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Fisioterapia em Movimento

On-line version ISSN 1980-5918

Fisioter. mov. vol.33  Curitiba  2020  Epub Jan 13, 2020

https://doi.org/10.1590/1980-5918.033.ao10 

ORIGINAL ARTICLE

Sociodemographic and psychological variables, physical activity and quality of life in elderly at Unati Campinas, São Paulo

Variáveis sociodemográficas, psicológicas, atividade física e qualidade de vida em idosos da Unati de Campinas, São Paulo

Variables sociodemográficas, psicológicas, de actividad física y de calidad de vida en ancianos de universidad para personas mayores de Campinas, São Paulo

Valéria Melo Claudino Alvesa 
http://orcid.org/0000-0003-0952-2078

Vinícius Nagy Soaresa 
http://orcid.org/0000-0003-0363-5186

Daniel Vicentini de Oliveirab 
http://orcid.org/0000-0002-0272-9773

Paula Teixeira Fernandesa  * 
http://orcid.org/0000-0002-0492-1670

aUniversidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil

bCentro Universitário de Maringá (Unicesumar), Maringá, PR, Brazil


Abstract

Introduction:

Although previous studies have characterized the sociodemographic profile and physical activity level of older people at the Universities of the Third Age (Unati - Universidade Aberta da Terceira Idade), there are research gaps regarding the relationship of these variables with the psychological aspects and the quality of life.

Objective:

To assess the relationship between sociodemographic and psychological variables, physical activity level and quality of life (QoL) in older people at Unati in Campinas, São Paulo, Brazil.

Method:

This is a cross-sectional study that recruited 116 older participants of both gender, aged between 60 and 89 years. They were submitted to the following tests: the Rosenberg Self-Esteem Scale (RSES), the Wagnild & Young’s Resilience Scale (RS), the General Self-Efficacy Scale (GSE), the WHOQOL BREF, the Mini-Mental State Examination (MMSE), the Self-Reporting Questionnaire (SRQ20) and the International Physical Activity Questionnaire (IPAQ). The data were analyzed using the Kolmogorov-Smirnov, chi-squared, Fisher’s exact, t- and Mann-Whitney U tests, as well as the generalized linear models.

Results:

Self-esteem was associated with age, income, schooling level, membership time, and the psychological domain of the WHOQOL-BREF (p < 0.05). Resilience was associated with the schooling level and the psychological domain of the WHOQOL-BREF (p < 0.05), and the self-efficacy with the psychological domain of the WHOQOL-BREF. Common mental disorders were related to the physical and psychological domains of the WHOQOL-BREF, as well as the self-efficacy and being male. The physical activity level showed no correlation with the psychological aspects and the sociodemographic variables studied (p > 0.05).

Conclusion:

The sociodemographic variables influence emotional aspects, particularly older people’s self-esteem and resilience at Unati. Additionally, the psychological domain of the WHOQOL-BREF was a predictor of all the emotional variables in this sample.

Keywords: Aging; Psychology; Self-Esteem; Resilience, Psychological; Quality of Life

Resumo

Introdução:

apesar de o perfil sociodemográfico e o nível de atividade física de idosos das Universidades da Terceira Idade (Unati) terem sido caracterizados em estudos anteriores, encontram-se lacunas acerca das relações com os aspectos psicológicos e a qualidade de vida.

Objetivo:

verificar as relações entre variáveis sociodemográficas, psicológicas, nível de atividade física e qualidade de vida em idosos frequentadores da Unati de Campinas, São Paulo.

Método:

estudo transversal, no qual foram recrutados 116 idosos de ambos os sexos, com idade entre 60 e 89 anos, submetidos à Escala de Autoestima de Rosenberg, Escala de Resiliência de Wagnild & Young, Escala de autoeficácia geral percebida, WHOQoL Bref, Miniexame do estado mental, Self-report Questionnaire (SRQ20) e o Questionário Internacional de atividade física (IPAQ). Os dados foram analisados pelos testes Kolmogorov-Smirnov, Qui Quadrado, Exato de Fisher, teste t, U de Mann-Whitney e pelos Modelos Lineares Generalizados.

Resultados:

a autoestima associou-se à idade, renda, escolaridade, ao tempo no programa e ao domínio psicológico do WHOQoL-bref (p < 0,05). A resiliência apresentou associação com a escolaridade e ao domínio psicológico do WHOQoL-bref (p < 0.05). A autoeficácia associou-se ao domínio psicológico do WHOQoL-bref. Os transtornos mentais comuns mostraram associação com os domínios físico e psicológico do WHOQoL-bref, à autoeficácia e ao sexo masculino. O nível de atividade física não se associou com os aspectos psicológicos e as variáveis sociodemográficas estudadas (p > 0,05).

Conclusão:

as variáveis sociodemográficas influenciam aspectos emocionais, sobretudo autoestima e resiliência de idosos da Unati. Além disso, o domínio psicológico do WHOQoL-bref foi preditor de todas as variáveis emocionais nesta amostra.

Palavras-chave: Envelhecimento; Psicologia; Autoestima; Resiliência Psicológica; Qualidade de Vida

Resumen

Introducción:

aunque el perfil sociodemográfico y el nivel de actividad física de los ancianos de las Universidades de Tercera Edad (Unati) se han caracterizado en estudios anteriores, existen lagunas sobre las relaciones con los aspectos psicológicos y la calidad de vida.

Objetivo:

verificar las relaciones entre las variables sociodemográficas y psicológicas, el nivel de actividad física y la calidad de vida en ancianos que asisten a Unati Campinas, São Paulo.

Método:

estudio transversal en el que 116 hombres y mujeres de edad avanzada de 60 a 89 años fueron reclutados y sometidos a la Escala de autoestima de Rosenberg, la Escala de resistencia de Wagnild & Young, la Escala de autoeficacia general percibida, WHOQoL Bref, Miniexame. Cuestionario de autoinforme (SRQ20) y el Cuestionario internacional de actividad física (IPAQ). Los datos fueron analizados por Kolmogorov-Smirnov, Chi-cuadrado, prueba exacta de Fisher, prueba t de Mann-Whitney y modelos lineales generalizados.

Resultados:

la autoestima se asoció con la edad, los ingresos, la educación, el tiempo en el programa y el dominio psicológico de WHOQoL-bref (p < 0.05). La resiliencia se asoció con la educación y con el dominio psicológico de WHOQoL-bref (p < 0.05). La autoeficacia se asoció con el dominio psicológico de WHOQoL-bref. Los trastornos mentales comunes se asociaron con los dominios físicos y psicológicos de WHOQoL-bref, la autoeficacia y el género masculino. El nivel de actividad física no se asoció con los aspectos psicológicos y las variables sociodemográficas estudiadas (p > 0.05).

Conclusión:

las variables sociodemográficas influyen en los aspectos emocionales, especialmente la autoestima y la capacidad de recuperación de ancianos en Unati. Además, el dominio psicológico WHOQoL-bref fue un predictor de todas las variables emocionales en esta muestra.

Palabras clave: Envejecimiento; Psicología; Autoestima; Resiliencia Psicológica; Calidad de Vida

Introduction

Staying active is essential to mitigate the physical and emotional decline that occurs with aging by increasing the likelihood of preserving independence and autonomy in old age. The concept of an “active life” does not only encompass the physical domain, since socioenvironmental interactions and emotional balance are decisive factors in life satisfaction1. As a result, the recent decades have seen the creation of special programs for older people at higher education institutions, known as Universities of the Third Age (Unati in Brazil). These programs promote active aging through a range of stimulating activities and provide a valuable arena for physical, mental and social development.

Several studies2), (3), (4), (5), (6 have demonstrated that older individuals who remain active, when compared to their nonactive counterparts, tend to have positive emotional skills, with less prevalence of common mental disorders2, better quality of life3, resilience4 and self-esteem5, in addition to better self-efficacy6. It is important to highlight that these studies were conducted with community-dwelling older people’s heterogeneous groups, characterized by marked differences in physical and socioeconomic aspects. This heterogeneity is not echoed in the Unatis, whose unique context cannot be extrapolated to the national scenario. Regarding this observation, Roque et al.7 reported that Unati members are mostly women, with higher schooling levels (78.7% > 9 years of study) and more economically active than the average Brazilian older population.

Although previous studies7), (8 have characterized the sociodemographic profile and the physical activity level of older people at Universities of the Third Age (Unati), there are research gaps regarding their relationship with psychological aspects. The authors found that more involvement in the Unati for more than one year is associated with lower depressive symptom scores8), (9 and better perceived quality of life in the physical, psychological and social domains8. They also observed a significant prevalence in the physical activity (> 75%)8), (9, but did not investigate its correlation with the psychological aspects. This study believes that identifying the determinants of psychological aspects is essential to provide a new insight on healthy aging, particularly in specific populations. As such, this study aimed to assess the relationship between sociodemographic and psychological variables, physical activity level and quality of life (QoL) in older people at Unati in Campinas, São Paulo, Brazil.

Methods

Participants

This is a cross-sectional study with 116 older participants of both sexes from the UniversIDADE Program, a Unati affiliated with the State University of Campinas (UNICAMP). The inclusion criteria were a minimum age of 60 years, proven membership in the UniversIDADE Program and no cognitive impairment. The cognitive screening was performed using the Mini-Mental State Examination (MMSE), considering the following cutoff points: illiterate = 20; ≤ 4 years of schooling = 25; > 4 and ≤ 8 years of schooling = 26.5; > 8 and ≤ 11 years of schooling = 28; > 11 years of schooling = 2910. The study was approved by the UNICAMP Research Ethics Committee, under protocol number 2.161.868.

Instruments

Sociodemographic and health status questionnaire: a semi-structured questionnaire in which participants were asked their age, gender, race, schooling level, marital status, income, occupation, membership time, chronic diseases, continued use of medication and reasons for joining the Unati.

The International Physical Activity Questionnaire - Short Form (IPAQ-SF)11 contains 8 questions on the time spent engaging in physical activity in the last week. Each participant was classified considering participation and intensity,12 as: Very Active (vigorous physical activity ≥ 5 days/week and ≥ 30 minutes per session or vigorous physical activity ≥ 3 days/week and ≥ 20 minutes walking per session ≥ 5 days/week and ≥ 30 minutes per session.); Active (vigorous physical activity ≥ 3 days/week and ≥ 20 minutes per session or moderate physical activity or walking ≥ 5 days/week and ≥ 30 minutes per session or any combined activity ≥ 5 days/week, totaling ≥ 150 minutes/week); Irregularly Active A (meets at least one of the recommended criteria regarding frequency and duration: 5 days/week or 150 minutes/week); Irregularly Active B (did not meet the frequency and duration recommendations), and Sedentary (did not participate in any physical activity lasting at least 10 minutes during the week).

The WHOQOL-BREF (World Health Organization Quality of Life), a translated and abbreviated version13 of the WHOQOL-100 was used to assess the quality of life. The questionnaire contains 24 items distributed into four domains (social relationships, psychological, physical health and environment) and 2 questions on the overall QoL. The answers are scored from 1 to 5, generating a total score from 0 to 100 for each domain, with the QoL directly proportional to the score.

The General Self-Efficacy Scale (GSE)14, validated for Brazil15, consists of 10 items on a scale of 1 (not at all true) to 4 (exactly true), generating a score from 10 to 40, with the self-efficacy directly proportional to the final score.

The Rosenberg Self-Esteem Scale (RSES)16 assesses the self-perception of the following aspects: competence, personal satisfaction, strengths and virtues, weaknesses, pride, self-worth, respect and feelings of failure. It contains 10 questions on a scale of 0 (strongly disagree) to 3 (strongly agree) for a final score of 0 to 30, with self-esteem directly proportional to the score.

The Resilience Scale (RS)17 evaluates the psychosocial response to important life events and consists of 25 positive statements rated on a scale from 1 (strongly disagree) to 7 (strongly agree). The final score varies from 25 to 175 and is directly proportional to resilience.

Procedures

Data were collected from May 2017 to February 2018 in classrooms with groups of up to 15 older adults who had been previously informed of the collection by email at Unicamp’s UniversIDADE Program. The volunteers remained to participate in the study after completing their activities at the facility. Six of the seven instruments were applied collectively to the whole group, with the main researcher reading the questions aloud and providing guidance, although each participant responded to their own questionnaire. For the cognitive screening, the MMSE was applied individually by a trained researcher. The data collection procedures were explained at the interview, after which a written informed consent was given. The same conditions were used for all subjects, with an average application time of 60 minutes.

Statistical Analysis

The descriptive statistics (absolute and relative frequencies, mean and standard deviation) were used to characterize the data. The Kolmogorov-Smirnov test was applied to assess the normality of the continuous variables. The chi-squared or Fisher’s exact tests were used to compare the categorical variables, and the t-test for independent samples or the Mann-Whitney test to compare continuous variables. The generalized linear models were applied to identify factors, as independent variables, that were associated with self-esteem, resilience, self-efficacy and common mental disorders, with the sociodemographic aspects, chronic diseases, polypharmacy (≥ continued-use medications), physical activity classification (IPAQ) and the WHOQOL-BREF domains (social relationships, psychological, physical health and environment). Given the low prevalence of ‘sedentary’ and ‘very active’ classifications in the sample, a binary variable was created categorizing the participants as “sedentary or insufficiently active” and “active or very active”. Initially, all the variables were manually/input into generalized linear models. Next, the less relevant variables (p > 0.05) were removed one by one until reaching the lowest Akaike Information Criterion (AIC). Significance was set at 5% and all analyses were performed using the Statistical Package for the Social Sciences, version 23.

Results

Of the 128 older adults interviewed for the study, 116 were included in the final analysis and 12 were excluded due to cognitive impairment, with MMSE values between 18 and 20. With respect to their reasons for joining the UniversIDADE program, approximately 41% stated they did so to make friends, 37% to care for their physical health and 35% for their emotional health, with a low prevalence of motives such as medical (5%) or family recommendation (13%) and becoming a widow(er) (8%). Regarding the activities carried out, 38% reported they participated in physical activities to improve their physical (83%) and/or mental health (41.4%).

Table 1 presents the remaining characteristics of the participants, grouped by gender. Statistically significant differences were observed for marital status, schooling level, income, chronic diseases and common mental disorders, suggesting worse sociodemographic conditions and health status for the women.

Table 1 Characterization of the sociodemographic and emotional variables of older people members of Unati, Campinas, São Paulo 

Variable Women (n = 84) Men (n = 32) p value
N (%) N (%)
Age, mean (SD) 68.6 (7.9) 69.8 (6.8) 0.232
Marital status
Lives alone 50 (59.5) 9 (28.1) 0.002
Lives with a partner 34 (40.5) 23 (71.9)
Race
White 71 (84.5) 26 (81.3) 0.282
Black 9 (10.7) 2 (6.3)
Schooling
Complete elementary education 18 (21.4) 1 (3.1) 0.029
High school diploma 20 (23.8) 13 (40.6)
College degree 46 (54.8) 18 (56.3)
Retired 69 (84.1) 29 (90.6) 0.371
Salary in minimum monthly wages
1 to 2 21 (52.6) 1 (3.1) 0.004
2 to 3 18 (22.0) 4 (12.5)
3 or more 43 (52.4) 27 (84.4)
Membership time
Recent membership 31 (36.9) 12 (37.5) 0.841
1 year 17 (20.2) 8 (25.0)
2 year 22 (26.2) 6 (18.8)
3 year 14 (16.7) 6 (18.8)
Polypharmacy (≥ 5 continued-use medications) 14 (16.7) 4 (12.5) 0.580
Heart disease 5 (6.0) 3 (9.4) 0.516
Hypertension 40 (47.6) 14 (43.8) 0.709
Stroke 3 (3.6) 3 (9.4) 0.207
Diabetes 15 (17.9) 4 (12.5) 0.486
Cancer 3 (3.6) 2 (6.3) 0.525
Lung disease 8 (9.5) 1 (3.1) 0.250
Arthritis 28 (33.3) 3 (9.4) 0.009
Osteoporosis 22 (26.2) 1 (3.1) 0.005
Depression 13 (15.5) 4 (12.5) 0.685
Number of diseases, mean (SD) 1.6 (1.4) 1,1 (1.1) 0.071
IPAQ classification
Active or very active 42 (50.0) 15 (46.9) 0.763
Irregularly active or sedentary 42 (50.0) 17 (53.1)
WHOQLL domains, mean (SD)
Psychological 70.6 (11.7) 72,0 (15.2) 0.423
Physical 72.1 (14.0) 75,6 (15.6) 0.148
Social 67.9 (15.5) 62,7 (18.6) 0.196
Environmental 71.6 (11.5) 74,1 (13.9) 0.433
Psychological aspects, mean (SD)
Self-esteem 33.4 (5.3) 33.9 (5.2) 0.678
Resilience 141.4 (20.6) 137.8 (19.1) 0.151
Self-efficacy 33.8 (4.2) 33.4 (5.7) 0.936
Common mental disorders 4.6 (3.9) 2.4 (3.4) 0.001

Note: N: absolute frequency; %: relative frequency; SD: Standard deviation; IPAQ: International Physical Activity Questionnaire; WHOQOL: World Health Organization Quality of Life. Categorical variables compared via the chi-squared and Fisher’s exact test. Continuous variables compared using the t-test for independent samples and Mann-Whitney test. Statistical significance was set at 5%.

The variables associated with psychological aspects are presented in the tables below. In this sample, classifying physical activity via the IPAQ did not exhibit explanatory power in any of the models for the related variables to psychological aspects and as such has not been included in tables 2 to 5. Table 2 shows the variables associated with self-esteem, whereby age exhibited a negative correlation, while income, schooling level, membership time, and the psychological domain of the WHOQOL-BREF exhibited a positive correlation.

Table 2 Factors associated with elderly members of the Unati, Campinas, São Paulo 

Predictor β 95% CI for β p value
Age 0.997 0.995 - 1.000 0.036
Income (minimum monthly wages)
1 to 2 1
2 to 3 1.027 0.958 - 1.101 0.445
3 or more 1.075 1.010 - 1.144 0.022
Schooling Level
Incomplete Elementary Education 1
Complete Elementary Education 0.864 0.776 - 0.962 0.008
High School 0.986 0.891 - 1.052 0.446
College 1.055 0.934 - 1.104 0.720
Membership time
Recent member 1
1 year 1.028 0.961 - 1.100 0.423
2 years 1.053 0.981 - 1.130 0.150
3 years 1.076 1.011 - 1.146 0.021
Number of diseases 0.986 0.969 - 1.003 0.105
Psychological domain (WHOQOL) 1.007 1.006 - 1.009 < 0.001

Note: Results refer to the generalized linear model, with self-esteem as a dependent variable and sociodemographic and psychological aspects, chronic diseases, polypharmacy and physical activity level as initial predictors. The final model corresponds to the most explanatory variables, defined by the lowest AIC value (Akaike Information Criterion). Statistical significance was set at 5%.

Table 3 Factors associated with resilience in older people members of the UniversIDADE program 

Predictor β 95% CI for β p value
Gender
Female 1
Male 0.942 0.887 - 1.001 0.053
Marital status
Lives alone 1
Lives with a partner 1.040 0.988 - 1.095 0.132
Income
1 to 2 minimum monthly wages 1
2 to 3 minimum monthly wages 1.061 0.981 -1.148 0.141
3 or more 1.022 0.950 -1.100 0.557
Schooling Level
Incomplete Elementary Education 1
Complete Elementary Education 0.977 0.882 - 1.127 0.958
High School 1.063 0.965 - 1.171 0.216
College 1.126 1.023 - 1.239 0.015
Polypharmacy
No 1
Yes 1.063 0.994 - 1.137 0.073
Membership time
Recent member 1
1 year 0.993 0.918 - 1.073 0.853
2 years 0.974 0.899 - 1.055 0.518
3 years 0.938 0.873 - 1.009 0.086
Psychological domain (WHOQOL) 1.006 1.004 - 1.008 < 0.001

Note: Results refer to the generalized linear model, with resilience as a dependent variable and sociodemographic and psychological aspects, chronic diseases, polypharmacy and physical activity level as initial predictors. The final model corresponds to the most explanatory variables, defined by the lowest AIC value (Akaike Information Criterion). Statistical significance was set at 5%.

Table 4 Factors associated with self-efficacy in older people members of the UniversIDADE program 

Predictor β 95% CI for β p value
Age 0.998 0.995 - 1.001 0.170
Income
1 to 2 minimum monthly wages 1
2 to 3 minimum monthly wages 1.048 0.977 - 1.125 0.192
3 or more 1.009 0.947 - 1.076 0.782
Schooling Level
Incomplete Elementary Education 1
Complete Elementary Education 1.108 0.989 - 1.241 0.077
High School 1.027 0.940 - 1.121 0.561
College 1.075 0.984 - 1.175 0.109
Polypharmacy
No 1
Yes 1.052 0.988 - 1.120 0.113
Physical domain (WHOQOL) 1.001 0.999 - 1.003 0.358
Social domain (WHOQOL) 1.001 0.999 - 1.002 0.340
Psychological domain (WHOQOL) 1.004 1.002 - 1.007 < 0.001

Note: Results refer to the generalized linear model, with self-efficacy as a dependent variable and sociodemographic and psychological aspects, chronic diseases, polypharmacy and physical activity level as initial predictors. The final model corresponds to the most explanatory variables, defined by the lowest AIC value (Akaike Information Criterion). Statistical significance was set at 5%.

Table 5 Factors associated with common mental disorders in older people members of the UniversIDADE program 

Predictor β 95% CI for β p value
Sex
Female 1
Male 0.480 0.304 - 0.760 0.002
Income
1 to 2 minimum monthly wages 1
2 to 3 minimum monthly wages 1.299 0.777 - 2.174 0.319
3 or more 0.877 0.560 - 1.374 0.566
Age 0.989 0.965 - 1.013 0.357
Number of diseases 1.124 0.988 - 1.280 0.077
Physical domain (WHOQOL) 0.978 0.963 - 0.993 0.005
Psychological domain (WHOQOL) 0.979 0.961 - 0.997 0.025
Self-efficacy 0.951 0.909 - 0.995 0.028

Note: Generalized linear model with common mental disorders as a dependent variable and social aspects, polypharmacy (5 ≥ continued-use medications), self-reported diseases, physical activity level (IPAQ), WHOQOL domains, self-esteem, resilience and self-efficacy as initial predictors. The final model corresponds to the lowest AIC value (Akaike Information Criterion). Statistical significance was set at 5%.

The variables related to resilience are presented in Table 3. While the schooling level and the psychological domain of the WHOQOL-BREF displayed a positive association, the remaining variables could not predict resilience in the participants.

Table 4 shows the variables related to self-efficacy, whereby only the psychological domain of the WHOQOL-BREF was a statistically significant predictor, exhibiting a positive correlation.

The variables related to common mental disorders are shown in Table 5, with the physical and psychological domains of the WHOQOL-BREF, self-efficacy and being male found to be statistically significant and negatively correlated with these disorders.

Discussion

This study assessed the relationship between sociodemographic variables, physical activity level and psychological aspects in older people members of the Unati. The most relevant results suggest an association between sociodemographic variables, self-esteem and resilience, demonstrating the influence of the adaptive skills and individual adjustment on understanding the investigated emotional aspects (i.e. self-esteem, resilience, self-efficacy and common mental disorders).

It is important to characterize the study participants before investigating their emotional aspects, particularly for older women. This contextual analysis is important because the sample consisted primarily of women who, compared to men, lived alone, had a lower income and a worse clinical condition due to the greater prevalence of arthritis and osteoporosis, as well as higher scores for common mental disorders. These results reflect historical social roles, whereby women were tasked with being caregivers and often relegated to the home. Isolation is a known risk factor for physical, cognitive and emotional decline18, making confinement to the home harmful to older people’s health. By contrast, aging can also benefit women, especially once they are widows, since it represents a phase of social emancipation and female empowerment that frees them from their historical gender-based roles19, which could explain the greater female involvement in social programs aimed at the third age.

Self-esteem is a multidimensional concept that encompasses feelings of self-worth, self-confidence, competence and self-respect20, and involves both affective and cognitive spheres, with feelings and thoughts varying from approval to contempt. The oldest adults in this study were more prone to exhibiting low self-esteem, whereas income and schooling level were protective factors. These findings can be explained by the proximity of death21 and the multifactorial interactions of the aging process, which affect the physical, social and cognitive domains.

Advancing age is accompanied by a decline in muscle mass and strength22 that gradually reduces the older people’s participation in activities that require mobility. Those with low mobility are less able to take advantage of anti-inflammatory and neuroprotective mechanisms23), (24, exacerbating the cognitive decline. Additionally, friends’ death and/or family’s structural changes often lead to smaller social circles, with negative consequences for the older people’s emotional health, who feel increasingly alone. These losses can result in feelings of vulnerability and in difficulty coping with everyday demands, prompting negative emotions, such as low self-esteem. By contrast, older adults with high schooling and income levels have more resources to deal with the difficulties of life, whether in the form of a better cognitive reserve or because of their financial advantage.

In the field of psychology, resilience is defined as a set of social and intrapsychic processes that enable healthy development even in the face of difficult experiences25, as well as the ability to adjust to life events26, which seems to be influenced by schooling level, corroborating previous studies27), (28. A high level of education is a protective factor for cognitive decline29), (30 due to the accumulation of cognitive reserves. Stimulating cognitive skills promotes the neuroplasticity and the formation of alternative neural pathways31, increasing the ability to cope with the neurophysiological damage inherent to the aging process. In other words, the extent of the cognitive reserve is directly related to resilience and plays a vital role in adjusting to the internal and circumstantial demands of the everyday life.

According to Bandura32, self-efficacy is an individual’s perception of their ability to successfully deal with prospective situations. It is a latent skill based on environmental interactions, directly linked to the task or situation at hand. The results obtained in this study suggest that low self-efficacy increases the likelihood of developing common mental disorders, defined as minor psychiatric disturbances with a set of non-psychotic symptoms that do not meet the formal criteria for a anxiety and/or depression diagnosis33. Symptoms of common mental illness include fatigue, depression, insomnia, anxiety, somatic concerns and difficulty concentrating34. On analyzing the GSE, this study found that the questions are highly subjective and focus on an individual’s ability to deal with difficult everyday situations, relatively similar to resilience. The fact that the physical domain of the WHOQOL-BREF was also a predictor of common mental disorders led this research program to infer the importance of physical abilities, since the difficulty to move or to perform activities of daily living, especially due to chronic pain35, can lead to emotional suffering, which corroborates studies indicating that physical activity reduces the chances of developing mental illness2), (34.

This study was conducted with an underexplored population in Brazil, making further research important in order to understand the psychological and physical effects of older people’s participation in the Unati programs. Limitations include the fact that the sample consisted of members of a Unati from a specific Brazilian region. As a result, the extrapolation of the outcome is limited to older adults who took part in higher education programs and not the country as a whole. Nevertheless, it is important to note that their characteristics corroborate those of other studies with the same population, indicating that the results of this study contribute towards understanding this specific group. As such, the findings of this research program should be interpreted with caution, given its cross-sectional design and the homogeneity of the sample, whose schooling and physical activity levels are superior to those normally seen in older people. The same applies to the self-reported measurements obtained, which may have been influenced by social desirability.

Conclusion

In a sample of the Unati members, this study identified sociodemographic, emotional and health-related differences between genders, with sociodemographic variables related to emotional aspects and the psychological domain of the WHOQOL-BREF as a predictor of all the emotional variables. In terms of practical applications, this study contextualized the social roles historically attributed to women and identified the Unati as a way of breaking with the convention and promoting physical, social and psychological development. This research program demonstrated that income and schooling play a vital role in emotional skills, particularly in self-esteem and resilience. Finally, the results showed that older adults with good adaptive skills exhibit higher levels of self-esteem, self-efficacy and resilience and fewer mental illnesses.

Considering that the assessed members of the Unati are above the national average in terms of their physical activity level and cognitive ability, the relationships identified do not reflect the general population. As such, although the results obtained cannot be extrapolated to the population as a whole, they do extend to all Unati members and demonstrate the importance of analyzing psychological variables in this population.

References

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Received: April 24, 2019; Accepted: January 07, 2020

*VMCA: Doctoral student, e-mail: valeriameloclaudino@gmail.com

VNS: Doctoral student, e-mail: viniciusnagy@gmail.com

DVO: PhD, e-mail: d.vicentini@hotmail.com

PTF: PhD, e-mail: paula@fef.unicamp.br

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