Association between diabetes, hypertension, activities of daily living and physical activity among elderly users of primary healthcare facilities

Martinez, Edson Zangiacomi; Silva, Anderson Soares da; Franco, Laercio Joel; Santos, Scarlet Feitosa; Terada, Natalia Akemi Yamada; Zucoloto, Miriane Lucindo

doi:10.1590/1980-0037.2019v21e55149

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Revista Brasileira de Cineantropometria & Desempenho Humano

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Original article • Rev. bras. cineantropom. desempenho hum 21 • 2019 • https://doi.org/10.1590/1980-0037.2019v21e55149 copy

Association between diabetes, hypertension, activities of daily living and physical activity among elderly users of primary healthcare facilities

Associação entre diabetes, hipertensão, atividades da vida diária e atividade física entre idosos usuários de serviços de atenção primária à saúde

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this cross-sectional study was to estimate the prevalence of self-reportedhypertension and diabetes among elderly users of primary healthcare facilities in Ribeirão Preto, Brazil, and to investigate the association between these chronic conditions and physical activity and the degree of independence on the performance of activities of daily living. The study included 357 subjects aged 60 years or older. The classification of physical activity was based on the International Physical Activity Questionnaire (IPAQ) and the Pfeffer FunctionalActivities Questionnaire (PFAQ) was applied to assess activities of daily living. Prevalence of diabetes was associated with the level of physical activity, the self-perception of health and the degree of independence on the performance of activities of daily living. No significant associations were found between the prevalence of hypertension and these variables. These findings reinforce the relevance of continuous strategies of management of diabetes in the primary healthcare facilities based on the promotion of physical and occupational activities.

Key words
Activities of daily living; Aged; Diabetes; Hypertension; Physical activity

			DM prevalence			AH prevalence
Variables	Total	n	%	PR (95%CI)	n	%	PR (95%CI)
Sex
Women	224	55	24.6	Ref.	139	62.1	Ref.
Men	133	38	28.6	1.2 (0.8 - 1.7)	71	53.4	0.8 (0.6 - 1.0)
Age groups (years)
60 - 65	93	23	24.7	Ref.	47	50.5	Ref.
66 - 74	156	45	28.9	1.1 (0.7 - 1.8)	91	58.3	1.2 (0.9 - 1.5)
75 or more	108	25	23.1	0.9 (0.5 - 1.5)	72	66.7	1.3 (1.1 - 1.7)*
Private health insurance
No	303	77	25.4	Ref.	178	58.8	Ref.
Yes	54	16	29.6	1.2 (0.8 - 1.7)	32	59.3	1.0 (0.7 - 1.3)
Educational level
No schooling	25	8	32.0	Ref.	18	72.0	Ref.
Elementary school	238	60	25.2	0.7 (0.3 - 1.3)	146	61.3	0.9 (0.7 - 1.2)
Intermediate school	68	21	30.9	0.9 (0.4 - 1.8)	36	52.9	0.8 (0.5 - 1.1)
Higher education	26	4	15.4	0.4 (0.1 - 1.3)	10	38.5	0.5 (0.3 - 1.0)
Marital status
Single	28	7	25.0	Ref.	12	42.9	Ref.
Married	197	53	26.9	1.1 (0.5 - 2.1)	117	59.4	1.5 (0.9 - 2.3)
Divorced	48	11	22.9	0.9 (0.3 - 2.1)	27	56.3	1.4 (0.8 - 2.3)
Widowed	84	22	26.2	1.1 (0.5 - 2.4)	54	64.3	1.4 (0.8 - 2.2)
Socioeconomic status
A, B1 or B2	92	22	23.9	Ref.	50	54.4	Ref.
C1	115	35	30.4	1.3 (0.8 - 2.0)	69	60.0	1.1 (0.8 - 1.3)
C2	95	16	16.8	0.6 (0.3 - 1.2)	63	66.3	1.2 (0.9 - 1.5)
D or E	55	20	36.4	1.6 (0.9 - 2.6)	28	50.9	0.9 (0.6 - 1.2)
Self-perception of health
Good	150	19	12.7	Ref.	70	46.7	Ref.
Regular	153	51	33.3	3.0 (1.8 - 4.8)*	105	68.6	1.4 (1.1 - 1.8)
Poor	54	23	42.6	3.6 (2.1 - 6.1)*	35	64.8	1.3 (1.0 - 1.8)
Smoking status
Current smoker	54	12	22.2	Ref.	26	48.2	Ref.
Exsmoker	110	31	28.2	1.2 (0.6 - 2.2)	62	56.4	1.2 (0.8 - 1.6)
Nonsmoker	193	50	25.9	1.8 (0.6 - 2.1)	122	63.2	1.3 (0.9 - 1.7)
IPAQ level
High	103	20	19.4	Ref.	58	56.3	Ref.
Moderate	196	50	25.5	1.3 (0.8 - 2.1)	116	59.2	1.0 (0.8 - 1.3)
Low	58	23	39.7	2.1 (1.2 - 3.5)*	36	62.1	1.0 (0.7 - 1.3)
Use of any device
No	332	86	25.9	Ref.	193	58.1	Ref.
Yes	25	7	28.0	1.1 (0.5 - 2.1)	17	68.0	1.1 (0.8 - 1.5)
Limitation due to pain
Never	143	32	22.4	Ref.	75	52.5	Ref.
Rarely	36	9	25.0	1.2 (0.6 - 2.3)	24	66.7	1.2 (0.8 - 1.6)
Occasionally	73	22	30.1	1.4 (0.8 - 2.3)	44	60.3	1.1 (0.8 - 1.4)
Oftentimes	47	9	19.2	0.8 (0.4 - 1.7)	27	57.5	1.1 (0.8 - 1.5)
Always	58	21	36.2	1.8 (1.1 - 2.9)*	40	69.0	1.2 (0.9 - 1.6)
Functional impairment (PFAQ)
No (score ≤ 5)	290	70	24.1	Ref.	166	57.2	Ref.
Yes (score > 5)	67	23	34.2	1.5 (1.1 - 2.2)*	44	65.7	1.1 (0.8 - 1.3)

	Participants who did not reported DM				Participants who reported DM
Age groups (years)	n	Mean (SD)	Min-Max	n	Mean (SD)	Min-Max	P value
60 - 65	70	1.86 (3.15)	0 - 19	23	2.70 (3.60)	0 - 13	0.10
66 - 74	111	2.69 (3.58)	0 - 18	45	2.84 (4.40)	0 - 26	0.99
75 or more	83	3.87 (4.45)	0 - 20	25	7.48 (6.94)	0 - 25	<0.01

	Participants who did not reported AH				Participants who reported AH
Age groups (years)	n	Mean (SD)	Min-Max	n	Mean (SD)	Min-Max	P value
60 - 65	46	2.09 (3.66)	0 - 19	47	2.04 (2.87)	0 - 11	0.76
66 - 74	65	2.25 (3.09)	0 - 16	91	3.09 (4.25)	0 - 26	0.60
75 or more	36	4.67 (5.87)	0 - 25	72	4.72 (5.07)	0 - 19	0.95

			DM prevalence
Activities of daily living	Total	n	%	PR (95%CI)
1. Writing checks, paying bills, or keeping financial records
Have no dependency	252	63	25.0	Ref.
Have some degree of dependency	105	30	28.6	1.2 (0.8 - 1.7)
2. Assembling tax records, business affairs, or papers
Have no dependency	194	46	23.7	Ref.
Have some degree of dependency	163	47	28.8	1.2 (0.8 - 1.7)
3. Shopping alone for clothes, household necessities, and groceries
Have no dependency	310	74	23.9	Ref.
Have some degree of dependency	47	19	40.4	1.8 (1.1 - 2.7)*
4. Playing a game of skill, working on a hobby
Have no dependency	289	69	23.9	Ref.
Have some degree of dependency	68	24	35.3	1.5 (1.1 - 2.3)*
5. Heat water, make a cup of coffee, turn off stove
Have no dependency	334	85	25.4	Ref.
Have some degree of dependency	23	8	34.8	1.4 (0.7 - 2.5)
6. Preparing a balanced meal
Have no dependency	325	85	26.2	Ref.
Have some degree of dependency	32	8	25.0	0.9 (0.4 - 1.8)
7. Keeping track of current events
Have no dependency	329	82	24.9	Ref.
Have some degree of dependency	28	11	39.3	1.7 (1.0 - 2.8)
8. Paying attention to, understanding, discussing TV, book, magazine
Have no dependency	319	80	25.1	Ref.
Have some degree of dependency	38	13	34.2	1.4 (0.8 - 2.3)
9. Remembering appointments, family occasions, holidays, medications
Have no dependency	253	58	22.9	.
Have some degree of dependency	104	35	33.7	1.5 (1.1 - 2.1)*
10. Traveling out of neighborhood, driving, arranging to take buses
Have no dependency	301	75	24.9	Ref.
Have some degree of dependency	56	18	32.1	1.4 (0.9 - 2.2)

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[1] Corresponding authorEdson Zangiacomi MartinezAv. Bandeirantes, 3900, Monte Alegre, 14049-900, Ribeirão Preto Medical School, University of São Paulo,Ribeirão Preto, SP, Brazil.Email: edson@fmrp.usp.br