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1.
Cells ; 7(11)2018 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-30400186

RESUMO

This study assessed whether telomere length is related to chronic conditions, cardiovascular risk factors, and inflammation in women aged 65 to 74 from Northeast Brazil. Participants were selected from two sources, a representative sample of the International Mobility in Aging Study (n = 57) and a convenience sample (n = 49) recruited at senior centers. Leukocyte telomere length was measured by quantitative polymerase chain reaction from blood samples in 83 women. Natural log-transformed telomere/single copy gene ratio was used as the dependent variable in the analysis. Blood analyses included inflammatory markers (high-sensitivity C-reactive protein and interleukin-6), total, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, glucose and glycosylated hemoglobin. Self-rated health, chronic conditions, cardiovascular risk factors and inflammatory markers were not associated with telomere length. No significant independent association was found between telomere length and anthropometric measures or blood markers, even after adjusting for age, education and adverse childhood events among these older women in Northeast Brazil. Our results did not confirm the hypothesis that chronic conditions, cardiovascular risk factors or inflammation are associated with shorter telomere length in these women who have exceptional survival relative to the life expectancy of their birth cohort.

3.
J Aging Health ; 30(9): 1369-1388, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-28645242

RESUMO

OBJECTIVE: To examine factors associated with visual impairment (VI) and eye care in the International Mobility in Aging Study (IMIAS). METHOD: IMIAS data were analyzed ( N = 1,995 with ages 65-74). Outcomes were VI defined as presenting visual acuity worse than 6/18 in the better eye and eye care utilization assessed by annual visits to eye care professionals. The Hurt-Insult-Threaten-Scream (HITS) questionnaire requested information on domestic violence. RESULTS: Among men, VI varied from 24% in Manizales (Colombia) to 0.5% in Kingston (Canada); among women, VI ranged from 20% in Manizales to 1% in Kingston; lifetime exposure to domestic violence was associated with VI (odds ratio [OR] = 1.87; 95% confidence interval [CI] = [1.17, 3.00]). Eye care utilization varied from 72% in Kingston's men to 25% in Tirana's men; it was associated with domestic violence (prevalence ratio [PR] = 1.3; 95% CI = [1.1, 1.6]). DISCUSSION: VI is more frequent where eye care utilization is low. Domestic violence may be a risk factor for VI.


Assuntos
Transtornos da Visão/epidemiologia , Testes Visuais/estatística & dados numéricos , Idoso , Brasil/epidemiologia , Canadá/epidemiologia , Colômbia/epidemiologia , Violência Doméstica/estatística & dados numéricos , Escolaridade , Feminino , Humanos , Renda , Masculino , Características de Residência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários
4.
Rejuvenation Res ; 21(4): 294-303, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28482745

RESUMO

We examined associations between adverse childhood experiences (ACEs) and shorter telomere length (TL) in 83 older women, including 42 women with less than secondary education and 41 with secondary or more education in a city of Northeast Brazil, a region with substantial socioeconomic inequalities. The low education sample was selected from a representative survey at local neighborhood health centers, while the high education group consisted of a convenience sample recruited by advertising in community centers and centers affiliated with the local university. Relative leukocyte TL was measured by quantitative polymerase chain reaction from blood samples. ACEs were self-reported. Spline linear regression was fitted to assess the strength of the associations between ACEs and TL. Among women with low education, median TL was 1.02 compared with 0.64 in the high education group (p = 0.0001). Natural log-transformed T/S ratio as the dependent variable was used in analysis. Women with low education had been exposed to more ACEs, and among them those experiencing two or more ACEs had longer TL than women exposed to ≤1 ACEs (p = 0.03); among women with high education, this difference was not significant (p = 0.49). In analyses adjusted by age, education, and parental abuse of alcohol, the linear trend of higher TL with increasing ACEs was confirmed (p = 0.02), and the mean difference in TL between groups remained significant (p = 0.002). The unexpected positive relationship between low education and ACEs with TL suggests that older adults who have survived harsh conditions prevailing in Northeast Brazil have the longest TL of their birth cohort.


Assuntos
Acontecimentos que Mudam a Vida , Encurtamento do Telômero/genética , Idoso , Alcoolismo/patologia , Brasil , Escolaridade , Feminino , Humanos , Pais , Análise de Regressão
5.
J Am Med Dir Assoc ; 18(9): 774-779, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28526584

RESUMO

OBJECTIVE: Primary care practitioners need simple algorithms to identify older adults at higher risks of falling. Classification and regression tree (CaRT) analyses are useful tools for identification of clinical predictors of falls. DESIGN: Prospective cohort. SETTING: Community-dwelling older adults at 5 diverse sites: Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). PARTICIPANTS: In 2012, 2002 participants aged 65-74 years from 5 international sites were assessed in the International Mobility in Aging Study. In 2014 follow-up, 86% of the participants (n = 1718) were reassessed. MEASUREMENTS: These risk factors for the occurrence of falls in 2014 were selected based on relevant literature and were entered into the CaRT as measured at baseline in 2012: age, sex, body mass index, multimorbidity, cognitive deficit, depression, number of falls in the past 12 months, fear of falling (FoF) categories, and timed chair-rises, balance, and gait. RESULTS: The 1-year prevalence of falls in 2014 was 26.9%. CaRT procedure identified 3 subgroups based on reported number of falls in 2012 (none, 1, ≥2). The 2014 prevalence of falls in these 3 subgroups was 20%, 30%, and 50%, respectively. The "no fall" subgroup was split using FoF: 30% of the high FoF category (score >27) vs 20% of low and moderate FoF categories (scores: 16-27) experienced a fall in 2014. Those with multiple falls were split by their speed in the chair-rise test: 56% of the slow category (>16.7 seconds) and the fast category (<11.2 seconds) had falls vs 28% in the intermediate group (between 11.2 and 16.7 seconds). No additional variables entered into the decision tree. CONCLUSIONS: Three simple indicators: FoF, number of previous falls, and time of chair rise could identify those with more than 50% probability of falling.


Assuntos
Acidentes por Quedas/prevenção & controle , Algoritmos , Limitação da Mobilidade , Atenção Primária à Saúde , Idoso , Brasil , Feminino , Previsões/métodos , Humanos , Masculino , Estudos Prospectivos , Quebeque , Fatores de Risco
6.
BMJ Open ; 6(10): e012339, 2016 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-27737884

RESUMO

BACKGROUND: Life course exposure to violence may lead to disability in old age. We examine associations and pathways between life course violence and mobility disability in older participants of the International Mobility in Aging Study (IMIAS). METHODS: A cross-sectional study using IMIAS 2012 baseline. Men and women aged 65-74 years were recruited at 5 cities (n=1995): Kingston and Saint-Hyacinthe (Canada), Tirana (Albania), Manizales (Colombia) and Natal (Brazil). Mobility was assessed by the Short Physical Performance Battery (SPPB) and by 2 questions on difficulty in walking and climbing stairs. Childhood physical abuse history and the HITS instrument were used to gather information on childhood exposure to violence and violence by intimate partners or family members. Multivariate logistic regression and mediation analysis models were constructed to explore the significance of direct and indirect effects of violence on mobility. Interaction effects of gender on violence and on each of the mediators were tested. RESULTS: Experiences of physical violence at any point of life were associated with mobility disability (defined as SPPB<8 or limitation in walking/climbing stairs) while psychological violence was not. Chronic conditions, C reactive protein, physical activity and depression mediated the effect of childhood exposure to violence on both mobility outcomes. Chronic conditions and depression were pathways between family and partner violence and both mobility outcomes. Physical activity was a significant pathway linking family violence to mobility. Gender interactions were not significant. CONCLUSIONS: Our results provide evidence for the detrimental effects of life course exposure to violence on mobility in later life.


Assuntos
Envelhecimento/psicologia , Avaliação da Deficiência , Pessoas com Deficiência/psicologia , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , Limitação da Mobilidade , Idoso , Albânia/epidemiologia , Brasil/epidemiologia , Canadá/epidemiologia , Doença Crônica/psicologia , Colômbia/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Prevalência , Fatores Sexuais , Fatores Socioeconômicos
7.
Can J Aging ; 35(3): 348-60, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27477107

RESUMO

This study investigated the measurement structure of the Bem Sex Role Inventory (BSRI) with different factor analysis methods. Most previous studies on validity applied exploratory factor analysis (EFA) to examine the BSRI. We aimed to assess the psychometric properties and construct validity of the 12-item short-form BSRI in a sample administered to 1,995 older adults from wave 1 of the International Mobility in Aging Study (IMIAS). We used Cronbach's alpha to assess internal consistency reliability and confirmatory factor analysis (CFA) to assess psychometric properties. EFA revealed a three-factor model, further confirmed by CFA and compared with the original two-factor structure model. Results revealed that a two-factor solution (instrumentality-expressiveness) has satisfactory construct validity and superior fit to data compared to the three-factor solution. The two-factor solution confirms expected gender differences in older adults. The 12-item BSRI provides a brief, psychometrically sound, and reliable instrument in international samples of older adults.


Assuntos
Feminilidade , Identidade de Gênero , Masculinidade , Idoso , Albânia , Brasil , Canadá , Colômbia , Análise Fatorial , Feminino , Humanos , Masculino , Análise de Componente Principal , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
8.
BMJ Open ; 6(6): e011503, 2016 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-27354077

RESUMO

OBJECTIVES: To examine whether the association between emotional support and indicators of health and quality of life differs between Canadian and Latin American older adults. DESIGN: Cross-sectional analysis of the International Mobility in Aging Study (IMIAS). Social support from friends, family members, children and partner was measured with a previously validated social network and support scale (IMIAS-SNSS). Low social support was defined as ranking in the lowest site-specific quartile. Prevalence ratios (PR) of good health, depression and good quality of life were estimated with Poisson regression models, adjusting for age, gender, education, income and disability in activities of daily living. SETTING: Kingston and Saint-Hyacinthe in Canada, Manizales in Colombia and Natal in Brazil. PARTICIPANTS: 1600 community-dwelling adults aged 65-74 years, n=400 at each site. OUTCOME MEASURES: Likert scale question on self-rated health, Center for Epidemiological Studies Depression Scale and 10-point analogical quality-of-life (QoL) scale. RESULTS: Relationships between social support and study outcomes differed between Canadian and Latin American older adults. Among Canadians, those without a partner had a lower prevalence of good health (PR=0.90; 95% CI 0.82 to 0.98), and those with high support from friends had a higher prevalence of good health (PR=1.09; 95% CI 1.01 to 1.18). Among Latin Americans, depression was lower among those with high levels of support from family (PR=0.63; 95% CI 0.48 to 0.83), children (PR=0.60; 95% CI 0.45 to 0.80) and partner (PR=0.57; 95% CI 0.31 to 0.77); good QoL was associated with high levels of support from children (PR=1.54; 95% CI 1.20 to 1.99) and partner (PR=1.31; 95% CI 1.03 to 1.67). CONCLUSIONS: Among older adults, different sources of support were relevant to health across societies. Support from friends and having a partner were related to good health in Canada, whereas in Latin America, support from family, children and partner were associated with less depression and better QoL.


Assuntos
Envelhecimento , Depressão/epidemiologia , Qualidade de Vida/psicologia , Apoio Social , Atividades Cotidianas , Idoso , Brasil/epidemiologia , Canadá/epidemiologia , Colômbia/epidemiologia , Estudos Transversais , Feminino , Avaliação Geriátrica , Humanos , Modelos Logísticos , Masculino , Escalas de Graduação Psiquiátrica , Fatores Sexuais
9.
Psychiatry Res ; 241: 236-41, 2016 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-27183110

RESUMO

Our aim is to assess cross-national variations in prevalence of clinically relevant depression and to examine the relationships of social and health factors with depression in five diverse populations of older adults, from Canada, Brazil, Colombia and Albania. We used the data from the International Mobility in Aging Study. Clinically relevant depression was defined as a score of ≥16 on the Center for Epidemiologic Study Depression Scale (CES-D). Poisson regressions with robust covariance correction were used to estimate prevalence ratios associated with potential risk factors. Prevalence of clinically relevant depression across research sites varied widely, being consistently higher in women than in men. It was lowest in men from Brazil (6.3%) and highest in women from Albania (46.6%). Low education and insufficient income, living alone, multiple chronic conditions, and poor physical performance were all significantly associated with depression prevalence. Poor physical performance was more strongly associated with depression in men than in women. Similar factors are associated with clinically relevant depression among men and women and across research sites. The large variation in depression prevalence population rates is unexplained by the classical individual factors considered in the study suggesting the impact of country characteristics on depression among older populations.


Assuntos
Envelhecimento/psicologia , Depressão/epidemiologia , Idoso , Albânia/epidemiologia , Brasil/epidemiologia , Canadá/epidemiologia , Doença Crônica , Colômbia/epidemiologia , Depressão/psicologia , Escolaridade , Exercício Físico/psicologia , Características da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Pobreza/psicologia , Prevalência , Escalas de Graduação Psiquiátrica , Análise de Regressão , Fatores de Risco , Fatores Sexuais
10.
PLoS One ; 11(4): e0153855, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27089219

RESUMO

OBJECTIVE: The aim of this study was to explore the validity of self-rated health across different populations of older adults, when compared to the Short Physical Performance Battery. DESIGN: Cross-sectional analysis of the International Mobility in Aging Study. SETTING: Five locations: Saint-Hyacinthe and Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). PARTICIPANTS: Older adults between 65 and 74 years old (n = 1,995). METHODS: The Short Physical Performance Battery (SPPB) was used to measure physical performance. Self-rated health was assessed with one single five-point question. Linear trends between SPPB scores and self-rated health were tested separately for men and women at each of the five international study sites. Poor physical performance (independent variable) (SPPB less than 8) was used in logistic regression models of self-rated health (dependent variable), adjusting for potential covariates. All analyses were stratified by gender and site of origin. RESULTS: A significant linear association was found between the mean scores of the Short Physical Performance Battery and ordinal categories of self-rated health across research sites and gender groups. After extensive control for objective physical and mental health indicators and socio-demographic variables, these graded associations became non-significant in some research sites. CONCLUSION: These findings further confirm the validity of SRH as a measure of overall health status in older adults.


Assuntos
Atividades Cotidianas , Envelhecimento/fisiologia , Exercício Físico/fisiologia , Avaliação Geriátrica/métodos , Limitação da Mobilidade , Autorrelato , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Agências Internacionais , Masculino , Pessoa de Meia-Idade , Atividade Motora , Fatores de Risco , Inquéritos e Questionários
11.
Age (Dordr) ; 38(1): 25, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26867805

RESUMO

The aims of this study were to compare cut points for weakness proposed by Foundation for the National Institutes of Health (FNIH) Sarcopenia Project with cut points estimated with our own data; to assess the prevalence of clinically relevant handgrip strength (HGS) weakness according to published criteria across distinct populations of older adults; to estimate the ability of HGS weakness to identify slowness. This is a cross-sectional analysis of International Mobility in Aging Study (IMIAS) involving 1935 community-dwelling older adults, between 65 and 74 years, who completed HGS and gait speed assessment. We used baseline data from Tirana (Albania), Natal (Brazil), Manizales (Colombia), Kingston (Ontario, Canada), and Saint-Hyacinthe (Quebec, Canada). Weakness was defined according to sex-specific HGS cut points associated with slowness proposed by FNIH Sarcopenia Project. Slowness was defined as gait speed <0.8 m/s. IMIAS cut points for clinical weakness had good agreement with those proposed by FNIH. Weakness prevalence across the research sites ranged from 1.1 % (Saint-Hyacinthe) to 19.2 % (Manizales) among men. Women from Manizales (13.5 %) and Natal (19.3 %) had higher prevalence of weakness than their counterparts. FNIH cut points had a strong association with slowness, for both sexes. The IMIAS population generated cut points which were close to those proposed by FNIH. There was large variability in prevalence of weakness across our research sites. The HGS cut points for weakness proposed by FNIH performed well in IMIAS populations, providing a useful tool for screening older adults at risk for functional problems.


Assuntos
Envelhecimento/fisiologia , Marcha/fisiologia , Força da Mão/fisiologia , Sarcopenia/fisiopatologia , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Ontário/epidemiologia , Prevalência , Estudos Prospectivos , Sarcopenia/epidemiologia , Fatores Sexuais , Fatores de Tempo
12.
Age Ageing ; 45(2): 274-80, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26822196

RESUMO

BACKGROUND AND OBJECTIVE: C-reactive protein (CRP) is a widely used cardiovascular risk marker, but questions remain about its role in the disability process in old age. This study examines the associations between CRP levels and physical performance in old age in different societies. METHODS: data were collected during the baseline survey of IMIAS in 2012 in Kingston (Canada), Saint-Hyacinthe (Canada), Manizales (Colombia) and Natal (Brazil). Approximately 200 men and 200 women aged 65-74 were recruited at each site. CRP was assessed using a high sensitivity assay and categorised as low (<1 mg/l), moderate (1-3 mg/l), high (3-10 mg/l) and very high (≥10 mg/l). Participants were interviewed at home; blood pressure, weight and height were measured. Physical function was assessed with the Short Physical Performance Battery (SPPB) and hand grip strength. Data were analysed using descriptive statistics, bivariate analysis (χ²) and linear or logistic regression. RESULTS: CRP was significantly associated with low hand grip strength and poor physical performance in bivariate analyses. Hand grip strength association with CRP disappeared after adjustment by socioeconomic factors and health behaviours. The odds of poor physical function was OR = 2.67 [95% CI 1.43-4.99] comparing the highest and lowest CRP categories after adjustment by relevant covariates. The three SPPB components were assessed separately. Graded associations between low CRP and faster gait speed and shorter time to rise from a chair were observed in adjusted models. Association between impaired balance and CRP was attenuated after adjustment by relevant covariates, OR = 1.15 [0.65-2.04]. CONCLUSIONS: CRP could be a possible pathway from inflammation to physical decline in older populations.


Assuntos
Envelhecimento/sangue , Proteína C-Reativa/análise , Nível de Saúde , Mediadores da Inflamação/sangue , Aptidão Física , Fatores Etários , Idoso , Biomarcadores/sangue , Brasil , Canadá , Distribuição de Qui-Quadrado , Colômbia , Estudos Transversais , Avaliação da Deficiência , Feminino , Avaliação Geriátrica , Força da Mão , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Modelos Logísticos , Masculino , Análise Multivariada , Razão de Chances , Fatores de Risco
13.
BMC Public Health ; 16: 43, 2016 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-26775160

RESUMO

BACKGROUND: Sarcopenia and obesity have been independently associated with physical function decline, however little information is currently available on the relationship between sarcopenic obesity and physical performance, mainly in middle aged women. The present study aims to estimate the prevalence of sarcopenic obesity and to explore the relationship between sarcopenic obesity and physical performance in middle-aged women from Northeast Brazil. METHODS: A cross-sectional study of women (40-65 years) living in Parnamirim, a city in Northeast Brazil (n = 491). Physical performance was assessed by grip strength, knee extensor and flexor strength (isometric dynamometry), gait speed, and chair stands. Using bioelectrical impedance analysis (BIA), appendicular skeletal muscle mass divided by height squared (kg / m(2)) was used to define sarcopenia. Waist circumference ≥ 88 cm was defined as abdominal obesity. Sarcopenic obesity was defined as the coexistence of obesity and sarcopenia. The physical performance outcomes were regressed in four groups defined by combinations of sarcopenia and obesity, adjusting for potential confounders (age, education and menopausal status). RESULTS: Prevalence rates of the four obesity-sarcopenia groups were: Sarcopenic obesity (7.1 %), obesity (67.4 %), sarcopenia (12.4 %) and normal (13 %). Women with sarcopenic obesity had significantly lower grip strength, weaker knee extension and flexion and longer time to raise from a chair compared with non-obese and non-sarcopenic women (p.values < 0.001). Except for the chair stands, these statistically significant differences were also found between sarcopenic obese and obese women. There was no significant difference for gait speed across the four groups (p = 0.50). CONCLUSION: Sarcopenic obesity was present in 7 % of this population of middle-aged women from Northeast Brazil and it was associated with poor physical performance. Sarcopenic obesity may occur in middle-aged women with performance limitations beyond pure sarcopenia-related muscle mass or obesity alone.


Assuntos
Nível de Saúde , Obesidade/epidemiologia , Sarcopenia/epidemiologia , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Feminino , Marcha , Força da Mão , Humanos , Joelho , Pessoa de Meia-Idade , Prevalência , Amplitude de Movimento Articular , Circunferência da Cintura
14.
BMC Geriatr ; 15: 102, 2015 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-26286183

RESUMO

BACKGROUND: Recent studies suggest potential associations between childhood adversity and chronic inflammation at older ages. Our aim is to compare associations between childhood health, social and economic adversity and high sensitivity C-reactive protein (hsCRP) in populations of older adults living in different countries. METHODS: We used the 2012 baseline data (n = 1340) from the International Mobility in Aging Study (IMIAS) of community-dwelling people aged 65-74 years in Natal (Brazil), Manizales (Colombia) and Canada (Kingston, Ontario; Saint-Hyacinthe, Quebec). Multiple linear and Poisson regressions with robust covariance were fitted to examine the associations between early life health, social, and economic adversity and hsCRP, controlling for age, sex, financial strain, marital status, physical activity, smoking and chronic conditions both in the Canadian and in the Latin American samples. RESULTS: Participants from Canadian cities have less adverse childhood conditions and better childhood self-reported health. Inflammation was lower in the Canadian cities than in Manizales and Natal. Significant associations were found between hsCRP and childhood social adversity in the Canadian but not in the Latin American samples. Among Canadian older adults, the fully-adjusted mean hsCRP was 2.2 (95% CI 1.7; 2.8) among those with none or one childhood social adversity compared with 2.8 (95% CI 2.1; 3.8) for those with two or more childhood social adversities (p = 0.053). Similarly, the prevalence of hsCRP > 3 mg/dL was 40% higher among those with higher childhood social adversity but after adjustment by health behaviors and chronic conditions the association was attenuated. No associations were observed between hsCRP and childhood poor health or childhood economic adversity. CONCLUSIONS: Inflammation was higher in older participants living in the Latin American cities compared with their Canadian counterparts. Childhood social adversity, not childhood economic adversity or poor health during childhood, was an independent predictor of chronic inflammation in old age in the Canadian sample. Selective survival could possibly explain the lack of association between social adversity and hsCRP in the Latin American samples.


Assuntos
Envelhecimento/fisiologia , Saúde da Criança/estatística & dados numéricos , Inflamação , Idoso , Brasil/epidemiologia , Proteína C-Reativa/análise , Canadá/epidemiologia , Causalidade , Criança , Doença Crônica , Efeito de Coortes , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , Inflamação/sangue , Inflamação/etnologia , Inflamação/fisiopatologia , Masculino , Prevalência , Fatores Socioeconômicos
15.
BMC Geriatr ; 15: 85, 2015 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-26188649

RESUMO

BACKGROUND: Elderly persons make greater use of psychotropic drugs, but there are few international studies on social differences in the use of these medications. The aim of this study is to examine social differences in the use of psychotropic drugs among persons aged 65-74 years in the International Mobility in Aging Study (IMIAS). METHODS: The sample consisted of 1,995 participants in the IMIAS 2012 baseline study in Saint-Hyacinthe (Canada), Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). During home visits, all medication taken by the participants in the previous 15 days was recorded. We then used the Anatomical Therapeutic Chemical classification system to code psychotropic drugs as anxiolytics, sedatives, hypnotics (ASH); antidepressants (ADP); or analgesics, antiepileptics, or antiparkinsonians (AEP). Prevalence ratios for psychotropic drug use according to sex, education, income, and occupation were estimated by fitting a Poisson regression and controlling for demographic and health covariates. RESULTS: Psychotropic drug use was higher among Canadian participants than among those living outside Canada. Prevalence of AEP drug use was higher for women than men in the Canadian and Latin American sites. In Tirana, antidepressant drugs were rarely used. Socioeconomic differences varied among sites. In the Canadian cities, low socioeconomic standing was associated with higher frequency of psychotropic drug use. In the Latin American cities, elderly people with high education and income levels showed a higher level of antidepressant drug use, while people with manual occupations had a higher use of AEP drugs. In Tirana, ASH drug use was higher among those with low income. CONCLUSION: An inverse association was observed between socioeconomic standing and psychotropic drug use in Canada, while the opposite was true in Latin America. Albania was notable for an absence of antidepressant use and greater use of ASH drugs among low-income groups.


Assuntos
Vida Independente , Psicotrópicos , Classe Social , Idoso , Albânia/epidemiologia , Brasil/epidemiologia , Canadá/epidemiologia , Colômbia/epidemiologia , Comparação Transcultural , Demografia , Feminino , Humanos , Vida Independente/psicologia , Vida Independente/estatística & dados numéricos , Masculino , Prevalência , Psicotrópicos/classificação , Psicotrópicos/uso terapêutico , Fatores Sexuais
16.
Rev Panam Salud Publica ; 37(4-5): 293-300, 2015 May.
Artigo em Português | MEDLINE | ID: mdl-26208199

RESUMO

OBJECTIVE: Describe the prevalence of domestic violence in older men and women in Natal, Brazil, and Manizales, Colombia and explore whether the differences by gender are due to lifetime differences in social and financial status. METHODS: Cross-sectional study with a random sampling of 802 men and women in the IMIAS Study (International Mobility in Aging Study) (65-74 years old) conducted in Natal (Brazil) and Manizales (Colombia). Incidents that occurred in the last six months and any time during their lives were evaluated using the HITS scale. Poisson regression was used to estimate the reasons for the prevalence of violence against women by men. RESULTS: Experience of physical violence occurring any time in life ranged from 2.2% to 18.3%, depending on the city and the sex. Psychological violence was higher in women: violence perpetrated by partners affected 25.7% of women in Natal and 19.4% in Manizales; and by the family, 18.3% in Manizales and 10% in Natal. Almost half of the participants reported suffering psychological violence at some time during their life. Experience of current violence or at some time during life was most frequent in women, even after adjustment for co-variables, with prevalence ratios of 1.60 to 2.14. CONCLUSIONS: The rates of prevalence of domestic violence in older adults show that women are more affected, which means that they should be considered a priority in the prevention policies on Latin America's health agenda.


Assuntos
Violência Doméstica/estatística & dados numéricos , Abuso de Idosos/estatística & dados numéricos , Relações Interpessoais , Abuso Físico/estatística & dados numéricos , Fatores Etários , Idoso , Brasil/epidemiologia , Colômbia/epidemiologia , Estudos Transversais , Feminino , Humanos , América Latina/epidemiologia , Masculino , Autonomia Pessoal , Estudos de Amostragem , Fatores Sexuais , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos
17.
Rev. panam. salud pública ; 37(4/5): 293-300, abr.-may. 2015. ilus, tab
Artigo em Português | LILACS | ID: lil-752657

RESUMO

OBJETIVO: Describir la prevalencia de violencia doméstica en hombres y mujeres mayores de Natal, Brasil y Manizales, Colombia y explorar si las diferencias de género se deben a diferencias en condiciones sociales y económicas a lo largo de la vida. MÉTODOS: Estudio transversal con muestra aleatoria de 802 hombres y mujeres del Estudio IMIAS (International Mobility in Aging Study) (65-74 años) desarrollado en Natal y Manizales. La violencia perpetrada, durante los últimos seis meses y alguna vez en la vida, fue evaluada por la escala HITS. La regresión de Poisson fue utilizada para estimar las razones de prevalencia de violencia de las mujeres respecto a los hombres. RESULTADOS: La experiencia de violencia física ocurrida alguna vez en la vida varió entre 2,2 y 18,3% según la ciudad y el sexo. La violencia psicológica fue más elevada en mujeres, siendo la violencia perpetrada por el compañero de 25,7% en Natal y 19,4% en Manizales; y por la familia de 18,3% en Manizales y 10% en Natal. Casi la mitad de los participantes informaron haber sufrido violencia psicológica alguna vez en la vida. La violencia actual o alguna vez en la vida fue más frecuente en las mujeres, incluso tras ajustes por covariables, presentando razones de prevalencia entre 1,60 y 2,14. CONCLUSIONES: Las tasas de prevalencia de violencia doméstica en los adultos mayores revelan que las mujeres son más afectadas, por lo cual deben ser consideradas como prioridad en las políticas de prevención de la agenda de salud para Latinoamérica.


OBJECTIVE: Describe the prevalence of domestic violence in older men and women in Natal, Brazil, and Manizales, Colombia and explore whether the differences by gender are due to lifetime differences in social and financial status. METHODS: Cross-sectional study with a random sampling of 802 men and women in the IMIAS Study (International Mobility in Aging Study) (65-74 years old) conducted in Natal (Brazil) and Manizales (Colombia). Incidents that occurred in the last six months and any time during their lives were evaluated using the HITS scale. Poisson regression was used to estimate the reasons for the prevalence of violence against women by men. RESULTS: Experience of physical violence occurring any time in life ranged from 2.2% to 18.3%, depending on the city and the sex. Psychological violence was higher in women: violence perpetrated by partners affected 25.7% of women in Natal and 19.4% in Manizales; and by the family, 18.3% in Manizales and 10% in Natal. Almost half of the participants reported suffering psychological violence at some time during their life. Experience of current violence or at some time during life was most frequent in women, even after adjustment for co-variables, with prevalence ratios of 1.60 to 2.14. CONCLUSIONS: The rates of prevalence of domestic violence in older adults show that women are more affected, which means that they should be considered a priority in the prevention policies on Latin America's health agenda.


Assuntos
Violência Doméstica/etnologia , Violência de Gênero/psicologia , América Latina/etnologia
18.
PLoS One ; 10(3): e0119480, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25822526

RESUMO

OBJECTIVE: To examine associations between menopausal status and physical performance in middle-aged women from the Northeast region of Brazil. METHODS: Cross-sectional study of women between 40 to 65 years old living in Parnamirim. Women were recruited by advertisements in primary care neighborhood centers across the city. Physical performance was assessed by grip strength, gait speed and chair stands. Menopausal status was determined using the Stages of Reproductive Aging Workshop classification and women were classified in: premenopausal, perimenopausal or postmenopausal. Multiple linear regression analyses were performed to model the effect of menopausal status on each physical performance measure, adjusting for covariates (age, family income, education, body mass index, parity and age at first birth). RESULTS: The premenopausal women were significantly stronger and performed better in chair stands than perimenopausal and postmenopausal women. Gait speed did not vary significantly by menopausal status. In multivariate analyses, menopausal status remained statistically significant only for grip strength. In fully adjusted analyses, premenopausal women had grip strength mean of 2.226 Kgf (95% CI: 0.361 - 4.091) higher than the postmenopausal group. CONCLUSIONS: This study provides further evidence for the associations between menopause and physical performance in middle-aged women, since grip strength is weaker in peri and postmenopausal women compared to premenopausal, even adjusted for age and other covariates.


Assuntos
Menopausa/fisiologia , Aptidão Física , Adulto , Brasil , Pesquisa Participativa Baseada na Comunidade , Feminino , Marcha , Força da Mão , Humanos , Pessoa de Meia-Idade , Movimento
19.
Arch Gerontol Geriatr ; 60(3): 492-500, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25704920

RESUMO

PURPOSE: To determine whether gender, socioeconomic conditions, and/or social relations are related to recent experiences of DV in older adult populations. MATERIALS AND METHODS: Data on socioeconomic status and social relations were collected in 2012 from 1995 community-dwelling older adults in Canada, Colombia, Brazil, and Albania. Violence experienced in the last 6 months was measured using the Hurt, Insulted, Threatened with harm, or Screamed at (HITS) scale and classified according to type (physical or psychological) and perpetrator (partner or family member). Binary logistic regression analyses were used to assess associations between experiences of violence and gender, socioeconomic conditions, and social relations. RESULTS: Physical violence (by partner or family member) was reported by 0.63-0.85% of participants; the prevalence of psychological violence (by partner or family member) ranged from 3.2% to 23.5% in men and 9% to 26% in women. After adjustment for socioeconomic status, social relations, age and site, women experienced more psychological violence perpetrated by family members than did men (odds ratio (OR): 1.8; 95% CI: 1.2-2.6). Social relations, such as multifamily living arrangements and low levels of support from partners, children, and family, were associated with psychological DV. Current working status was associated with greater odds of victimization by partners among men (OR: 2.35 95% CI: 1.34-1.41), but not among women. CONCLUSIONS: Gender and social relations are important determinants of experiencing violence in older adults. The findings of this study demonstrate the importance of a gender-based approach to the study of DV in older adults.


Assuntos
Vítimas de Crime/estatística & dados numéricos , Violência Doméstica/estatística & dados numéricos , Abuso de Idosos/estatística & dados numéricos , Apoio Social , Idoso , Albânia/epidemiologia , Brasil/epidemiologia , Colômbia/epidemiologia , Violência Doméstica/prevenção & controle , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores Socioeconômicos
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