Aspecto funcional da linguagem oral: associação com as características sociodemográficas e com a autoavaliação da qualidade vocal e auditiva de idosos ativos

Abstract

INTRODUCTION: The life expectancy of the Brazilian population has increased in recent decades along with the growth of the elderly population in Brazil. Aging is a progressive process, with biological, functional and psychological changes which tend to determine a marked loss of the individual's ability to adapt to the environment. In healthcare work with this elderly population there is the speech therapist, who performs diagnoses and treatments of speech-language disorders which affec tthe quality of life of the elderly. This professional's health working envolves the family, the multidisciplinary team, health education, research, service management, among others. The speech therapist is a fundamental professional for preserving the communicative skills of the elderly and promoting active aging. Communication is a way for human being stointeract with the environment in which they live. This skill is acquired and developed through interaction with others, and is also a fundamental way of maintaining autonomy and independence a tall stages of life. Oral communication is na interaction with the environment, and with the presence of understanding a expression in which language is expressed through speech in the procedural (cognitive), functional (interaction) and structural (language organization) aspects. It is believed that the functionality of oral language, tha tis, havingt heability to deliver a message through speech effectively in different social contexts, depends on the completeness of the voice and hearing. PURPOSE: Tounder stand the association between self-reporting of f unctional aspects of oral language and the vocal and auditory perception of physically active elderly people. METHODS: Crosssectional study, carried out in public City Gyms in the Central South Region of Belo Horizonte, Minas Gerais, Brazil. The Central South region was selected afte r surveying the number of elderly people who participate in activities of feredat City Gyms (n=474), in addition to considering the best access for data collection by the team involved. The sample calculation was carried out taking into account the Central Limit Theorem, and based on a sample stratified by sex and academy. The assumptions used were: 20% loss, 40% prevalenceof speech therapy problems and 95% confidence interval, considering a sampling error of 5%. The estimated sample size was 235 subjects. The sample was composed of elderly people over the age of 60, of both sexes, users of the six units of the City Gyms in the Central South region, in the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, who agreed to participate in the study. Data collection was carried out through structured interviews and took place between October 2017 and February 2018. Of the 259 interviews carried out, 5 were excluded for reasons of duplication. 254 elderly people participated in the study, considering the stratification of the sample by gender and gym attended. The response variables were: sociodemographic data (age, sex, retirement, level of education and marital status); vocal changes in the elderly measured by the Tracking of Vocal Changes in the Elderly (RAVI) protocol; vocal self-assessment using the Vocal Disadvantage Index (IDV-10); the restriction of auditory participation in the elderly assessed by the Hearing Handicap Inventory for the Elderly Screening Version questionnaire (HHIE-S). Another response variable was called “Functional aspect of oral language”, constructed from the combination of two aspects relating to communication present in the Activity and Participati on component of the International Classification of Functioning (ICF): production (code d33) and conversation (code d350) . A combination of two questions was asked: “Do you have difficulty producing words or phrases to tell a factor a story?” and “Do you have difficulty starting, maintaining and finishing a conversation?” The answer options for each question were “yes” or “no”. The categorization of the response variable was defined as follows: 1) no change: answer “no” for both questions;2) partial change: answer “yes” for one of the questions mentioned above; 3) presence of change: answer “yes” to the two questions mentioned above. Initially, a descriptive analysis of the frequency distribution of categorical variables and analysis of measures of central tendency and dispersion for continuous variables were carried out. Univariate analysis was performed using Pearson's Chi-square test and KruskallWallis test. In the multivariate analysis, the multinomial logistic regression model was used. The “no change” category was considered as a reference, comparing it to the other two categories. To enter the explanatory variables in the model, a p-value less than 0.20 was considered in the univariate analysis. The backward criterion was used to remove the variables from the model and, for the variable store main in the final model, a 5% level of significance was adopted. The Odds Ratio (OR) estimate was also evaluated with the respective 95% Confidence Interval (95%CI). The model adjustment was evaluate dusing the Deviance statistic. The research was approved by the Ethics Committee under opinion 2,373,001