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- Association between physical activity, functional fitness and fall risk in the elderly: a cross-sectional population-based study from the Oporto regionPublication . Carmo, Paulo Jorge Quintela Cardoso do; César, Adjane P.; Santos, Rubim; Carvalho, Joana M.Falls among the elderly are important clinical and health problems being one of the major causes of morbidity and mortality worldwide. Its high incidence and functional and social repercussions cause a significant financial burden on older adults, health systems and communities. According to different methodologies, the relationship between fall risk, physical activity and physical fitness found some inconsistent results. This study aims to examine the association between objective physical activity (PA) levels, fall risk (FR) and different components of functional fitness (FF) creating an appropriate model to explain variability in fall risk. Methods: One hundred and seventy elderly adults (72.34±6.70 years old, 124 female), completed a Functional-Fitness-Test (FFT) and a Performance-Orientated-Mobility-Assessment (POMA). Ambulatory-PA was assessed by 7-day accelerometry. Pearson’s correlation was used to verify association between FR, PA and FF. Analyses were adjusted either for gender, age, or both. Inferential stepwise multiple linear regression (MLR) was used to investigate the impact of PA and components of FF on FR. RESULTS: MLR Showed that FR variability was mainly explained by motor agility (46.0%) and also by lower-body strength (14.1%) independently, and 49% when associated. Physical activity and also age were excluded from the models. MLR analysis by gender, only motor agility explains fall risk variability, more in female (45.0%) than in male (23.6%). The authors concluded that low motor agility and lower-body strength may increase fall risk. However, further evidence from a prospective study is required to establish directions of causality between physical activity behavior and risk of falls.
- Indicators and instruments to assess components of disability in community-dwelling older adults: a systematic reviewPublication . Moreira, Juliana Santos; Melo, Ana; Santos, Rubim; Pinheiro De Sousa, Andreia SofiaThe epidemiological demands of aging point to the need for characterizing older adults regarding health and disability. This systematic review aims to summarize the indicators (instruments) identifying different components of disability as a result of aging exposition in community-dwelling older adults, considering the International Classification of Functioning, Disability, and Health framework. Taking the PRISMA 2020 recommendations as a reference, studies with community-dwelling older adults, reporting the development and/or age disability modifications were included. Two reviewers analyzed the observational studies searched in the MEDLINE, CINAHL, Web of Science, Scopus, and Embase databases. Of the 137 potentially eligible studies, 49 were included in this review. Several indicators (instruments) demonstrated older adults’ disabilities according to the different domains of the ICF. Objective measures assessed Body Structures, Body Functions, and Environmental Factors and included handgrip strength (dynamometry, n = 8), cognitive function (Mini-Mental State examination, n = 7), gait speed (walk test, n = 6), and endurance (Chair stand-test, n = 4). Self-reported measures assessed Activities and Participation, but not the Body Structures, and included the basic and instrumental activities of daily living (ADL) (the Katz Index of ADL, n = 4 studies, the Lawton and Brody Instrumental ADL, n = 4 studies). The summary of the measures gathered can guide researchers and health professionals to select indicators (instruments) to assess and monitor older adults’ disabilities resulting from aging exposition, to support the development of new wearables, and to provide improvements to the existing ones, allowing the tailored assessment of different health and disability dimensions.