Nível de atividade física e quedas em idosos da comunidade: um estudo exploratório

• Ano de defesa: 2011
• Autor(a) principal: Teixeira, Luiza Faria
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Cidade de São Paulo; Brasil; Pós-Graduação; Programa de Pós-Graduação Mestrado em Fisioterapia; UNICID
• Palavras-chave em Português: Quedas acidentais; Idoso; Nível de atividade; Avaliação gerontológica; Desempenho físico; FISIOTERAPIA E TERAPIA OCUPACIONAL
• Link de acesso: https://repositorio.cruzeirodosul.edu.br/handle/123456789/1156

Background: There is no consensus in the literature about the correlation between the physical activity level and the risk of falls in community-dwelling elderly. Some studies suggest that older adults with low level of physical activity would have greater risk of falls, while others suggest that older adults with higher level of physical activity would also have an increased risk of falls. However, few studies have directly investigated this relation and some findings are based on studies that sought to investigate the profile of the older adults who have fallen in and out their homes. The aim of this present study was identify whether there is an association between physical activity level and falls and explore sociodemographic and physical function factors and health conditions related with falls in a representative sample of older adults with high and moderate/low physical activity level. Methods: It is a cross-sectional study in a representative sample of from a population-based sample of 385 Brazilian, men and women aged 65 and older, living in the city of Barueri – São Paulo. This place has part of the older adults population studied by FIBRA (Frailty in Brazilian Older Adults). The occurrence of falls was observed from the self-report of the number of falls in the last year and physical activity level was assessed in the last two weeks by a short version of the Minnesota Leisure Time Activities Questionnaire (MLTPA-Q). The sample was classified in two groups according to the total caloric expenditure in Kg/min/week ascertained for each participant: the Most Active Group (third tertile) and the Less Active Group (first and second tertiles). Data were collected through a multidimensional questionnaire that accomplished socio-demographic (gender, age, education, housing), body mass index (BMI), mental status (Mini-Mental State Examination – MMSE), depressive symptoms (Geriatric Depression Scale – GDS), concern about falling (Falls Efficacy Scale International - FES-I), subjective health perception, number of comorbidities and drugs, poor memory and dizziness complaint, sleeping, vision and hearing problems, fatigue, Advanced Activities of Daily Living (AADL) limitation and physical-functioning tests: handgrip strength, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG), Unipodal Time Stance, Five Step Test, and usual gait speed. We performed a univariate (significance level of α < 0.10) and a multivariate (significance level of α < 0.05) logistic regression analysis through Stepwise – Backward method Results: The average age of participants was 71.4 (5.71SD) and 248 (64%) were woman. The average caloric expenditure among non fallers was 2222.11 kcal/min compared to 1822.38 kcal/ min among the fallers (p = 0.063). There was a higher prevalence of falls in the Less Active Group (69.3%) when compared to the More Active Group (30.7%), but the difference was not statistically significant (p=0.439). Among the most active elderly, the fall was associated with: aged 75 years or more (OR: 3.60, 95% CI: 1,12 to 11,58, p = 0.031), low education (OR: 3.88 , 95% CI: 1.25 - 11.97, p = 0.018), depression (OR: 6.94, 95% CI: 2.00 - 8.24, p = 0.002) and hypertension (OR: 3.30, 95% CI: 1.32 - 8.23, p = 0.010). The specificity and sensitivity of the model were 71.6% and 68.1%, respectively. The adjusted model for the Less Active Group was composed by dizziness (OR: 1.75, 95% CI: 1.04 - 2.93, p = 0.032) and osteoporosis (OR: 2.67, 95% CI: 1.45 - 4.91, p = 0.001), with a specificity of 52.3% and sensitivity of 71.4%. Conclusion: There was no association between physical activity level and falls in this representative population of older adults living in the community, but it is remarkable that about a third of the most active elderly have suffered at least one fall in the previous year. Fallers with higher level of physical activity presented modifiable characteristics that may reduce fall risk and should be addressed in specified fall prevention programs for this population