Navegando por Palavras-chave "Idosos Longevos"

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    Locomoção em idosos longevos: um estudo de coorte prospectiva
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Carmo, Sabrina Nascimento Do [UNIFESP]; Santos, Fania Cristina Dos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Problems in locomotor organs in the elderly are related to functional decline, which in turn lead us to the process of failure in aging. Conditions such as osteoarthritis, osteoporosis, chronic pain, among others, are pointed as important causes of locomotive disabilities in the elderly. This led Japan in 2007 to establish the concept of "Locomotive Syndrome" (SLo), establishing its early screening using simple tools and preventive measures for such conditions, reducing disability, need of care and institutionalization of the elderly. In 2016, the LOCOMOV Project was developed in the Discipline of Geriatrics and Gerontology of the Federal University of São Paulo, which purpose is to follow up a cohort of elderly aged 80 years or older who had, or not, the SLo diagnosis based on GLFS-25P. Objective: To evaluate the physical performance at the 4-meter gait speed test (VM4M), 5 times sit to stand test (SL5x) and 100m walking ability in elderly aged 80 years or more with SLo or without it, after 2 year-follow up. Methods: This is an observational prospective cohort study that consists in the follow-up of community-dwelling elderly participants of the LOCOMOV Project, who were diagnosed with SLo or not (by GLFS-25P), after two years of the baseline research. The data, collected in 2018 and 2019, includes sociodemographic and anthropometric information, functional status based on scales (Katz and Lawton), chronic pain, quality of life (WHOQOL-Bref) and social participation (WHOQOL-OLD social scale). In addition, physical performance tests were also conduced (VM4m, SL5x, Two-Step Test - TST and handgrip strenght - HG). In the statistical analysis, the Chi-square and Fisher's exact tests (for small samples) were applied, also McNemar test, Student's test, Analysis of Variance, non-parametric Mann-Whitney test and non-parametric Wilcoxon test were performed. We set the significance level at 0.05 (5%). Results: Data were analyzed from 87 elderly. The mean age of the participants was 87.3 years, and the majority was female (72.4%). OA prevalence increased by 8.9% among individuals with SLo (p 0.029). There were no interactions between time and group for all variables, except for WHOQOL - Physical Domain xvii (p 0.015). The means, by initial condition of SLo, were described differently, at both moments of evaluation, in the following variables: the ones without SLo, compared to those who have SLo, had higher means of WHOQOL-Psychological Domain (p <0.001), WHOQOL- OLD Social Dimension ( p <0.001) and TSS (p <0.001), and smaller means of SL5x (p <0.001). For WHOQOL-bref Social and Environmental Domains, there was an average increase from the 1st to the 2nd assessment in both groups (p 0.02 and p 0.004), and the group without SLo maintained higher means than the group with SLo (p <0.001 and p <0.001, respectively). In both groups, there was a mean reduction in VM4M and HG from the 1st to the 2nd assessment (p <0.001 and p 0.004, respectively), but the group without SLo remained with a higher mean than the group with SLo (p <0.001 and p 0.018, respectively). There was a 24% worsening in 100m walking ability in the SLo group, while a worsening in the group without SLo was only 2.4% (p 0.003). Similarly, analysing the Katz’s scale, the SLo group worsened 20%, compared to the group without SLo, that worsened 4.8% (p 0.035). Regarding the intensity of chronic pain, there was a difference in the means by SLo condition in both the 1st. And 2nd. evaluations (p <0.001 and p <0.001, respectively). In the multiple linear regression, which coefficients were interpreted as mean effects of a specific variable on the variation of GLFS-25P, female gender (p 0.021), osteoporosis (p <0.001), VM4M (p 0.001) BMI (p <0.001) remained significant. Conclusion: The elderly with SLo, after 2 yeras, exhibit a significant worsening in functionality, measured by physical tests, when compared to the elderly without the syndrome. In addition, the sample with SLo, who often presents OA, severe pain, obesity or osteoporosis, maintain a poorer quality of life compared to those without the syndrome. As a result, this SLo group has become progressively more dependent. With the longitudinal analysis of these elderlies, we could establish the following clinical predictors for SLo: female gender, diagnosis of OP, inadequate VM4M and high BMI.