Atividade física, comportamento sedentário e multimorbidade em idosos residentes na comunidade

Abstract

Multimorbidity is a medical condition increasingly prevalent in the elderly population and is related to the behaviors that the person exhibits throughout life. However, little is known about how the interaction of these behaviors can influence multimorbidity. Two articles were produced with the following objectives: Article 1) to estimate the prevalence of multimorbidity in the elderly and its association with physical activity (PA) and sedentary behavior (SB), in an isolated and combined way; and Article 2) to analyze the hypothetical effects of replacing sleep time, SB and moderate to vigorous physical activity (MVPA) in relation to multimorbidity in the elderly. This is a cross- sectional population-based study, carried out with 473 elderly people living in the urban area of the city of Alcobaça, Bahia, and registered in the Family Health Strategy. Data collection took place in the form of an interview through a structured questionnaire, composed of previously validated instruments, referring to sociodemographic, health and behavioral aspects. Multimorbidity was assessed by a list of 12 chronic diseases, and classified in two ways, multimorbidity of two or more chronic diseases (MM2) and multimorbidity of three or more chronic diseases (MM3). The associations were estimated by the Prevalence Ratio (PR), by Poisson regression. The prevalence of MM2 was 59.2% and that of MM3 36.4% in the elderly. After adjusting for sex, in the isolated analysis, only the SB was associated with MM2 (PR: 1.25, 95%CI: 1.08-1.45), in relation to the combined analysis, the elderly who did not achieved the PA recommendations and exhibited high SB time had a prevalence rate of MM2 29% higher than the elderly physically active and with low SB (PR: 1.29, 95%CI: 1.07-1.55). The reallocation of 10 (PR: 0.98, 95%CI: 0.96-0.99), 30 (PR: 0.94; 95%CI: 0.89-0.99) and 60 minutes (PR: 0.88; 95%CI: 0.79-0.98) of SB for MVPA resulted in a lower prevalence rate of MM3. In addition, there was a significant effect on the prevalence of MM2 and MM3 with the replacement of all SB times for sleep. The findings of the present study demonstrate the importance of following the health recommendations regarding the practice of PA and time spent in SB to reduce the prevalence of multimorbidity in the elderly. Also found in the study that the reallocation of SB time for the same amount of time in MVPA or sleep can bring beneficial results in relation to multimorbidity in the elderly population.