ABSTRACT Objective: To evaluate the association of TSH, free T3 (FT3), free T4 (FT4), and conversion (FT3:FT4) ratio values with incident hypertension. Materials and methods: The study included data from participants of the ELSA-Brasil study without baseline hypertension. Serum TSH, FT4 and FT3 levels, and FT3:FT4 ratio values were assessed at baseline, and incident hypertension (defined by blood pressure levels ≥ 140/90 mmHg) was estimated over a median of 8.2 years of follow-up. The risk of incident hypertension was evaluated considering a 1-unit increase in TSH, FT4, FT3, and conversion ratio values and after dividing these variables into quintiles for further analysis using Poisson regression with robust variance. The results are presented as relative risks (RR) and 95% confidence intervals (CIs) before and after adjustment for multiple variables. Results: The primary analysis incorporated data from 5,915 euthyroid individuals, and the secondary analysis combined data from all euthyroid individuals, 587 individuals with subclinical hypothyroidism, and 31 individuals with subclinical hyperthyroidism. The rate of incident hypertension was 28% (95% CI: 27%-29.3%). The FT4 levels in the first quintile (0.18-1.06 ng/dL) were significantly associated with incident hypertension (RR: 1.03, 95% CI: 1.01-1.06) at follow-up. The association between FT4 levels in the first quintile and incident hypertension was also observed in the analysis of combined data from euthyroid individuals and participants with subclinical thyroid dysfunction (RR: 1.04, 95% CI: 1.01-1.07). The associations were predominantly observed with systolic blood pressure levels in euthyroid individuals. However, in the combined analysis incorporating euthyroid participants and individuals with subclinical thyroid dysfunction, the associations were more pronounced with diastolic blood pressure levels. Conclusion: Low FT4 levels may be a mild risk factor for incident hypertension in euthyroid individuals and persons with subclinical thyroid dysfunction. Objective TSH T FT , (FT3) (FT4) FT3FT4 FTFT (FT3:FT4 methods ELSABrasil ELSA Brasil FT3:FT defined 14090 140 90 140/9 mmHg 82 8 2 8. followup. followup follow up. up follow-up 1unit unit 1 variance RR (RR 95 CIs (CIs Results 5915 5 915 5,91 58 hypothyroidism 3 hyperthyroidism 28 (95 CI 27%29.3%. 27293 27% 29.3% . 27 29 27%-29.3%) 0.181.06 018106 0.18 1.06 0 18 06 (0.18-1.0 ng/dL ngdL ng dL 103 03 1.03 1.011.06 101106 1.01 01 1.01-1.06 104 04 1.04 1.011.07. 101107 1.07 07 1.01-1.07) However Conclusion (FT3 (FT4 FT3FT (FT3:FT 1409 14 9 140/ 591 91 5,9 (9 27%29.3% 2729 293 29.3 27%-29.3% 181 0.181.0 01810 018 0.1 106 1.0 (0.18-1. 10 011 1.011.0 10110 101 1.01-1.0 1.011.07 107 1.01-1.07 (FT 59 5, ( 27%29.3 272 29. 27%-29.3 0.181. 0181 0. 1. (0.18-1 1.011. 1011 1.01-1. 27%29. 27%-29. 0.181 (0.18- 1.011 1.01-1 27%29 27%-29 (0.18 1.01- 27%2 27%-2 (0.1 27%- (0. (0

SUMMARY OBJECTIVE: This study investigated the association of psoriasis with cardiovascular risk factors and psychological aspects among participants of the Brazilian Longitudinal Study of Adult Health. METHODS: This is a cross-sectional study from the baseline data of the Brazilian Longitudinal Study of Adult Health cohort, collected between 2008 and 2010 in six state capitals of Brazil (i.e., Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitória). Participants were active and retired civil servants from college and research institutions, aged between 35 and 74 years. Exclusion criteria included the intention to quit working at the institution, pregnancy, severe cognitive impairment, and, if retired, residence outside of a study center's corresponding area. Psoriasis case identification was based on a previous medical diagnosis of psoriasis. Cardiovascular risk profile, psychological aspects, and sociodemographic variables were investigated. RESULTS: Data from 15,105 participants were analyzed (mean age of 52.3 years, 51.3% women). The prevalence of psoriasis was 1.6% (n=236). Psoriasis was associated with higher education (OR 1.94 [CI 1.07–3.52]), health insurance plan (OR 1.56 [CI 1.08–2.25]), central obesity (OR 1.63 [CI 1.10–2.40]), smoking status (former OR 1.40 [CI 1.03–1.88]; current OR 1.61 [CI 1.08–2.40]), and very bad self-perception of health (OR 7.22 [CI 2.41–21.64]), remaining significant even after multivariate adjustment. Self-reported Black participants were less likely to have psoriasis (OR 0.45 [CI 0.26–0.75]). CONCLUSION: In a sample of healthy workers, psoriasis was associated with central obesity, smoking, and a very bad self-perception of health, which may contribute to future cardiovascular disease. OBJECTIVE METHODS crosssectional cross sectional cohort 200 201 i.e., ie i e (i.e. Horizonte Alegre Janeiro Salvador Paulo Vitória. Vitória . Vitória) institutions 3 7 years institution pregnancy impairment centers center s area profile RESULTS 15105 15 105 15,10 mean 523 52 52. 513 51 51.3 women. women women) 16 1 6 1.6 n=236. n236 n n=236 236 (n=236) 194 94 1.9 CI 1.07–3.52, 107352 1.07–3.52 , 07 1.07–3.52]) 156 56 1.5 1.08–2.25, 108225 1.08–2.25 08 2 25 1.08–2.25]) 163 63 1.10–2.40, 110240 1.10–2.40 10 40 1.10–2.40]) former 140 1.4 1.03–1.88 103188 03 88 1.03–1.88] 161 61 1.08–2.40, 108240 1.08–2.40 1.08–2.40]) selfperception self perception 722 22 7.2 2.41–21.64, 2412164 2.41–21.64 41 21 64 2.41–21.64]) adjustment Selfreported Self reported 045 0 45 0.4 0.26–0.75. 026075 0.26–0.75 26 75 0.26–0.75]) CONCLUSION workers disease 20 i.e. (i.e 1510 15,1 5 51. 1. n23 n=23 23 (n=236 19 9 10735 1.07–3.5 1.07–3.52] 10822 1.08–2.2 1.08–2.25] 11024 1.10–2.4 4 1.10–2.40] 14 1.03–1.8 10318 8 10824 1.08–2.4 1.08–2.40] 72 7. 241216 2.41–21.6 2.41–21.64] 04 0. 02607 0.26–0.7 0.26–0.75] i.e 151 15, n2 n=2 (n=23 1073 1.07–3. 1082 1.08–2. 1102 1.10–2. 1.03–1. 1031 24121 2.41–21. 0260 0.26–0. n= (n=2 107 1.07–3 108 1.08–2 110 1.10–2 1.03–1 103 2412 2.41–21 026 0.26–0 (n= 1.07– 1.08– 11 1.10– 1.03– 241 2.41–2 02 0.26– (n 1.07 1.08 1.10 1.03 24 2.41– 0.26 1.0 1.1 2.41 0.2 2.4 2.

ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis. Objective thyroidstimulating stimulating TSH , (TSH) FT (FT4) (FT3) TPOAb, (TPOAb) middleaged middle aged adults methods Crosssectional Cross sectional selfreported self reported rd 20172019 2017 2019 (2017-2019 ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) yesno yes no variable age, age (age sex level raceethnicity race ethnicity race/ethnicity smoking. smoking smoking) Results 9649 9 649 9,64 52.3% 523 52 3 (52.3 592 59 2 59. 87 8 7 8. old, old old) 28 2.8 n 270. 270 270) analysis OR 2.01 201 01 95 1.053.84 105384 1.05 3.84 1 05 84 1.05-3.84 0.036 0036 0 036 2.13 213 13 1.124.05 112405 1.12 4.05 12 4 1.12-4.05 0.022 0022 022 0.43 043 43 0.190.98 019098 0.19 0.98 19 98 0.19-0.98 0.046 0046 046 st 1.66 166 66 1.112.46 111246 1.11 2.46 11 46 1.11-2.46 0.013 0013 013 2.25 225 25 1.254.04 125404 1.25 4.04 04 1.25-4.04 0.007 0007 007 sexstratified Conclusions Ushaped U shaped nonthyroidal non thyroidal syndrome (TSH (FT4 (FT3 (TPOAb 2017201 (2017-201 (ELSA-Brasil 964 64 9,6 52.3 5 (52. 2. 27 2.0 20 053 1.053.8 10538 105 1.0 384 3.8 1.05-3.8 0.03 003 03 2.1 21 124 1.124.0 11240 112 1.1 405 4.0 1.12-4.0 0.02 002 02 0.4 190 0.190.9 01909 019 0.1 098 0.9 0.19-0.9 0.04 004 1.6 16 6 1.112.4 11124 111 246 2.4 1.11-2.4 0.01 001 2.2 22 254 1.254.0 12540 125 1.2 404 1.25-4.0 0.00 000 00 (FT 201720 (2017-20 96 9, 52. (52 1.053. 1053 10 1. 38 3. 1.05-3. 0.0 1.124. 1124 40 4. 1.12-4. 0. 0.190. 0190 09 0.19-0. 1.112. 1112 24 1.11-2. 1.254. 1254 1.25-4. 20172 (2017-2 (5 1.053 1.05-3 1.124 1.12-4 0.190 0.19-0 1.112 1.11-2 1.254 1.25-4 (2017- ( 1.05- 1.12- 0.19- 1.11- 1.25- (2017 (201 (20 (2

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

ABSTRACT BACKGROUND: Being active has been shown to have beneficial effects for the health of individuals with chronic diseases. However, data on the association between multimorbidity and physical activity are limited. OBJECTIVE: To investigate the association between chronic diseases, multimorbidity and insufficient physical activity among older adults in southern Brazil, according to sex. DESIGN AND SETTING: Cross-sectional population-based and household-based study derived from the second wave (2013-2014) of the EpiFloripa Aging Cohort Study. METHODS: Insufficiency of physical activity (outcome) was ascertained using the long version of the International Physical Activity Questionnaire (≤ 150 minutes/week). Eleven self-reported chronic diseases were identified. Multimorbidity was defined from the number of chronic diseases (none; 2 or 3; or 4 or more). The adjustment variables were age, schooling, marital status, income, smoking, alcohol consumption and cognition. Additionally, each chronic disease was adjusted for the others. Associations were tested using logistic regression (crude and adjusted). RESULTS: Among the 1197 participants (≥ 63 years), women (54.0%) were more likely than men (39.6%) to be insufficiently active. In the adjusted analysis, women and men with depressive symptoms, and men with diabetes, were more likely to be insufficiently active than those without symptoms. Multimorbid women were more likely to be insufficiently active, and the magnitude of the effect was strongest for 4 or more diseases. CONCLUSION: This study indicates that the associations were sex-specific. Depressive symptoms and multimorbidity were associated with insufficient physical activity among women, while diabetes was associated with insufficient physical activity among men.

ABSTRACT Objective: To verify the variation of the premature mortality rate caused the group of the main chronic noncommunicable diseases. Method: This is a time-series ecological study, which used secondary data of the Mortality Information System, from 2006 to 2014, from the 26 federal units and from the Federal District. Deaths caused by circulatory system diseases, cancer, diabetes and chronic respiratory diseases were included. The trend of adjusted mortality rate was analyzed by segmented linear regression. Results: Premature mortality tended to be reduced in most states, except for Maranhão and Rio Grande do Norte, which presented a stable premature mortality rate. Bahia, Pernambuco, Sergipe, Roraima and all the states from the South, Southeast and Central-West Regions reached the goal of reducing 2% per year in premature mortality caused by main diseases. Conclusion: Most of the states showed a reduced mortality rate and are reaching the proposed target.

RESUMEN Objetivo: Verificar la variación de la tasa de mortalidad prematura por el conjunto de las principales enfermedades crónicas no transmisibles. Método: Estudio ecológico de series temporales, en que se utilizaron datos secundarios del Sistema de Información sobre Mortalidad, de 2006 a 2014, de las 26 Unidades Federativas y del Distrito Federal. Se incluyeron muertes con causa básica las enfermedades del aparato circulatorio, cáncer, diabetes y enfermedades respiratorias crónicas. La tendencia de la tasa ajustada de mortalidad se analizó por la regresión lineal segmentada. Resultados: Hubo tendencia de reducción de la mortalidad prematura en la mayoría de los estados, excepto Maranhão y Rio Grande do Norte que presentaron estabilidad de la tasa de mortalidad prematura. Los estados de Bahía, Pernambuco, Sergipe, Roraima y todos de la Región Sur, Sudeste y Centro-Oeste alcanzaron la meta de reducción del 2% al año en la mortalidad prematura por las principales enfermedades. Conclusión: La mayoría de los estados presentan reducción de la tasa de mortalidad y están alcanzando la meta propuesta.

RESUMO Objetivo: Verificar a variação da taxa de mortalidade prematura pelo conjunto das principais doenças crônicas não transmissíveis. Método: Estudo ecológico de séries temporais, que utilizou dados secundários do Sistema de Informações sobre Mortalidade, de 2006 a 2014, das 26 unidades federativas e do Distrito Federal. Foram incluídos óbitos que tiveram como causa básica doenças do aparelho circulatório, câncer, diabetes e doenças respiratórias crônicas. A tendência da taxa ajustada de mortalidade foi analisada pela regressão linear segmentada. Resultados: Houve tendência de redução da mortalidade prematura na maioria dos estados, exceto Maranhão e Rio Grande do Norte, que apresentaram estabilidade da taxa de mortalidade prematura. Os estados da Bahia, Pernambuco, Sergipe, Roraima e todos das regiões Sul, Sudeste e Centro-Oeste atingiram a meta de redução de 2% ao ano na mortalidade prematura pelas principais doenças. Conclusão: A maioria dos estados apresentaram redução da taxa de mortalidade e estão atingindo a meta proposta.

RESUMO Objetivo: Verificar a variação da taxa de mortalidade prematura pelo conjunto das principais doenças crônicas não transmissíveis. Método: Estudo ecológico de séries temporais, que utilizou dados secundários do Sistema de Informações sobre Mortalidade, de 2006 a 2014, das 26 unidades federativas e do Distrito Federal. Foram incluídos óbitos que tiveram como causa básica doenças do aparelho circulatório, câncer, diabetes e doenças respiratórias crônicas. A tendência da taxa ajustada de mortalidade foi analisada pela regressão linear segmentada. Resultados: Houve tendência de redução da mortalidade prematura na maioria dos estados, exceto Maranhão e Rio Grande do Norte, que apresentaram estabilidade da taxa de mortalidade prematura. Os estados da Bahia, Pernambuco, Sergipe, Roraima e todos das regiões Sul, Sudeste e Centro-Oeste atingiram a meta de redução de 2% ao ano na mortalidade prematura pelas principais doenças. Conclusão: A maioria dos estados apresentaram redução da taxa de mortalidade e estão atingindo a meta proposta.

ABSTRACT Objective: To verify the variation of the premature mortality rate caused the group of the main chronic noncommunicable diseases. Method: This is a time-series ecological study, which used secondary data of the Mortality Information System, from 2006 to 2014, from the 26 federal units and from the Federal District. Deaths caused by circulatory system diseases, cancer, diabetes and chronic respiratory diseases were included. The trend of adjusted mortality rate was analyzed by segmented linear regression. Results: Premature mortality tended to be reduced in most states, except for Maranhão and Rio Grande do Norte, which presented a stable premature mortality rate. Bahia, Pernambuco, Sergipe, Roraima and all the states from the South, Southeast and Central-West Regions reached the goal of reducing 2% per year in premature mortality caused by main diseases. Conclusion: Most of the states showed a reduced mortality rate and are reaching the proposed target.

RESUMEN Objetivo: Verificar la variación de la tasa de mortalidad prematura por el conjunto de las principales enfermedades crónicas no transmisibles. Método: Estudio ecológico de series temporales, en que se utilizaron datos secundarios del Sistema de Información sobre Mortalidad, de 2006 a 2014, de las 26 Unidades Federativas y del Distrito Federal. Se incluyeron muertes con causa básica las enfermedades del aparato circulatorio, cáncer, diabetes y enfermedades respiratorias crónicas. La tendencia de la tasa ajustada de mortalidad se analizó por la regresión lineal segmentada. Resultados: Hubo tendencia de reducción de la mortalidad prematura en la mayoría de los estados, excepto Maranhão y Rio Grande do Norte que presentaron estabilidad de la tasa de mortalidad prematura. Los estados de Bahía, Pernambuco, Sergipe, Roraima y todos de la Región Sur, Sudeste y Centro-Oeste alcanzaron la meta de reducción del 2% al año en la mortalidad prematura por las principales enfermedades. Conclusión: La mayoría de los estados presentan reducción de la tasa de mortalidad y están alcanzando la meta propuesta.

Resumo O objetivo deste artigo é investigar a associação entre demência e indicadores antropométricos em idosos de Florianópolis. Estudo transversal, de base populacional, realizado com 1.197 idosos (≥ 60 anos) em 2013/2014. A demência foi considerada como a presença conjunta de escore baixo no Miniexame do Estado Mental (MEEM) e a incapacidade funcional moderada/grave nas atividades de vida diária (AVD). As variáveis independentes avaliadas foram: índice de massa corporal (IMC), perímetro da cintura (PC), índice de conicidade e relação cintura/estatura (RCEst). A regressão logística (bruta e ajustada) foi utilizada para identificar os fatores associados. A prevalência estimada de demência foi de 15,1%. Após ajustes para características sociodemográficas, estilo de vida e sintomas depressivos, a demência foi positivamente associada aos tercis superiores do IMC (OR: 2,32; IC95%: 1,26-4,25), PC (OR: 2,22; IC95%: 1,20-4,11) e RCEst. (OR: 2,30; IC95%: 1,19-4,43). De acordo com os resultados, tanto a obesidade quanto a gordura abdominal foram associados ao desfecho, sugerindo que o IMC, o PC e a RCEst. devam ser considerados na investigação dessa relação.

Abstract Objective To investigate the association between dementia and anthropometric indicators in the elderly from Florianópolis. Method This is a cross-sectional population-based survey performed with 1,197 elderly (≥ 60 years) in 2013/2014. Dementia was defined as the combined evidence of low MMSE (Mini-Mental State Examination) score and moderate/severe disability in the activities of daily living. The independent variables were body mass index (BMI), waist circumference (WC), conicity index and waist-to-height ratio (WHtR). Logistic regression (crude and adjusted) was performed to identify associated factors. Results Dementia prevalence was estimated at 15.1%. After adjustment for sociodemographic characteristics, lifestyle and depressive symptoms, dementia was positively associated with the upper tertiles of the BMI (OR: 2.32; CI95%: 1.26-4.25), WC (OR: 2.22; CI95%: 1.20-4.11) and WHtR (OR: 2.30; CI95%: 1.19-4.43). Conclusion Results have shown that both obesity and abdominal fat were associated with the outcome, suggesting that BMI, WC and WHtR should be considered in the investigation of this relationship.

Resumo O objetivo deste artigo é investigar a associação entre demência e indicadores antropométricos em idosos de Florianópolis. Estudo transversal, de base populacional, realizado com 1.197 idosos (≥ 60 anos) em 2013/2014. A demência foi considerada como a presença conjunta de escore baixo no Miniexame do Estado Mental (MEEM) e a incapacidade funcional moderada/grave nas atividades de vida diária (AVD). As variáveis independentes avaliadas foram: índice de massa corporal (IMC), perímetro da cintura (PC), índice de conicidade e relação cintura/estatura (RCEst). A regressão logística (bruta e ajustada) foi utilizada para identificar os fatores associados. A prevalência estimada de demência foi de 15,1%. Após ajustes para características sociodemográficas, estilo de vida e sintomas depressivos, a demência foi positivamente associada aos tercis superiores do IMC (OR: 2,32; IC95%: 1,26-4,25), PC (OR: 2,22; IC95%: 1,20-4,11) e RCEst. (OR: 2,30; IC95%: 1,19-4,43). De acordo com os resultados, tanto a obesidade quanto a gordura abdominal foram associados ao desfecho, sugerindo que o IMC, o PC e a RCEst. devam ser considerados na investigação dessa relação.

Abstract Objective To investigate the association between dementia and anthropometric indicators in the elderly from Florianópolis. Method This is a cross-sectional population-based survey performed with 1,197 elderly (≥ 60 years) in 2013/2014. Dementia was defined as the combined evidence of low MMSE (Mini-Mental State Examination) score and moderate/severe disability in the activities of daily living. The independent variables were body mass index (BMI), waist circumference (WC), conicity index and waist-to-height ratio (WHtR). Logistic regression (crude and adjusted) was performed to identify associated factors. Results Dementia prevalence was estimated at 15.1%. After adjustment for sociodemographic characteristics, lifestyle and depressive symptoms, dementia was positively associated with the upper tertiles of the BMI (OR: 2.32; CI95%: 1.26-4.25), WC (OR: 2.22; CI95%: 1.20-4.11) and WHtR (OR: 2.30; CI95%: 1.19-4.43). Conclusion Results have shown that both obesity and abdominal fat were associated with the outcome, suggesting that BMI, WC and WHtR should be considered in the investigation of this relationship.

RESUMO Objetivo O objetivo deste estudo foi verificar a associação entre fatores sociodemográficos, estilo de vida e condições de saúde, e a Força de Preensão Manual baixa em idosos. Métodos Trata-se de estudo transversal, de base populacional, com 598 idosos. A Força de Preensão Manual baixa (primeiro quartil) foi verificada por meio de dinamômetro. As variáveis independentes incluíram grupo etário, escolaridade, arranjo familiar, trabalho atual, ingestão de bebida alcoólica, tabagismo, atividade física de lazer e deslocamento, dependência funcional nas Atividades Básicas e Atividades Instrumentais da Vida Diária, histórico de quedas e provável déficit cognitivo. Foram realizadas análises de regressão logística (bruta e ajustada). Resultados O grupo etário, a dependência nas Atividades Instrumentais da Vida Diária e a inatividade física foram associadas à Força de Preensão Manual baixa para o sexo feminino. Já para o sexo masculino, não houve associação. Conclusão A Força de Preensão Manual baixa foi associada positivamente ao grupo etário à dependência nas Atividades Instrumentais da Vida Diária; e negativamente associada à prática de atividade física, no sexo feminino.

ABSTRACT Objective To investigate the association between sociodemographic factors, lifestyle, health conditions and low Handgrip Strength in older adults. Methods A cross-sectional study was conducted in a sample of 598 older adults. The Handgrip Strength (first quartile) was verified using a dynamometer. Independent variables included age group, schooling, living arrangement, paid work, alcohol consumption, smoking, leisure-time physical activity and transportation, disability in activities of daily living and instrumental activities of daily living, history of falls and probable cognitive impairment. Logistic regression analyses were performed (crude and adjusted). Results Age group, disability in instrumental activities of daily living and physical inactivity were associated with low Handgrip Strength for women. For men, there was no association. Conclusion Low Handgrip Strength was positively associated with age, disability in instrumental activities of daily living, and negatively associated with the practice of physical activity in women.

RESUMO Objetivo Este estudo transversal, populacional, teve como objetivo determinar pontos de corte de indicadores antro-pométricos e força de preensão manual para triagem de sarcopenia e verificar a associação entre sarcopenia e estes indicadores. Métodos A amostra foi composta por 601 idosos e a sarcopenia foi identificada pelo índice de massa muscular apendicular. A curva Receiver Operating Characteristic identificou os valores de pontos de corte para: índice de massa corporal, razão cintura-estatura, perímetro de cintura e força de preensão manual para triagem da sarcopenia. A partir dos pontos de corte foi realizada análise de componentes principais para definir os que mais se adequaram como discriminantes, compondo um indicador, e realizado análise de regressão logística com este indicador como variável independente principal. Resultados Os resultados mostraram que todos os indicadores antropométricos e a força de preensão manual foram considerados discriminadores de sarcopenia, entretanto o índice de massa corporal, o perímetro da cintura e a razão cintura estatura mostram-se como os melhores discriminantes na análise de componentes principais, compondo o novo indicador. A análise de regressão logística (ajustada) mostrou que a sarcopenia foi associada com o indicador em ambos os sexos. Conclusão A presença de índice de massa corporal baixo, baixa relação cintura estatura e baixo perímetro da cintura concomitantemente podem auxiliar na discriminação da sarcopenia.

ABSTRACT Objective This cross-sectional population-based study aimed to determine the cutoff points of anthropometric indicators to screen for sarcopenia and the association between sarcopenia and these indicators. Methods The sample consisted of 601 older adults. Sarcopenia was detected by appendicular skeletal muscle index. The receiver operating characteristic curve identified the cutoff points for body mass index, waist-to-height ratio, waist circumference, and handgrip strength to screen for sarcopenia. Based on the cut-off points, principal component analysis determined which indicators had a better fit as discriminants to compose an indicator. Finally, logistic regression analysis was performed with this indicator as the main independent variable. Results The results showed that all anthropometric indicators and handgrip strength were capable of discriminating sarcopenia; however, body mass index, waist circumference, and waist-to-height ratio were the best discriminants in principal components analysis, composing the new indicator. Adjusted logistic regression analysis showed that sarcopenia was associated with the indicator in both sexes. Conclusion The concomitant presence of low body mass index, low waist circumference, and low waist-to-height ratio may help to discriminate sarcopenia.

Resumo O estudo teve como objetivo analisar a associação entre doenças e condições crônicas de saúde, multimorbidade e índice de massa corporal (IMC) em idosos do sul do Brasil. Estudo epidemiológico transversal, de base domiciliar. Foram entrevistados 477 pessoas, sendo 343 de 60 a 79 anos (amostragem probabilística) e todos aqueles com 80 anos ou mais (n=134). A hipertensão, diabetes, câncer, doença crônica pulmonar, doença coronariana, doença vascular cerebral, artrite, osteoporose, depressão, o histórico de quedas e dependência nas atividades da vida diária foram avaliados por meio de autorrelato. As associações entre as variáveis independentes e o IMC (desfecho) foram testadas por meio de regressão linear simples e múltipla. Participaram da pesquisa 270 mulheres (73,2±8,8 anos) e 207 homens (73,3±9,0 anos). Após ajuste (idade, escolaridade, arranjo familiar, tabagismo, consumo de álcool, circunferência da cintura, estado cognitivo e todas as doenças e condições crônicas de saúde) as associações identificadas foram: hipertensão e maiores valores de IMC (β 3,43; IC95%: 2,38 a 4,48), para as mulheres e; doença crônica pulmonar e menores valores de IMC (β -2,05; IC95%: -3,50 a -0,60). Houve tendência linear entre o número de doenças e condições crônicas de saúde e o IMC, para ambos os sexos. Os resultados mostraram associação independente entre doenças crônicas específicas e IMC. O monitoramento do estado nutricional da população idosa é importante para identificar valores extremos de IMC, especialmente naqueles com mais de duas doenças e condições crônicas de saúde.

Abstract The aim of this study was to analyze the association between diseases and chronic health conditions, multimorbidity and body mass index (BMI) in older adults from southern Brazil. Epidemiological cross-sectional study, with household basis was carried out with 343 older adults aged 60-79 years, selected by probability sampling and all aged 80 years or older (n=134). Hypertension, diabetes, cancer, chronic pulmonary diseases, coronary heart disease, cerebrovascular disease, arthritis, osteoporosis, depression, history of falls and dependency in activities of the daily living were assessed by self-report. Associations between independent variables and BMI (outcome) were tested using simple and multiple linear regression. Participated in the study 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years). After adjustment (age, education, living arrangement, smoking, alcohol consumption, waist circumference, cognitive status and all other disease and chronic health conditions), the associations identified were: hypertension with higher BMI values (β 3.43; 95%CI: 2.38 to 4.48), for women, and chronic pulmonary disease with lower BMI values (β -2.05; 95%CI: -3.50 to -0.60). There was a linear trend between number of diseases and BMI for both sexes. Conclusion: The results showed an independent association between specific chronic diseases and BMI. Monitoring of nutritional status in older adults is important to identify extreme BMI values, especially those with more than two diseases and chronic health conditions.

Resumo Os exergames, videogames ativos, necessitam do movimento corporal e vêm sendo utilizados como alternativa para aumentar o nível de atividade física de pessoas de diferentes faixas etárias. Este estudo qualitativo investigou a percepção de adultos mais velhos quanto à prática de exergames. O grupo focal (GF) foi conduzido após 12 semanas da realização de um programa de exercícios físicos com exergames (50 min., 3dias/semana), utilizando jogos eletrônicos que simulam atividades esportivas (Xbox 360 Kinect Sportstm). Participaram do GF 14 pessoas (55 a 77 anos). Um moderador treinado conduziu o GF, sendo as sessões gravadas em audio e transcritas, posteriormente, para análise. A técnica de análise de conteúdo foi realizada utilizando o software ATLAS.ti®. Os participantes relataram benefícios psicológicos (autoestima, concentração, humor, raciocínio, memória e bem estar), físicos (agilidade e condições físicas) e de interação social (troca de experiências, amizade e competitividade). Quanto às experiências vivenciadas pelo grupo, a inovação, a ludicidade e o estímulo visual foram citados como características dos jogos. A percepção de benefícios com a prática de exergames facilita a adesão ao exercício e aumenta a motivação dos participantes.

Abstract Exergames are active video games that monitor body movement and are being used as an alternative to increase the level of physical activity of people from different age groups. This qualitative study investigated the perceptions of the elderly regarding exergaming. The focus group (FG) was conducted after 12 weeks of performing a program of exergaming-based exercise (50 min, 3 days/week) using electronic games that simulate sports activities (Xbox 360 Kinect Sportstm). Fourteen people (55-77 years of age) participated in the FG, and a trained moderator led each group. The sessions were videotaped and transcribed for subsequent analysis. The content analysis technique was performed using ATLAS.ti® (qualitative analysis software). Participants reported psychological benefits (self-esteem, concentration, mood, reasoning, memory and well-being), physical benefits (agility and physical conditions) and social interaction (exchange of experiences, friendship and competitiveness). Regarding the experiences of the group, innovation, playfulness and visual stimulation were cited as characteristics of the games. The perception of benefits from participation in exergames fosters adherence to exercise and increases the motivation of the participants.

Resumo Os exergames, videogames ativos, necessitam do movimento corporal e vêm sendo utilizados como alternativa para aumentar o nível de atividade física de pessoas de diferentes faixas etárias. Este estudo qualitativo investigou a percepção de adultos mais velhos quanto à prática de exergames. O grupo focal (GF) foi conduzido após 12 semanas da realização de um programa de exercícios físicos com exergames (50 min., 3dias/semana), utilizando jogos eletrônicos que simulam atividades esportivas (Xbox 360 Kinect Sportstm). Participaram do GF 14 pessoas (55 a 77 anos). Um moderador treinado conduziu o GF, sendo as sessões gravadas em audio e transcritas, posteriormente, para análise. A técnica de análise de conteúdo foi realizada utilizando o software ATLAS.ti®. Os participantes relataram benefícios psicológicos (autoestima, concentração, humor, raciocínio, memória e bem estar), físicos (agilidade e condições físicas) e de interação social (troca de experiências, amizade e competitividade). Quanto às experiências vivenciadas pelo grupo, a inovação, a ludicidade e o estímulo visual foram citados como características dos jogos. A percepção de benefícios com a prática de exergames facilita a adesão ao exercício e aumenta a motivação dos participantes.

Abstract Exergames are active video games that monitor body movement and are being used as an alternative to increase the level of physical activity of people from different age groups. This qualitative study investigated the perceptions of the elderly regarding exergaming. The focus group (FG) was conducted after 12 weeks of performing a program of exergaming-based exercise (50 min, 3 days/week) using electronic games that simulate sports activities (Xbox 360 Kinect Sportstm). Fourteen people (55-77 years of age) participated in the FG, and a trained moderator led each group. The sessions were videotaped and transcribed for subsequent analysis. The content analysis technique was performed using ATLAS.ti® (qualitative analysis software). Participants reported psychological benefits (self-esteem, concentration, mood, reasoning, memory and well-being), physical benefits (agility and physical conditions) and social interaction (exchange of experiences, friendship and competitiveness). Regarding the experiences of the group, innovation, playfulness and visual stimulation were cited as characteristics of the games. The perception of benefits from participation in exergames fosters adherence to exercise and increases the motivation of the participants.