Leisure-time physical activity as a protective factor for functional capacity loss in community dwelling elders

Ribeiro, Maria Claudia Martins; Sañudo, Adriana; Ramos, Luiz Roberto

doi:10.1590/rbce.42.2019.278

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ARTIGO ORIGINAL • Rev. Bras. Ciênc. Esporte 42 • 2020 • https://doi.org/10.1590/rbce.42.2019.278 copy

Leisure-time physical activity as a protective factor for functional capacity loss in community dwelling elders

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Populational aging led to the emergence of chronic diseases, all potentially incapacitating, thus affecting functional capacity (FC) of elders. Despite health evidences in favour of having regular physical activity, the majority of elders are not sufficiently active. Baseline data of an urban elder cohort in Brazil showed that only 28% were active and 68% had some functional loss, a figure that went up to 73% among the inactives. FC was associated with a network of sociodemographic, health and behavioral factors. In a multivariate analysis, the inactives showed twice the odds of being severely dependent when compared to the actives. Noteworthy that inactivity is as a modifiable factor that might prevent FC loss. Longitudinal studies are needed to verify.

Keywords:
Independent living; Exercise; Cross-sectional study; Aging

Variables	Total N=907		ADL Score								p	Crammer´s V
	Total N=907		Independent N=288 (31.7%)		Mild dependence N=376 (41.5%)		Moderate N=114 (12.6%)		Severe N=129 (14.2%)
	N	%	N	%	N	%	N	%	N	%
Sex											0.001	0.138
Male	297	32.8	104	36.1	139	37.0	28	24.6	26	20.2
Female	610	67.2	184	63.9	237	63.0	86	75.4	103	79.8
Age											<0.001	0.217
60-69	316	34.8	137	47.5	134	35.6	24	21.1	21	16.3
70-79	382	42.1	117	40.6	165	43.8	51	47.7	49	38.0
≥ 80	209	23.1	34	11.9	77	20.5	39	34.2	59	45.7
Marital status											<0.001	0.166
Married	471	52.0	163	56.6	212	56.5	53	46.5	43	33.3
Not married	435	48.0	125	43.4	163	43.5	61	53.5	86	66.7
Years of study											<0.001	0.134
≥ 8	601	66.3	211	73.3	259	68.9	68	59.7	63	48.8
4-7	240	26.5	59	20.5	99	26.3	34	29.8	48	37.2
≤ 3	66	7.2	18	6.2	18	4.8	12	10.5	18	14.0
Income (MW)											0.007	0.091
≤ 1	95	10.5	28	9.7	29	7.7	15	13.2	23	17.8
2-3	204	22.5	57	19.8	83	22.1	31	27.2	33	25.6
4-10	476	52.5	162	56.3	196	52.1	55	48.2	63	48.8
> 10	132	14.5	41	14.2	68	18.1	13	11.4	10	7.8

Variables	Total N=907		ADL Score								p	Crammer´sV
	Total N=907		Independent N=288 (31.7%)		Mild dependence N=376 (41.5%)		Moderate N=114 (12.6%)		Severe N=129 (14.2%)
	N	%	N	%	N	%	N	%	N	%
Nr Diagnoses											<0.001	0.201
0-2	35	3.9	21	7.3	12	3.2	1	0.9	1	0.8
3-6	277	30.5	131	45.5	111	29.5	19	16.7	16	12.4
7-9	283	42.2	81	28.1	126	33.5	42	36.8	34	26.3
≥10	312	34.4	55	19.1	127	33.8	52	45.6	78	60.5
Nr Drugs											<0.001	0.170
Do not take	63	7.0	27	9.4	28	7.4	5	4.4	3	2.3
1-4	381	42.0	145	50.3	171	45.5	33	28.9	32	24.8
≥5	463	51.0	116	40.3	177	47.1	76	66.7	94	72.9
Dysthymia											<0.001	0.283
Negative (<5)	709	78.2	254	88.2	308	81.9	78	68.4	69	53.5
Positive (≥5)	198	21.8	34	11.8	68	18.1	36	31.6	60	46.5
BMI											<0.001	0.131
Eutrophic	398	45.9	146	54.3	160	44.1	44	40.4	48	39.0
Low weight	150	17.3	61	22.7	60	16.5	14	12.8	15	12.0
Overweight	115	13.3	23	8.5	60	16.5	13	11.9	19	15.1
Obese	204	23.5	39	14.5	83	22.9	38	34.9	44	35.9

Variables	Total N=907		ADL Score								p	Crammer´s V
	Total N=907		Independent N=288 (31.7%)		Mild dependence N=376 (41.5%)		Moderate N=114 (12.6%)		Severe N=129 (14.2%)
	N	%	N	%	N	%	N	%	N	%
Tobacco											0.092	0.078
Do not smoke	579	64.2	182	63.2	232	62.0	69	60.5	96	75.6
Smoker	60	6.6	23	8.0	22	5.9	10	8.8	5	3.9
Ex-smoker	264	29.2	83	28.8	120	32.1	35	30.7	26	20.5
Alcohol											0.307	0.063
No	510	56.4	172	59.9	198	52.8	65	57.0	75	58.1
Yes	395	43.6	115	40.1	177	47.2	49	43.0	54	41.9
LTPA											0.001	0.113
Active	252	27.8	103	35.8	100	26.6	24	21.0	25	19.4
Insuff. active	159	17.5	50	17.3	73	19.4	20	17.6	16	12.4
Inactive	496	54.7	135	46.9	203	54.0	70	61.4	88	68.2

Variables	Crude analysis
	Mild x Independent			Moderate x Independent			Severe x Independent
	OR	95%CI	p	OR	95%CI	p	OR	95%CI	p
Sex
Female x Male	0.96	0.70-1.32	0.820	1.74	1.06-2.83	0.027	2.24	1.37-3.66	0.001
Age
70-79 x 60-69	1.44	1.03-2.02	0.033	2.49	1.44-4.29	0.001	2.73	1.55-4.82	0.001
≥ 80 x 60-69	2.31	1.45-3.70	<0.001	6.55	3.48-12.32	0.001	11.32	6.07-21.12	<0.001
Marital status
Not married x Married	1.00	0.73-1.37	0.987	1.50	0.97-2.32	0.068	2.61	1.69-4.02	<0.001
Years of study
4-7 x ≥ 8	1.37	0.94-1.98	0.098	1.79	1.08-2.96	0.023	2.72	1.70-4.37	<0.001
≤ 3 x ≥ 8	0.81	0.41-1.60	0.554	2.07	0.95-4.51	0.068	3.35	1.64- 6.82	0.001
BMI
Low weight x Eutrophic	0.90	0.59-1.37	0.615	0.76	0.39-1.49	0.427	0.75	0.39-1.43	0.383
Overweight x Eutrophic	2.38	1.40-4.04	0.001	1.87	0.88-4.01	0.104	2.51	1.26-5.01	0.009
Obese x Eutrophic	1.94	1.25-3.02	0.003	3.23	1.85-5.66	<0.001	3.43	2.00-5.89	<0.001
Income (MW)
2-3 x ≤ 1	1.40	0.76-2.61	0.281	1.01	0.47-2.18	0.969	0.70	0.35-1.42	0.326
4-10 x ≤ 1	1.17	0.67-2.04	0.586	0.63	0.31-1.27	0.200	0.47	0.25-0.88	0.019
> 10 x ≤ 1	1.60	0.84-3.06	0.154	0.59	0.24-1.43	0.245	0.30	0.12-0.72	0.007
Nr diagnoses
3-6 x 0-2	1.48	0.70-3.15	0.305	3.05	0.39-23.97	0.290	2.56	0.32-20.37	0.373
7-9 x 0-2	2.72	1.27-5.83	0.010	10.89	1.41-83.77	0.022	8.81	1.14-68.17	0.037
≥ 10 x 0-2	4.04	1.86-8.78	<0.001	19.85	2.58-152.93	0.004	29.78	3.89-228.01	0.001
Nr drugs
1-4 x None	1.14	0.64-2.02	0.660	1.23	0.44-3.43	0.694	1.99	0.57-6.95	0.283
≥ 5 x None	1.47	0.82-2.62	0.190	3.54	1.30-9.59	0.013	7.29	2.15-24.79	0.001
Dysthymia
Positice x Negative	1.65	1.06-2.57	0.027	3.45	2.02-5.87	<0.001	6.50	3.95-10.69	<0.001
LTPA
Insuff Active x Active	1.50	0.96-2.36	0.077	1.72	0.87-3.40	0.121	0.65-2.69	0.447	0.447
Inactive x Active	1.55	1.09-2.20	0.015	2.22	1.31-3.78	0.003	1.61-4.48	<0.001	<0.001
Tobacco
Smoker x Non-smoker	0.75	0.40-1.39	0.361	1.15	0.52-2.53	0.735	0.15-1.12	0.082	0.082
Ex-Smoker x Non-smoker	1.13	0.81-1.59	0.469	1.11	0.69-1.80	0.666	0.36-0.98	0.043	0.043
Alcohol
Yes x No	1.34	0.98-1.82	0.067	1.13	0.73-1.75	0.593	0.71-1.64	0.731	0.731

Variáveis	Adjusted analysis
	Mild x Independent			Moderate x Independent			Severe x Independent
	OR	95%CI	p	OR	95%CI	p	OR	95%CI	p
Sex
Female x Male	0.87	0.61-1.25	0.460	1.37	0.78-2.42	0.270	1.46	0.81-2.62	0.208
Age
70-79 x 60-69	1.28	0.89-1.85	0.187	2.19	1.20-4.00	0.011	2.92	1.52-5.63	0.001
≥ 80 x 60-69	2.44	1.45-4.10	0.001	8.66	4.18-17.91	<0.001	21.16	9.79-45.73	<0.001
BMI
Low weight x Eutrophic	0.93	0.59-1.45	0.742	0.66	0.32-1.38	0.270	0.57	0.26-1.23	0.151
Overweight x Eutrophic	2.52	1.45-4.37	0.001	2.00	0.89-4.50	0.095	3.12	1.41-6.93	0.005
Obese x Eutrophic	2.06	1.29-3.29	0.002	3.41	1.82-6.37	<0.001	4.49	2.35-8.57	<0.001
Nr diagnoses
3-6 x 0 to 2	1.31	0.58-2.98	0.515	1.53	0.18-13.06	0.697	1.10	0.12-10.08	0.933
7-9 x 0-2	2.58	1.12-5.95	0.026	4.92	0.59-41.06	0.141	2.88	0.32-25.94	0.345
≥ 10 x 0-2	2.98	1.26-7.06	0.013	6.00	0.71-50.55	0.099	5.69	0.64-50.78	0.119
Nr drugs
1-4 x None	1.04	0.55-1.97	0.898	0.98	0.32-3.06	0.978	1.70	0.42-6.77	0.454
≥ 5 x None	1.09	0.56-2.11	0.800	2.03	0.66-6.19	0.215	3.21	0.82-12.54	0.093
LTPA
Insuff Active x Active	1.25	0.75-2.08	0.393	1.41	0.64-3.13	0.390	0.65	0.27-1.51	0.326
Inactive x Active	1.39	0.95-2.03	0.094	2.10	1.14-3.87	0.018	2.02	1.10-3.71	0.023
Dysthymia
Positive x Negative	1.61	0.99-2.62	0.056	3.69	2.00-6.82	<0.001	6.88	3.72-12.76	<0.001

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[1] *Autor correspondente: Luiz Roberto Ramos. E-mail: lrramos1953@gmail.com