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 inabsolute numbers of the elderly. Improvements in living conditions, decreased fertilityand mortality, increased longevity, and access to health services reflect thedemographic changes observed in the population of developing countries. Accordingto the Brazilian Institute of Geography and Statistics (IBGE) (2013) it is estimatedthat by 2020 the number of elderly will reach 13.8% of the population. Living more isassociated with functional alterations, reflecting the autonomy and independence ofthe individual in performing their daily activities and involve aspects of physical,mental health, socioeconomic, cultural, psychosocial and self-care conditions thatgenerate 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 socialbenefits such as increase / maintenance of aerobic capacity and muscle volume andstrength, reduction of risk of sarcopenia, improvement of self-esteem, selfconfidence,reduction of anxiety and stress, and improvement humor and quality oflife. In this context, assessing levels of physical activity, functional level and healthperception become of paramount importance in the elderly population. Thus, theobjective of this study was to determine, by means of discriminant analysis, whetherelderly community residents, declared as "active" or "not active", can bediscriminated by the tests of Walking Speed (WS), Short Physical PerformanceBattery (SPPB) and Instrumental Shuttle Walk Test (ISWT). It was an observationalcross-sectional study, approved by the Research Ethics Committee of the FederalUniversity of Minas Gerais (CAAE 14129513.7.1001.5149). Elderly persons, aged 65years 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 theMini Mental State Examination, acute musculoskeletal alterations and neurologicalsequelae. The study protocol consisted of the application of a sociodemographicquestionnaire with information on the social, environmental and economic conditionand health perception including weight and height measurement for the calculation ofBody Mass Index (BMI). The level of physical activity was assessed by self-reportand functional capacity through SPPB, Walking Speed (WS) and ISWT. Thenormality of the data was analyzed by the Shapiro-Wilk test. The means of thevariables of the WS, SPPB and ISWT tests were compared between the groupsusing Analysis of Variance (One-way Anova). To determine the effect or interactionof the dependent variables to be active or not and health perception in gait speed, weused Anova Factor (two-way Anova). The Bonferroni correction was performed inboth tests to avoid the Type I error. To assess the sensitivity and diagnostic accuracyof the WS measure in relation to being active or not, and to establish a cut-off pointfor this sample, the area under study was calculated. the Receiver OperatingCharacteristics (ROC) curve, with a 95% confidence interval. Significance level of5%. 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 theactive and non-active groups (p <0.05). After analysis by the ROC curve, it wasobserved low specificity and sensitivity of the proposed variables. The best cutoffpoint for WS was 1.06 m / s, corresponding to a specificity of 0.43 and sensitivity of0.76. The positive self-perception of health was reported by 60.4% of the elderly andthere was a significant effect of the health perception with the WS [F (1.94) = 15.716,p <0.001, 2 = 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 resultsshowed a higher cutoff point than the one indicated in the literature and its use inclinical practice should be evaluated in community-based elderly in this region.Elderly people who reported a good perception of health were more active and withgreater walking speed. These results suggest that the practice of physical activitymay be an intervention strategy for the elderly.