RESUMO
OBJECTIVE: To determine which factors, especially those related to nutrition, are associated with cognitive function in the oldest old, here considered those at least 80 years of age. DESIGN: A cross-sectional, population-based study. SETTING: Veranópolis, Rio Grande do Sul, Brazil, and surrounding rural areas. PARTICIPANTS: Individuals aged 80 years and older. MEASUREMENTS: The Mini Nutritional Assessment, anthropometric measurements, and serum levels of albumin and vitamin B12 were associated with cognitive function according to the Mini Mental State Examination (MMSE) and the Clock Drawing Test (CDT). Socio-demographic data were obtained through a structured questionnaire. Multivariate analysis was used to determine the associations. RESULTS: According to the MMSE and the CDT, the prevalence of cognitive impairment was 47.7% [95%CI 39.7-55.7] and 58.2% [95%CI 50.3-66.1], respectively. In the adjusted analysis, the only positive linear association with MMSE scores indicating cognitive impairment was age. However, CDT scores indicating cognitive impairment were five times higher among those with low serum vitamin B12 concentrations. For the other variables, there was a positive association between age, being widowed, a low educational level and central nervous system drugs. Being single, living with children and living alone were protective factors for cognitive impairment. CONCLUSIONS: Although cognitive impairment was positively associated with old age, being widowed and low educational level in this population, the only nutritional variable positively associated with cognitive impairment was a low vitamin B12 concentration.
Assuntos
Disfunção Cognitiva/etiologia , Avaliação Nutricional , Estado Nutricional/fisiologia , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , PrevalênciaRESUMO
The objective of this study was to systematically evaluate gender differences in the prevalence of TMD. A systematic review was performed in PubMed, EMBASE, Web of Science and LILACS in duplicate by two independent reviewers. The inclusion criteria were cross-sectional studies that reported the prevalence of TMD for men and women and that used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I group diagnostic criteria:(group I = muscle disorders; group II = disc displacements; group III = arthralgias/arthritis/arthrosis).To be eligible for inclusion, studies must include adult individuals (>18 years) from a non-clinical population (ie without pre-diagnosis of TMD); in other words, from population-based studies. There were no restrictions on the year and language of publication. The quality of the articles was assessed by an adapted version of the Newcastle-Ottawa Scale(NOS), and the publication bias was assessed by a funnel plot graph. Data were quantitatively analysed by meta-analysis using odds ratio (OR) as the measure effect. The electronic search retrieved a total of 6104 articles, of which 112 articles were selected for full-text reading according to the eligibility criteria. By means of manual search, one study was retrieved. Five articles were selected for meta-analysis with a combined sample of 2518 subjects. Women had higher prevalence of TMD in all RDC/TMD diagnostic groups. The meta-analysis yielded the following results: (a) OR = 2.24 for global TMD (groups I, II and III combined), (b) OR = 2.09 for group I, (c) OR = 1.6 for group II and (d) OR = 2.08 for group III. The importance of gender in the development of TMD has been demonstrated, with a two times greater risk of women to develop it as compared to men.
Assuntos
Dor Facial/fisiopatologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Transtornos da Articulação Temporomandibular/fisiopatologia , Adulto , Estudos Transversais , Dor Facial/epidemiologia , Feminino , Humanos , Masculino , Fatores Sexuais , Transtornos da Articulação Temporomandibular/epidemiologiaRESUMO
OBJECTIVE: The relationship between social capital and mortality is not clear-cut. There have been few longitudinal studies investigating this association so far. The objective was to assess the effect of different dimensions of social capital on mortality among adults of a Brazilian city. STUDY DESIGN: This is a prospective multilevel study. Baseline data were obtained from a population-based random sample of 846 adults (aged 18 years or more) residing in 38 neighbourhoods (census blocks). METHODS: Participants were interviewed in 2006-7 and their vital status investigated in 2013. Social capital was assessed by five scales (social cohesion, informal social control, neighbours' support, social action and political efficacy). The outcome was all-cause mortality. Data analysis used multilevel logistic regression models. RESULTS: At the individual level social cohesion was positively related to mortality in the unadjusted model but this association lost significance after adjustment for other variables in multivariable models. At the neighbourhood level, high mortality rates were associated with low social action independently of demographic, socio-economic, behavioural and health-related variables. CONCLUSION: We found more evidence for a contextual than individual level effect of social capital on mortality.
Assuntos
Mortalidade , Características de Residência/estatística & dados numéricos , Capital Social , Adolescente , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Estudos Prospectivos , Adulto JovemRESUMO
This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.