ABSTRACT BACKGROUND: The impact of metabolic syndrome (MetS) on healthcare costs remains unclear in the literature. OBJECTIVES: To determine the impact of MetS on primary healthcare costs of adults, as well as to identify the impact of physical activity and other covariates on this phenomenon. DESIGN AND SETTING: This cross-sectional study was conducted in the city of Presidente Prudente, State of São Paulo/Brazil, in 2016. METHODS: The sample comprised 159 older adults (> 50 years) of both sexes (110 women) who were identified from their medical records in the Brazilian National Health Service. Healthcare costs (US$) were assessed through medical records and divided into medical consultations, medications, laboratory tests, and total costs. MetS was assessed using medical records. RESULTS: The Brazilian National Health Service spent more on consultations (US$ 22.75 versus US$ 19.39; + 17.3%) and medication (US$ 19.65 versus US$ 8.32; + 136.1%) among adults with MetS than among those without MetS, but the costs for laboratory tests were similar (P = 0.343). Total costs were 53.9% higher in adults with MetS than in those without the diagnosis of the disease (P = 0.001). Regarding total costs, there was an increase of US$ 38.97 when five components of MetS were present (P = 0.015), representing an increase of approximately 700%, even after adjusting for sex, age, and physical activity. CONCLUSION: In conclusion, the presence of the MetS is responsible for increasing primary care costs among older adults, especially in those related to medicines. BACKGROUND (MetS literature OBJECTIVES phenomenon SETTING crosssectional cross sectional Prudente PauloBrazil Paulo Brazil Paulo/Brazil 2016 METHODS 15 > ( 5 years 110 (11 women US medications RESULTS (US 2275 22 75 22.7 19.39 1939 19 39 17.3% 173 17 3 1965 65 19.6 8.32 832 8 32 136.1% 1361 136 1 P 0.343. 0343 0.343 . 0 343 0.343) 539 53 9 53.9 0.001. 0001 0.001 001 0.001) 3897 38 97 38.9 0.015, 0015 0.015 , 015 0.015) 700 700% sex age CONCLUSION conclusion medicines 201 11 (1 227 2 7 22. 19.3 193 17.3 196 6 19. 8.3 83 136.1 13 034 0.34 34 53. 000 0.00 00 389 38. 0.01 01 70 20 17. 8. 136. 03 0.3 0.0 0.

ABSTRACT BACKGROUND: The impact of metabolic syndrome (MetS) on healthcare costs remains unclear in the literature. OBJECTIVES: To determine the impact of MetS on primary healthcare costs of adults, as well as to identify the impact of physical activity and other covariates on this phenomenon. DESIGN AND SETTING: This cross-sectional study was conducted in the city of Presidente Prudente, State of São Paulo/Brazil, in 2016. METHODS: The sample comprised 159 older adults (> 50 years) of both sexes (110 women) who were identified from their medical records in the Brazilian National Health Service. Healthcare costs (US$) were assessed through medical records and divided into medical consultations, medications, laboratory tests, and total costs. MetS was assessed using medical records. RESULTS: The Brazilian National Health Service spent more on consultations (US$ 22.75 versus US$ 19.39; + 17.3%) and medication (US$ 19.65 versus US$ 8.32; + 136.1%) among adults with MetS than among those without MetS, but the costs for laboratory tests were similar (P = 0.343). Total costs were 53.9% higher in adults with MetS than in those without the diagnosis of the disease (P = 0.001). Regarding total costs, there was an increase of US$ 38.97 when five components of MetS were present (P = 0.015), representing an increase of approximately 700%, even after adjusting for sex, age, and physical activity. CONCLUSION: In conclusion, the presence of the MetS is responsible for increasing primary care costs among older adults, especially in those related to medicines. BACKGROUND (MetS literature OBJECTIVES phenomenon SETTING crosssectional cross sectional Prudente PauloBrazil Paulo Brazil Paulo/Brazil 2016 METHODS 15 > ( 5 years 110 (11 women US medications RESULTS (US 2275 22 75 22.7 19.39 1939 19 39 17.3% 173 17 3 1965 65 19.6 8.32 832 8 32 136.1% 1361 136 1 P 0.343. 0343 0.343 . 0 343 0.343) 539 53 9 53.9 0.001. 0001 0.001 001 0.001) 3897 38 97 38.9 0.015, 0015 0.015 , 015 0.015) 700 700% sex age CONCLUSION conclusion medicines 201 11 (1 227 2 7 22. 19.3 193 17.3 196 6 19. 8.3 83 136.1 13 034 0.34 34 53. 000 0.00 00 389 38. 0.01 01 70 20 17. 8. 136. 03 0.3 0.0 0.

Objetivo: Analisar a associação entre a massa óssea e capacidade funcional de idosos com 80 anos ou mais. Métodos: A amostra foi composta por 93 idosos entre 80 e 91 anos (83,2 ± 2,5 anos), 61 mulheres (83,3 ± 2,7 anos) e 32 homens (83,1 ± 2,2 anos) da cidade de Presidente Prudente. A avaliação da massa óssea foi feita pela absorptiometria de dupla energia de raios X (DXA), na qual foram mensurados os valores de conteúdo mineral ósseo (BMC) e densidade mineral óssea (BMD) do fêmur e da coluna (L1-L4). A capacidade funcional foi avaliada por meio dos testes de velocidade para caminhar, equilíbrio estático e força de membros inferiores contidos no questionário Saúde, Bem-Estar e Envelhecimento (Sabe). As variáveis da massa óssea e capacidade funcional foram categorizadas de acordo com os valores de mediana e a pontuação obtida nos testes, respectivamente. Para tratamento estatístico fez-se o teste qui-quadrado, o software usado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%. Resultados: Os idosos do sexo masculino com maior desempenho nos testes funcionais apresentaram maiores valores de BMC de fêmur comparados com os de menor desempenho, resultado não encontrado quando avaliadas as mulheres. Conclusão: Dessa forma, a massa óssea do fêmur para idosos longevos do sexo masculino está associada à capacidade funcional. A avaliação constante da massa mineral óssea e a prática de atividade física ao longo da vida seriam medidas para prevenção das quedas em idosos.

Objective: Analyzed the association of bone mass with the functional capacity of elderly aged 80 or more. Methods: The sample consisted of 93 elderly aged 80 and 91 years (83.2±2.5 years) being 61 women (83.3±2.7 years) and 32 men (83.1±2.2 years) living in the city of Presidente Prudente - São Paulo/Brazil. The assessment of bone mass was realized by absorptiometry dual-energy X-ray (DXA), where have been measured values bone mineral content (BMC) and bone mineral density (BMD) of the femur and spine (L1 -L4). The functional capacity was evaluated by means of walking speed tests, static equilibrium and strength of lower limbs contained in the questionnaire Wellness Health and Aging (SABE). The variables of bone mass and functional capacity were categorized according to the median values and score tests, respectively. For statistical analysis we carried out the chi-square test, the software used was SPSS (13.0) and the significance level was set at 5%. Results: Elderly male with higher performance in the functional tests showed higher femur BMC compared to lower performance, result not found when evaluated women. Conclusion: Thus, the bone of the femur for the oldest old male is associated with functional capacity. The constant assessment of the bone mineral mass and practive of physical activity throughout life would be measures to prevent falls in the elderly.

As doenças cardiovasculares são um problema crescente de saúde pública que afeta grande parte das pessoas acima de 65 anos, sendo a obesidade abdominal um dos vários fatores para o desenvolvimento dessas doenças. Existem vários métodos para mensurar gordura corporal, mas é necessário analisar a capacidade preditiva desses métodos, principalmente em algumas populações específicas como, por exemplo, os idosos. O objetivo do presente estudo foi analisar a capacidade preditiva de indicadores antropométricos na estimativa do percentual de gordura abdominal de idosos com 80 anos ou mais. Foram avaliados 125 idosos com idade entre 80 e 95 (83,5+ 3 anos), sendo 79 mulheres (82,4 ± 3 anos) e 46 homens (83,6 ± 3 anos). Utilizaram-se os indicadores antropométricos: Índice de Massa Corporal(IMC), Circunferência de Cintura(CC), Razão Cintura Quadril(RCQ) e Razão Cintura Estatura(RCEst), e o percentual de gordura de tronco foi mensurado por meio do DEXA. Foi realizada a análise de sensibilidade(SENS) e especificidade(ESP) mediante a curva ROC, e o IMC apresentou valores de SENS=0,578; ESP=0,934 e AUC= 0,756, a CC SENS= 0,703; ESP= 0,820 e AUC=0,761, a RCQ SENS=0,938; ESP=0,213 e AUC=0,575 e a RCEst SENS=0,984; ESP=0,344 e AUC=0,664. O IMC e a CC foram os indicadores antropométricos que apresentaram maior área sob a curva, e sucessivamente com maior capacidade em detectar aqueles que têm ou não obesidade abdominal.

Cardiovascular diseases are a growing public health problem that affects most people over the age of 65 years and abdominal obesity is one of the risk factors for the development of these diseases. There are several methods that can be used to measure body fat, but their accuracy needs to be evaluated, especially in specific populations such as the elderly. The aim of this study was to assess the accuracy of anthropometric indicators to estimate the percentage of abdominal fat in subjects aged 80 years or older. A total of 125 subjects ranging in age from 80 to 95 years (83.5 ± 3), including 79 women (82.4 ± 3 years) and 46 men (83.6 ± 3 years), were studied. The following anthropometric indicators were used: body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-to-height ratio (WHtR). The percentage of abdominal fat was measured by DEXA. Sensitivity and specificity were analyzed using an ROC curve. The sensitivity, specificity and AUC were 0. 578, 0. 934 and 0. 756 for BMI, respectively; 0.703, 0.820 and 0.761 for WC; 0.938, 0.213 and 0.575 for WHR, and 0.984, 0.344 and 0.664 for WHtR. BMI and WC were the anthropometric indicators with the largest area under the curve and were therefore more adequate to identify the presence or absence of abdominal obesity.