Idosos ativos e não ativos: discriminância pela velocidade de marcha, short physical performance battery e incremental shuttle walk test

Abstract

The Brazil, according to the WHO, in 2025, will be the sixth country in the world in absolute numbers of the elderly. Improvements in living conditions, decreased fertility and mortality, increased longevity, and access to health services reflect the demographic changes observed in the population of developing countries. According to the Brazilian Institute of Geography and Statistics (IBGE) (2013) it is estimated that by 2020 the number of elderly will reach 13.8% of the population. Living more is associated with functional alterations, reflecting the autonomy and independence of the individual in performing their daily activities and involve aspects of physical, mental health, socioeconomic, cultural, psychosocial and self-care conditions that generate a decline in functional capacity and increase in chronic diseases degenerative. In addition, physiological changes of the cardiovascular, musculoskeletal and emotional systems favor physical inactivity. Therefore, maintaining a more active lifestyle promotes biological, psychological and social benefits such as increase / maintenance of aerobic capacity and muscle volume and strength, reduction of risk of sarcopenia, improvement of self-esteem, selfconfidence, reduction of anxiety and stress, and improvement humor and quality of life. In this context, assessing levels of physical activity, functional level and health perception become of paramount importance in the elderly population. Thus, the objective of this study was to determine, by means of discriminant analysis, whether elderly community residents, declared as "active" or "not active", can be discriminated by the tests of Walking Speed (WS), Short Physical Performance Battery (SPPB) and Instrumental Shuttle Walk Test (ISWT). It was an observational cross-sectional study, approved by the Research Ethics Committee of the Federal University of Minas Gerais (CAAE 14129513.7.1001.5149). Elderly persons, aged 65 years and over, without distinction of sex or race, obese elderly (BMI> 32.1 kg / m²), were included. Excluded from the study, suspected cognitive deficit detected by the Mini Mental State Examination, acute musculoskeletal alterations and neurological sequelae. The study protocol consisted of the application of a sociodemographic questionnaire with information on the social, environmental and economic condition and health perception including weight and height measurement for the calculation of Body Mass Index (BMI). The level of physical activity was assessed by self-report and functional capacity through SPPB, Walking Speed (WS) and ISWT. The normality of the data was analyzed by the Shapiro-Wilk test. The means of the variables of the WS, SPPB and ISWT tests were compared between the groups using Analysis of Variance (One-way Anova). To determine the effect or interaction of the dependent variables to be active or not and health perception in gait speed, we used Anova Factor (two-way Anova). The Bonferroni correction was performed in both tests to avoid the Type I error. To assess the sensitivity and diagnostic accuracy of the WS measure in relation to being active or not, and to establish a cut-off point for this sample, the area under study was calculated. the Receiver Operating Characteristics (ROC) curve, with a 95% confidence interval. Significance level of 5%. The mean WS (1.14 ± 0.25 m / s), the SPPB (10.13 ± 1.87), the ISWT distance (286.65 ± 111.30 m) and the ISWT time (5.4 ± 1.51s) were different between the active and non-active groups (p <0.05). After analysis by the ROC curve, it was observed low specificity and sensitivity of the proposed variables. The best cutoff point for WS was 1.06 m / s, corresponding to a specificity of 0.43 and sensitivity of 0.76. The positive self-perception of health was reported by 60.4% of the elderly and there was a significant effect of the health perception with the WS [F (1.94) = 15.716, p <0.001, η2 = 0.143]. Health perception explained 14.3% of the variance in WS. SPPB and ISWT were not able to identify active and non-active elderly. The results showed a higher cutoff point than the one indicated in the literature and its use in clinical practice should be evaluated in community-based elderly in this region. Elderly people who reported a good perception of health were more active and with greater walking speed. These results suggest that the practice of physical activity may be an intervention strategy for the elderly.