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Short-term effect of physical activity and obesity on disability in a sample of rural elderly in Mexico. Efecto a corto plazo de la actividad física y la obesidad sobre la discapacidad en una muestra de ancianos rurales en México. Cuernavaca, Morelos, México. México DF, México. Corresponding author. To estimate the effects of physical activity PA and obesity on the cumulative incidence of disability on the basic activities of daily living in the elderly.
Materials and methods. Longitudinal study. We selected participants aged years from the impact evaluation study of a non-contributory pension program in Mexico. Participants were without disability at baseline. Katz index was used to assess whats fwb stand for both at baseline and follow-up. PA, body mass index, and covariates were measured at baseline.
After months of follow-up, the cumulative incidence of disability reached There is a need to perform a functional assessment of older adults in primary care to identify patients with functional dependence pdffiller upload, and to promote physical activity to maintain muscle mass and thus reduce the incidence of disability. Key words: disability; physical activity; obesity; aged.
Material y métodos. Estudio longitudinal. La AF, el índice de masa corporal y otras covariables se midieron en el estudio basal. La incidencia acumulada de discapacidad, a 14 meses de seguimiento, fue de Se requiere incorporar la valoración funcional de los adultos mayores en los niveles primarios de atención para identificar sujetos con dependencia funcional y fomentar la actividad física para mantener la masa muscular y así disminuir la incidencia de la discapacidad.
Palabras clave: discapacidad; actividad física; obesidad; adulto mayor. The negative consequences of disability in the elderly are multifold. It undermines their health, self-esteem, perception of well-being, and quality of life; 1,2 exacerbates the burden on hospital services, heightens the demand for health care 3 and constitutes an important mortality predictor. Numerous health conditions can lead to disability: cognitive impairment, depression, specific co-morbidities, arthritis, visual, and hearing problems, falls, lower extremity function limitations and slow gait, in addition to current smoking and alcohol consumption.
Obesity has also been mentioned in the literature as a correlate of disability, and has been associated with high risk for limited physical mobility, which in turn leads to the development and acceleration of disability among the elderly. Regarding physical activity PAseveral prospective studies have also identified that regular PA 8,9,15 or intense PA 7,16,17 decreases the risk of disability or mobility problems.
However, little has been studied about these relationships among rural populations in Mexico. In Mexico, older adults OA represent the highest-growth segment and constitutes almost 10 million individuals aged 60 and older 8. Furthermore, it has been reported that the poorer the elderly, the more likely they are to develop functional limitations, 22 thus confirming that the frequency of many chronic conditions affecting physical function escalates among populations suffer greater economic vulnerability.
Details of the methodology of evaluation as well as the sampling procedures have been previously reported. The evaluation study consisted what is 3 examples of body composition a prospective study of 6 elderly aged 65 to 74 years inand residents of seven Mexican states. Additionally, follow-up measurements were conducted in November and March In addition to the The OA excluded from the analysis generally shared similar characteristics with the subjects in the analytical sample in the following variables: age, literacy, living arrangement, smoking status, and current alcohol consumption.
However, OA excluded were significantly different in the following characteristics: more women 52 vs. Data collected featured the following socio-demographic characteristics: education, lifestyles, physical and mental health, nutrition and use what is 3 examples of body composition health services. Disability was evaluated based on self-report in relation to the basic ADLs. The elderly were asked whether they needed help in performing any ADLs ie. Disability incidence was established at follow-up after 14 months and only among those subjects who presented no disability at baseline.
Exposure variables. Participants self-reported the number of days and the time spent in the last seven days. Since many elderly performed activities of the primary sector of the economy, questions were adjusted and examples were provided. Vigorous activity included: aerobics, bicycling at high speed, lifting heavy objects, digging and performing agricultural tasks, such as harvesting, etc.
Moderate activity included: lifting light objects and moving them from one place to another, bicycling at normal speed, etc. Walking question included: walks for work, exercise, recreation or transport. Low PA was the reference group. Standardized personnel measured weight and height at baseline according to a protocol. Subjects with normal BMI were taken as the the meaning of fondly in malayalam group.
Co-morbidities were measured asking participants if a physician had diagnosed them with hypertension, diabetes, dyslipidemia, myocardial infarction, angina pectoris, heart disease, stroke, chronic lung disease, osteoporosis, and cancer. We computed the number of co-morbidities, and the sum ranged from 0 to 8 diseases. Descriptive statistics are presented as percentages for categorical variables. Chi-square what is 3 examples of body composition or t test was used to determine the the big short story explained in the onset of disability by socio-demographic and health-related characteristics.
A logistic regression model was used to estimate the effect of PA and BMI on the cumulative incidence of disability. We adjusted two consecutive models: the first reports the effect of PA and BMI without the covariates adjustment; while the second includes the covariates. Both models were evaluated in terms of residual analysis, influence measures and collinearity. Participants received a detailed explanation of the procedures and signed an informed consent declaration before data collection occurred.
What is 3 examples of body composition I shows the baseline characteristics of the elderly in our sample. Mean age was At the month follow-up, the cumulative incidence of disability in basic ADLs was Table I compares the baseline characteristics according to ADL disability status at the follow-up. Table II presents the results of the logistic regression model for the cumulative incidence of disability, for both models, with and without covariates adjustment.
There was no significant association between moderate level of PA and incidence of disability; however, it is possible to observe a trend of decreases in the risk of disability when PA increases. Being under- or overweight did not associate with the incidence of ADL what is 3 examples of body composition in the study sample. The results of our study found that, at the month follow-up, high PA is a protective factor against disability, and that obesity is associated with increased risk of disability.
Over the years, human beings become less physically active, 31 but the elderly in our study sample remained highly active; six in ten subjects reported participating in activities that, as a whole, generated a considerable requirement high PA. Some prospective studies have showed that high levels of PA in the elderly have a protective impact.
The idea that a high level of PA is associated with lower risk of disability is based on the fact that more demanding activities play a key role increasing insulin sensitivity, reducing risk of cardiovascular diseases and increasing life expectancy, and these mechanisms might have positive effects on posture balance, inflammation biomarkers, and maintaining muscular strength.
Some studies have found that obesity is associated with disability11,12,14 but we only found a marginal association. However, this is consistent with findings on the association between obesity and risk of disability in Hispanic populations. It is possible that the marginal effect of BMI on disability can be explained by the particular profile of our study group. The elderly in our study belong to a select group that has survived conditions of shortage, deprivation, infections and diseases throughout their lives and the effect of BMI could have been more evident.
Another explanation may reside in the use of BMI, which in itself is not an optimum indicator among elderly people. While BMI captures total body fat, it is seriously limited in its ability to distinguish body-fat distribution or between fat mass and lean mass. Our study revealed that This number is similar to those reported for Mexican and Hispanic populations, where disability incidence ranged between what is 3 examples of body composition.
Results suggest that unobserved variables, such as the environment, may influence disability. With mobility identified as the basic activity most affected in this population, 14 it can be argued that settings with substantial obstructions i. This is an issue of great concern, because it has been reported that functionally disabled individuals residing in marginalized social contexts have fewer labor opportunities, lower incomes and less tools to face adversity.
Additionally, they commonly lack access to medical how to play the game of dating rehabilitation services. The main limitation of this study is the duration of our follow-up which did not allow for identifying which OA were in the process of functional impairment. A longer follow-up period would have probably revealed a higher disability incidence. Another limitation was the self-reported functional status and PA what is 3 examples of body composition, which could be subject to recall bias.
In general, people tend to over-report PA. An additional limitation of our study is the definition of the analytical sample; elderly excluded from the analytical sample, were mostly women, with vision problems, and had a greater number of co-morbidities. In all likelihood, this means that the elderly excluded from the analysis, may have been in a position of greater disability and that it may be susceptible to selection bias.
Finally, the evidence presented here should prompt health personnel to refine routine check-ups with an assessment of ADL performance in the elderly as a means of detecting the risk of disability. In fact, this functional assessment could be performed in the primary care health services. On the other hand, assuming PA is important to minimize the impact of disability, it should be included as part of a strategy in maintaining muscle mass.
Rev Panam Salud Publica ; Progressive versus catastrophic loss of the ability to walk: implications for the prevention of mobility loss. J Am Geriatr Soc ; Functional transitions among the elderly: patterns, predictors, and related hospital use. Am J Public Health ; A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.
J Gerontol ;MM The impact of chronic multimorbidity and disability on functional decline and survival in elderly persons. A community-based, longitudinal study. J Intern Med ; Enfermedades crónicas y limitación funcional en adultos what is 3 examples of body composition estudio comparativo en siete ciudades de América Latina y el Caribe.
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