Resumo: Este estudo objetivou verificar os efeitos hipotéticos da substituição do comportamento sedentário por atividade física moderada a vigorosa, sono e diferentes domínios da atividade física por quantidades equivalentes sobre o declínio cognitivo em uma população idosa. Trata-se de um estudo transversal, com 473 idosos de ≥ 60 anos. O declínio cognitivo foi avaliado por meio do Mini Exame do Estado Mental. A atividade física, seus diferentes domínios e o tempo de exposição ao comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física. Para a análise dos dados, foram utilizados dois modelos de substituição isotemporal, por meio da regressão de Poisson. O primeiro modelo testou o efeito do tempo de sono, comportamento sedentário e atividade física moderada a vigorosa no declínio cognitivo. O segundo modelo foi utilizado para determinar o efeito dos domínios de atividade física (lazer, trabalho, transporte e casa), tempo de sono e comportamento sedentário no declínio cognitivo. A atividade física no lazer foi um fator protetivo contra declínio cognitivo em todos os domínios testados, substituindo comportamento sedentário, sono e transporte. Por outro lado, a substituição do domínio lazer por comportamento sedentário, sono e transporte foi considerada fator de risco para o declínio cognitivo. O tempo livre mostrou-se um forte fator protetor na redução do risco de declínio cognitivo, sendo necessário incentivar e estimular políticas públicas.

Resumen: Este estudio tuvo como objetivo verificar los efectos hipotéticos al reemplazar el comportamiento sedentario por actividad física de moderada a vigorosa, sueño y diferentes dominios de actividad física por cantidades equivalentes sobre el deterioro cognitivo en una población anciana. Se trata de un estudio transversal, con 473 ancianos ≥ 60 años. El deterioro cognitivo se evaluó mediante el Mini Examen del Estado Mental. La actividad física, sus diferentes dominios y el tiempo de exposición al comportamiento sedentario se evaluaron mediante el Cuestionario Internacional de Actividad Física. Para el análisis de los datos, se utilizaron dos modelos de reemplazo isotemporal, utilizando la regresión de Poisson. El primer modelo probó el efecto del tiempo de sueño, comportamiento sedentario y actividad física de moderada a vigorosa en el deterioro cognitivo. El segundo modelo se utilizó para determinar el efecto de los dominios de actividad física (ocio, trabajo, transporte y hogar), tiempo de sueño y comportamiento sedentario en el deterioro cognitivo. La actividad física en el tiempo libre fue un factor protector contra el deterioro cognitivo en todos los dominios evaluados, reemplazando el comportamiento sedentario, el sueño y el transporte. Por otra parte, reemplazar el dominio del ocio por comportamiento sedentario, sueño y transporte se consideró un factor de riesgo para el deterioro cognitivo. El tiempo libre demostró ser un fuerte factor protector para reducir el riesgo de deterioro cognitivo, por lo que es necesario fomentar y estimular políticas públicas.

Abstract: This study aimed to test hypothesized effects of replacing sedentary behavior with moderate-to-vigorous physical activity, sleep, and different domains of physical activity by equivalent amounts on suggestive cognitive decline in an older adult population. This was a cross-sectional study including 473 older adults aged ≥ 60 years. Cognitive decline was assessed using the Mini-Mental Health Examination. Physical activity, its different domains and the time of exposure to sedentary behavior were assessed using the International Physical Activity Questionnaire. For data analysis, two isotemporal substitution models were constructed using Poisson regression. The first model tested the effect of sleep time, sedentary behavior, and moderate-to-vigorous physical activity on cognitive decline. The second model was used to determine the effect of physical activity domains (leisure, work, transport, and home), sleep time, and sedentary behavior on cognitive decline. Physical activity during leisure time was protective against cognitive decline among all domains tested, replacing sedentary behavior, sleep, and transport. Conversely, substitution of the leisure domain for sedentary behavior, sleep, and transport was considered a risk factor for cognitive decline. Leisure time proved to be a strong protective factor in reducing the risk of cognitive decline, and it is necessary to encourage and stimulate public policies that include it.

ABSTRACT BACKGROUND: Compared to young individuals, older adults participate more in sedentary behavior (SB) and less in physical activity (PA). These behaviors are associated with numerous adverse health factors. OBJECTIVE: The purpose of the study was to examine the hypothetical effects of substituting time spent sleeping, performing SB, and performing moderate-to-vigorous physical activity (MVPA) on depressive symptomatology in older adults. DESIGN AND SETTING: An analytical cross-sectional study employing exploratory survey methods was conducted in the city of Alcobaça in the state of Bahia, Brazil METHODS: The study included 473 older adults who answered a structured questionnaire during an interview. Exposure time to SB and PA level were assessed using the International Physical Activity Questionnaire, and depressive symptoms were analyzed using the short version of the Geriatric Depression Scale. An isotemporal replacement model was used to evaluate the effects of different SB sessions on depressive symptomatology. RESULTS: An increase in the risk of depressive symptoms was observed when MVPA and sleep time were substituted for the same SB time at all times tested, with maximum values of 40% and 20%, respectively. Opposite substitution of MVPA and sleep time increments reduced the risk of depressive symptomatology by 28% and 17%, respectively. CONCLUSIONS: The results of the present study indicate that replacing SB with the same amount of sleep or MVPA may reduce depressive symptoms. The longer the reallocation time, the greater are the benefits. BACKGROUND individuals (SB PA. . (PA) factors OBJECTIVE sleeping moderatetovigorous moderate vigorous (MVPA SETTING crosssectional cross sectional Bahia METHODS 47 interview Questionnaire Scale RESULTS tested 40 20 20% respectively 28 17 17% CONCLUSIONS benefits (PA 4 2 1

Resumo: Este estudo objetivou verificar os efeitos hipotéticos da substituição do comportamento sedentário por atividade física moderada a vigorosa, sono e diferentes domínios da atividade física por quantidades equivalentes sobre o declínio cognitivo em uma população idosa. Trata-se de um estudo transversal, com 473 idosos de ≥ 60 anos. O declínio cognitivo foi avaliado por meio do Mini Exame do Estado Mental. A atividade física, seus diferentes domínios e o tempo de exposição ao comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física. Para a análise dos dados, foram utilizados dois modelos de substituição isotemporal, por meio da regressão de Poisson. O primeiro modelo testou o efeito do tempo de sono, comportamento sedentário e atividade física moderada a vigorosa no declínio cognitivo. O segundo modelo foi utilizado para determinar o efeito dos domínios de atividade física (lazer, trabalho, transporte e casa), tempo de sono e comportamento sedentário no declínio cognitivo. A atividade física no lazer foi um fator protetivo contra declínio cognitivo em todos os domínios testados, substituindo comportamento sedentário, sono e transporte. Por outro lado, a substituição do domínio lazer por comportamento sedentário, sono e transporte foi considerada fator de risco para o declínio cognitivo. O tempo livre mostrou-se um forte fator protetor na redução do risco de declínio cognitivo, sendo necessário incentivar e estimular políticas públicas. Resumo idosa Tratase Trata se transversal 47 6 anos Mental Física dados isotemporal Poisson lazer, (lazer trabalho casa, casa , casa) testados lado mostrouse mostrou públicas 4

Abstract: This study aimed to test hypothesized effects of replacing sedentary behavior with moderate-to-vigorous physical activity, sleep, and different domains of physical activity by equivalent amounts on suggestive cognitive decline in an older adult population. This was a cross-sectional study including 473 older adults aged ≥ 60 years. Cognitive decline was assessed using the Mini-Mental Health Examination. Physical activity, its different domains and the time of exposure to sedentary behavior were assessed using the International Physical Activity Questionnaire. For data analysis, two isotemporal substitution models were constructed using Poisson regression. The first model tested the effect of sleep time, sedentary behavior, and moderate-to-vigorous physical activity on cognitive decline. The second model was used to determine the effect of physical activity domains (leisure, work, transport, and home), sleep time, and sedentary behavior on cognitive decline. Physical activity during leisure time was protective against cognitive decline among all domains tested, replacing sedentary behavior, sleep, and transport. Conversely, substitution of the leisure domain for sedentary behavior, sleep, and transport was considered a risk factor for cognitive decline. Leisure time proved to be a strong protective factor in reducing the risk of cognitive decline, and it is necessary to encourage and stimulate public policies that include it. Abstract moderatetovigorous moderate vigorous population crosssectional cross sectional 47 6 years MiniMental Mini Mental Examination Questionnaire analysis regression leisure, (leisure work home, home , home) Conversely 4

Resumen: Este estudio tuvo como objetivo verificar los efectos hipotéticos al reemplazar el comportamiento sedentario por actividad física de moderada a vigorosa, sueño y diferentes dominios de actividad física por cantidades equivalentes sobre el deterioro cognitivo en una población anciana. Se trata de un estudio transversal, con 473 ancianos ≥ 60 años. El deterioro cognitivo se evaluó mediante el Mini Examen del Estado Mental. La actividad física, sus diferentes dominios y el tiempo de exposición al comportamiento sedentario se evaluaron mediante el Cuestionario Internacional de Actividad Física. Para el análisis de los datos, se utilizaron dos modelos de reemplazo isotemporal, utilizando la regresión de Poisson. El primer modelo probó el efecto del tiempo de sueño, comportamiento sedentario y actividad física de moderada a vigorosa en el deterioro cognitivo. El segundo modelo se utilizó para determinar el efecto de los dominios de actividad física (ocio, trabajo, transporte y hogar), tiempo de sueño y comportamiento sedentario en el deterioro cognitivo. La actividad física en el tiempo libre fue un factor protector contra el deterioro cognitivo en todos los dominios evaluados, reemplazando el comportamiento sedentario, el sueño y el transporte. Por otra parte, reemplazar el dominio del ocio por comportamiento sedentario, sueño y transporte se consideró un factor de riesgo para el deterioro cognitivo. El tiempo libre demostró ser un fuerte factor protector para reducir el riesgo de deterioro cognitivo, por lo que es necesario fomentar y estimular políticas públicas. Resumen anciana transversal 47 6 años Mental Física datos isotemporal Poisson ocio, (ocio trabajo hogar, hogar , hogar) evaluados parte públicas 4

ABSTRACT BACKGROUND: Frailty syndrome is associated with various physical, cognitive, social, economic, and environmental factors. Although frailty syndrome occurs progressively with age, prevention and treatment are possible. Reducing or eliminating risks and increasing protective factors may be potential strategies for reducing the prevalence of injuries related to frailty. One of the most effective actions is to decrease the time spent in sedentary behavior (SB) by increasing regular physical activity (PA). OBJECTIVE: To examine the hypothetical effect of substitution of the time spent in sleep or SB with an equivalent time spent performing moderate or vigorous PA on frailty syndrome in the older population. DESIGN AND SETTING: An analytical cross-sectional study conducted using exploratory methods of survey, carried out in Alcobaça city, Bahia, Brazil. METHODS: A total of 456 older adults of both sexes, aged ≥ 60 years, participated in this study. Frailty syndrome was identified according to the criteria of the Study of Osteoporotic Fractures. PA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. The effects of time substitution on these behaviors were verified using Poisson regression. RESULTS: The replacement of 60 min/day of SB (prevalence ratio, PR = 0.52; 95% confidence interval, CI: 0.28–0.96) or sleep (PR = 0.52; 95% CI: 0.27–0.98) with 60 min/day of moderate PA (MPA) was associated with a 48% reduction in the prevalence of frailty syndrome. CONCLUSIONS: Replacing the time spent sitting or sleeping with the same amount of MPA time may reduce frailty; the longer the duration of time spent in the substitution of sleep or SB with MPA, the greater the benefits.

Abstract BACKGROUND: Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES: To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING: A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS: Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS: The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION: Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

Abstract BACKGROUND: Obesity is a risk factor for falls in older adults, but the effects of body fat distribution and its interaction with other factors are not well established. OBJECTIVES: To verify the occurrence of falls among older adults with and without abdominal obesity and the effects of sociodemographic, health, and behavioral variables on this outcome. DESIGN AND SETTING: A cross-sectional study in an urban area of Alcobaça, Brazil. METHODS: Men and women older than 60 years with (270) and without (184) abdominal obesity were included. Sociodemographic, health, and behavioral data were collected using validated questionnaires in Brazil. Descriptive and path analyses were performed (P < 0.05). RESULTS: The occurrence of falls was high in participants with abdominal obesity (33.0%). In both groups, a higher number of morbidities (β = 0.25, P < 0.001; β = 0.26, P = 0.002) was directly associated with a higher occurrence of falls. Among participants without abdominal obesity, a lower number of medications (β = -0.16; P = 0.04), a higher number of depressive symptoms (β = 0.15; P = 0.04), worse performance on the agility and dynamic balance tests (β = 0.37; P < 0.001), and lower functional disability for basic activities of daily living (β = -0.21; P = 0.006) were directly associated with the occurrence of falls. CONCLUSION: Adults older than 60 years with abdominal obesity have a higher prevalence of falls. Different factors were associated with the occurrence of falls in both groups.

RESUMEN Objetivo. Investigar la relación entre un cuadro sintomático de depresión y la mortalidad en personas mayores en América Latina. Métodos. Se realizó una revisión sistemática con metanálisis de los estudios indexados en las bases de datos PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus y Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). El estudio se registró en la base de datos PROSPERO (Registro Prospectivo Internacional de Revisiones Sistemáticas) y se estructuró según la referencia metodológica PRISMA (Elementos preferidos de notificación para revisiones sistemáticas y metanálisis). El metanálisis se realizó con modelos de efectos aleatorios, y los datos analizados incluyeron los valores de riesgo relativo (RR) bruto y de heterogeneidad, con estimaciones puntuales e intervalos de confianza de 95% (IC 95%). Resultados. En el metanálisis se incluyeron cinco estudios realizados en Brasil y México con 8 954 personas mayores. El RR de mortalidad en presencia de un cuadro sintomático de depresión fue de 1,44 (IC 95%: 1,16; 1,78). La heterogeneidad fue de 80,87%. Las metarregresiones mostraron que cuanto mayor era la proporción de mujeres en las muestras de los estudios, mayor era el riesgo de mortalidad relacionada con el cuadro sintomático de depresión, y que cuanto mayor era el tiempo de seguimiento del estudio, menor era el riesgo de mortalidad relacionada con dicho cuadro sintomático. Conclusión. La presencia de un cuadro sintomático de depresión guardó una relación positiva con la mortalidad de personas mayores en América Latina, con un RR de muerte 44% mayor en comparación con las personas sin síntomas. Las principales limitaciones del estudio fueron el reducido número de estudios encontrados en la revisión sistemática y la variación entre las escalas utilizadas para determinar la presencia de un cuadro sintomático de depresión.

ABSTRACT Objective. To determine the existence of association between depressive symptoms and mortality in older individuals in Latin America. Method. A systematic review with meta-analysis was performed based on published studies indexed in PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus, and LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde). The review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO), and structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Meta-analysis was performed using random effects models, and the data analyzed included crude relative risk (RR) and heterogeneity, with poin estimates and 95% confidence intervals (95%CI). Results. Five studies, performed in Brazil and Mexico, were included in the meta-analysis, for a total of 8 954 older individuals. RR for mortality in the presence of depressive symptoms was 1.44 (95%CI: 1.16; 1.78). Heterogeneity was 80.87%. Meta-regression showed that the higher the proportion of women in the sample, the higher the mortality risk associated with depressive symptoms; and that the longer the study follow-up, the lower the risk of mortality associated with depressive symptoms. Conclusion. The presence of depressive symptoms was positively associated with mortality in older Latin American individuals. The RR for death was 44.0% higher in individuals with depressive symptoms as compared to those without depressive symptoms. The main study limitations were the lower number of studies retrieved through systematic review and the variety of scales used to determine the presence of depressive symptoms.

RESUMO Objetivo. Averiguar a associação entre sintomatologia depressiva e mortalidade em idosos da América Latina. Métodos. Realizou-se uma revisão sistemática com metanálise de estudos indexados nas bases PubMed, Scientific Electronic Library Online (SciELO), Web of Science, Cochrane Library, Scopus e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). O estudo foi registrado na base PROSPERO (International Prospective Register of Systematic Reviews) e estruturado de acordo com o referencial metodológico PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A metanálise foi realizada usando modelos de efeitos aleatórios, e os dados analisados incluíram as medidas de risco relativo (RR) bruto e heterogeneidade, com estimativas pontuais e intervalos de confiança de 95% (IC95%). Resultados. Cinco estudos, realizados no Brasil e no México, foram incluídos na metanálise, abrangendo 8 954 idosos. O RR para mortalidade na presença de sintomatologia depressiva foi de 1,44 (IC95%: 1,16; 1,78). A heterogeneidade encontrada foi de 80,87%. As metarregressões mostraram que quanto maior a proporção de mulheres nas amostras dos estudos, maior o risco de mortalidade associada à sintomatologia depressiva, e quanto maior o tempo de acompanhamento do estudo, menor o risco de mortalidade associada à sintomatologia depressiva. Conclusão. A presença de sintomatologia depressiva associou-se positivamente à mortalidade em idosos latino-americanos, com RR de óbito 44% maior em relação aos idosos sem sintomatologia depressiva. As principais limitações do estudo foram o pequeno número de trabalhos encontrados na revisão sistemática e a variação entre as escalas utilizadas para determinar a presença de sintomatologia depressiva.

RESUMO Trata-se de um estudo metodológico quantitativo para validação de um instrumento de pesquisa. O objetivo era validar os dados do dispositivo de acelerometria TrackHealth. A amostra foi composta por 30 indivíduos adultos de ambos os sexos selecionados por conveniência que atenderam aos critérios de inclusão e exclusão. Os monitores de atividade física utilizados para o protocolo de pesquisa foram o acelerômetro triaxial ActiGraph® wGT3X-BT e o acelerômetro TrackHealth (TH). O protocolo de atividades consistiu em 4 (quatro) atividades (caminhada a 4,8 e 6,4 km h1 e corrida a 9,7 e 12 km h1) realizadas em laboratório, em esteira Ibramed, com duração de 5 (cinco) minutos em cada etapa. Foi encontrada uma diferença entre os dados brutos de aceleração dos dois dispositivos, no entanto, o dispositivo TrackHealth apresentou maior sensibilidade nas velocidades de 4,8 e 6,4 km / h, e um alto nível de concordância (2,7-2,8%) nas velocidades iniciais da magnitude vetores. Porém, ainda há necessidade de melhorias no funcionamento do aparelho, para que o TrackHealth possa ser comercializado.

ABSTRACT This is a quantitative methodological study for the validation of a research instrument. It aimed to validate the data from the TrackHealth accelerometry device. The sample consisted of 30 adult individuals of both sexes selected by convenience who met the inclusion and exclusion criteria. The physical activity monitors used for the research protocol were the ActiGraph® wGT3X-BT triaxial accelerometer and the TrackHealth accelerometer (TH). The activity protocol consisted of 4 (four) activities (walking at 4.8 and 6.4 km h1 and running at 9.7 and 12 km h1) performed in the laboratory, on an Ibramed treadmill, lasting 5 (five) minutes at each stage. A difference was found between the raw acceleration data of the two devices, however the TrackHealth device showed higher sensitivity at speeds of 4.8 and 6.4 km/h, and a high level of agreement (2.7-2.8%) at the initial speeds of the magnitude vectors. However, there is still a need for improvement in the functioning of the device, so that TrackHealth can be commercialized.

ABSTRACT OBJECTIVE To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults. METHODS Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB. RESULTS Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time. CONCLUSION Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

ABSTRACT OBJECTIVE To examine the effects of physical activity (PA) and sedentary behaviour (SB), in isolation and combination, on all-cause mortality in older adults. METHODS Prospective, population-based cohort study. The data were collected from first wave in 2015 and the follow-up continued until 2020. The sample consisted of 332 older adult people aged ≥ 60 years-old, out of which 59 died. The level of PA and SB was assessed by the International Physical Activity Questionnaire (IPAQ). The older adults were divided into PA categorized as sufficiently active and insufficiently active and into high and low SB. We built four combinations of PA and SB. Also, we used the Cox proportional hazards regression with a 95% confidence interval with hazard ratio estimate so as to verify the mortality risks between PA, SB, and the combinations of PA and SB. RESULTS Insufficiently active individuals had higher risks of mortality compared to sufficiently active people. We observed no associations between SB and mortality separately; however, when evaluated in a combined way, insufficiently active individuals and with a high SB time had a higher chance of mortality compared to active individuals with a low SB time. CONCLUSION Our isolated analyses demonstrate that complying with PA recommendations reduces the risk of mortality; however, no association was found between the time of PA exposure with the time of SB. When analysing the combination, being physically inactive and with a long time of SB showed higher mortality rates, with SB being an enhancer of this risk. The results of this study show the interdependence of SB for PA performed at moderate to vigorous intensity. The understanding of this interrelation must be considered in the formulation of public health guidelines.

RESUMO Objetivo Estimar a prevalência de sintomatologia depressiva em idosos brasileiros residentes na comunidade. Métodos Foi realizada uma revisão sistemática nas bases de dados Medline, SciELO, Web of Science, Scopus e CINAHL, sendo selecionados estudos com idosos brasileiros que identificaram a prevalência de sintomatologia depressiva. De forma independente, dois pesquisadores selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica. A metanálise foi realizada para estimar a prevalência de sintomatologia depressiva usando um modelo de efeito aleatório. Resultados Foram identificados 176 artigos e 33 foram incluídos na revisão, que investigaram 34 prevalências, com um total de 39.431 idosos. A distribuição geográfica dos estudos indicou pesquisas em todas as regiões do Brasil. A versão curta da Escala de Depressão Geriátrica foi a mais utilizada. A prevalência estimada de sintomatologia depressiva foi de 21,0% (IC de 95%: 18,0-25,0; I2 = 98,3%). As análises de subgrupos revelaram elevada heterogeneidade em todas as categorias analisadas. A metarregressão não identificou as causas da heterogeneidade. Conclusão Apesar da heterogeneidade entre os estudos analisados, os resultados indicam a necessidade de estratégias de intervenção para reduzir a prevalência de sintomatologia depressiva.

ABSTRACT Objective To estimate the prevalence of depressive symptoms in Brazilian elderly people living in the community. Methods We searched the electronic databases Medline (PubMed), SciELO, Web of Science, Scopus and CINAHL, and also selected studies with Brazilian elderly people that identified the prevalence of depressive symptoms. Independently, two researchers selected the studies, extracted the data and assessed the methodological quality. The meta-analysis was performed to estimate the prevalence of depressive symptoms using a random effect model. Results We identified 176 articles and 33 were included in the review, which investigated 34 prevalences, with a total of 39,431 elderly people. The geographical distribution of the studies indicated researches in all regions of Brazil. The short version of the Geriatric Depression Scale was the most used. The estimated prevalence of depressive symptoms for Brazilian community-dwelling older adults was 21.0% (95% CI: 18.0-25.0, I2 = 98.3%). Subgroup analyzes revealed high heterogeneity in all categories analyzed. Meta-regression did not identify the causes of heterogeneity. Conclusion Despite the heterogeneity between the studies analyzed, the results indicate the need for intervention strategies to reduce the prevalence of depressive symptoms.

Resumo O estilo de vida moderno está associado a maior exposição ao comportamento sedentário (CS), sobretudo em idosos, entretanto, há uma carência de questionários validados para medida do CS em idosos brasileiros. Objetivou-se adaptar transculturalmente e validar a versão brasileira do questionário “Measure of Older Adults Sedentary Time” (MOST). Adotou-se para adaptação e validação os critérios de validade de conteúdo, clareza e concorrente. Responderam ao MOST adaptado e utilizaram acelerômetro ActiGraph wGT3X-BT por sete dias, 57 idosos (68,7 ± 3,5 anos). Após esse período, o MOST adaptado foi reaplicado e o acelerômetro recolhido. Realizou-se o somatório dos tempos das questões do MOST, download dos dados do acelerômetro em counts/min e reintegração dos dados brutos para counts em epochs de 60 segundos no software ActiLife 6.0. Foi utilizado o ponto de corte <100 counts/min. A relação entre CS através do MOST e acelerômetro foi verificada pela correlação de Pearson, reprodutibilidade pelo coeficiente de correlação intraclasse (CCI), consistência interna pelo alpha de Cronbach (α) e concordância pelo Bland-Altman. Adotou-se p ≤ 0,05 para significância estatística. O índice de validade de conteúdo foi de 100% e clareza 98%. O CCI foi de 0,72 (IC95%: 0,56-0,82) para o tempo total em CS pelo MOST. A correlação entre o CS do MOST e do acelerômetro foi de 0,37 (IC95%:0,13-0,58). Houve tendência de subestimação do CS pelo MOST adaptado comparado ao acelerômetro (viés de medida: 732,8 min/sem [2087,6; -3553,2 min/sem]). O questionário MOST adaptado apresenta parâmetros psicométricos adequados para avaliação do CS em idosos brasileiros.

Abstract Modern lifestyle is associated with prolonged exposure to sedentary behavior (SB), especially in older adults; however, there is a lack of validated questionnaires to measure SB in Brazilian older adults. The aim of this study was to adapt and validate the Brazilian version of the "Measure of Older Adults Sedentary Time" (MOST) questionnaire in Brazilian older adults. Content validity, clarity and concurrent validity of the adapted MOST were examined. Fifty-seven participants (68.7 ± 3.47 years) answered the adapted version of the MOST questionnaire and wore an ActiGraph wGT3X-BT accelerometer for seven days. After this period, participants answered the adapted MOST again and the accelerometer was collected. MOST answers were summed over for calculating self-reported time spent in SB. A cutoff point of < 100 counts/min was applied to accelerometer data for estimating time spent in SB. The relationship between SB estimates from MOST and accelerometer was verified by Pearson correlation, reproducibility was verified by intra-class correlation coefficient (ICC), internal consistency by Cronbach's alpha (α) and concordance by Bland-Altman. Significance was set at P <0.05. Content validity index and clarity index were 100% and 98%, respectively. ICC was 0.72 (95% CI: 0.56-0.82) for total time in SB assessed with the MOST questionnaire. The correlation between SB estimates from MOST and accelerometer data was 0.37 (95% CI: 0.13-0.58). The adapted MOST systematically underestimated SB compared to accelerometer (measurement bias: -732.8 min/week [2087.6; -3553.2 min/wk]). The adapted MOST questionnaire presents adequate validity for assessing SB in the Brazilian older adults.

Resumo A prática de atividades físicas no lazer representa um comportamento que auxilia na obtenção de potenciais beneficios para a saúde. Os objetivos deste estudo foram i) comparar as prevalências de universitários ativos no lazer entre três inquéritos transvesais; ii) analisar os fatores associados à prática de atividade física no lazer, em cada inquérito. Foram realizados três inquéritos nos anos de 2010, 2012 e 2014. O desfecho deste estudo foram os ativos no lazer (≥1 dia por semana). As variáveis exploratórias foram as sociodemográficas e de vínculo com a universidade. As prevalências entre os inquéritos foram comparadas pelo teste qui-quadrado para tendência e a associação foi estimada pelas Razões de Prevalências. A participação foi de 1.084, 1.085 e 1.041 universitários nos anos de 2010, 2012 e 2014, respectivamente. As prevalências de ativos no lazer foram de aproximadamente 50% nos três inquéritos. As mulheres foram menos ativas no lazer nos três inquéritos. Os universitários vinculados aos cursos da Biomedicina, Geografia – bacharelado, Educação Física – licenciatura e Geografia – licenciatura foram associados com maiores razões de prevalências de prática de atividades físicas no lazer. Os universitários com menores razões de prevalências de prática de atividades físicas no lazer foram provenientes dos cursos de Química – licenciatura, Ciência da computação, Pedagogia e Letras (sem habilitação). Conclui-se que houve a estabilização da prevalência de universitários ativos no lazer ao longo do período de análise e que as mulheres apresentaram menores prevalências de prática de atividades físicas no lazer nos três inquéritos.

Abstract The practice of leisure physical activity represents a behavior that must be monitored in different population groups. The objectives of this study were i) to compare the prevalence of leisure-time physical activity in university students along the survey years in three separate years; ii) to analyze the factors associated with practice of leisure-time physical activity in each survey. Three surveys in a college institution in northeastern Brazil in 2010, 2012 and 2014 were carried out. The dependent variable was practice of leisure-time physical activity. Exploratory variables were sociodemographic factors and link with the university. The prevalence was compared using the chi-square test for linear trend and association for Prevalence Ratio. Participation was of 1,084, 1,085 and 1,041 college students in 2010, 2012 and 2014, respectively. The prevalence of leisure-time physical activity was approximately 50% in the three surveys. Women were less active in leisure time on the three surveys. In each survey, associations were different in relation the courses, and Chemistry – teacher training, Computer Science, Pedagogy – teacher training and Linguistics (no specialization) students showed lower levels of leisure-time physical activity and Biomedicine, Geography – Bachelor, Physical Education – teacher training and Geography – teacher training students were more active in leisure time. It was concluded that there was a stabilization of the prevalence of active leisure over time and that women showed lower prevalence of leisure-time physical activity in the three surveys.

O objetivo desse estudo foi analisar a produção de artigos sobre comportamentos sedentários em idosos. Trata-se de uma revisão sistemática a partir da base de dados Pubmed. Os descritores utilizados foram “sedentary behavior” e “sitting time” combinados com elderly, older e aging. Foram incluídos artigos originais completos disponíveis até dezembro de 2013, que apresentassem medida do comportamento sedentário. Considerou-se o tipo de inquérito e delineamento, local da coleta dos dados, instrumentos, definição operacional e ponto de corte para comportamento sedentário. Foram encontrados 559 artigos, e desses 130 foram excluídos por duplicação, resultando em 429, desses 39 atenderam os critérios de inclusão estabelecidos. Os artigos foram publicados entre 2003 a 2013. Acelerômetro e questionário foram os instrumentos mais pronunciados para medida do comportamento sedentário nos artigos analisados. Foram identificadas lacunas na produção científica em relação aos pontos de corte para definir a quantidade de tempo sentado que representa risco à saúde das pessoas idosas, definição operacional universal, bem como falta de padronização dos instrumentos. Sugerem-se mais estudos relacionados com essa temática a fim de reduzir as lacunas existentes.

The aim of this study was to analyze the production of articles on sedentary behaviors in the elderly. This is a systematic review from the Pubmed database. The descriptors used were “sedentary behavior” and “sitting time” combined with elderly, older and aging. We included original articles available until December 2013, to submit measure of sedentary behavior. We considered the type of survey and design, instruments, operational definition and cutoff for sedentary behavior. The initial electronic searches resulted in 559 manuscripts, and of these 130 were excluded for duplication, resulting in 429 manuscripts. The process of analysis of the studies involved reading titles, abstracts and full texts. After all these phases, 39 manuscripts met the inclusion criteria of the review. The articles were published between 2003 and 2013. Accelerometer and questionnaire were instruments more pronounced for the measurement of sedentary behavior in the analyzed articles. We identified gaps in scientific production in relation to the cutoff points to define the amount of time sitting that poses a risk to the health of the elderly, operational definition universal, as well as lack of standardization of instruments. We suggest further studies related to this theme in order to reduce the gaps.

Resumo Em meados do século passado, transformações na economia e sociedade brasileira somaram-se para desencadear uma rápida transição demográfica, que se caracterizou pelo aumento de idosos. Assim, presenciou-se um envelhecimento populacional, que foi acompanhado pelo aumento da incidência de doenças crônicas não transmissíveis. Alguns fatores de risco estão bem estabelecidos para o desenvolvimento das doenças crônicas não transmissíveis, como excesso de peso, consumo de tabaco e álcool, alimentação inadequada e inatividade física. Adicionalmente, o comportamento sedentário mostrou-se relacionado a importantes efeitos deletérios à saúde, como, por exemplo, diabetes mellitus tipo 2, obesidade e mortalidade.O estudo teve como objetivo investigar a associação entre tempo sentado e diabetes mellitus em idosos. Estudo transversal, realizado em 24 municípios integrantes da Superintendência Regional de Saúde de Uberaba, MG. Os indivíduos selecionados responderam um questionário estruturado e foram submetidos à avaliação antropométrica. Foram analisados 3.265 idosos. A prevalência de diabetes mellitus foi de 20,0% e a mediana de tempo sentado de 240,00 (P25º=137,14 e P75º=330,00) minutos/dia. A análise de regressão logística ajustada demonstrou que o tempo sentado superior a 330,00 minutos/dia associou-se positivamente com a diabetes mellitus (OR=1,329; IC95%: 1,040-1,700). Pode-se concluir que os idosos que ficam sentados por longos períodos diariamente apresentam maior chance de ter diabetes mellitus quando comparados com aqueles que ficam sentados por menor tempo.

Abstract By the middle of the last century, changes in the Brazilian economy and society triggered a rapid demographic transition characterized by an increased number of older adults in the population. Thus, Brazil has witnessed population aging, which was accompanied by an increased incidence of non-communicable chronic diseases. Some risk factors for the development of the chronic non-communicable diseases have been well established, such as overweight, tobacco and alcohol consumption, inadequate nutrition, and physical inactivity. Additionally, sedentary behavior has been related to significant deleterious effects on health, such as diabetes mellitus type 2, obesity and mortality. The objective of this study was to investigate the association between sitting time and diabetes mellitus in older adults. A cross-sectional study was conducted in 24 municipalities in the Regional Health Superintendence of Uberaba, MG. Selected subjects answered a structured questionnaire and underwent anthropometric assessment. A total of 3,265 elderly subjects, with a median time spent sitting of 240.00 (P25th=137.14 and P75th=330.00) minutes/day and a 20.0% prevalence of diabetes mellitus were detected. Adjusted logistic regression analysis showed that a sitting time of more than 330.00 minutes/day was positively associated with diabetes mellitus (OR=1.351, 95%CI: 1.057-1.729). It was concluded that older adults who daily sit for long periods of time have higher chances of having diabetes compared to those who sit for less time.