Yeda Duarte - Academia.edu (original) (raw)
Papers by Yeda Duarte
A Deus e à Nossa Mãe, pelo amor maior que tens por mim, por toda a força e a determinação que me ... more A Deus e à Nossa Mãe, pelo amor maior que tens por mim, por toda a força e a determinação que me fizeram descobrir em mim mesma, a continuar nessa luta, chegar até aqui e ser uma pessoa melhor, não pelo título que irei conquistar, mas pelo muito que aprendi na minha vida pessoal, com essa oportunidade. Aos meus pais, Luís Holanda do Rêgo e Ana Maria Magalhães da Cunha Rêgo, que não mediram forças para que fosse possível esse sonho, o apoio e o incentivo, principalmente nas quedas, o amor incondicional e a companhia sempre tão presente e, ao mesmo tempo, tão distante, mas nunca longe. Amo demais. Ao Leonardo Mascarenhas, meu noivo, pelo companheirismo, carinho, paciência, incentivo e amor, que me dedicaste nesses anos distante fisicamente. Em breve, estaremos juntos para sempre. "Perto está quem mora dentro do coração"! Aos professores da Faculdade de Saúde Pública, que tanto me ensinaram e me apoiaram, em especial, à minha orientadora, Maria de Fátima Nunes Marucci, pelos grandes ensinamentos, contribuições e oportunidade de fazer parte do seu grupo de estudos. Aos meus colegas de orientação, principalmente à Daniele Lima de Alencar Castelo, me incentivando a me manter sempre focada nos meus sonhos profissionais e me mostrando que é possível conciliar com o lado pessoal. Aos meus amigos cearenses, à minha TURMASSA, pois a amizade verdadeira é para sempre, na alegria e na tristeza, longe ou perto, em especial ao Antônio Augusto Ferreira Carioca, grande amigo, companheiro, vizinho de república e aprendiz de muita coisa em comum; e à minha amiga e companheira de república Joana Bisol Balardin, pelos exemplos, pelos ensinamentos e pela forma que me ensinou para viver longe de casa. A Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES, pelo apoio financeiro da bolsa de estudos. 9vtuito o6rigatfa! EPÍGRAFE "Quanáo (j)eus tira afgo de você, pIe não o está punináo, mas apenas a6rináo suas mãos para que rece6a ara0 muito me{lior".
As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics ... more As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics and medical applications, data on diverse non-European and admixed individuals are still scarce. Here, we present a high-coverage WGS dataset of 1,171 highly admixed elderly Brazilians from a census-based cohort, providing over 76 million variants, of which ~ 2 million are absent from large public databases. WGS enabled identifying ~ 2,000 novel mobile element insertions, nearly 5 Mb of genomic segments absent from human genome reference, and over 140 novel alleles from HLA genes. We reclassified and curated nearly four hundred variant's pathogenicity assertions in genes associated with dominantly inherited Mendelian disorders and calculated the incidence for selected recessive disorders, demonstrating the clinical usefulness of the present study. Finally, we observed that whole-genome and HLA imputation could be significantly improved compared to available datasets since rare variat...
Revista de saude publica, Jan 25, 2018
To estimate the prevalence of frailty and to evaluate the associated factors in the non-instituti... more To estimate the prevalence of frailty and to evaluate the associated factors in the non-institutionalized Brazilian population aged 50 years or older. The analyses were conducted in 8,556 participants of the baseline survey of the Longitudinal Study of Health of the Brazilian Elderly (ELSI-Brazil) conducted in 2015 and 2016. Frailty was defined based on five characteristics: weight loss, weakness, slowness, exhaustion and low level of physical activity. Participants with three or more characteristics were classified as frail. A Poisson regression model was used to examine the association between frailty and sociodemographic and health factors. The prevalence of frailty was 9.0% (95%CI 8.0-10.1) among participants aged 50 years or over. Among the older adults aged 60 or over, the prevalence was 13.5% (95%CI 11.9-15.3) and 16.2% (95%CI 14.3-18.3) among those 65 aged years or over. Factors associated with higher prevalence of frailty were low schooling, residence without a partner, hea...
Revista de saude publica, Jan 25, 2018
To evaluate the magnitude of wealth-related inequalities in basic activities of daily living amon... more To evaluate the magnitude of wealth-related inequalities in basic activities of daily living among community-dwelling Brazilian older adults and to determine the contribution of demographic, socioeconomic, and health conditions to the inequality. We used data from the 2015 Brazilian Longitudinal Study of Aging (ELSI-Brazil) with a nationally representative sample of adults aged 50 years or older. We assessed wealth-related inequalities in basic activities of daily living by the concentration index. Concentration index was decomposed to determine the contribution of demographic, health, and socioeconomic factors to wealth-related inequalities in basic activities of daily living. The prevalence of disability in the sample was 15.7% (95%CI 14.9-17.6). The concentration index was -0.145 (95%CI -0.194- -0.097), which indicates that disability is concentrated in the poorest individuals in Brazil. Inequalities in basic activities of daily living disability are primarily explained by socioe...
Revista brasileira de enfermagem, 2018
To propose a care need classification for elderly people by identifying their functional demands.... more To propose a care need classification for elderly people by identifying their functional demands. Cross-sectional study carried out in São Paulo, in 2006, with 1,413 elderly (≥ 60 years old), participants in the Health, Well-being and Aging study (SABE - Saúde, Bem Estar e Envelhecimento). For the care need classification, we used the Guttman Scaling method e the frequency of assistance required by the elderly. The hierarchy of activities of daily living had good internal consistency (α = 0.92) and satisfactory coefficients of reproducibility (98%), scalability (84%) and minimum marginal reproducibility (87%). Care need was categorized into: no need (requires no caregiver), minimum need (requires caregiver sporadically), moderate need (requires caregiver intermittently) and maximum need (requires full-time caregiver). This classification will allow identifying elderly that need assistance in everyday activities and will orientante health professionals in the development of a line of...
Brazilian Journal of Physical Therapy
To investigate whether abdominal obesity, dynapenia and dynapenic-abdominal obesity are associate... more To investigate whether abdominal obesity, dynapenia and dynapenic-abdominal obesity are associated to the prevalence of single or recurrent falls in older adults. We analyzed data from 1,046 community-dwelling participants of the SABE Study (Saúde, Bem-estar e Envelhecimento/Health, Well-Being and Ageing). Participants were classified as non-dynapenic/non-abdominal obese, abdominal obese only, dynapenic only, and dynapenic-abdominal obese based on waist circumference (>102cm for men and >88cm for women) and handgrip strength (<26kg for men and <16kg for women). Multinomial logistic regression models were ran to determine associations between dynapenia/obesity/dynapenic-abdominal obesity and single/recurring falls, taking non-fallers as reference. Abdominal obesity (RRR=1.90 95% CI: 1.02-3.55), dynapenia (RRR=1.80 95% CI: 1.02-3.19), and dynapenic-abdominal obesity (RRR=2.06 95% CI: 1.04-4.10) were associated with a single fall. A stronger association for dynapenic-abdominal obesity compared to the other two conditions alone was found. Dynapenia was the unique condition associated with recurrent falls (RRR=2.33, 95% CI: 1.13-4.81). The present findings have important implications for the identification of older adults with a greater chance of falls and can help in the development of rehabilitation strategies. Therefore, abdominal obese, dynapenic, and dynapenic abdominal obese individuals should be target groups for the management of falls and their consequences.
Frontiers in immunology, 2018
The increased number of individuals older than 80 years, centenarians, and supercentenarians is n... more The increased number of individuals older than 80 years, centenarians, and supercentenarians is not a synonym for healthy aging, since severe infections, hospitalization, and disability are frequently observed. In this context, a possible strategy is to preserve the main characteristics/functions of the immune system with the aim to cause less damage to the organism during the aging process. Vitamin D acts on bone marrow, brain, breast, malignant cells, and immune system and has been recommended as a supplement. We aimed to evaluate whether immune parameters and vitamin D serum levels are correlated. We evaluated some features of the immune system using the peripheral blood of individuals older than 80 years ( = 12) compared to young subjects ( = 10). In addition, we correlated these findings with vitamin D serum levels. Old individuals presented metabolic parameters of healthy aging and maintained preserved some features of immunity such as CD4/CD8 ratio, and low production of pro-...
American journal of epidemiology, Jan 31, 2018
Brazil is experiencing one of the world's fastest demographic aging worldwide. This demograph... more Brazil is experiencing one of the world's fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years and over, residing in 70 municipalities across the 5 great Brazilian regions. The study allows investigations of the aging process, its health, psychosocial and economic determinants and societal consequences. The baseline examination (2015-16) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, timed walk and balance tests). Blood tests and samples storage were performed in a sub-sample of study participants. Subsequent waves are planned every 3 years. The study adopts a common conceptual framework of other great-scale longitudinal studies of aging in the world, namely Health and Retirement family, allowin...
PloS one, 2017
Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiolo... more Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases. This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging]), a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when <60 mL/min/1.73m2. Kidney damage was defined as dipstick-positive hematuria or urinary protein:creatinine > 0.20 g/g. The prevalence ...
The Journal of clinical endocrinology and metabolism, Feb 15, 2017
Genetic evaluation has been recognized as an important tool to elucidate the causes of growth dis... more Genetic evaluation has been recognized as an important tool to elucidate the causes of growth disorders. To investigate the etiology of short stature and to determine the phenotype of patients with IHH mutations, including the response to growth hormone (rhGH) therapy. We studied 17 families with autosomal dominant short stature using whole exome sequencing and screened IHH defects in 290 patients with growth disorders. Molecular analyses were performed to evaluate the potential impact of N-terminal IHH variants. We identified 10 pathogenic or possibly pathogenic variants in IHH, an important regulator of endochondral ossification. Molecular analyses revealed a smaller potential energy of mutated IHH molecules. The allele frequency of rare predicted to be deleterious IHH variants found in short stature samples (1.6%) was higher than that observed in two control cohorts (0.017% and 0.08%; p<0.001). Identified IHH variants segregate with short stature in a dominant inheritance patt...
Clinical nutrition (Edinburgh, Scotland), Jan 2, 2017
The concept of dynapenic obesity has been gaining great attention recently. However, there is lit... more The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications ...
Cadernos de Saúde Pública
Resumo: Objetivou-se a identificação de fatores preditores de dor em idosos. Trata-se de um estud... more Resumo: Objetivou-se a identificação de fatores preditores de dor em idosos. Trata-se de um estudo longitudinal de base populacional, realizado por meio de entrevista domiciliar com idosos residentes no Município de São Paulo, Brasil, participantes do Estudo SABE, nos anos de 2006 e de 2010. A análise dos fatores preditores de dor foi realizada por regressão logística hierarquizada e baseada em modelo teórico-conceitual, com variáveis em níveis distal, intermediário e proximal. A incidência acumulada de dor foi de 27,9%. Após ajustes, permaneceram como fatores preditores de dor no idoso, ter entre 0 e 3 anos de estudo (OR = 2,21; IC95%: 1,18-4,15), ser portador de hipertensão (OR = 1,98; IC95%: 1,24-2,88), possuir Apgar familiar insatisfatório (OR = 2,31; IC95%: 1,15-4,64) e autorrelato de saúde ruim/regular (OR = 2,23; IC95%: 1,35-3,69). A identificação desses preditores pode ser um alerta para as equipes de saúde, na atenção direcionada à pessoa idosa, e pode indicar possíveis açõ...
Public health nutrition, 2017
To assess the role of abdominal obesity in the incidence of disability in older adults living in ... more To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period. Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI. São Paulo, Brazil. Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed. The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001)...
Clinical nutrition (Edinburgh, Scotland), Jan 10, 2017
There is little evidence showing that dynapenic obesity is associated with lipid and glucose meta... more There is little evidence showing that dynapenic obesity is associated with lipid and glucose metabolism disorders, high blood pressure, chronic disease and metabolic syndrome. Our aim was to analyze whether dynapenic abdominal obesity can be associated with lipid and glucose metabolism disorders, high blood pressure, metabolic syndrome and cardiovascular diseases in older adults living in São Paulo. This cross-sectional study included 833 older adults who took part of the third wave of the Health, Well-being and Aging Study in 2010. Based on waist circumference (>88 cm women and >102 cm men) and handgrip strength (<16 kg women and <26 kg men), four groups were identified: non-dynapenic/non-abdominal obese (ND/NAO), abdominal obese alone (AOA), dynapenic alone (DA) and dynapenic/abdominal obese (D/AO). Dependent variables were blood pressure, lipid profile, fasting glucose and glycated-haemoglobin, metabolic syndrome and cardiovascular diseases. Logistic regression was us...
International urogynecology journal, Feb 15, 2017
Double Incontinence (DI) is incontinence of urine and stool and is an extreme manifestation of pe... more Double Incontinence (DI) is incontinence of urine and stool and is an extreme manifestation of pelvic floor dysfunction. The objective of this study was to estimate the prevalence and incidence of DI and the risk factors in elderly women in São Paulo, Brazil. This was a prospective study in women aged 65 years or older evaluated in 2006 and re-evaluated in 2010. The sample was selected by two-phase stratified sampling with replacement and probability proportional to size. The likelihood ratio test was performed and Cox regression curves were generated to evaluate the equality of survival. Poisson's regression was used to evaluate risk factors. This is the first study on the incidence of DI in elderly women. A total of 864 elderly women were interviewed in 2006. The prevalence rate of DI was 4.9%. The incidence rate of DI in the period between 2006 and 2010 was 13.8/1,000 person-years. Associated factors were the presence of chronic obstructive pulmonary disease, hypertension, di...
Human mutation, Jul 23, 2017
Brazilians are highly admixed with ancestry from Europe, Africa, America, and Asia yet still unde... more Brazilians are highly admixed with ancestry from Europe, Africa, America, and Asia yet still underrepresented in genomic databanks. We hereby present a collection of exomic variants from 609 elderly Brazilians in a census-based cohort (SABE609) with comprehensive phenotyping. Variants were deposited in ABraOM (Online Archive of Brazilian Mutations), a web-based public database. Population representative phenotype and genotype repositories are essential for variant interpretation through allele frequency filtering; since elderly individuals are less likely to harbor pathogenic mutations for early and adult-onset diseases, such variant databases are of great interest. Among the over 2.3 million variants from the present cohort, 1,282,008 were high-confidence calls. Importantly, 207,621 variants were absent from major public databases. We found 9,791 potential loss of function variants with about 300 mutations per individual. Pathogenic variants on clinically relevant genes (ACMG) were...
Journal of aging and health, Jan 14, 2016
To identify socioeconomic and contextual factors associated with functional mobility and falls in... more To identify socioeconomic and contextual factors associated with functional mobility and falls in elderly residents of São Paulo, Brazil. We used data from the Health, Well-Being, and Aging (Saúde, Bem-estare Envelhecimento [SABE]) Study. The dependent variables were falling in the last year and functional mobility impairment. Individual (marital status, race, education, and perception of income sufficiency) and contextual (green area and violence) factors were analyzed by multilevel logistic models. Having 8 or more years of schooling was a protective factor for mobility impairment. Neighborhoods with moderate homicide rate were associated with higher odds of falling. Moderate green spaces were associated with higher odds of falling and lower odds to have mobility impairment for individuals 80 years and older. Our findings support the concern that neighborhood characteristics are associated with falls and mobility impairment. Strategies to prevent these outcomes should consider con...
Revista de Saúde Pública, 2016
OBJECTIVE Analyze the use of antihypertensives among seniors and the association with socioeconom... more OBJECTIVE Analyze the use of antihypertensives among seniors and the association with socioeconomic and behavioral characteristics. METHODS In this seriate cross-sectional study, we used data from the Saúde, Bem Estar e Envelhecimento study (SABE – Health, Well-being, and Aging), conducted in 2000, 2006, and 2010 in the city of São Paulo. Association between the use of antihypertensives and the demographic, behavioral, and socioeconomic characteristics and risk factors was analyzed by using multilevel logistic regression models. RESULTS We observed increased proportion of use of antihypertensive, from 48.7% in 2000 to 61.3% in 2006, reaching 65.7% in 2010. Among the seniors who made use of this type of medicine, we also observed increased adoption of combined therapy in the period, from 69.9% to 82.6% from 2000 to 2006 and reaching 91.6% in 2010. Multilevel analysis indicated statistically significant increase in use of antihypertensives, even after control by socioeconomic and beha...
The journals of gerontology. Series A, Biological sciences and medical sciences, Jan 13, 2016
Existing mortality prediction models for older adults have been each developed using a single stu... more Existing mortality prediction models for older adults have been each developed using a single study from the United States or Western Europe. We aimed to develop and validate a 10-year mortality prediction model for older adults using data from developed and developing countries. We used data from five cohorts, including data from 16 developed and developing countries: ELSA (English Longitudinal Study of Aging), HRS (Health and Retirement Study), MHAS (Mexican Health and Aging Study), SABE-Sao Paulo (The Health, Well-being and Aging), and SHARE (Survey on Health, Ageing and Retirement in Europe). 35,367 older adults were split into training (two thirds) and test (one third) data sets. Baseline predictors included age, sex, comorbidities, and functional and cognitive measures. We performed an individual participant data meta-analysis using a sex-stratified Cox proportional hazards model, with time to death as the time scale. We validated the model using Harrell's C statistic (dis...
A Deus e à Nossa Mãe, pelo amor maior que tens por mim, por toda a força e a determinação que me ... more A Deus e à Nossa Mãe, pelo amor maior que tens por mim, por toda a força e a determinação que me fizeram descobrir em mim mesma, a continuar nessa luta, chegar até aqui e ser uma pessoa melhor, não pelo título que irei conquistar, mas pelo muito que aprendi na minha vida pessoal, com essa oportunidade. Aos meus pais, Luís Holanda do Rêgo e Ana Maria Magalhães da Cunha Rêgo, que não mediram forças para que fosse possível esse sonho, o apoio e o incentivo, principalmente nas quedas, o amor incondicional e a companhia sempre tão presente e, ao mesmo tempo, tão distante, mas nunca longe. Amo demais. Ao Leonardo Mascarenhas, meu noivo, pelo companheirismo, carinho, paciência, incentivo e amor, que me dedicaste nesses anos distante fisicamente. Em breve, estaremos juntos para sempre. "Perto está quem mora dentro do coração"! Aos professores da Faculdade de Saúde Pública, que tanto me ensinaram e me apoiaram, em especial, à minha orientadora, Maria de Fátima Nunes Marucci, pelos grandes ensinamentos, contribuições e oportunidade de fazer parte do seu grupo de estudos. Aos meus colegas de orientação, principalmente à Daniele Lima de Alencar Castelo, me incentivando a me manter sempre focada nos meus sonhos profissionais e me mostrando que é possível conciliar com o lado pessoal. Aos meus amigos cearenses, à minha TURMASSA, pois a amizade verdadeira é para sempre, na alegria e na tristeza, longe ou perto, em especial ao Antônio Augusto Ferreira Carioca, grande amigo, companheiro, vizinho de república e aprendiz de muita coisa em comum; e à minha amiga e companheira de república Joana Bisol Balardin, pelos exemplos, pelos ensinamentos e pela forma que me ensinou para viver longe de casa. A Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-CAPES, pelo apoio financeiro da bolsa de estudos. 9vtuito o6rigatfa! EPÍGRAFE "Quanáo (j)eus tira afgo de você, pIe não o está punináo, mas apenas a6rináo suas mãos para que rece6a ara0 muito me{lior".
As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics ... more As whole-genome sequencing (WGS) becomes the gold standard tool for studying population genomics and medical applications, data on diverse non-European and admixed individuals are still scarce. Here, we present a high-coverage WGS dataset of 1,171 highly admixed elderly Brazilians from a census-based cohort, providing over 76 million variants, of which ~ 2 million are absent from large public databases. WGS enabled identifying ~ 2,000 novel mobile element insertions, nearly 5 Mb of genomic segments absent from human genome reference, and over 140 novel alleles from HLA genes. We reclassified and curated nearly four hundred variant's pathogenicity assertions in genes associated with dominantly inherited Mendelian disorders and calculated the incidence for selected recessive disorders, demonstrating the clinical usefulness of the present study. Finally, we observed that whole-genome and HLA imputation could be significantly improved compared to available datasets since rare variat...
Revista de saude publica, Jan 25, 2018
To estimate the prevalence of frailty and to evaluate the associated factors in the non-instituti... more To estimate the prevalence of frailty and to evaluate the associated factors in the non-institutionalized Brazilian population aged 50 years or older. The analyses were conducted in 8,556 participants of the baseline survey of the Longitudinal Study of Health of the Brazilian Elderly (ELSI-Brazil) conducted in 2015 and 2016. Frailty was defined based on five characteristics: weight loss, weakness, slowness, exhaustion and low level of physical activity. Participants with three or more characteristics were classified as frail. A Poisson regression model was used to examine the association between frailty and sociodemographic and health factors. The prevalence of frailty was 9.0% (95%CI 8.0-10.1) among participants aged 50 years or over. Among the older adults aged 60 or over, the prevalence was 13.5% (95%CI 11.9-15.3) and 16.2% (95%CI 14.3-18.3) among those 65 aged years or over. Factors associated with higher prevalence of frailty were low schooling, residence without a partner, hea...
Revista de saude publica, Jan 25, 2018
To evaluate the magnitude of wealth-related inequalities in basic activities of daily living amon... more To evaluate the magnitude of wealth-related inequalities in basic activities of daily living among community-dwelling Brazilian older adults and to determine the contribution of demographic, socioeconomic, and health conditions to the inequality. We used data from the 2015 Brazilian Longitudinal Study of Aging (ELSI-Brazil) with a nationally representative sample of adults aged 50 years or older. We assessed wealth-related inequalities in basic activities of daily living by the concentration index. Concentration index was decomposed to determine the contribution of demographic, health, and socioeconomic factors to wealth-related inequalities in basic activities of daily living. The prevalence of disability in the sample was 15.7% (95%CI 14.9-17.6). The concentration index was -0.145 (95%CI -0.194- -0.097), which indicates that disability is concentrated in the poorest individuals in Brazil. Inequalities in basic activities of daily living disability are primarily explained by socioe...
Revista brasileira de enfermagem, 2018
To propose a care need classification for elderly people by identifying their functional demands.... more To propose a care need classification for elderly people by identifying their functional demands. Cross-sectional study carried out in São Paulo, in 2006, with 1,413 elderly (≥ 60 years old), participants in the Health, Well-being and Aging study (SABE - Saúde, Bem Estar e Envelhecimento). For the care need classification, we used the Guttman Scaling method e the frequency of assistance required by the elderly. The hierarchy of activities of daily living had good internal consistency (α = 0.92) and satisfactory coefficients of reproducibility (98%), scalability (84%) and minimum marginal reproducibility (87%). Care need was categorized into: no need (requires no caregiver), minimum need (requires caregiver sporadically), moderate need (requires caregiver intermittently) and maximum need (requires full-time caregiver). This classification will allow identifying elderly that need assistance in everyday activities and will orientante health professionals in the development of a line of...
Brazilian Journal of Physical Therapy
To investigate whether abdominal obesity, dynapenia and dynapenic-abdominal obesity are associate... more To investigate whether abdominal obesity, dynapenia and dynapenic-abdominal obesity are associated to the prevalence of single or recurrent falls in older adults. We analyzed data from 1,046 community-dwelling participants of the SABE Study (Saúde, Bem-estar e Envelhecimento/Health, Well-Being and Ageing). Participants were classified as non-dynapenic/non-abdominal obese, abdominal obese only, dynapenic only, and dynapenic-abdominal obese based on waist circumference (&amp;gt;102cm for men and &amp;gt;88cm for women) and handgrip strength (&amp;lt;26kg for men and &amp;lt;16kg for women). Multinomial logistic regression models were ran to determine associations between dynapenia/obesity/dynapenic-abdominal obesity and single/recurring falls, taking non-fallers as reference. Abdominal obesity (RRR=1.90 95% CI: 1.02-3.55), dynapenia (RRR=1.80 95% CI: 1.02-3.19), and dynapenic-abdominal obesity (RRR=2.06 95% CI: 1.04-4.10) were associated with a single fall. A stronger association for dynapenic-abdominal obesity compared to the other two conditions alone was found. Dynapenia was the unique condition associated with recurrent falls (RRR=2.33, 95% CI: 1.13-4.81). The present findings have important implications for the identification of older adults with a greater chance of falls and can help in the development of rehabilitation strategies. Therefore, abdominal obese, dynapenic, and dynapenic abdominal obese individuals should be target groups for the management of falls and their consequences.
Frontiers in immunology, 2018
The increased number of individuals older than 80 years, centenarians, and supercentenarians is n... more The increased number of individuals older than 80 years, centenarians, and supercentenarians is not a synonym for healthy aging, since severe infections, hospitalization, and disability are frequently observed. In this context, a possible strategy is to preserve the main characteristics/functions of the immune system with the aim to cause less damage to the organism during the aging process. Vitamin D acts on bone marrow, brain, breast, malignant cells, and immune system and has been recommended as a supplement. We aimed to evaluate whether immune parameters and vitamin D serum levels are correlated. We evaluated some features of the immune system using the peripheral blood of individuals older than 80 years ( = 12) compared to young subjects ( = 10). In addition, we correlated these findings with vitamin D serum levels. Old individuals presented metabolic parameters of healthy aging and maintained preserved some features of immunity such as CD4/CD8 ratio, and low production of pro-...
American journal of epidemiology, Jan 31, 2018
Brazil is experiencing one of the world's fastest demographic aging worldwide. This demograph... more Brazil is experiencing one of the world's fastest demographic aging worldwide. This demographic transition is occurring in a context of few resources and great social inequalities. The Brazilian Longitudinal Study of Aging (ELSI-Brazil) is a nationally representative study of 9,412 people aged 50 years and over, residing in 70 municipalities across the 5 great Brazilian regions. The study allows investigations of the aging process, its health, psychosocial and economic determinants and societal consequences. The baseline examination (2015-16) included detailed household and individual interviews and physical measurements (blood pressure, anthropometry, grip strength, timed walk and balance tests). Blood tests and samples storage were performed in a sub-sample of study participants. Subsequent waves are planned every 3 years. The study adopts a common conceptual framework of other great-scale longitudinal studies of aging in the world, namely Health and Retirement family, allowin...
PloS one, 2017
Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiolo... more Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases. This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging]), a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when <60 mL/min/1.73m2. Kidney damage was defined as dipstick-positive hematuria or urinary protein:creatinine > 0.20 g/g. The prevalence ...
The Journal of clinical endocrinology and metabolism, Feb 15, 2017
Genetic evaluation has been recognized as an important tool to elucidate the causes of growth dis... more Genetic evaluation has been recognized as an important tool to elucidate the causes of growth disorders. To investigate the etiology of short stature and to determine the phenotype of patients with IHH mutations, including the response to growth hormone (rhGH) therapy. We studied 17 families with autosomal dominant short stature using whole exome sequencing and screened IHH defects in 290 patients with growth disorders. Molecular analyses were performed to evaluate the potential impact of N-terminal IHH variants. We identified 10 pathogenic or possibly pathogenic variants in IHH, an important regulator of endochondral ossification. Molecular analyses revealed a smaller potential energy of mutated IHH molecules. The allele frequency of rare predicted to be deleterious IHH variants found in short stature samples (1.6%) was higher than that observed in two control cohorts (0.017% and 0.08%; p<0.001). Identified IHH variants segregate with short stature in a dominant inheritance patt...
Clinical nutrition (Edinburgh, Scotland), Jan 2, 2017
The concept of dynapenic obesity has been gaining great attention recently. However, there is lit... more The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications ...
Cadernos de Saúde Pública
Resumo: Objetivou-se a identificação de fatores preditores de dor em idosos. Trata-se de um estud... more Resumo: Objetivou-se a identificação de fatores preditores de dor em idosos. Trata-se de um estudo longitudinal de base populacional, realizado por meio de entrevista domiciliar com idosos residentes no Município de São Paulo, Brasil, participantes do Estudo SABE, nos anos de 2006 e de 2010. A análise dos fatores preditores de dor foi realizada por regressão logística hierarquizada e baseada em modelo teórico-conceitual, com variáveis em níveis distal, intermediário e proximal. A incidência acumulada de dor foi de 27,9%. Após ajustes, permaneceram como fatores preditores de dor no idoso, ter entre 0 e 3 anos de estudo (OR = 2,21; IC95%: 1,18-4,15), ser portador de hipertensão (OR = 1,98; IC95%: 1,24-2,88), possuir Apgar familiar insatisfatório (OR = 2,31; IC95%: 1,15-4,64) e autorrelato de saúde ruim/regular (OR = 2,23; IC95%: 1,35-3,69). A identificação desses preditores pode ser um alerta para as equipes de saúde, na atenção direcionada à pessoa idosa, e pode indicar possíveis açõ...
Public health nutrition, 2017
To assess the role of abdominal obesity in the incidence of disability in older adults living in ... more To assess the role of abdominal obesity in the incidence of disability in older adults living in São Paulo, Brazil, in a 5-year period. Longitudinal study, part of the SABE Study (Health, Wellbeing and Aging). We assessed the disability incidence in the period (reported difficulty in at least one activity of daily living (ADL) in 2010) in relation to abdominal obesity in 2006 (waist circumference ≥102 cm in men and ≥88 cm in women). We used Poisson regression to evaluate the association between obesity and disability incidence, adjusting for sociodemographic and clinical factors including BMI. São Paulo, Brazil. Older adults (n 1109) who were independent in ADL in 2006. In 2010, 789 of these were located and re-interviewed. The crude disability incidence (at least one ADL) was 27·1/1000 person-years in the period. The incidence rate was two times higher in participants with abdominal obesity compared with those without (39·1/1000 and 19·4/1000 person-years, respectively; P<0·001)...
Clinical nutrition (Edinburgh, Scotland), Jan 10, 2017
There is little evidence showing that dynapenic obesity is associated with lipid and glucose meta... more There is little evidence showing that dynapenic obesity is associated with lipid and glucose metabolism disorders, high blood pressure, chronic disease and metabolic syndrome. Our aim was to analyze whether dynapenic abdominal obesity can be associated with lipid and glucose metabolism disorders, high blood pressure, metabolic syndrome and cardiovascular diseases in older adults living in São Paulo. This cross-sectional study included 833 older adults who took part of the third wave of the Health, Well-being and Aging Study in 2010. Based on waist circumference (>88 cm women and >102 cm men) and handgrip strength (<16 kg women and <26 kg men), four groups were identified: non-dynapenic/non-abdominal obese (ND/NAO), abdominal obese alone (AOA), dynapenic alone (DA) and dynapenic/abdominal obese (D/AO). Dependent variables were blood pressure, lipid profile, fasting glucose and glycated-haemoglobin, metabolic syndrome and cardiovascular diseases. Logistic regression was us...
International urogynecology journal, Feb 15, 2017
Double Incontinence (DI) is incontinence of urine and stool and is an extreme manifestation of pe... more Double Incontinence (DI) is incontinence of urine and stool and is an extreme manifestation of pelvic floor dysfunction. The objective of this study was to estimate the prevalence and incidence of DI and the risk factors in elderly women in São Paulo, Brazil. This was a prospective study in women aged 65 years or older evaluated in 2006 and re-evaluated in 2010. The sample was selected by two-phase stratified sampling with replacement and probability proportional to size. The likelihood ratio test was performed and Cox regression curves were generated to evaluate the equality of survival. Poisson's regression was used to evaluate risk factors. This is the first study on the incidence of DI in elderly women. A total of 864 elderly women were interviewed in 2006. The prevalence rate of DI was 4.9%. The incidence rate of DI in the period between 2006 and 2010 was 13.8/1,000 person-years. Associated factors were the presence of chronic obstructive pulmonary disease, hypertension, di...
Human mutation, Jul 23, 2017
Brazilians are highly admixed with ancestry from Europe, Africa, America, and Asia yet still unde... more Brazilians are highly admixed with ancestry from Europe, Africa, America, and Asia yet still underrepresented in genomic databanks. We hereby present a collection of exomic variants from 609 elderly Brazilians in a census-based cohort (SABE609) with comprehensive phenotyping. Variants were deposited in ABraOM (Online Archive of Brazilian Mutations), a web-based public database. Population representative phenotype and genotype repositories are essential for variant interpretation through allele frequency filtering; since elderly individuals are less likely to harbor pathogenic mutations for early and adult-onset diseases, such variant databases are of great interest. Among the over 2.3 million variants from the present cohort, 1,282,008 were high-confidence calls. Importantly, 207,621 variants were absent from major public databases. We found 9,791 potential loss of function variants with about 300 mutations per individual. Pathogenic variants on clinically relevant genes (ACMG) were...
Journal of aging and health, Jan 14, 2016
To identify socioeconomic and contextual factors associated with functional mobility and falls in... more To identify socioeconomic and contextual factors associated with functional mobility and falls in elderly residents of São Paulo, Brazil. We used data from the Health, Well-Being, and Aging (Saúde, Bem-estare Envelhecimento [SABE]) Study. The dependent variables were falling in the last year and functional mobility impairment. Individual (marital status, race, education, and perception of income sufficiency) and contextual (green area and violence) factors were analyzed by multilevel logistic models. Having 8 or more years of schooling was a protective factor for mobility impairment. Neighborhoods with moderate homicide rate were associated with higher odds of falling. Moderate green spaces were associated with higher odds of falling and lower odds to have mobility impairment for individuals 80 years and older. Our findings support the concern that neighborhood characteristics are associated with falls and mobility impairment. Strategies to prevent these outcomes should consider con...
Revista de Saúde Pública, 2016
OBJECTIVE Analyze the use of antihypertensives among seniors and the association with socioeconom... more OBJECTIVE Analyze the use of antihypertensives among seniors and the association with socioeconomic and behavioral characteristics. METHODS In this seriate cross-sectional study, we used data from the Saúde, Bem Estar e Envelhecimento study (SABE – Health, Well-being, and Aging), conducted in 2000, 2006, and 2010 in the city of São Paulo. Association between the use of antihypertensives and the demographic, behavioral, and socioeconomic characteristics and risk factors was analyzed by using multilevel logistic regression models. RESULTS We observed increased proportion of use of antihypertensive, from 48.7% in 2000 to 61.3% in 2006, reaching 65.7% in 2010. Among the seniors who made use of this type of medicine, we also observed increased adoption of combined therapy in the period, from 69.9% to 82.6% from 2000 to 2006 and reaching 91.6% in 2010. Multilevel analysis indicated statistically significant increase in use of antihypertensives, even after control by socioeconomic and beha...
The journals of gerontology. Series A, Biological sciences and medical sciences, Jan 13, 2016
Existing mortality prediction models for older adults have been each developed using a single stu... more Existing mortality prediction models for older adults have been each developed using a single study from the United States or Western Europe. We aimed to develop and validate a 10-year mortality prediction model for older adults using data from developed and developing countries. We used data from five cohorts, including data from 16 developed and developing countries: ELSA (English Longitudinal Study of Aging), HRS (Health and Retirement Study), MHAS (Mexican Health and Aging Study), SABE-Sao Paulo (The Health, Well-being and Aging), and SHARE (Survey on Health, Ageing and Retirement in Europe). 35,367 older adults were split into training (two thirds) and test (one third) data sets. Baseline predictors included age, sex, comorbidities, and functional and cognitive measures. We performed an individual participant data meta-analysis using a sex-stratified Cox proportional hazards model, with time to death as the time scale. We validated the model using Harrell's C statistic (dis...