Lower Cognitive Status Research Articles

Factors related to low social participation in older adults: findings from the Fibra study, Brazil

Abstract Objective To investigate the factors related to low social participation in older adults. Method A hierarchical model was drawn using data from 2,251 participants of the Fibra study, aged 65 years or more, without cognitive impairment suggestive of dementia, who were living in seven Brazilian cities. Three blocks of variables were considered: macrostructural, socioeconomic and health conditions. Results Factors related to low social participation were low perceived social support (OR:2.18;CI:0.73-1.53; <0.001), vision impairment (OR:2.04; CI:1.16-3.61;0.014), age over 80 years (OR:2.03;CI:1.22-3.38;0.006), depressive symptoms (OR:1.86;CI:1.29-2.68; <0.001), low cognitive status (OR:1.85;CI:1.20-2.85;0.005) and slowness (OR:1.83;CI:1.26-2.65;0.001). Older adults with those conditions have higher odds to be less socially engaged than their counterparts. Conclusion Personal conditions, such as socioeconomic and health status were predictors of low social participation in older adults. Initiatives aiming at active aging promotion should focus primarily on vulnerable elderly, especially those with health and/or social disadvantages.

Life-space and movement behavior in nursing home residents: results of a new sensor-based assessment and associated factors

BackgroundStudies on life-space (LS) and its determinants have previously been limited to community-dwelling subjects but are lacking in institutionalized older persons. The purpose of this study was to provide an advanced descriptive analysis of LS in nursing home residents and to identify associated factors based on an established theoretical framework, using an objective, sensor-based assessment with a high spatiotemporal resolution.MethodsCross-sectional study in two nursing homes in Heidelberg, Germany (n = 65; mean age: 82.9 years; 2/3 female). Changes of location in the nursing home (Transits) as well as time spent away from the private room (TAFR) were assessed using a wireless sensor network. Measures of physical, psychosocial, cognitive, socio-demographic, and environmental factors were assessed via established motor performance tests, interviews, and proxy-reports.ResultsLS of residents was largely restricted to the private room and the surrounding living unit (90%); 10% of daytime was spent outside the living unit and/or the facility. On average, TAFR was 5.1 h per day (±2.3; Range: 0–8); seven Transits (6.9 ± 3.2; Range: 0–18) were performed per day. Linear regression analyses revealed being male, lower gait speed, higher cognitive status, and lower apathy to be associated with more Transits; higher gait speed, lower cognitive status, and less depressive symptoms were associated with more TAFR. LS was significantly increased during institutional routines (mealtimes) as compared to the rest of the day.ConclusionsThe sensor-based LS assessment provided new, objective insights into LS of institutionalized persons living in nursing homes. It revealed that residents’ LS was severely limited to private rooms and adjacent living units, and that in institutional settings, daily routines such as meal times seem to be the major determinant of LS utilization. Gait speed, apathy, and depressive symptoms as well as institutional meal routines were the only modifiable predictors of Transits and/or TAFR, and thus have greatest potential to lead to an enhancement of LS when targeted with interventions.Trial registrationCurrent Controlled Trials ISRCTN96090441 (retrospectively registered).

Rivastigmine patch reduces the incidence of postoperative delirium in older patients with cognitive impairment.

To date, data regarding the efficacy of acetylcholinesterase inhibitors in preventing postoperative delirium (POD) are inconsistent and conflicting. Older individuals with cognitive dysfunction are thought to show POD more frequently. Our aim was to study the effectiveness of rivastigmine prophylaxis on the incidence, severity, and risk factors for POD in older patients with cognitive impairment undergoing hip fracture surgery. Of 62 older patients with cognitive impairment about to undergo surgery after a hip fracture, 31 were randomly assigned to receive a rivastigmine patch from 3 days before to 7 days after the operation (Group I), and the other 31 did not receive a rivastigmine patch (Group II). The two groups were compared with regard to incidence and severity of delirium on postoperative days 2 or 3 and 7. Multivariate logistic regression analysis was performed to assess factors associated with POD. Postoperative delirium occurred in five Group I patients and 14 Group II patients (p = 0.013). The mean severity of delirium in the two groups as determined by the Delirium Rating Scale was 2.2 and 6.2 respectively (p = 0.033). The odds ratio for POD was 0.259 (95% CI: 0.074-0.905, p = 0.034) after adjusting for American Society of Anesthesiologists score (p = 0.058), age (p = 0.203), and gender (p = 0.560). There were no rivastigmine-related perioperative complications. Perioperative rivastigmine patch application could reduce the occurrence of POD in older patients with low cognitive status. Copyright © 2016 John Wiley & Sons, Ltd.

Abstract P167: Insulin Resistance and Cognitive Status Among Adults 50 Years and Older: Data From National Health and Nutrition Examination Survey (NHANES)

Introduction: Alzheimer’s disease (AD) is a progressive neurodegenerative disease that results in cognitive impairment. As there are no treatments available so far, identification of risk factors are crucial. A link has been proposed between defective insulin signaling in the brain and the cognitive decline observed in AD. Our purpose is to determine the relationship between homeostatic model of insulin resistance (HOMA-IR) and cognitive status among population ≥50 years. Hypothesis: Increase in insulin resistance is associated with lower cognitive status in the population ≥50 years. Methods: We analyzed data from the NHANES 1999-2002 population ≥50 years. Cognitive status was measured by the digit symbol substitution exercise score. The main independent variable was HOMA-IR. We used bivariate analysis and multiple linear regression adjusting for age, gender, race, triglyceride levels, systolic and diastolic blood pressure, total cholesterol, LDL, HDL levels, and diabetes. SAS V9.3 was used to analyze the data taking into consideration the design, strata and weight. Results: Of the 2,975 participants ≥50 years old, 45% were male and 80% were white. The mean age was 70.5+/- 0.30 years. Their average HOMA-IR was 5.0+/- 0.54 and they had a mean of 48+/-0.99 correct score in the cognitive test. Adjusting for the confounding variables, HOMA-IR was associated with decline in cognitive status (adjusted B=-0.34, 95% confidence interval=-0.58 to - 0.09, p=0.01). Significant predictors of decline in cognitive status among population ≥50 years were older age, male gender, high systolic and low diastolic blood pressure, non-white race (p=0.01). The association between HOMA-IR and decline in cognitive status was also found among non-diabetic population ≥50 years old (adjusted B=-0.54, 95% confidence interval=-1.1 to - 0.02, p=0.04). Conclusions: In the national representative sample, Insulin resistance as measured by HOMA-IR was independently associated with lower cognitive status score among participants ≥50 years and also found among non-diabetic population. Prospective studies are needed to determine the causal relationship.

Malnutrition and frailty in community dwelling older adults living in a rural setting

Malnutrition and frailty are frequent and serious conditions within the geriatric population. Both are of multifactorial origin and linked to adverse outcomes. The purpose of this study was to analyze the relationships between these two concepts in a representative sample of rural elderly Lebanese with a high prevalence of malnutrition. A cross-sectional study including a representative sample of 1200 elderly Lebanese aged 65 and over living in the community. The following measurements were recorded: information on socio-demographic status, comorbidities, Activities of Daily Living (ADL), screening for depression (5 item Geriatric Depression Scale [GDS]) and cognitive status (Mini-Mental-State [MMS]). Frailty was assessed through the Study of Osteoporotic Fractures (SOF) index whereas nutritional status was measured through the Mini Nutritional Assessment (MNA). Stepwise backwards multinomial logistic regression was used to analyze the association between nutritional status and frailty, independent of these covariates. Frailty or prefrailty were present in respectively 36.4% and 30.4% of the participants. The proportion of individuals suffering from poor nutritional status increased with growing level of frailty (p<0.001). Fourteen out of the 18 MNA items were associated with frailty in age-adjusted analyses. In the final multinominal logistic regression, both malnutrition and risk of malnutrition were related to a significantly increased risk of frailty, respectively (OR: 3.72, 95% IC: 1.40-9.94/OR: 3.66, 95% IC: 2.32-5.76), whereas the relation between poor nutritional status and prefrailty was not significant, independently of reporting less than three comorbidities, being ADL independent, depressive symptoms, illiteracy, and low cognitive status. Frailty and malnutrition are two closely related but distinct concepts that share common determinants in this elderly population.

Early mortality after hip fracture: what matters?

Hip fractures in the elderly are followed by increased mortality, which is highest in the period immediately after the fracture. Predictors for early mortality have neither been well identified nor summarized. Identification of early postoperative mortality predictors enables the stratification of high-risk patients and can help in the development of strategies aimed at reducing risk and improving outcome after hip fracture. The primary aim of this study was to investigate the incidence of 30-day mortality. The secondary aim was to investigate factors related to early mortality. We examined 384 elderly patients with hip fracture. Multivariate logistic regression analysis was used to explore independent prognostic factors for 30-day mortality. By the end of the 30-day follow-up period, 22 patients (6.4%) had died. Postoperative delirium was the only variable independently related to 30-day mortality after hip fracture. Older, male patients with a lower cognitive status had a higher chance of developing postoperative delirium. Postoperative delirium is a strong independent marker of high risk for 30-day mortality. Older, male patients with more severe cognitive impairment are at increased risk of developing postoperative delirium. Identifying patients at risk for developing postoperative delirium upon admission and early detection of delirium enable the development of targeted prevention and intervention strategies in older patients with hip fracture.

Apathy in untreated early-stage Parkinson disease: relationship with other non-motor symptoms.

Apathy is a frequent and disabling behavioral disorder in patients with Parkinson's disease (PD). Its prevalence in treatment-naive patients with early-stage PD has not been extensively investigated. Moreover, whether apathy is related to other non-motor symptoms in early-stage PD is unknown. Our objective was to determine the prevalence and features of apathy and associated factors in a group of treatment-naive patients with early-stage PD. Ninety-five treatment-naive patients with early-stage PD participated in the study. Apathy, depression, motor symptoms, and overall cognitive efficiency were assessed. The presence of the main non-motor symptoms was checked during a detailed clinical interview. Group comparisons were carried out to investigate the association with apathy. Eighteen patients (18.95%) were diagnosed as apathetic, and five of the latter had concomitant depression. Apathetic patients had significantly more severe motor symptoms (P < 0.001) and a lower cognitive status (P = 0.032) than non-apathetic patients. When considering non-motor symptoms, apathy was significantly associated only with fatigue (P = 0.007) and anhedonia (P = 0.010), both of which were more prevalent in apathetic patients than in non-apathetic patients. In treatment-naive patients with early-stage PD, apathy was significantly associated with more severe motor symptoms and a lower cognitive status. After adjustment for these factors, apathy appeared to be a relatively isolated, independent symptom because the only other associated non-motor symptoms were fatigue and anhedonia.

Low Cognitive Status Is Associated with a Lower Ability to Maintain Standing Balance in Elderly Outpatients

Background: Evidence is emerging that cognitive performance is involved in maintaining balance and thereby involved in falls in the elderly. Objective: To investigate the association of cognitive status with measures of standing balance in elderly outpatients. Methods: In a cross-sectional study, 197 community-dwelling elderly [mean age (SD) 81.9 (7.1) years] referred to a geriatric outpatient clinic were included and subsequently dichotomized into a group with low and normal cognitive status based on cut-off values of the Mini-Mental State Examination, Montreal Cognitive Assessment and Visual Association Test. The ability to maintain standing balance as well as the center of pressure (CoP) movement were assessed during 10 s of side-by-side, semi-tandem and tandem stance with eyes open and eyes closed. Logistic and linear regression were used to examine the association between cognitive status and measures of standing balance adjusted for age, gender and highest completed education. Results: Low cognitive status in elderly outpatients was associated with a lower ability to maintain 10 s of balance in side-by-side stance with eyes closed [OR (95% CI): 3.57 (1.60; 7.97)] and in semi-tandem stance with eyes open and eyes closed [OR (95% CI): 3.93 (1.71; 9.00) and OR (95% CI): 2.32 (1.11; 4.82), respectively]. Cognitive status was not associated with CoP movement. Conclusion: Low cognitive status associates with a lower ability to maintain standing balance in more demanding standing conditions in elderly outpatients. This may have implications for routine geriatric screening strategies and interpretation of results of either standing balance or cognitive tests.

Motor planning in Parkinson’s disease patients experiencing freezing of gait: The influence of cognitive load when approaching obstacles

Freezing of gait (FOG) in Parkinson’s disease (PD) is typically assumed to be a pure motor deficit, although it is important to consider how an abrupt loss of gait automaticity might be associated with an overloaded central resource capacity. If resource capacity limits are a factor underlying FOG, then obstacle crossing may be particularly sensitive to dual task effects in eliciting FOG. Participants performed a dual task (auditory digit monitoring) in order to increase cognitive load during obstacle crossing. Forty-two non-demented participants (14 PD patients with FOG, 13 PD who do not freeze, and 14 age-matched healthy control participants) were required to walk and step over a horizontal obstacle set at 15% of the participants’ height. Kinematic data were split into two phases of their approach: early (farthest away from the obstacle), and late (just prior to the obstacle). Interestingly, step length variability and step time variability increased when PD patients with FOG performed the dual task, but only in the late phase prior to the obstacle (i.e. when closest to the obstacle). Additionally, immediately after crossing, freezers landed the lead foot abnormally close to the obstacle regardless of dual task condition, and also contacted the obstacle more frequently (planning errors). Strength of the dual task effect was associated with low general cognitive status, declined executive function, and inappropriate spatial planning, but only in the PD-FOG group. This study is the first to demonstrate that cognitive load differentially impacts planning of the final steps needed to avoid an obstacle in PD patients with freezing, but not non-freezers or healthy controls, suggesting specific neural networks associated with FOG behaviours.

Cross-sectional associations of oral health measures with cognitive function in late middle–aged adults: A community-based study

It has not been established to what extent oral health is associated with cognitive function in late middle-aged adults. In this study, which is part of the national Atherosclerosis Risk in Communities (ARIC) study, the authors investigated whether tooth loss and periodontitis are associated with lower cognitive function.The authors analyzed ARIC data measuring cognitive function in 11,097 participants from 1996 through 1998 according to tests of delayed word recall, digit-symbol substitution (DSS) and word fluency; 9,874 participants answered dental screening questions. Of the 8,554 dentate participants, 5,942 received oral examinations. The authors used measures of dental status, number of teeth and periodontitis (classified according to the Biofilm-Gingival Interface Index) in multiple linear regression models to estimate these factors' cross-sectional association with cognitive scores, adjusting for sociodemographic factors, cigarette smoking, alcohol use and diabetes.Approximately 13 percent of participants were edentulous. Of the dentate participants, 27.3 percent had fewer than 20 teeth and 12.4 percent had pocket depth of 4 millimeters or more with severe bleeding. Compared with dentate participants, edentulous participants had lower scores for all cognitive tests. Among the dentate participants, having fewer teeth and gingival bleeding were associated with lower DSS and word fluency test scores, although periodontal pocket depth was not.In this cohort, edentulism was correlated with lower cognitive status. Tooth loss and gingival bleeding were markers of poorer executive function among dentate people. Practical Implications. The association of lower cognitive scores with edentulism suggests that past oral diseases may be a risk indicator for cognitive decline, whereas the association with gingival inflammation indicates a possible effect of cognitive decline on oral health. Practitioners should be aware that both current and historical markers of oral disease might be associated with decline in cognitive function, even in adults of late middle age.

Characteristics of nursing home residents and physical restraint: a systematic literature review

To analyse and to summarise factors associated with nursing home residents' characteristics which could lead to physical restraint, and to investigate the consequences of physical restraint use for this population. Even though the application of physical restraint is highly controversial, prevalence rates show that it is a common intervention in nursing homes. Residents' characteristics seem to be important to predict the use of physical restraint. Evidence suggests that restrained nursing home residents may have physical and psychological disadvantages as a consequence of being restrained. A systematic literature research involving the databases PubMed, Cumulative Index to Nursing and Allied Health Literature, ISI Web of Science and Cochrane Library was carried out for articles published from January 2005-November 2011. Nine Studies fulfilled the inclusion criteria and the quality assessment. Restrained residents had low activities of daily living (ADL) scores and severe cognitive impairment. Residents with low cognitive status and serious mobility impairments were at high risk to be restrained, as well as residents with previous fall and/or fracture. Repeated verbal and physical agitation was found to be positively associated with restraint use. Possible consequences of physical restraint were as follows: lower cognitive and ADL performance, higher walking dependence, furthermore falls, pressure ulcers, urinary and faecal incontinence. This systematic literature review reveals notable resident-related factors for physical restraint use. The consequences of restraint seem to negatively influence residents' physical and psychological well-being. Physical restraint seems to be an important risk factor for residents' further health problems. Resident's characteristics appear to be decisive factors for the use of physical restraint. Nurses need a high level of expertise and competence in evaluating the individual residents' situation and deciding further steps, with respect for the autonomy and dignity of the person.

Physical strength is associated with Mini‐Mental State Examination scores in Spanish institutionalized elderly

The present cross-sectional study aimed at assessing muscle strength of hands, the dominant arm and legs in Spanish institutionalized elderly people according to sex, age and cognitive status. A total of 153 elderly subjects (102 females, 51 males, mean age 83.6 ± 6.8 years) living in the region of Madrid were measured for handgrip strength (kg) with a Takei TKK 5101 digital dynamometer (range 5-100 kg, precision 0.1 kg), and arm and leg endurance strength (repetitions) according to the Rikli and Jones tests. Cognitive status was determined with the Mini-Mental State Examination (MMSE). The values for men and women were, respectively: 23.5 ± 7.3 kg and 11.6 ± 4.6 kg (right handgrip), 22.0 ± 7.8 kg and 10.7 ± 4.8 kg (left handgrip), 13 ± 5 and 10 ± 5 repetitions (arm strength), 8 ± 5 and 5 ± 4 repetitions (legs strength), and 21 ± 6 and 17 ± 7 (MMSE score). All parameters were significantly higher for men (P ≤ 0.01), but strength decline with age was less pronounced in women. In all MMSE groups, lower strength was associated with lower cognitive status. Strength values were lower in older subjects in both sexes; this difference was higher in men than in women. Higher strength values were associated with better cognitive status, which was the most influencing variable, even more than sex and age.

A longitudinal study of risk factors for community-based home help services in Alzheimer&amp;rsquo;s disease: the influence of cholinesterase inhibitor therapy

BackgroundTo investigate the long-term effects of cholinesterase inhibitor (ChEI) therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS) by patients with Alzheimer’s disease (AD).MethodsThis 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL), and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and multiple linear regression was used to predict the volume of HHS used.ResultsDuring the study, 332 patients (38%) used HHS. Factors that both postponed HHS use and predicted lower amounts of HHS were higher doses of ChEIs, better IADL ability, and living with family. Men, younger individuals, and those with a slower IADL decline showed a longer time to HHS, whereas female sex, a lower cognitive status, or more medications at baseline predicted fewer hours of HHS.ConclusionsHigher doses of ChEI might reduce the use of HHS, possibly reducing the costs of community-based care. Female spouses provide more informal care than do male spouses, so the likelihood of using HHS is greater among women with AD. The “silent group” of more cognitively impaired and frail elderly AD patients receives less HHS, which might precipitate institutionalization.

The Effect of Carotid Occlusion in Cognition before Endarterectomy

The role of carotid stenosis on cognition remains to be determined. To study whether people with stenosis of the carotid artery have increased cognitive impairments, we studied 53 patients with moderate or severe carotid stenosis (with no symptoms of stroke or dementia) and 53 controls. We describe which cognitive functions were impaired in the patients and whether there were differences based on the side, the severity of the stenosis or the presence of neurological symptoms. Using the Repeatable Battery for the Assessment of Neuropsychological Status, we found that the patients with carotid stenosis had lower cognitive performances in attention, verbal memory, visuospatial capacity and verbal fluency. Patients with lesser degrees of stenosis than healthy control patients had better scores in learning and memory. The results from this study suggest that patients with severe carotid stenosis have a lower cognitive status than healthy control patients, which is associated with the degree of total carotid stenosis.

Article 20 Correlates of Participation in Patient Satisfaction Survey Among Stroke Patients of Inpatient Rehabilitation

Patient satisfaction surveys (PSS) are often used to identify medical care and rehabilitation issues important to patients, and assess success of clinical and administrative strategies. However, many stroke patients do not return PSS information post-discharge. We tested the hypothesis that lower cognitive status at discharge is associated with PSS non-participation, by examining clinical and rehabilitative correlates associated with PSS participation after acute inpatient stroke rehabilitation.

Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking

Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology. Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden. The strongest predictors of burden were care-recipients' lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients' behavioral and emotional states were also positively related to caregiver burden. The findings stress the importance of maintaining older persons' out-of-home mobility during cognitive decline.

Breast and Colorectal Cancer Screening and Associated Correlates among Chinese Older Women

To explore the participation rates for breast and colorectal cancer screening and identify associated correlates among elderly women. Logistic regressions were conducted using data collected in 2006 from 1,533 elderly women aged 60 years or above who had completed a screening instrument, the Minimum Data Set-Home Care, while applying for long-term care services at the first time in Hong Kong. The participation rates for breast and colorectal cancer screening among frail older Chinese women were 3.7% and 10.8% respectively. Cognitive status was inversely associated with the likelihood of participation in screening (breast: OR = 0.66, 95%CI = 0.47-0.94; colon: OR = 0.81, 95%CI = 0.66-0.99), as was educational level with the likelihood of participation in breast cancer screening (no formal education: OR = 0.20, 95%CI = 0.06-0.61, some primary education: OR = 0.31, 95%CI = 0.10-1.00). The delivery of cancer preventive health services to frail older women is less than ideal. Cognitive status and educational level were important factors in cancer screening behaviour. Tailor-made strategic promotion programmes targeting older women with low cognitive status and educational levels are needed to enhance awareness and acceptance within this vulnerable group.

訪問リハビリテーション利用者における在宅生活継続を阻害する要因

The purpose of this study was to determine the predictors of interruption to living at home as a result of death, hospitalization, or admission to a long-term care facility in frail elderly people enrolled in a home visit rehabilitation service. A total of 311 patients entered a home visit rehabilitation service within a study period of 1 September, 2005 to 31 March, 2010, 146 of whom met the criteria to be enrolled in this study and gave consent. Of these, 73 received a continuous home visit rehabilitation service (continuous group) of over 2 years and 73 experienced interruption to this service due to death, hospitalization, or admission to a long-term care facility (interruption group). The following physical, social, and medical factors were recorded and analyzed: age, sex, care level, disease diagnoses, gait disability, cognitive impairment, living with another person and cause of the interruption to the home-visit rehabilitation service. We compared each item between the interruption and continuous groups. Logistic regression analysis was used to identify the significant predictors of interruptions to living at home. Patients in the interruption group demonstrated significantly lower functioning in activities of daily living (ADL), gait ability and lower cognitive status, and higher rates of respiratory diseases and cancer compared with the continuous group. On logistic regression analysis, ADL score (odds ratio [OR]=0.97, p<0.01), and the presence of respiratory diseases (OR=4.35, p=0.04) and cancer (OR=13.46, p<0.01) were significantly associated with interruptions to living at home. Lower ADL functioning, respiratory diseases and cancer were significant predictors of interruption to living at home in frail elderly adults.

Atividade física e acidentes por quedas em idosos que frequentam centro de convivência

Abstract de Tese de Doutorado Physical activity and accidental falls in senior center users Priscila Carneiro Valim-Rogatto UNIFESP - Universidade Federal de Sao Paulo, Escola Paulista de Medicina. Depto. de Enfermagem, Sao Paulo, SP, Brasil The aims of this observational, cross-sectional study were: i) investigate the prevalence of accidental falls in Senior Citizen Centers (SCC) users and the influence of factors associated with these falls such as age group, sex, civil status, level of education, family/person income, retirement, labor market participation, cognitive status, registration period and activities carried out at SCC, and level of physical activity; ii) estimate the level of physical activity in this elderly population relating to the variables described above as well as the possible association with accidental falls; and iii) analyze the association among level of physical activity and related-factors and/or consequences on the most recent fall (number, daytime and fall location, fracture or injury occurrence, search for medical services and fear of falling). The sample included 350 Senior Citizens from three different SCC from Cuiaba City (Mato Grosso State, Brazil) that answered the Mini-mental State Examination–MMSE and the International Physical Activity Questionnaire-IPAQ short version. The Characterization of Falls Questionnaire was answered only by those elderly who had fallen. Descriptive Statistic, Binary Logistic Regression and Ordinal Logistic Regression by Proportional Odds Model (POM) were used for data analyses (p<0.05) from a 291 elderly sub-sample. About 40% of the elderly suffered falls in the last year. From this group, 45.3% declared to have fallen two or more times in the same period. The predictive model of falls was comprised by the following variables: female gender (OR= 5.12; IC= 2.48–10.56), 75-79 years old age group (OR=3.0; IC= 1.20–7.47), divorced marital status (OR=4.09; IC= 1.27–13.22), and to be pensioner (OR=2.82; IC= 1.20–6.64). Analyzing the level of physical activity (LPA), 38.1% of voluntaries were classified as high level, 49.8% as moderate level and 12.1% as low level. The results of POM indicated that the oldest group showed lower chance to be classified as high LPA (OR=0.78: IC=0.96-2.92) than elderly younger groups. Seniors that do not have a job (OR=0.38: IC=0.22–0.67) and those with low cognitive status (OR=0.31; IC=0.31-0.38) had little possibility to be in high LPA in opposition to the other levels. Regarding to the last fall reported, it was verified that 46.2% occurred in the afternoon, 9.4% resulted in fractures, 70.9% resulted in some sort of injury and 23.9% did not result in any impairments. It was also verified that 54.7% of the elderly suffered outdoor falls, 61.5% did not seek any medical

Nível de atividade física e sua relação com quedas acidentais e fatores psicossociais em idosos de centro de convivência

Este estudo seccional teve por objetivo estimar o nível de atividade física (NAF) de idosos que frequentam centros de convivência (CCI), analisando a possível associação com quedas acidentais e outras variáveis relacionadas. Uma amostra de 291 idosos de três CCI da cidade de Cuiabá (MT, Brasil) respondeu ao Mini-Exame do Estado Mental (MEEM) e ao Questionário Internacional de Atividades Físicas (IPAQ). Foram utilizadas para a análise de dados, estatística descritiva e a regressão logística ordinal pelo Modelo de Odds Proporcional (MOP) (p&lt;0,05). Cerca de 40% dos idosos disseram ter caído no ano anterior ao inquérito. Quanto ao NAF, 38,1% dos voluntários foram classificados no NAF "alto", 49,8% no "moderado" e 12,1% no "baixo". Os resultados do MOP para NAF indicaram que idosos mais velhos têm menos chance de estar no NAF alto (OR=0,78: IC=0,96-2,92) do que idosos nas faixas etárias mais jovens. O mesmo foi observado em idosos que não trabalham (OR=0,38: IC=0,22-0,67) e aqueles com baixo índice cognitivo (OR=0,31; IC=0,31-0,38). A ocorrência de quedas não mostrou associação com o NAF.