Espaço de vida e declínio cognitivo em idosos de diferentes contextos sociais e econômicos: resultados longitudinais do estudo IMIAS
Psychosocial, socioeconomic and sociocultural aspects can influence cognitive function among community-dwelling older adults. Life-space restriction is potentially related to cognitive status. We examined the longitudinal association between lifespace mobility and changes in cognitive function in...
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| Aineistotyyppi: | doctoralThesis |
| Kieli: | pt_BR |
| Julkaistu: |
Universidade Federal do Rio Grande do Norte
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| Linkit: | https://repositorio.ufrn.br/handle/123456789/30986 |
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| Yhteenveto: | Psychosocial, socioeconomic and sociocultural aspects can influence cognitive
function among community-dwelling older adults. Life-space restriction is potentially
related to cognitive status. We examined the longitudinal association between lifespace mobility and changes in cognitive function in community-dwelling older adults in
different social settings of North and South America and Europe. We analyze mobility
and use of space as predictors of cognitive decline in elderly residents in the
community. The International Mobility in Aging Study (IMIAS) is a population-based,
multicenter and multidisciplinary study that investigates the decline in mobility in the
elderly, considering the perspective of the life course. The sample consists of elderly
people living in five different cities: Tirana (Albania), Natal (Brazil), Manizales
(Colombia), Kingston and Saint-Hyacinthe (Canada). Each city selected 200 men and
200 women, between 65 and 74 years of age to participate in the sample. The elderly
were excluded from the sample, who presented severe cognitive decline, obtaining
less than 4 points in the orientation assessment of the Leganés Cognitive Test. The
sample from this study was composed of 1486 elderly people. To analyze the
relationship between cognition and the use of living space, a quantile regression (RQ)
was used. The analysis evaluated factors related to cognitive function in 2016, by
adjusting the score obtained in 2012. For this analysis, two models were made: an
initial model with socioeconomic characteristics, living arrangements and social
support; and a second model with the same previous variables adding measures of
physical performance, depressive symptoms and chronic conditions (group of clinical
variables). The use of living space was assessed using the Life-Space Assessment
(LSA) applied at the baseline (2012). For the analysis in the RQ model, the score
obtained on the scale was transformed into a categorical variable, with five categories,
where the highest scores correspond to the greatest use of space. The Leganés
Cognitive Test (PCL) was used to assess cognitive function at baseline and at followup (2016), using a continuous variable, corresponding to the total score obtained on
the scale. Women had a more restricted use of living space than men (p <0.001), and
these gender differences were present in all research sites. The gender difference
becomes even more evident than in the categories bordering the LSA (categories I and
V). Most women were classified in category I (p <0.001) and this gender difference was greater in locations outside Canada. A decline in the cognitive function of the
elderly was observed in all cities, except in Manizales. Participants who used less living
space at baseline showed a significant decline in cognitive function at follow-up (β = -
0.79, 95% CI: -1,400 to -0.18, p-value <0.01), when compared to those with greater
use of space. This decrease was independent of gender, age, city, education,
insufficient income, social support, depression, cognitive function at baseline, chronic
conditions and physical performance. Restriction in life-space is an important
prognostic factor for cognitive function. Maintaining life-space can be a goal in public
policies aimed at encouraging healthy aging, and might be useful in clinical practice to
promote health status and to monitor older people at higher risk of cognitive decline. |
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