ABSTRACT BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85–0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01–2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40–0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults.

ABSTRACT Objective: To analyze the association of anthropometric indicators of adiposity in older people, according to sex, with hypertension; to compare the scores of these variables between participants with and without hypertension; and to identify among them those with better predictive ability for screening the outcome. Methods: Epidemiological, population-based, cross-sectional study conducted with 210 older people. The anthropometric indicators analyzed were: body mass index, waist circumference, abdominal circumference, body adiposity index, triceps skinfold, waist-to-hip ratio, waist-to-height ratio, and conicity index. Hypertension diagnosis was self-reported. Results: The indicators of adiposity increased the probability of hypertension. Additionally, hypertensive older people of both sexes showed higher scores on adiposity indicators than non-hypertensive subjects (p < 0.05). For men, the most sensitive indicator for the outcome was conicity index (81.82%; cut-off point: 1.30) and the most specific was body mass index (69.77%; cut-off point: 25.05 kg/m2). For women, the most sensitive indicator for the outcome was the body adiposity index (86.08%; cut-off point: 31.03%), and the most specific was the abdominal circumference (82.82%; cut-off point: 98.70 cm). Conclusion: In both sexes, the indicators of adiposity were positively associated with hypertension; hypertensive participants showed higher values in the scores of the indicators. Additionally, the body adiposity index (women) and conicity index (men) demonstrated greater ability to screen for hypertension, while the abdominal circumference and body mass index demonstrated greater ability to screen for non-hypertensive women and men, respectively.

RESUMO Objetivo: Analisar a associação de indicadores antropométricos de adiposidade com a hipertensão, em pessoas idosas, de acordo com o sexo; comparar os escores dessas variáveis entre os participantes com e sem hipertensão; e identificar os indicadores com melhor capacidade preditiva à triagem do desfecho. Métodos: Estudo epidemiológico, populacional, transversal, realizado com 210 pessoas idosas. Os indicadores antropométricos analisados foram: índice de massa corporal, circunferência da cintura, circunferência abdominal, índice de adiposidade corporal, dobra cutânea tricipital, relação cintura/quadril, relação cintura/altura e índice de conicidade. O diagnóstico de hipertensão arterial foi autorreferido. Resultados: Observou-se que os indicadores de adiposidade aumentaram a probabilidade à hipertensão. Além disso, as pessoas idosas hipertensas, de ambos os sexos, apresentaram maiores escores nos indicadores de adiposidade quando comparadas às não hipertensas (p < 0,05). Para os homens, o indicador mais sensível ao desfecho foi o índice de conicidade (81,82%; ponto de corte: 1,30) e o mais específico foi o índice de massa corporal (69,77%; ponto de corte: 25,05 kg/m2). Nas mulheres, o indicador mais sensível ao desfecho foi o índice de adiposidade corporal (86,08%; ponto de corte: 31,03%) e o mais específico foi a circunferência abdominal (82,82%; ponto de corte: 98,70 cm). Conclusão: Em ambos os sexos, os indicadores de adiposidade mostraram-se positivamente associados à hipertensão; os participantes hipertensos apresentaram valores mais elevados nos escores dos indicadores. Ademais, identificou-se para os sexos, feminino e masculino, que os indicadores com melhor capacidade de rastrear a hipertensão, foram, respectivamente, o índice de adiposidade corporal e índice de conicidade. Enquanto a circunferência abdominal e o índice de massa corporal mostraram maior capacidade de rastrear, respectivamente, as mulheres e os homens não hipertensos.

RESUMO Este estudo identificou os fatores associados à dinapenia em idosos residentes em um município de pequeno porte do Nordeste brasileiro. Trata-se de um estudo populacional, conduzido com 208 idosos (58,7% mulheres) de Aiquara-BA. As informações sociodemográficas, comportamentais e de condições de saúde foram obtidas em entrevistas face a face, e o estado nutricional foi avaliado pelo índice de massa corporal. Para mensuração do nível de atividade física e do comportamento sedentário, utilizou-se o International Physical Activity Questionnaire. O diagnóstico da dinapenia foi realizado por sexo, a partir do percentil 25 da força de preensão manual, averiguada com um dinamômetro hidráulico. Para análises inferenciais foi utilizada a regressão de Poisson, com estimador robusto, cálculo das Razões de Prevalência (RP) e de seus respectivos intervalos de confiança de 95% (IC). A prevalência de dinapenia foi maior nos idosos com idade entre 70-79 (RP: 3,21; IC95%: 1,55-6,64) e ≥80 anos (RP: 4,91; IC95%: 2,32-10,39), nos com baixo peso (RP: 2,20; IC95%: 1,26-3,82), nos insuficientemente ativos (RP: 1,99; IC95%: 1,12-3,54) e entre os com elevado comportamento sedentário (RP: 1,88; IC95%: 1,19-2,98). Identificou-se que os fatores associados à dinapenia foram: idade entre 70-79 e ≥80 anos, nível de atividade física insuficiente; elevado comportamento sedentário e baixo peso.

ABSTRACT This study identified factors associated with dynapenia in older adults residing in a small town in northeastern Brazil. It is a population-based study conducted with 208 senior citizens (58.7% women) from Aiquara, BA. Sociodemographic, behavioral and health information were obtained from face-to-face interviews, and nutritional status was assessed by body mass index. To measure their level of physical activity and sedentary behavior, the International Physical Activity Questionnaire was used. Dynapenia was diagnosed by sex, from the 25th percentile of handgrip strength, by means of a hydraulic dynamometer. For inferential analyses, Poisson regression was used, with a robust estimator, calculation of Prevalence Ratios (PRs) and their respective 95% Confidence Intervals (CIs). The prevalence of dynapenia was higher in older adults aged 70-79 (PR: 3.21; 95%CI: 1.55-6.64) and ≥80 years (PR: 4.91; 95%CI: 2.32-10.39), in those with low weight (PR: 2.20; 95%CI: 1.26-3.82), in those who are insufficiently active (PR: 1.99; 95%CI: 1.12-3.54), and among those with high level of sedentary behavior (PR: 1.88; 95%CI: 1.19-2.98). The factors identified as being associated with dynapenia were: age between 70 and 79 and ≥80 years, insufficient level of physical activity; high level of sedentary behavior, and low weight.

ABSTRACT BACKGROUND: Dynapenia is characterized by mobility limitations in the older population when combined with aggravating behavioral factors that can increase the risk of morbidity and mortality. OBJECTIVE: To investigate the hypothetical effects of reallocation of time spent on sedentary behavior (SB), moderate-to-vigorous physical activity (MVPA), and sleep on dynapenia in older adults. DESIGN AND SETTING: A prospective cohort study using exploratory surveys in Alcobaça City, Bahia State, Brazil. METHODS: In total, 176 older adults (≥ 60 years) of both sexes participated in this study. Dynapenia was assessed using the handgrip strength test with cutoff points of < 27 kg for men and < 16 kg for women. MVPA and SB were assessed using the International Physical Activity Questionnaire, and sleep was assessed using the Pittsburgh Sleep Quality Index. RESULTS: Effects on reallocation were found for the shortest times, such as 10 minutes (odds ratio (OR) 0.92; 95% confidence interval (CI): 0.85–0.99); substituting MVPA with SB increased the chances of dynapenia by 58.0% (95% CI: 1.01–2.49). Analyzing the substitution of 60 minutes/day of SB with 60 minutes/day of MVPA revealed a protective effect, with a lower OR for dynapenia of 37.0% (OR 0.63; 95% CI: 0.40–0.99). The reallocation of sleep time did not significantly reduce dynapenia. CONCLUSIONS: Substituting the time spent sitting with the same amount of time spent on MVPA can reduce dynapenia, and a longer reallocation time confers greater health benefits in older adults.

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.