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动力不足的流行率及其与残疾、抑郁和执行功能障碍的重叠。

Prevalence of dynapenia and overlap with disability, depression, and executive dysfunction.

机构信息

Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria. Rio de Janeiro, RJ, Brasil.

Universidade do Estado do Rio de Janeiro, Instituto de Medicina Social. Rio de Janeiro, RJ, Brasil.

出版信息

Rev Saude Publica. 2023 Aug 4;57:43. doi: 10.11606/s1518-8787.2023057004580. eCollection 2023.

Abstract

OBJECTIVE

This study aims to investigate handgrip strength and dynapenia prevalence among older adults stratified by Brazilian macroregions. Additionally, we aim to evaluate the overlap between dynapenia and Instrumental Activities of Daily Living (IADL) disability, depression, and executive dysfunction on a national basis and by each Brazilian macroregion.

METHODS

This cross-sectional analysis was based on data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). A multistage cluster sample design was used, with a representative population-based study of non-institutionalized community-dwelling Brazilians aged ≥ 50 years from 70 municipalities across all five macroregions of the country. The outcome variable was dynapenia. Covariables were IADL disability, depression, and executive dysfunction. The Brazilian macroregions were used for stratification. In addition, the following additional variables were included: age group, gender, education level, macroregions (North, Northeast, Southeast, South, and Midwest), self-reported health, multimorbidity, and falls.

RESULTS

A total of 8,849 (94%) of the sample provided complete information for the handgrip strength assessment and were included in this analysis. Dynapenia prevalence was higher in North and Northeast regions (28.5% and 35.1%, respectively). We identified statistically significant differences between different macroregions for dynapenia, IADL disability, and verbal fluency, with worse values in the North and Northeast regions. In the North and Northeast macroregions, nearly half of the subjects that presented executive dysfunction and IADL disability also had dynapenia. There was a more significant overlap in the prevalence of all four conditions in the North and Northeast regions (4.8% and 5.5%, respectively), whereas the overlap was smaller in the South (2.3%). There was also a smaller overlap in the prevalence of dynapenia and depression in the South (5.8%) compared with other macroregions.

CONCLUSIONS

Macroregions in Brazil exhibit marked differences in the prevalence of dynapenia and in its overlap with IADL disability, depression, and executive dysfunction.

摘要

目的

本研究旨在调查按巴西宏观区域分层的老年人的握力和动力不足患病率。此外,我们旨在评估动力不足与日常生活活动(IADL)障碍、抑郁和执行功能在全国范围内以及每个巴西宏观区域的重叠情况。

方法

这是一项基于巴西老龄化纵向研究(ELSI-Brazil)数据的横断面分析。采用多阶段聚类抽样设计,对来自全国 70 个城市的 50 岁及以上非机构化社区居住的巴西人进行了具有代表性的基于人群的研究。因变量是动力不足。协变量是 IADL 障碍、抑郁和执行功能。巴西宏观区域用于分层。此外,还包括以下附加变量:年龄组、性别、教育水平、宏观区域(北部、东北部、东南部、南部和中西部)、自我报告的健康状况、多种疾病和跌倒。

结果

在提供了完整的握力评估信息的 8849 名(94%)样本中,有 8849 名被纳入了本次分析。北部和东北部地区的动力不足患病率较高(分别为 28.5%和 35.1%)。我们发现不同宏观区域之间在动力不足、IADL 障碍和言语流畅性方面存在统计学显著差异,北部和东北部地区的数值较差。在北部和东北部地区,近一半存在执行功能障碍和 IADL 障碍的患者也患有动力不足。在北部和东北部地区,所有四种情况的患病率重叠更为显著(分别为 4.8%和 5.5%),而在南部地区则较小(2.3%)。在南部地区,动力不足与抑郁的患病率重叠也较小(5.8%),与其他宏观区域相比。

结论

巴西的宏观区域在动力不足的患病率及其与 IADL 障碍、抑郁和执行功能的重叠方面存在明显差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4a2/10355316/0cce284e2c17/1518-8787-rsp-57-43-gf01.jpg

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