Obesidade abdominal e ocorrência de quedas em idosos residentes em comunidade: uma análise caminhos

Abstract

Falls represent an important public health problem related to aging. Obesity is reported to be a risk factor for falls among the elderly, but the effects of body fat distribution and the interaction with other factors are not well established. Thus, this study aimed to analyze the prevalence and the factors associated with the occurrence of falls among elderly people with and without abdominal obesity , living in community. This is a cross-sectional survey conducted in 2015 comprising 454 elderly people living in the municipality of Alcobaça-BA. The Mini Mental State Examination was used for cognitive screening, questionnaires for sociodemographic, economic, health and behavioral characterization, and anthropometric and physical performance measures were also performed. Descriptive analysis and analysis of paths to verify associations were conducted with a significance level of α <0.05. The average age of the participants was 70.08 years and the occurrence of falls (33%) was higher in the group with abdominal obesity . In the group with abdominal obesity , the number of morbidities was directly associated with the occurrence of falls and mediated the relation between sedentary behavior and falls. In the group without abdominal obesity, direct relations were found between falls and fewer medications, greater occurrence of depressive symptoms, worse performance at the agility and dynamic balance test and less functional disability for Basic Activities of Daily Living (BADL). In indirect relationships for the occurrence of falls, the lowest functional disability for BADL mediated an association between older age and lower functional disability for Instrumental Activities of Daily Living (IADL). Lower handgrip strength, older age and greater sedentary behavior were mediated by the longer time in the agility and dynamic balance test; sedentary behavior by the greater number of morbidities, and greater functional disability for IADL by the greater occurrence of depressive symptoms. The results obtained highlight the multifactorial nature of falls and show different behavior in the associations of the two groups enhancing the need to consider abdominal obesity in the evaluation of the elderly in order to avoid the occurrence of falls and its resulting losses.