Institute of Geography and Statistics. The absolute and relative frequency of the data were analyzed using Microsoft Excel 2010 software. The analysis of trends in mortality rates and segmented linear regression was conducted using Joinpoint, with statistical significance assessed through the Monte Carlo test. Results During the investigated period, 572,608 deaths due to external causes were identified in individuals aged 60 years or older. Regarding the mortality pattern due to external causes in older adults, an increasing trend in mortality rates was observed for the majority of the studied period (2000 to 2013) with an annual percent change (APC) of 1.86 (95% CI: 1.5–2.2). Conclusion The results indicate a growing trend in mortality among older individuals due to external causes, highlighting the need for prioritizing public policies that address this issue.

Intergeracionalidade e promoção da saúde: reflexões e desafios na atenção à pessoa idosa

Abstract Objective To discuss the promotion of health for older adults through intergenerationality, with an emphasis on intergenerational education within Intergenerational Programs, as a proposal for education fostering the protagonism of older adults and successful aging. Method Theoretical essay, reflective in nature with a qualitative approach. Grounded in the examination of documents emphasizing the increase in longevity and the concern for health promotion among older adults in Brazil, the aim is to contemplate intergenerationality in health promotion and the utilization of intergenerational education to foster successful aging through Intergenerational Programs. Results Organized into three topics: Health promotion for older adults: challenges for their protagonism; Understanding aging for intergenerational learning; Intergenerational program: protagonism for the health promotion of older adults. Conclusion Successful experiences in health, specifically within the realms of Primary Health Care, still appear to be limited or insufficiently recognized for the development of transformative education in health promotion for older adults. The challenge lies in fostering scientific research so that professionals, through continuous education, can enhance health education moments through intergenerational education. Thus, the establishment and implementation of Intergenerational Programs may represent this promising possibility.