ABSTRACT. Frailty is defined as a recognizable state of increased vulnerability resulting from age-associated decline of function in various physiological systems, such that the ability to deal with acute or everyday stressors is compromised. Objective: The aim of the study was to characterize the sample of older adults with cognitive impairment, according to the frailty status indirectly assessed by family members, other clinical and sociodemographic variables; and to assess the overlap of clinical conditions evaluated in this sample with cognitive impairment. Methods: Data were extracted from the follow-up database of the Frailty in Brazilian Older Adults (FIBRA) study (2016-2017). The sample consisted of 130 elderly people with cognitive impairment assessed by the Mini Mental State Examination (MMSE). The scores for the Clinical Dementia Scale (CDR), Cornell Scale for Depression in Dementia and Functional Activities Questionnaire were described. Frailty was indirectly measured through questions answered by family members about the five criteria that compose the frailty phenotype. Results: The sample consisted mostly of older women (n=91) with a mean age of 82.4 (SD=5.3) years, mean schooling of 3.3 years (SD=3.07), widowed (47.7%) and who lived with children and/or grandchildren (68%). More than half had multimorbidity (74.90%), 39.5% had depression symptoms suggestive of major depression, 57% had impaired functionality, 49.3% were frail, 37.6% pre-frail, and 13.10% robust. Conclusion: Among older adults with cognitive impairment, frailty and functional limitations are common. ABSTRACT ageassociated associated systems compromised Objective variables Methods followup follow up FIBRA (FIBRA 20162017. 20162017 2016 2017 . (2016-2017) 13 MMSE. MMSE (MMSE) CDR, CDR , (CDR) described phenotype Results n=91 n91 n 91 (n=91 824 82 4 82. SD=5.3 SD53 SD 5 3 (SD=5.3 33 3. SD=3.07, SD307 SD=3.07 07 (SD=3.07) 47.7% 477 47 7 (47.7% andor 68%. 68 68% (68%) 74.90%, 7490 74.90% 74 90 (74.90%) 395 39 39.5 57 functionality 493 49 49.3 frail 376 37 6 37.6 prefrail, prefrail pre pre-frail 1310 10 13.10 robust Conclusion common 2016201 201 (2016-2017 1 (MMSE (CDR n=9 n9 9 (n=9 8 SD=5. SD5 (SD=5. SD30 SD=3.0 0 (SD=3.07 47.7 (47.7 (68% 749 74.90 (74.90% 39. 49. 37. 131 13.1 201620 20 (2016-201 n= (n= SD=5 (SD=5 SD3 SD=3. (SD=3.0 47. (47. (68 74.9 (74.90 13. 20162 2 (2016-20 (n SD= (SD= SD=3 (SD=3. (47 (6 74. (74.9 (2016-2 (SD (SD=3 (4 ( (74. (2016- (74 (2016 (7 (201 (20 (2

RESUMO. A fragilidade é definida como um estado reconhecível de vulnerabilidade aumentada resultante do declínio da função associado à idade em vários sistemas fisiológicos, de modo que a capacidade de lidar com estressores agudos ou cotidianos fica comprometida. Objetivo: Caracterizar uma amostra de pessoas idosas com comprometimento cognitivo, segundo o estado de fragilidade, avaliado de forma indireta por familiares, assim como outras variáveis clínicas e sociodemográficas; e avaliar a sobreposição das condições clínicas avaliadas nesta amostra com o comprometimento cognitivo. Métodos: Os dados foram extraídos do banco de dados de acompanhamento do estudo Fragilidade em Idosos Brasileiros (FIBRA - 2016-2017). A amostra foi composta por 130 idosos com comprometimento cognitivo avaliado pelo Mini-Exame do Estado Mental (MEEM). Foram descritos os escores da Escala Clínica de Demência (CDR), da Escala Cornell de Depressão em Demência e do Questionário de Atividades Funcionais. A fragilidade foi mensurada indiretamente por meio de questões respondidas junto aos familiares sobre os cinco critérios que compõem o fenótipo de fragilidade. Resultados: A amostra foi composta em sua maioria por mulheres idosas (n=91) com idade média de 82,4 (DP=5,3) anos, escolaridade média de 3,3 anos (DP=3,07), viúvas (47,7%) e que viviam com filhos e/ou netos (68%). Mais da metade apresentava multimorbidade (74,90%), 39,5% apresentavam sintomas depressivos sugestivos de depressão maior, 57% tinham funcionalidade prejudicada, 49,3% eram frágeis, 37,6% pré-frágeis e 13,10% robustos. Conclusão: Entre idosos com alterações cognitivas, é comum a co-ocorrência de fragilidade e de limitações funcionais. RESUMO fisiológicos comprometida Objetivo sociodemográficas Métodos FIBRA 20162017. 20162017 2016 2017 . 2016-2017) 13 MiniExame Mini Exame MEEM. MEEM (MEEM) CDR, CDR , (CDR) Funcionais Resultados n=91 n91 n 91 (n=91 824 82 4 82, DP=5,3 DP53 DP 5 3 (DP=5,3 33 3, DP=3,07, DP307 DP=3,07 07 (DP=3,07) 47,7% 477 47 7 (47,7% eou 68%. 68 68% (68%) 74,90%, 7490 74,90% 74 90 (74,90%) 395 39 39,5 maior 57 prejudicada 493 49 49,3 frágeis 376 37 6 37,6 préfrágeis pré 1310 10 13,10 robustos Conclusão cognitivas coocorrência co ocorrência funcionais 2016201 201 2016-2017 1 (MEEM (CDR n=9 n9 9 (n=9 8 DP=5, DP5 (DP=5, DP30 DP=3,0 0 (DP=3,07 47,7 (47,7 (68% 749 74,90 (74,90% 39, 49, 37, 131 13,1 201620 20 2016-201 n= (n= DP=5 (DP=5 DP3 DP=3, (DP=3,0 47, (47, (68 74,9 (74,90 13, 20162 2 2016-20 (n DP= (DP= DP=3 (DP=3, (47 (6 74, (74,9 2016-2 (DP (DP=3 (4 ( (74, 2016- (74 (7

Abstract Background With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects. Objective To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults. Methods This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) – Animal, Clock Drawing Test (CDT), Episodic Memory (name and address). Results There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant. Conclusion Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults. aging processes aspects neuroticism life communitydwelling community dwelling adults crosssectional cross sectional FIBRA (FIBRA study 201 2017 41 ≥ ( 7 old sociodemographic NEOPIR, NEOPIR NEO PI R, R NEO-PI-R GDS, GDS , (GDS) (PiL scale MiniMental Mini Mental MMSE, MMSE (MMSE) subitems sub items MiniAddenbrookes Addenbrooke s MACE, MACE M ACE (M-ACE) namely VF (VF Animal CDT, CDT (CDT) name address. address . address) 70%, 70 70% (70%) median 8 7782, 7782 77 82 77-82) 25. 25 2 5 2-5) correlations ρ 0.415 0415 0 415 0.001 0001 001 0.220 0220 220 0.175 0175 175 -0.175 0.185 0185 185 -0.185 regression OR 2.04 204 04 0.007 0007 007 1.32 132 1 32 significant 20 (GDS (MMSE (M-ACE (CDT (70% 778 77-82 2-5 0.41 041 0.00 000 00 0.22 022 22 0.17 017 17 -0.17 0.18 018 18 -0.18 2.0 1.3 13 3 (70 77-8 2- 0.4 0.0 0.2 02 0.1 01 -0.1 2. 1. (7 77- 0. -0. -0 -

Resumo Antecedentes Com o envelhecimento, algumas habilidades cognitivas mudam devido a processos neurobiológicos. A cognição também pode ser influenciada por aspectos psicossociais. Objetivo Descrever as relações entre uma medida de neuroticismo, sintomas depressivos, propósito de vida e o desempenho cognitivo em pessoas idosas residentes na comunidade. Métodos Trata-se de uma análise transversal com base nos dados da segunda onda do estudo de Fragilidade em Idosos Brasileiros (FIBRA), realizado entre 2016 e 2017. A amostra foi composta por 419 pessoas idosas (≥ 72 anos) cognitivamente saudáveis e em maior parte com baixa escolaridade. As variáveis de interesse foram as sociodemográficas, domínio Neuroticismo do NEO-PI-R, Escala de Depressão Geriátrica (EDG) e Escala de Propósito de Vida (PV) e um escore cognitivo composto que incluiu o Miniexame de Estado Mental (MEEM) e as pontuações dos subitens do Miniexame Cognitivo de Addenbrooke (M-ACE), a saber, Fluência Verbal (FV) Animal, Teste do Desenho do Relógio (TDR) e Memória Episódica (nome e endereço). Resultados Houve um maior número de mulheres (70%), com idade elevada (mediana = 80 anos, IIQ = 77-82) e baixa escolaridade (mediana = 4 anos, IIQ = 2-5). Nas correlações bivariadas, anos de escolaridade (ρ = 0,415; p < 0,001) e PV (ρ = 0,220; p < 0,001) foram positivamente associadas à cognição. Neuroticismo (ρ = -0,175; p < 0,001) e sintomas depressivos (ρ = -0,185; p < 0,001) foram negativamente associados à cognição. Na regressão logística, após a inclusão de variáveis de confusão, as associações entre cognição e PV (OR = 2,04; p = 0,007) e escolaridade (OR = 1,32; p < 0,001) permaneceram significativas. Conclusão Baixo PV e baixa escolaridade foram associados à pior cognição em idosos. Tais resultados podem ser relevantes em programas que visam a melhorar a cognição entre pessoas idosas. envelhecimento neurobiológicos psicossociais neuroticismo comunidade Tratase Trata se FIBRA, FIBRA , (FIBRA) 201 2017 41 ≥ ( 7 sociodemográficas NEOPIR, NEOPIR NEO PI R, R NEO-PI-R EDG (EDG (PV MEEM (MEEM MACE, MACE M ACE (M-ACE) saber FV (FV Animal TDR (TDR nome endereço. endereço . endereço) 70%, 70 70% (70%) mediana 8 7782 77 82 77-82 25. 25 2 5 2-5) bivariadas ρ 0,415 0415 0 415 0,001 0001 001 0,220 0220 220 0,175 0175 175 -0,175 0,185 0185 185 -0,185 logística confusão OR 2,04 204 04 0,007 0007 007 1,32 132 1 32 significativas idosos (FIBRA 20 (M-ACE (70% 778 77-8 2-5 0,41 041 0,00 000 00 0,22 022 22 0,17 017 17 -0,17 0,18 018 18 -0,18 2,0 1,3 13 3 (70 77- 2- 0,4 0,0 0,2 02 0,1 01 -0,1 2, 1, (7 0, -0, -0 -

ABSTRACT Objective To determine whether low muscle strength and low gait speed increase the risk of disability related to basic activities of daily living in community-dwelling older adults. Methods A longitudinal study (9 years of follow-up) was conducted with 390 older adults who were independent in basic activities of daily living at baseline and answered the Katz Index at follow-up. Associations were determined using Pearson’s χ2 test with a 5% significance level and logistic regression analysis. Results Increases in prevalence between baseline and follow-up were observed for low muscle strength (17.5%-38.2%), slow gait speed (26.0%-81.1%), and functional dependence (10.8%-26.6%). At follow-up, 11.7% of the participants had concomitant functional dependence, slow gait speed, and low muscle strength. Slow gait speed remained a predictor of dependence in basic activities of daily living (odds ratio=1.90; 95% confidence interval=1.06-3.41). Conclusion Slow gait speed is a predictor of functional dependence, constituting an important variable for screening functional decline. communitydwelling community dwelling 9 ( followup follow up 39 followup. up. Pearsons Pearson s χ 5 analysis 17.5%38.2%, 175382 17.5% 38.2% , 17 38 2 (17.5%-38.2%) 26.0%81.1%, 260811 26.0% 81.1% 26 0 81 1 (26.0%-81.1%) 10.8%26.6%. 108266 10.8% 26.6% . 10 8 6 (10.8%-26.6%) followup, up, 117 11 7 11.7 odds ratio=1.90 ratio190 ratio 90 95 interval=1.063.41. interval106341 interval interval=1.06 3.41 06 3 41 interval=1.06-3.41) decline 17.5%38.2% 17538 175 17.5 382 38.2 (17.5%-38.2% 26.0%81.1% 26081 260 26.0 811 81.1 (26.0%-81.1% 10.8%26.6% 10826 108 10.8 266 26.6 (10.8%-26.6% 11. ratio=1.9 ratio19 063 interval=1.063.41 interval10634 interval106 interval=1.0 341 3.4 4 interval=1.06-3.41 17.5%38.2 1753 17. 38. (17.5%-38.2 26.0%81.1 2608 26. 81. (26.0%-81.1 10.8%26.6 1082 10. (10.8%-26.6 ratio=1. ratio1 interval=1.063.4 interval1063 interval10 interval=1. 34 3. interval=1.06-3.4 17.5%38. (17.5%-38. 26.0%81. (26.0%-81. 10.8%26. (10.8%-26. ratio=1 interval=1.063. interval1 interval=1 interval=1.06-3. 17.5%38 (17.5%-38 26.0%81 (26.0%-81 10.8%26 (10.8%-26 ratio= interval=1.063 interval= interval=1.06-3 17.5%3 (17.5%-3 26.0%8 (26.0%-8 10.8%2 (10.8%-2 interval=1.06- (17.5%- (26.0%- (10.8%- (17.5% (26.0% (10.8% (17.5 (26.0 (10.8 (17. (26. (10. (17 (26 (10 (1 (2

ABSTRACT Purpose: to investigate the association between swallowing symptoms and dynapenia in Brazilian older adults, of an 8-year follow-up cohort study. Methods: a retrospective cohort analysis using data from the FIBRA (Brazilian Elderly Frailty) study, at a baseline survey in 2008-2009 and follow-up in 2016-2017. Swallowing complaints were assessed by nine dichotomous questions and dynapenia was assessed using handgrip strength. Principal component analysis was used to determine the swallowing complaints, and logistic regression models were used to associate swallowing complaints at the baseline with dynapenia at the follow-up. Statistical models were adjusted for demographic characteristics, body mass index (BMI), chronic diseases, cognition, and physical performance. Descriptive and comparative statistics were used, considering p < 0.05. Results: 404 older adults were included, predominantly women (68.3%). Principal Component Analysis determined the swallowing symptoms change in taste, difficulty or pain in chewing hard food, difficulty or pain to swallow, and feeling of still or stuck food. According to the logistic regression model, older adults who reported swallowing symptoms at baseline, exhibited risk of developing dynapenia at the follow-up (odds ratio=1.384, 95% CI: 1.119 to 1.713, p=0.003). The difficulty or pain to swallow associated with age, sex, years of education, and number of chronic diseases consisted of self-report, cognitive functioning, and physical performance increased the risk of dynapenia in four times for (OR=5.744; 95% CI: 2.187 to 15.088; p<0.001). Conclusions: the study revealed that the swallowing symptoms at baseline exhibited risk of developing dynapenia at follow-up in older adults. This research reinforces the importance of longitudinal studies incorporating variables such as swallowing symptoms, sociodemographic aspects, BMI, cognitive decline, and physical performance and muscular strength to better understand the significance of swallowing symptoms in the aging process. Purpose 8year year 8 followup follow up Methods Frailty 20082009 2008 2009 2008-200 20162017. 20162017 2016 2017. 2017 2016-2017 followup. up. characteristics BMI , (BMI) cognition 005 0 05 0.05 Results 40 included 68.3%. 683 68.3% . 68 3 (68.3%) taste food model odds ratio1384 ratio 1 384 ratio=1.384 95 CI 1119 119 1.11 1713 713 1.713 p=0.003. p0003 p=0.003 003 p=0.003) age sex education selfreport, selfreport self report, report self-report functioning OR=5.744 OR5744 OR 5 744 (OR=5.744 2187 2 187 2.18 15.088 15088 15 088 p<0.001. p0001 p<0.001 001 p<0.001) Conclusions aspects decline process 2008200 200 2008-20 2016201 201 2016-201 (BMI 00 0.0 4 68.3 6 (68.3% ratio138 38 ratio=1.38 9 111 11 1.1 171 71 1.71 p000 p=0.00 OR=5.74 OR574 74 (OR=5.74 218 18 2.1 15.08 1508 08 p<0.00 200820 20 2008-2 201620 2016-20 0. 68. (68.3 ratio13 ratio=1.3 1. 17 7 1.7 p00 p=0.0 OR=5.7 OR57 (OR=5.7 21 2. 15.0 150 p<0.0 20082 2008- 20162 2016-2 (68. ratio1 ratio=1. p0 p=0. OR=5. OR5 (OR=5. 15. p<0. 2016- (68 ratio=1 p=0 OR=5 (OR=5 p<0 (6 ratio= p= OR= (OR= p< ( (OR

Resumo O objetivo foi avaliar a influência da multimorbidade e seus padrões nas atividades básicas de vida diária da pessoa idosa residente na comunidade. Trata-se de estudo de coorte com dados provenientes do Estudo FIBRA, linha de base (2008-2009) e seguimento (2016-2017). As atividades básicas de vida diária (ABVD) foram avaliadas pelo questionário de Katz e as doenças crônicas foram classificadas como (1) multimorbidade e padrões de multimorbidade: (2) cardiopulmonar; (3) vascular-metabólico; e (4) mental-musculoesquelético. Para a análise de dados, utilizou-se o teste qui-quadrado e a regressão de Poisson. Foram analisados 861 indivíduos sem limitação para ABVD na linha de base. As pessoas idosas com multimorbidade (RR = 1,58; IC95%: 1,19-2,10) e classificados nos padrões cardiopulmonar (RR = 2,43; IC95%: 1,77-3,33), vascular-metabólico (RR = 1,50; IC95%: 1,19-1,89) e mental-musculoesquelético (RR = 1,30; IC95%: 1,03-1,65) tiveram maior risco de apresentar declínio funcional nas ABVD no seguimento em comparação aos que não tinham os mesmos padrões de doenças. A multimorbidade e seus padrões aumentaram o risco de incapacidade na pessoa idosa ao longo de nove anos.

Abstract The scope of this article was to evaluate the influence of multimorbidity and associated effects on the activities in the day-to-day lives of community-dwelling elderly individuals. It involved a cohort study with data from the FIBRA Study, the baseline (2008-2009) and follow-up (2016-2017). The basic activities in daily living (ADL) were evaluated using Katz’s index, and the chronic diseases were classified as: (1) multimorbidity and multimorbidity patterns; (2) cardiopulmonary; (3) vascular-metabolic; and (4) mental-musculoskeletal. The chi-square test and Poisson regression data were used for analysis. A total of 861 older adults with no functional dependency at baseline were analyzed. Elderly individuals with multimorbidity (RR = 1.58; 95%CI: 1.19-2.10) and classified according to cardiopulmonary (RR = 2.43; 95%CI: 1.77-3.33), vascular-metabolic (RR = 1.50; 95%CI: 1.19-1.89) and mental-musculoskeletal (RR = 1.30; 95%CI: 1.03-1.65) had a higher risk of presenting functional decline in ADL in the follow-up compared to those who didn’t have the same disease patterns. Multimorbidity and its patterns increased the risk of functional disability in older adults over the nine-year period.

Abstract The scope of this article was to evaluate the influence of multimorbidity and associated effects on the activities in the day-to-day lives of community-dwelling elderly individuals. It involved a cohort study with data from the FIBRA Study, the baseline (2008-2009) and follow-up (2016-2017). The basic activities in daily living (ADL) were evaluated using Katz’s index, and the chronic diseases were classified as: (1) multimorbidity and multimorbidity patterns; (2) cardiopulmonary; (3) vascular-metabolic; and (4) mental-musculoskeletal. The chi-square test and Poisson regression data were used for analysis. A total of 861 older adults with no functional dependency at baseline were analyzed. Elderly individuals with multimorbidity (RR = 1.58; 95%CI: 1.19-2.10) and classified according to cardiopulmonary (RR = 2.43; 95%CI: 1.77-3.33), vascular-metabolic (RR = 1.50; 95%CI: 1.19-1.89) and mental-musculoskeletal (RR = 1.30; 95%CI: 1.03-1.65) had a higher risk of presenting functional decline in ADL in the follow-up compared to those who didn’t have the same disease patterns. Multimorbidity and its patterns increased the risk of functional disability in older adults over the nine-year period. daytoday day communitydwelling community dwelling Study 20082009 2008 2009 (2008-2009 followup follow up 20162017. 20162017 2016 2017 . (2016-2017) (ADL Katzs Katz s index as 1 (1 2 (2 3 (3 vascularmetabolic vascular metabolic 4 (4 mentalmusculoskeletal. mentalmusculoskeletal mental musculoskeletal. musculoskeletal chisquare chi square analysis 86 analyzed RR 1.58 158 58 95%CI 95CI CI 95 1.192.10 119210 1.19 2.10 19 10 1.19-2.10 2.43 243 43 1.773.33, 177333 1.77 3.33 , 77 33 1.77-3.33) 1.50 150 50 1.191.89 119189 1.89 89 1.19-1.89 1.30 130 30 1.031.65 103165 1.03 1.65 03 65 1.03-1.65 didnt didn t nineyear nine year period 2008200 200 (2008-200 2016201 201 (2016-2017 ( 8 1.5 15 5 9 192 1.192.1 11921 119 1.1 210 2.1 1.19-2.1 2.4 24 773 1.773.33 17733 177 1.7 333 3.3 7 1.77-3.33 191 1.191.8 11918 189 1.8 1.19-1.8 1.3 13 031 1.031.6 10316 103 1.0 165 1.6 0 6 1.03-1.6 200820 20 (2008-20 201620 (2016-201 1. 1.192. 1192 11 21 2. 1.19-2. 1.773.3 1773 17 3. 1.77-3.3 1.191. 1191 18 1.19-1. 1.031. 1031 16 1.03-1. 20082 (2008-2 20162 (2016-20 1.192 1.19-2 1.773. 1.77-3. 1.191 1.19-1 1.031 1.03-1 (2008- (2016-2 1.19- 1.773 1.77-3 1.03- (2008 (2016- 1.77- (200 (2016 (20 (201

Resumo O objetivo foi avaliar a influência da multimorbidade e seus padrões nas atividades básicas de vida diária da pessoa idosa residente na comunidade. Trata-se de estudo de coorte com dados provenientes do Estudo FIBRA, linha de base (2008-2009) e seguimento (2016-2017). As atividades básicas de vida diária (ABVD) foram avaliadas pelo questionário de Katz e as doenças crônicas foram classificadas como (1) multimorbidade e padrões de multimorbidade: (2) cardiopulmonar; (3) vascular-metabólico; e (4) mental-musculoesquelético. Para a análise de dados, utilizou-se o teste qui-quadrado e a regressão de Poisson. Foram analisados 861 indivíduos sem limitação para ABVD na linha de base. As pessoas idosas com multimorbidade (RR = 1,58; IC95%: 1,19-2,10) e classificados nos padrões cardiopulmonar (RR = 2,43; IC95%: 1,77-3,33), vascular-metabólico (RR = 1,50; IC95%: 1,19-1,89) e mental-musculoesquelético (RR = 1,30; IC95%: 1,03-1,65) tiveram maior risco de apresentar declínio funcional nas ABVD no seguimento em comparação aos que não tinham os mesmos padrões de doenças. A multimorbidade e seus padrões aumentaram o risco de incapacidade na pessoa idosa ao longo de nove anos. comunidade Tratase Trata se FIBRA 20082009 2008 2009 (2008-2009 20162017. 20162017 2016 2017 . (2016-2017) (ABVD 1 (1 2 (2 3 (3 vascularmetabólico vascular metabólico 4 (4 mentalmusculoesquelético. mentalmusculoesquelético mental musculoesquelético. musculoesquelético utilizouse utilizou quiquadrado qui quadrado Poisson 86 RR 1,58 158 58 IC95% IC95 IC 1,192,10 119210 1,19 2,10 19 10 1,19-2,10 2,43 243 43 1,773,33, 177333 1,77 3,33 , 77 33 1,77-3,33) 1,50 150 50 1,191,89 119189 1,89 89 1,19-1,89 1,30 130 30 1,031,65 103165 1,03 1,65 03 65 1,03-1,65 anos 2008200 200 (2008-200 2016201 201 (2016-2017 ( 8 1,5 15 5 IC9 192 1,192,1 11921 119 1,1 210 2,1 1,19-2,1 2,4 24 773 1,773,33 17733 177 1,7 333 3,3 7 1,77-3,33 191 1,191,8 11918 189 1,8 1,19-1,8 1,3 13 031 1,031,6 10316 103 1,0 165 1,6 0 6 1,03-1,6 200820 20 (2008-20 201620 (2016-201 1, 1,192, 1192 11 21 2, 1,19-2, 1,773,3 1773 17 3, 1,77-3,3 1,191, 1191 18 1,19-1, 1,031, 1031 16 1,03-1, 20082 (2008-2 20162 (2016-20 1,192 1,19-2 1,773, 1,77-3, 1,191 1,19-1 1,031 1,03-1 (2008- (2016-2 1,19- 1,773 1,77-3 1,03- (2008 (2016- 1,77- (200 (2016 (20 (201

Resumen Este estudio tuvo como objetivo estimar la prevalencia de satisfacción global con la vida y referenciada a los dominios propósito de vida, morbilidades y salud autoevaluada, e identificar asociaciones directas e indirectas de morbilidades, autoevaluación general de salud y propósito con la satisfacción general con la vida en adultos mayores comunitarios. Es un diseño transversal que evaluó a 419 adultos mayores. Las morbilidades se evaluaron mediante una pregunta dicotómica, la autoevaluación de salud y la satisfacción con la vida por la escala Likert de 5 puntos, y el propósito mediante la escala de 10 ítems de Ryff y Keyes. Se utilizó análisis de ecuaciones estructurales vía análisis de trayectoria. La relación entre morbilidades y satisfacción general con la vida estuvo mediada por autoevaluación de la salud; el propósito de vida medió la relación entre autoevaluación de salud y satisfacción general con la vida. Más allá del manejo de enfermedades crónicas, las evaluaciones subjetivas de salud y bienestar son clave para un envejecimiento exitoso. autoevaluada comunitarios 41 dicotómica puntos 1 Keyes trayectoria crónicas exitoso 4

Abstract This study aims to estimate the prevalence of overall satisfaction with life regarding sense of purpose in life, morbidities, and self-reported health, and to identify their direct and indirect associations among the domains in community-dwelling older adults. The research has a cross-sectional design, and we evaluated 419 older adults. Morbidities were assessed using a dichotomous question; self-reported health and satisfaction with life were assessed using a 5-point Likert scale; and sense of purpose was assessed using the Ryff and Keyes 10-item scale. An analysis of structural equations was conducted using Path Analysis. The relationship between morbidities and overall satisfaction with life was mediated by self-reported health; purpose in life mediated the relationship between self-reported health and overall satisfaction with life. Beyond managing chronic illnesses, subjective assessments of health and well-being are key to successful aging. selfreported self reported communitydwelling community dwelling adults crosssectional cross sectional design 41 question 5point point 5 scale 10item item 10 Analysis illnesses wellbeing well being aging 4 1

Resumo Este estudo teve como objetivo estimar a prevalência de satisfação global com a vida e referenciada a domínios, propósito de vida, morbidades e autoavaliação de saúde e identificar associações diretas e indiretas de morbidades, autoavaliação geral de saúde e propósito de vida com satisfação global com a vida em idosos comunitários. Trata-se de um delineamento transversal que avaliou 419 idosos. Morbidades foram avaliadas por questão dicotômica, autoavaliação de saúde e satisfação com a vida por escala tipo Likert de 5 pontos, e propósito pela escala de 10 itens de Ryff e Keyes. Utilizou-se análise de equações estruturais via análise de caminhos. A relação entre morbidades e satisfação global com a vida foi mediada pela autoavaliação de saúde; propósito de vida mediou a relação entre autoavaliação de saúde e satisfação global com a vida. Além do tratamento de doenças crônicas, avaliações subjetivas da saúde e bem-estar são essenciais para o envelhecimento bem-sucedido. domínios comunitários Tratase Trata se 41 dicotômica pontos 1 Keyes Utilizouse Utilizou caminhos crônicas bemestar bem estar bemsucedido. bemsucedido sucedido. sucedido bem-sucedido 4

Resumen: El objetivo fue investigar la prevalencia de la soledad y sus asociaciones con indicadores sociodemográficos y de salud en una muestra nacionalmente representativa de adultos y ancianos brasileños. Se analizaron datos de la línea base (2015-2016) del Estudio Longitudinal de la Salud de los Ancianos Brasileños (ELSI-Brasil) y se incluyeron los participantes con información completa en las variables de interés (n = 7.957). La soledad fue la variable de desenlace, cuya medida se basó en la pregunta “¿Con qué frecuencia te sentiste solo(a) o solitario(a): siempre, a veces o nunca?”. Las variables independientes incluyeron indicadores sociodemográficos y comportamientos y condiciones de salud. Los análisis incluyeron la prueba de chi-cuadrado de Pearson para calcular las frecuencias relativas, y la regresión de Poisson, para estimar las razones de prevalencia (RP) y los respectivos intervalos de 95% de confianza (IC95%). La prevalencia de sentirse siempre solo fue de 16,8%; a veces, 31,7%; y nunca, 51,5%. Se observaron asociaciones significativas entre sentir siempre soledad y depresión (RP = 4,49; IC95%: 3,93-5,11), vivir solo (RP = 2,44; IC95%: 2,12-2,82), baja escolaridad (RP = 1,93; IC95%: 1,61-2,32), sexo femenino (RP = 1,53; IC95%: 1,36-1,72), autoevaluación de salud mala/muy mala (RP = 1,48; IC95%: 1,27-1,73) y calidad del sueño mala/muy mala (RP = 1,21; IC95%: 1,05-1,41). Dado su potencial para perjudicar la calidad de vida, es necesario conocer longitudinalmente las trayectorias de la soledad y las variables asociadas, y usar ese conocimiento para diseñar políticas públicas e intervenciones en salud que puedan beneficiar el bienestar biopsicosocial de adultos y ancianos brasileños. Resumen brasileños 20152016 2015 2016 (2015-2016 ELSIBrasil ELSI Brasil (ELSI-Brasil n 7.957. 7957 7.957 . 7 957 7.957) desenlace ¿Con Con soloa solo(a solitarioa solitario solitario(a) nunca. nunca nunca?” chicuadrado chi cuadrado relativas Poisson RP 95 IC95%. IC95 IC IC95% (IC95%) 16,8% 168 16 8 31,7% 317 31 515 51 5 51,5% 4,49 449 4 49 3,935,11, 393511 3,93 5,11 , 3 93 11 3,93-5,11) 2,44 244 2 44 2,122,82, 212282 2,12 2,82 12 82 2,12-2,82) 1,93 193 1 1,612,32, 161232 1,61 2,32 61 32 1,61-2,32) 1,53 153 53 1,361,72, 136172 1,36 1,72 36 72 1,36-1,72) malamuy muy 1,48 148 48 1,271,73 127173 1,27 1,73 27 73 1,27-1,73 1,21 121 21 1,051,41. 105141 1,05 1,41 05 41 1,05-1,41) vida asociadas 2015201 201 (2015-201 795 7.95 solitario(a nunca? 9 IC9 (IC95% 16,8 31,7 51,5 4,4 935 3,935,11 39351 393 3,9 511 5,1 3,93-5,11 2,4 24 122 2,122,82 21228 212 2,1 282 2,8 2,12-2,82 1,9 19 612 1,612,32 16123 161 1,6 232 2,3 6 1,61-2,32 1,5 15 361 1,361,72 13617 136 1,3 172 1,7 1,36-1,72 1,4 14 271 1,271,7 12717 127 1,2 173 1,27-1,7 051 1,051,41 10514 105 1,0 141 0 1,05-1,41 201520 20 (2015-20 79 7.9 (IC95 16, 31, 51, 4, 3,935,1 3935 39 3, 5, 3,93-5,1 2, 2,122,8 2122 28 2,12-2,8 1, 1,612,3 1612 23 1,61-2,3 1,361,7 1361 13 17 1,36-1,7 1,271, 1271 1,27-1, 1,051,4 1051 10 1,05-1,4 20152 (2015-2 7. (IC9 3,935, 3,93-5, 2,122, 2,12-2, 1,612, 1,61-2, 1,361, 1,36-1, 1,271 1,27-1 1,051, 1,05-1, (2015- (IC 3,935 3,93-5 2,122 2,12-2 1,612 1,61-2 1,361 1,36-1 1,27- 1,051 1,05-1 (2015 3,93- 2,12- 1,61- 1,36- 1,05- (201 (20 (2 (

Abstract: This study aimed to investigate the prevalence of loneliness and its associations with sociodemographic and health indicators in a nationally representative sample of Brazilian adults and older adults. Data from the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed, and participants with complete information on the variables of interest (n = 7,957) were included. Loneliness was the outcome variable, which was based on the question “How often do you feel alone or lonely: always, sometimes, or never?” Independent variables included sociodemographic indicators and health behaviors and conditions. The analyses included the Pearson’s chi-square test for calculating relative frequencies, and Poisson regression for estimating prevalence ratios (PR) and their respective 95% confidence intervals (95%CI). The prevalence of always feeling lonely was 16.8%; sometimes, 31.7%; and never, 51.5%. Significant associations were observed between always feeling lonely and depression (PR = 4.49; 95%CI: 3.93-5.11), living alone (PR = 2.44; 95%CI: 2.12-2.82), low education level (PR = 1.93; 95%CI: 1.61-2.32), being a woman (PR = 1.53; 95%CI: 1.36-1.72), self-rated poor/very poor health (PR = 1.48; 95%CI: 1.27-1.73), and poor/very poor sleep quality (PR = 1.21; 95%CI: 1.05-1.41). Given its potential to harm quality of life, it is necessary to longitudinally understand the trajectories of loneliness and associated variables, and to use this knowledge to design public policies and health interventions that could benefit the biopsychosocial well-being of Brazilian adults and older adults. Abstract 20152016 2015 2016 (2015-2016 ELSIBrazil ELSI Brazil (ELSI-Brazil analyzed n 7,957 7957 7 957 variable How sometimes never never? conditions Pearsons Pearson s chisquare chi square frequencies PR 95 95%CI. 95CI CI 95%CI . (95%CI) 16.8% 168 16 8 31.7% 317 31 515 51 5 51.5% 4.49 449 4 49 3.935.11, 393511 3.93 5.11 , 3 93 11 3.93-5.11) 2.44 244 2 44 2.122.82, 212282 2.12 2.82 12 82 2.12-2.82) 1.93 193 1 1.612.32, 161232 1.61 2.32 61 32 1.61-2.32) 1.53 153 53 1.361.72, 136172 1.36 1.72 36 72 1.36-1.72) selfrated self rated poorvery very 1.48 148 48 1.271.73, 127173 1.27 1.73 27 73 1.27-1.73) 1.21 121 21 1.051.41. 105141 1.05 1.41 05 41 1.05-1.41) life wellbeing well 2015201 201 (2015-201 7,95 795 9 (95%CI 16.8 31.7 51.5 4.4 935 3.935.11 39351 393 3.9 511 5.1 3.93-5.11 2.4 24 122 2.122.82 21228 212 2.1 282 2.8 2.12-2.82 1.9 19 612 1.612.32 16123 161 1.6 232 2.3 6 1.61-2.32 1.5 15 361 1.361.72 13617 136 1.3 172 1.7 1.36-1.72 1.4 14 271 1.271.73 12717 127 1.2 173 1.27-1.73 051 1.051.41 10514 105 1.0 141 0 1.05-1.41 201520 20 (2015-20 7,9 79 16. 31. 51. 4. 3.935.1 3935 39 3. 5. 3.93-5.1 2. 2.122.8 2122 28 2.12-2.8 1. 1.612.3 1612 23 1.61-2.3 1.361.7 1361 13 17 1.36-1.7 1.271.7 1271 1.27-1.7 1.051.4 1051 10 1.05-1.4 20152 (2015-2 7, 3.935. 3.93-5. 2.122. 2.12-2. 1.612. 1.61-2. 1.361. 1.36-1. 1.271. 1.27-1. 1.051. 1.05-1. (2015- 3.935 3.93-5 2.122 2.12-2 1.612 1.61-2 1.361 1.36-1 1.271 1.27-1 1.051 1.05-1 (2015 3.93- 2.12- 1.61- 1.36- 1.27- 1.05- (201 (20 (2 (

Resumo: O objetivo foi investigar a prevalência de solidão e suas associações com indicadores sociodemográficos e de saúde em amostra nacionalmente representativa de adultos e idosos brasileiros. Foram analisados dados da linha de base (2015-2016) do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil) e incluídos os participantes com informações completas nas variáveis de interesse (n = 7.957). Solidão foi a variável de desfecho, cuja medida baseou-se na pergunta “Com que frequência o(a) senhor(a) se sentiu sozinho(a) ou solitário(a): sempre, algumas vezes ou nunca?”. As variáveis independentes compreenderam indicadores sociodemográficos e comportamentos e condições de saúde. As análises incluíram o teste qui-quadrado de Pearson, para cálculo das frequências relativas, e a regressão de Poisson, para estimativa das razões de prevalência (RP) e respectivos intervalos de 95% de confiança (IC95%). A prevalência de sempre sentir solidão foi de 16,8%; de algumas vezes, 31,7%; e de nunca, 51,5%. Foram observadas associações significativas entre sempre sentir solidão e depressão (RP = 4,49; IC95%: 3,93-5,11), morar só (RP = 2,44; IC95%: 2,12-2,82), baixa escolaridade (RP = 1,93; IC95%: 1,61-2,32), sexo feminino (RP = 1,53; IC95%: 1,36-1,72), autoavaliação de saúde ruim/muito ruim (RP = 1,48; IC95%: 1,27-1,73) e qualidade do sono ruim/muito ruim (RP = 1,21; IC95%: 1,05-1,41). Dado seu potencial de prejuízo à qualidade de vida, é necessário conhecer longitudinalmente as trajetórias da solidão e as variáveis associadas e usar esse conhecimento para o delineamento de políticas públicas e intervenções em saúde que poderão beneficiar o bem-estar biopsicossocial de adultos e idosos brasileiros. Resumo brasileiros 20152016 2015 2016 (2015-2016 ELSIBrasil ELSI Brasil (ELSI-Brasil n 7.957. 7957 7.957 . 7 957 7.957) desfecho baseouse baseou Com oa o(a senhora senhor senhor(a sozinhoa sozinho sozinho(a solitárioa solitário solitário(a) nunca. nunca nunca?” quiquadrado qui quadrado Pearson relativas Poisson RP 95 IC95%. IC95 IC IC95% (IC95%) 16,8% 168 16 8 31,7% 317 31 515 51 5 51,5% 4,49 449 4 49 3,935,11, 393511 3,93 5,11 , 3 93 11 3,93-5,11) 2,44 244 2 44 2,122,82, 212282 2,12 2,82 12 82 2,12-2,82) 1,93 193 1 1,612,32, 161232 1,61 2,32 61 32 1,61-2,32) 1,53 153 53 1,361,72, 136172 1,36 1,72 36 72 1,36-1,72) ruimmuito muito 1,48 148 48 1,271,73 127173 1,27 1,73 27 73 1,27-1,73 1,21 121 21 1,051,41. 105141 1,05 1,41 05 41 1,05-1,41) vida bemestar bem estar 2015201 201 (2015-201 795 7.95 solitário(a nunca? 9 IC9 (IC95% 16,8 31,7 51,5 4,4 935 3,935,11 39351 393 3,9 511 5,1 3,93-5,11 2,4 24 122 2,122,82 21228 212 2,1 282 2,8 2,12-2,82 1,9 19 612 1,612,32 16123 161 1,6 232 2,3 6 1,61-2,32 1,5 15 361 1,361,72 13617 136 1,3 172 1,7 1,36-1,72 1,4 14 271 1,271,7 12717 127 1,2 173 1,27-1,7 051 1,051,41 10514 105 1,0 141 0 1,05-1,41 201520 20 (2015-20 79 7.9 (IC95 16, 31, 51, 4, 3,935,1 3935 39 3, 5, 3,93-5,1 2, 2,122,8 2122 28 2,12-2,8 1, 1,612,3 1612 23 1,61-2,3 1,361,7 1361 13 17 1,36-1,7 1,271, 1271 1,27-1, 1,051,4 1051 10 1,05-1,4 20152 (2015-2 7. (IC9 3,935, 3,93-5, 2,122, 2,12-2, 1,612, 1,61-2, 1,361, 1,36-1, 1,271 1,27-1 1,051, 1,05-1, (2015- (IC 3,935 3,93-5 2,122 2,12-2 1,612 1,61-2 1,361 1,36-1 1,27- 1,051 1,05-1 (2015 3,93- 2,12- 1,61- 1,36- 1,05- (201 (20 (2 (

Resumo: O objetivo foi investigar a prevalência de solidão e suas associações com indicadores sociodemográficos e de saúde em amostra nacionalmente representativa de adultos e idosos brasileiros. Foram analisados dados da linha de base (2015-2016) do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil) e incluídos os participantes com informações completas nas variáveis de interesse (n = 7.957). Solidão foi a variável de desfecho, cuja medida baseou-se na pergunta “Com que frequência o(a) senhor(a) se sentiu sozinho(a) ou solitário(a): sempre, algumas vezes ou nunca?”. As variáveis independentes compreenderam indicadores sociodemográficos e comportamentos e condições de saúde. As análises incluíram o teste qui-quadrado de Pearson, para cálculo das frequências relativas, e a regressão de Poisson, para estimativa das razões de prevalência (RP) e respectivos intervalos de 95% de confiança (IC95%). A prevalência de sempre sentir solidão foi de 16,8%; de algumas vezes, 31,7%; e de nunca, 51,5%. Foram observadas associações significativas entre sempre sentir solidão e depressão (RP = 4,49; IC95%: 3,93-5,11), morar só (RP = 2,44; IC95%: 2,12-2,82), baixa escolaridade (RP = 1,93; IC95%: 1,61-2,32), sexo feminino (RP = 1,53; IC95%: 1,36-1,72), autoavaliação de saúde ruim/muito ruim (RP = 1,48; IC95%: 1,27-1,73) e qualidade do sono ruim/muito ruim (RP = 1,21; IC95%: 1,05-1,41). Dado seu potencial de prejuízo à qualidade de vida, é necessário conhecer longitudinalmente as trajetórias da solidão e as variáveis associadas e usar esse conhecimento para o delineamento de políticas públicas e intervenções em saúde que poderão beneficiar o bem-estar biopsicossocial de adultos e idosos brasileiros.

Resumen: El objetivo fue investigar la prevalencia de la soledad y sus asociaciones con indicadores sociodemográficos y de salud en una muestra nacionalmente representativa de adultos y ancianos brasileños. Se analizaron datos de la línea base (2015-2016) del Estudio Longitudinal de la Salud de los Ancianos Brasileños (ELSI-Brasil) y se incluyeron los participantes con información completa en las variables de interés (n = 7.957). La soledad fue la variable de desenlace, cuya medida se basó en la pregunta “¿Con qué frecuencia te sentiste solo(a) o solitario(a): siempre, a veces o nunca?”. Las variables independientes incluyeron indicadores sociodemográficos y comportamientos y condiciones de salud. Los análisis incluyeron la prueba de chi-cuadrado de Pearson para calcular las frecuencias relativas, y la regresión de Poisson, para estimar las razones de prevalencia (RP) y los respectivos intervalos de 95% de confianza (IC95%). La prevalencia de sentirse siempre solo fue de 16,8%; a veces, 31,7%; y nunca, 51,5%. Se observaron asociaciones significativas entre sentir siempre soledad y depresión (RP = 4,49; IC95%: 3,93-5,11), vivir solo (RP = 2,44; IC95%: 2,12-2,82), baja escolaridad (RP = 1,93; IC95%: 1,61-2,32), sexo femenino (RP = 1,53; IC95%: 1,36-1,72), autoevaluación de salud mala/muy mala (RP = 1,48; IC95%: 1,27-1,73) y calidad del sueño mala/muy mala (RP = 1,21; IC95%: 1,05-1,41). Dado su potencial para perjudicar la calidad de vida, es necesario conocer longitudinalmente las trayectorias de la soledad y las variables asociadas, y usar ese conocimiento para diseñar políticas públicas e intervenciones en salud que puedan beneficiar el bienestar biopsicosocial de adultos y ancianos brasileños.

Abstract: This study aimed to investigate the prevalence of loneliness and its associations with sociodemographic and health indicators in a nationally representative sample of Brazilian adults and older adults. Data from the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) were analyzed, and participants with complete information on the variables of interest (n = 7,957) were included. Loneliness was the outcome variable, which was based on the question “How often do you feel alone or lonely: always, sometimes, or never?” Independent variables included sociodemographic indicators and health behaviors and conditions. The analyses included the Pearson’s chi-square test for calculating relative frequencies, and Poisson regression for estimating prevalence ratios (PR) and their respective 95% confidence intervals (95%CI). The prevalence of always feeling lonely was 16.8%; sometimes, 31.7%; and never, 51.5%. Significant associations were observed between always feeling lonely and depression (PR = 4.49; 95%CI: 3.93-5.11), living alone (PR = 2.44; 95%CI: 2.12-2.82), low education level (PR = 1.93; 95%CI: 1.61-2.32), being a woman (PR = 1.53; 95%CI: 1.36-1.72), self-rated poor/very poor health (PR = 1.48; 95%CI: 1.27-1.73), and poor/very poor sleep quality (PR = 1.21; 95%CI: 1.05-1.41). Given its potential to harm quality of life, it is necessary to longitudinally understand the trajectories of loneliness and associated variables, and to use this knowledge to design public policies and health interventions that could benefit the biopsychosocial well-being of Brazilian adults and older adults.

ABSTRACT Objective To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults. Methods Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p<0.05. Results Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities. Conclusion The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components. communitydwelling community dwelling adults 41 crosssectionally cross sectionally Geriatric 15 [1 items, items , items]) phenotype criteria, criteria criteria) Brody. Brody . Brody) variables p005 p 0 05 p<0.05 698 69 8 69.8 593 59 3 59.3 14 1 4 (1- years years) 80346 80 6 80.3±4. disabilities [ items] p00 p<0.0 69. 5 59. (1 8034 80.3±4 p0 p<0. ( 803 80.3± p<0 80.3 p< 80.

ABSTRACT CONTEXT: Dyspnea is a symptom present in several chronic diseases commonly seen among older adults. Since individuals with dyspnea tend to stay at rest, with consequently reduced levels of physical activity, they are likely to be at greater risk of developing frailty, especially at older ages. DESIGN AND SETTING: Cross-sectional study at community level, Brazil. OBJECTIVE: To analyze the relationships between self-reported dyspnea, health conditions and frailty status in a sample of community-dwelling older adults. METHOD: Secondary data from the follow-up of the Frailty in Brazilian Elderly (FIBRA) study, involving 415 community-dwelling older adults (mean age: 80.3 ± 4.68 years), were used. The variables analyzed were sociodemographic characteristics, reported dyspnea, clinical data and frailty phenotype. Associations between dyspnea and other variables (age, sex, education and body mass index) were verified through the crude (c) and adjusted (a) odds ratios. RESULTS: The prevalence of dyspnea in the entire sample was 21.0%. Dyspnea was more present in individuals with pulmonary diseases, heart disease, cancer and depression. Older adults with multimorbidities (adjusted odds ratio, ORa = 2.91; 95% confidence interval, CI = 1.41-5.99) and polypharmacy (ORa = 2.02; 95% CI = 1.15-3.54) were more likely to have dyspnea. Those who reported dyspnea were 2.54 times more likely to be frail (ORa = 2.54; 95% CI = 1.08-5.97), and fatigue was their most prevalent phenotype component. CONCLUSION: Dyspnea was associated with different diseases, multimorbidities, polypharmacy and frailty. Recognizing the factors associated with dyspnea may contribute to its early identification and prevention of its negative outcomes among older adults.

Resumo Objetivo Investigar a incidência e variáveis associadas à estabilidade e à mudança da satisfação com a vida (SV) em medidas de linha de base (LB) e seguimento (SG) realizadas a um intervalo de nove anos, em idosos recrutados na comunidade. Método Estudo longitudinal prospectivo com dados da LB (2008-2009) e do SG (2016-2017) do Estudo Fragilidade em Idosos Brasileiros, envolvendo 360 idosos com 71,7±5,0 anos na LB (68,9% mulheres). Foram calculadas associações entre variáveis sociodemográficas, indicadores objetivos e subjetivos de saúde e variáveis psicossociais em LB e a incidência de estabilidade e mudança em SV no SG. Resultados Nove anos depois da LB, foram observadas: maior incidência de estabilidade (61,1%) do que de piora (26,4%) ou melhora (12,5%) da SV; menor incidência de piora no grupo de 80 anos e mais do que no de 70 a 79; maior incidência de mudança do que estabilidade da SV entre os idosos com multimorbidades e com pontuação > 6 em sintomas depressivos; maior incidência de piora da SV entre os idosos com baixos níveis de autoavaliação de saúde (risco relativo; RR=2,26) e de satisfação com a memória (RR=2,33). Conclusões A incidência de estabilidade em SV em idosos foi mais frequente do que a de piora ou melhora. Indicadores subjetivos de saúde física e satisfação com a memória podem ser sinalizadores de deterioração em bem-estar no tempo e sintomas depressivos de instabilidade nas avaliações, possivelmente acompanhando a redução ou o aumento da SV. Foi observada considerável heterogeneidade nas manifestações de SV entre idosos.

Abstract Objective The purpose of this study was to identify the incidence and variables associated with stability and change in life satisfaction (LS) between baseline and 9-year follow-up, in community-dwelling-older adults. Method A prospective longitudinal study of baseline (BL; 2008-2009) and follow-up (FW; 2016-2017) data from the Frailty in Elderly Brazilians Study involving 360 individuals aged 71.7±5.0 years at BL, 68.9% women, was conducted. Associations of sociodemographic and psychosocial variables, and objective and subjective health indicators measured at BL with the incidence of stability and change in LS between BL and FW were investigated. Results Nine years after the BL collection, the following results were observed: higher incidence of stability (61.1%) than of worsening (26.4%) or improvement (12.5%) in LS; lower incidence of worsening of LS in the ≥80 age group than in the 70-79 years group; higher incidence of change than stability of LS among the participants with multimorbidities and scores > 6 for depressive symptoms; higher incidence of LS worsening among participants with low self-rated health (relative risk; RR=2.26) and low satisfaction with memory (RR=2.33). Conclusions The incidence of stability in LS was more frequent than that of worsening or improvement. Subjective indicators of physical health and satisfaction with memory may serve as indicators of deterioration in wellbeing over time and the presence of depressive symptoms may suggest instability in self-assessments, possibly accompanying a reduction or increase in LS over time. There was considerable heterogeneity in the manifestations of LS among the older adults assessed.

Resumo O objetivo deste artigo é estimar a prevalência de doenças/condições crônicas em octogenários segundo sexo, faixas etárias e plano de saúde, e sua relação com a dificuldade para realização de atividades habituais. Estudo transversal de base populacional com dados de idosos (n = 6.098) da Pesquisa Nacional de Saúde 2019. Estimaram-se as prevalências e intervalos de confiança de 95%. As prevalências foram: hipertensão 61,7%, problema de coluna 30,0%, hipercolesterolemia 22,0%, diabetes 20,3%, artrite/reumatismo 19,4%, cardiopatias 19,3%, depressão 9,4%, câncer 8,9%, AVC 7,5%, asma 4,9%, doença pulmonar (DP) 4,2% e insuficiência renal (IR) 3,0%. Hipertensão, problema de coluna, hipercolesterolemia, artrite/reumatismo e depressão maiores nas mulheres, e câncer nos homens. Cardiopatias, hipercolesterolemia, artrite/reumatismo, IR, câncer e depressão maiores naqueles com plano de saúde. Restrição de atividades habituais, 14,8% mais frequente nos cardiopatas, com problema de coluna, artrite/reumatismo, IR, depressão, AVC, câncer e DP. Observaram-se maiores prevalências nas mulheres e nos que possuem plano de saúde. Dificuldades para atividades habituais relacionadas às doenças demandam a ampliação do cuidado aos mais idosos.

Abstract This article aims to estimate the prevalence of chronic diseases/conditions in octogenarians according to sex, age groups and private health insurance, and its relationship with difficulty in performing usual activities. Cross-sectional population-based study with elderly data (n = 6,098) from the National Health Survey (PNS) 2019. Prevalences and 95% confidence intervals were estimated. The prevalences were: hypertension 61.7%, chronic back problem 30.0%, hypercholesterolemia 22.0%, diabetes 20.3%; arthritis/rheumatism 19.4%, heart disease 19.3%, depression 9.4%, cancer 8.9%, cerebrovascular accident (CA) 7.5%, asthma 4.9%, lung disease (LD) 4.2% and kidney failure (KF) 3.0%. Hypertension, chronic back problem, hypercholesterolemia, major arthritis/rheumatism and depression in women, and cancer in men. Major heart disease, hypercholesterolemia, arthritis/rheumatism, KF, cancer and depression in those with private health insurance. Restriction of usual activities 14.8%, more frequent in cardiac patients, with chronic back problem, arthritis/rheumatism, KF, depression, CA, cancer and LD. There were higher prevalences in women and in those who have health insurance. Difficulties in usual activities related to diseases demand the expansion of care for the older adults.

Resumo O objetivo deste artigo é estimar a prevalência de doenças/condições crônicas em octogenários segundo sexo, faixas etárias e plano de saúde, e sua relação com a dificuldade para realização de atividades habituais. Estudo transversal de base populacional com dados de idosos (n = 6.098) da Pesquisa Nacional de Saúde 2019. Estimaram-se as prevalências e intervalos de confiança de 95%. As prevalências foram: hipertensão 61,7%, problema de coluna 30,0%, hipercolesterolemia 22,0%, diabetes 20,3%, artrite/reumatismo 19,4%, cardiopatias 19,3%, depressão 9,4%, câncer 8,9%, AVC 7,5%, asma 4,9%, doença pulmonar (DP) 4,2% e insuficiência renal (IR) 3,0%. Hipertensão, problema de coluna, hipercolesterolemia, artrite/reumatismo e depressão maiores nas mulheres, e câncer nos homens. Cardiopatias, hipercolesterolemia, artrite/reumatismo, IR, câncer e depressão maiores naqueles com plano de saúde. Restrição de atividades habituais, 14,8% mais frequente nos cardiopatas, com problema de coluna, artrite/reumatismo, IR, depressão, AVC, câncer e DP. Observaram-se maiores prevalências nas mulheres e nos que possuem plano de saúde. Dificuldades para atividades habituais relacionadas às doenças demandam a ampliação do cuidado aos mais idosos.

Abstract This article aims to estimate the prevalence of chronic diseases/conditions in octogenarians according to sex, age groups and private health insurance, and its relationship with difficulty in performing usual activities. Cross-sectional population-based study with elderly data (n = 6,098) from the National Health Survey (PNS) 2019. Prevalences and 95% confidence intervals were estimated. The prevalences were: hypertension 61.7%, chronic back problem 30.0%, hypercholesterolemia 22.0%, diabetes 20.3%; arthritis/rheumatism 19.4%, heart disease 19.3%, depression 9.4%, cancer 8.9%, cerebrovascular accident (CA) 7.5%, asthma 4.9%, lung disease (LD) 4.2% and kidney failure (KF) 3.0%. Hypertension, chronic back problem, hypercholesterolemia, major arthritis/rheumatism and depression in women, and cancer in men. Major heart disease, hypercholesterolemia, arthritis/rheumatism, KF, cancer and depression in those with private health insurance. Restriction of usual activities 14.8%, more frequent in cardiac patients, with chronic back problem, arthritis/rheumatism, KF, depression, CA, cancer and LD. There were higher prevalences in women and in those who have health insurance. Difficulties in usual activities related to diseases demand the expansion of care for the older adults.

Resumo Objetivo Investigar e comparar o perfil sociodemográfico, cognitivo e de fragilidade dos participantes do Estudo Fragilidade em Idosos Brasileiros em medidas de seguimento (SG) e linha de base (LB) realizadas em 2016-2017 e 2008-2009, respectivamente. Métodos Participaram da LB 1.284 idosos residentes em Campinas e Ermelino Matarazzo (SP), Brasil, que compuseram amostra única. No SG foram novamente entrevistados 549 participantes (42,5%); 192 tinham falecido (14,9%) e 543 foram perdidos (42,4%). Em ambos os momentos, foram avaliadas as variáveis sexo, idade, escolaridade, estado conjugal, renda familiar, arranjo de moradia, status cognitivo (Mini-Exame do Estado Mental) e fenótipo de fragilidade (três ou mais de cinco critérios). As diferenças intergrupos e intragrupos foram verificadas pelos testes qui-quadrado de Pearson e de McNemar, respectivamente. O nível de significância foi estabelecido em p<0,05. Resultados Entre os sobreviventes, os participantes eram mais jovens (72,2±5,3 anos) do que entre os falecidos (75,5±6,8 anos) e havia mais idosos casados, com nível educacional mais elevado, sem deficit cognitivo e pré-frágeis. Da LB para o SG, houve aumento estatisticamente significativo do número de idosos que moravam sozinhos (17,1% vs. 22,0%), não tinham companheiro(a) (46,4% vs. 55,4%), tinham renda familiar menor que três salários-mínimos (52,2% vs. 62,2%), apresentavam deficit cognitivo (17,7% vs. 23,5%) e eram frágeis (9,8% vs. 24,5%) Conclusão Da LB para o SG, ocorreu aumento da vulnerabilidade física, cognitiva e social dos idosos. Estes resultados reforçam a importância de políticas públicas que favoreçam a qualidade de vida dos idosos e a redução das iniquidades de saúde ao longo da vida.

Abstract Objective To investigate and compare the sociodemographic, cognitive and frailty profile of participants from the Frailty in Brazilian Older Adults (Fibra) study regarding follow-up (FW) and baseline (BL) measurements carried out in 2016-2017 and 2008-2009, respectively. Methods A total of 1,284 older adults living in Campinas and Ermelino Matarazzo (SP), Brazil, participated in the BL, comprising a pooled sample. At FW, 549 older adults (42.7%) were interviewed again; 192 had died (14.9%) and 543 were lost to follow-up (42.4%). Sex, age, education, marital status, family income, housing arrangement, cognitive status (Mini-Mental State Examination) and frailty phenotype (score ≥3 out of 5) were evaluated at both timepoints. Intergroup and intragroup differences were verified by Pearson's chi-square and McNemar's tests. Statistical significant level was set at p<0.05 Results The survivors were younger (72.2±5.3 years) than the deceased (75.5±6.8 years) and individuals included in the FW were mostly married, higher educated, cognitively unimpaired and pre-frail. Between BL and FW there was an increase in the number of participants who lived alone (17.1% vs. 22.0%), had no partner (46.4% vs. 55.4%), a family income <3 minimum wages (52.2% vs. 62.2%), cognitive impairment (17.7% vs. 23.5%) and frailty (9.8% vs. 24.5%). Conclusion Between BL and FW there was an increase in the physical, cognitive and social vulnerability of the older adults. These results reinforce the importance of public policies that favor the quality of life of older people and a reduction in health inequities throughout life.