Background: The COVID-19 pandemic hit Brazil in a scenario of substantial socioeconomic and health inequalities. It is unknown the immediate impact of social restriction recommendations (i.e., lockdown, stay-at-home) on the life-space mobility of older people.Objective: To investigate the immediate impact of COVID-19 pandemic on life-space mobility of community-dwelling Brazilian older adults and examine the social determinants of health associated with change in life-space mobility.Design: Baseline data from a prospective cohort study (REMOBILIZE Study).Setting: Community.Subject: A convenience snowball sample of participants aged 60 and older (n = 1,482) living in 22 states in Brazil.Methods: We conducted an online and phone survey using an adapted version of the Life-Space Assessment (LSA). Linear regression models were used to investigate social determinants of health on the change in LSA score.Results: Regardless of their gender and social determinants of health, participants showed a significant reduction in life-space mobility since COVID-19 pandemic outbreak. Life-space mobility reduction was higher among black individuals, those living alone and aged between 70 and 79. Other variables associated with change in life-space mobility, to a lesser extent, were sex, education and income.Conclusion: Social restriction measures due to pandemic caused substantial reduction in older adults' life-space mobility in Brazil. Social inequalities strongly affected vulnerable groups. Concerted actions should be put in place to overcome the deterioration in life-pace mobility amongst these groups. Failure in minimizing health inequalities amplified by the pandemic may jeopardize the desired achievements of the Decade of Healthy Aging.
BackgroundSarcopenia is a multifactorial geriatric syndrome with complex interrelationships. Increased plasma levels of inflammatory mediators increase the catabolic stimuli of the musculature, thereby causing a decrease in mass and muscular function.ObjectiveThe objective of this study was to compare the performance of the knee extensors test (by isokinetic dynamometer) and plasma levels of interleukin-6 (IL-6) and soluble receptors of tumor necrosis factor alpha (sTNFR1) between sarcopenics and non-sarcopenics community-dwelling elderly women residents of Brazil.Material and methodsThe diagnosis of sarcopenia included measurements of body composition (by densitometry with dual energy source of X-ray), handgrip strength (by Jamar® dynamometer), and the usual gait velocity according to the recommendations of the European Working Group on Sarcopenia in Older People. In both sarcopenics and non-sarcopenics elderly women, we evaluated the muscle function by knee extensors test (using an isokinetic dynamometer Byodex System 4 Pro®) at angular speeds of 60°/s and 180°/s) and also we evaluated the plasma concentrations of IL-6 and sTNFR1. Comparisons of muscle performance between groups were carried out using mixed factorial ANOVA with post hoc Bonferroni test; sTNFR1 and IL-6 variables were analyzed by applying Mann–Whitney U test.ResultsStatistical differences were observed between groups regarding muscle power (P=0.01), total work adjusted to body weight (P=0.01) at a rate of 180°/s, and plasma levels of sTNFR1 (P=0.01).ConclusionSarcopenic elder women showed lower performance of the lower limbs, especially at a higher speed, predisposing these older women to greater vulnerability in functional activities that require agility and postural stability. Plasma levels of sTNFR1 were higher for non-sarcopenics elderlies. However, due to the observational nature of the study, it was impossible to infer causality among the variables surveyed.
Introduction: Resistance training is quoted as one of the best pathways to manage sarcopenia and progressive resistance training is supposed to improve muscle mass, strength and performance in older adults. Objective: The aim was to examine the impact of a progressive resistance exercise program (PREP) on muscle and function performance in sarcopenic community-dwelling elder women. Methods: Quasiexperimental study (pre -post intervention). Participated 18 sarcopenic community-dwelling elder women (65 years or older). PREP based on 75% of the participant's maximum load (12/wk, 3 times/wk). Main * JUV: PhD, e-mail: joana_ude@yahoo.com.br JMDD: PhD, e-mail: jmdd@eeffto.ufmg.com PPB: Doctoral student, e-mail: patriciaparreira@gmail.com SLAS: PhD, e-mail: silviafisiojf@yahoo.com.br RCD: PhD, e-mail: rcd@ufmg.br LPL: PhD, e-mail: llustosa@ufmg.br Fisioter Mov. 2018;31:e003111 Viana JU, Dias JMD, Batista PP, Silva SLA, Dias RC, Lustosa LP. 2 outcome measures: muscle strength of knee extensors (isokinetic dynamometry), muscle mass (dual-x ray absorptiometry -DXA), functional performance (Short Physical Performance Battery -SPPB). Paired t-test was used to evaluate differences pre and post intervention. Results: Improvements on power (p = 0.01) and peak torque (p = 0.01) were observed when measured by the isokinetic dynamometer at low speed (60º/s). Improvements on DXA (pre PREP: 5.49 kg/m2 vs. post PREP: 6.01 kg/m2; p = 0.03) and SPPB scores (pre PREP: 9.06 vs. post PREP: 10.28; p = 0.01) were also observed. Conclusion: The PREP was able to improve muscle and functional performance in sarcopenic community-dwelling elder women. This program should be considered in clinical practice. DXA (5,49 kg/m2 vs. 6,01 kg/m2; p = 0,03) e melhora nos escores do SPPB (9,06 vs. 10,28; p = 0,01 DXA (5,49 kg/m² vs. 6,01 kg/m², p = 0,03) y mejora en los escores del SPPB (9,06 vs. 10,28, p = 0,01 Keywords mais). PECP foi baseado em 75% de uma resistência máxima (12/semanas, 3 x/ semana). Medidas de desfecho: força muscular dos extensores de joelho (dinamômetro isocinético), massa muscular (dual-x ray absorptiometry -DXA), desempenho funcional (Short Physical Performance Battery -SPPB). Comparações pré-pós intervenção foi por meio do teste t-test pareado. Resultados: Houve aumento na potência (p = 0,01) e no torque (p = 0,01), observados nas medidas do isocinético em baixa velocidade (60º/s). Observou-se também aumento no
Aims and objectives To identify the most frequent determinants of contact limitation on older adults' mobility addressed by the recommendations to mitigate mobility limitation during the COVID‐19 pandemic and identify the recommendations characteristics and means of dissemination that might guide coping actions. Background Measures for physical contact restriction were implemented to prevent COVID‐19 spread. These measures directly impacted older people, reducing their mobility, especially outside home environment. Health systems worldwide need to be prepared to implement strategies to mitigate negative effects of reduced mobility in this population. Design Scoping review using Arksey and O′Malley's methodological framework. Method Therefore, a scoping review was conducted in LILACS, CINAHL, MEDLINE, WEB OF SCIENCE and SCOPUS databases. Documents and reports with recommendations from government agencies were also consulted. Results were presented in a narrative synthesis based on a conceptual model of mobility proposed by Webber ( The Gerontologist , 2010, 50 , 443) regarding the most frequently addressed determinants, characteristics of the proposed interventions, and means of dissemination for the older person population. Findings Twenty‐eight studies were selected for the final sample. According to Webber's model, most articles ( n = 14) presented the impacts on mobility from the perspective of physical determinants, relating this aspect to biological losses in the musculoskeletal system, and a minority assessed mobility in vital spaces, encompassing environmental ( n = 3) and financial ( n = 1) determinants. Also, the most frequent recommendation was that physical activity promotes maintenance of mobility and prevents the occurrence of adverse results, such as falls, fractures and functional decline. As to dissemination, digital technologies were recognised as a strategy to motivate, instruct and monitor exercise practice to increase mobility in older adults. Conclusion The main conditions related to the decline in mobility of older adults during COVID‐19 pandemic were physical inactivity and sedentary lifestyle. The practice of physical activity is widespread and needs to be adapted according to individual needs. Finally, digital technologies are essential tools in this period, but other alternatives should also be considered for low‐income seniors. Implications for practice It is hoped that the gaps identified through this scoping review can help enhance the discussion on the broader assessment of mobility in older adults and the design of interventions when contact restriction is a reality.
BACKGROUND: Social distancing has led to lifestyle changes among older adults during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES: This study aimed to estimate the prevalence risk of sarcopenia (RS) and investigate its associated factors during the COVID-19 pandemic in older Brazilian adults. DESIGN AND SETTING: Cross-sectional observational analysis of baseline data as part of the Remobilize Study. METHODS: Participants in the study were older adults (≥ 60 years), excluding those who were bedridden or institutionalized. The data collected consisted of answers about the RS (SARC-F), functional status, walking, sedentary behavior (SB), pain, comorbidity, and life space mobility. RESULTS: A total of 1,482 older adults (70 ± 8.14 years, 74% women) participated in the study, and an RS prevalence of 17.1% was found. (95% confidence interval [CI] 15.25-19.15%). The adjusted multivariate model showed a significant association between RS and functional limitation (odds ratio [OR]:
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