Factors associated with functional capacity in the elderly enrolled in the Family Health Strategy

Effects of multicomponent exercise on frailty status and physical function in frail older adults: A meta-analysis and systematic review

OBJECTIVES

The study aimed to carry out a systematic review and meta-analysis to explore the effects of multicomponent exercise on frailty status and physical function in frail older adults.

DESIGN

A systematic review and meta-analysis.

SETTING AND PARTICIPANTS

Older adults aged ≥60 years diagnosed with frailty using the Frailty Assessment Tool.

METHODS

PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang were searched from inception to March 10, 2024. Two reviewers independently screened and selected the publications, extracted the data, and assessed risk of bias. This study included randomized controlled trials and quasi-experimental designs. Review Manager 5.4 was used for data analysis.

RESULTS

Twenty-eight randomized controlled trials with 4857 older adults were included. Multicomponent exercise significantly improved frailty status (SMD = -1.40, 95 % CI:-2.05 to -0.75, P < .05) and had a significant impact on physical function (muscle strength: SMD = 0.31, 95 % CI: 0.01-0.61, P < .05; gait speed: SMD = 0.27, 95 % CI: 0.02-0.52, P < .001; balance: SMD = 0.27, 95 % CI: 0.05-0.49, P = .02; Short Physical Performance Battery [SPPB]: SMD = 1.03, 95 % CI: 0.65-1.42, P < .001; and Timed Up and Go [TUG]: SMD = -3.05, 95 % CI: -3.90 to -2.19, P < .001). Subgroup analysis suggested that a 12-week duration is optimal for multicomponent exercise interventions, demonstrating significantly greater effectiveness in hospital compared with out-of-hospital.

CONCLUSIONS

Multicomponent exercise intervention can improve frailty status in older adults and promote enhancement of physical functional abilities (muscle strength, gait speed, balance, SPPB, and TUG). Therefore, a possible protective effect of multicomponent exercise in frailty older adults is suggested.

Prevalence and factors associated with low functional mobility in older adults

Objective

To analyze the factors associated with low functional mobility in older adults residing in Alcobaça, BA.

Methods

This is an epidemiological survey with a cross-sectional design, conducted in 2015 with 473 older adults (62.4% women; mean age 70.2 ± 8.2 years) from Alcobaça, BA. The interview script addressed sociodemographic characteristics, health, and behavioral aspects. Functional mobility was assessed using the Short Physical Performance Battery (≤6 points). Inferential analyses were conducted using the Mann-Whitney U test and Poisson regression (with robust variance and estimation of prevalence ratios and their respective 95.0% confidence intervals).

Results

The prevalence of low functional mobility was 9.6%, with associated factors including the use of alcoholic beverages (PR = 1.7, 95% CI: 1.01-1.13) and the number of repetitions in elbow flexion (PR = 1.01, 95% CI: 1.01-1.05). Additionally, older adults with low mobility had lower height, thigh circumference, and lower performance in handgrip strength tests, elbow flexion, and flexibility. They also spent more time in sedentary behavior and less time in physical activity compared to older adults with preserved mobility (p < 0.05).

Conclusion

Older adults with low mobility exhibit poorer values in anthropometric parameters, lower performance in motor tests, spend less time engaged in physical activities, and more time in sedentary behavior.

Physical Activity Levels in Leisure Time, Sociodemographic Characteristics, and Chronic Non-Communicable Diseases in Brazilian Older Adults: National Health Survey, 2019

Health interventions for elderly people must understand the association between physical activity, sociodemographic factors, and non-communicable diseases. This study aimed to verify the association between physical activity in leisure time, sociodemographic factors, and NCDs in Brazilian older people. This is a descriptive study, with a cross-sectional design, carried out using secondary data from the 2019 National Health Survey-Brazil. It used data from 23,144 subjects aged over 60 years. Statistical analyses included descriptive and quantile regression with cutoff points 0.25, 0.50 (Median), 0.75, and 0.90 to verify the association between the variables. The statistical software R version 4.1.3 was used. Older people aged between 60 and 79 years were highlighted up to the 50th quantile. Females showed lower values in all quantiles, with emphasis from quantile 50 onwards. Subjects who self-declared as "white" showed significant differences up to quantile 50, not indicating significant values from this cutoff point. Residents of the rural area had lower values than residents of the urban area in all quantiles, with emphasis starting from the median. For cardiovascular diseases, it was found that subjects who did not report having this type of disease had better results for the amount of physical activity during leisure time, especially from the 75th quantile. It was concluded that there is a direct relationship between time spent in leisure-time performing physical activity, sociodemographic variables, and NCDs. It is necessary to review and validate cutoff points according to each category viewed, which can favor the adjustment of interventions according to each population. Actions of this nature can favor adherence by groups of older people to the weekly practice of physical activity.

A rapid literature review on the health-related outcomes of long-term person-centered care models in adults with chronic illness

Introduction

The strong association between age and the increasing prevalence of chronic diseases, makes it imperative to promote self-care throughout life. Systematic knowledge on the health findings of person-centered care models may contribute to designing effective healthcare strategies to promote empowerment for self-care in long-term care.

Objective

To assess the association between the implementation of person-centered care models that promote self-care training in long-term care and health-related outcomes, among adults with chronic illness.

Methods

A rapid review of the literature was performed following the Cochrane rapid review methodology. The electronic databases CINAHL, MedicLatina, MEDLINE, and Psychology and Behavioral Sciences Collection were searched for randomized experimental studies, published between 2017 and 2022, that implemented interventions based on person-centered models to promote self-care in adults aged ≥18 years with chronic diseases and needing long-term health care. Verification of the eligibility of the articles and the extraction of data were performed by two independent investigators. Quantitative data on the health-related variables assessed were collected and, through narrative synthesis, health outcomes were grouped into individual, institutional and societal levels.

Results

Eight studies, mostly conducted in European countries, were included. All satisfied more than 60% of the methodological quality score. A large variability among studies was found regarding the number of participants, the data collection period and duration of the intervention, the samples selected and the care model implemented. A high number of health-related outcomes (n = 17) were analyzed in the studies, using 52 different instruments. The main health-related outcomes were multidimensional, with implications at the individual, institutional and societal levels. The promotion of overall health and wellbeing (n = 4), the implementation of patient-centered care models (n = 1), the positive and more frequent interactions with health professionals (2), the decrease on staff psychosocial distress (n = 1), and the absence of added costs (n = 1), while improving family caregivers' skills (n = 1) were the main health-related outcomes described.

Conclusion

There is a need to develop robust experimental studies focused on the views and experiences of all stakeholders and conducted in different countries and cultures. Short-, medium- and long-term health outcomes should be measured using internationally accepted and validated scales for chronic patients.

Diseases, health behaviors, psychological health and associated factors among women aged 50-70 years: a cross-sectional study in Hunan Province, China

This cross-sectional study identified 2, 585 women aged 50-70 with certain diseases, health behaviors and psychological health problems among a representative and community-conducted sample of women in Hunan Province of China. It disclosed their poor health status: 51.0% had chronic diseases, 49.6% had gynecopathy, 23.6% had mastopathy, 57.1% failed to avoid secondhand smoke, less than 50% completed periodic health examinations, and 3.1% were anxious. Chronic diseases are expected to be serious health problems in the next 10 years, emphasizing the importance of women discussing their health status. Common diseases should be managed via public health service projects, and free screening and treatment of common diseases should be provided. To enhance women's health knowledge and awareness, targeted health education is necessary in accordance with their physiological and psychological characteristics.