Velocidade de marcha e sobrevida idosos residentes na comunidadde

Abstract

With aging, there are several physiological changes that corroborate the decline in functional capacity in the elderly, including the progressive reduction in gait speed (MV). MV below 1 m/s represents not only the need to prevent falls, but also a greater risk of functional dependence, hospitalization and death. Thus, the earlier functional limitations are identified, the greater the chances of reversing or minimizing the consequences caused by the loss of functionality. Among the various aspects of mobility, MV is extremely important for the independence of older individuals. The present study has the following objectives: a) to identify the predictive value of MV of 4.57m on all-cause mortality in the elderly; b) to verify the relationship between MV (2.44m and 4.57m) with risk for all-cause mortality in the elderly in the community. The present study is a population-based prospective cohort with a five-year follow-up (2015-2020). A total of 473 elderly people aged ≥ 60 years participated in the first wave, of the participants included in the first study, 105 were not located, 36 moved to another city and 11 did not undergo the MV test, totaling 270 segment losses, of the 321 returns obtained,59 died and 262 were alive. Vital status was determined through telephone follow-up, information from family members with the presentation of the death certificate, information obtained from the municipal registry office (RCPN Registry of Alcobaça) and/or public consultation on the website of the Court of Justice of the State of Bahia. The MV (in meters/second) was determined by the Short Physical Performance Battery Assessing Lower Extremity Function (SPPB) walking test (NAKANO; 2007). The predictive power and cutoff points of MV on all-cause mortality were identified using Receiver Operating Characteristic (ROC) curves. For the relationship between MV and mortality, the hazard ratios were estimated from the Cox proportional hazards regression analysis, as measures of the Hazard Ratio (HR), with 95% confidence intervals (CI) for mortality for all causes, with survival time in months. A significance level of 5% was adopted in all analyses. Results: The areas under the ROC curve for the analyzes were 0.55 overall, for women 0.56 and for men 0.70. Providing an indication that overall the 4.57 meter MV test does not have the potential to predict mortality in the elderly, except for males. Elderly people with insufficient MV (2.44 m) (≥3.24s) showed, on average, a higher mortality rate than those with sufficient (≤3.23s) (HR=2.20; 95%CI=1.11 – 4, 34). Regarding gender, elderly women with MV ≥1.83 m/s had a risk of death (HR=4.62; 95%CI=4.62-8.70) compared to elderly women with sufficient MV 10 (≤ 1.82s). In turn, in males, no statistical differences were identified for low MV and risk of death (p=0.345). For the distance of 4.57 m, the elderly with insufficient MV (>4.79s) showed, on average, a higher risk of death compared to sufficient (<4.79s) (HR=2.31; 95%CI=1.17 – 4.55). Regarding gender, elderly women with insufficient MV (>2.86 m/s) had a higher risk of death (HR=2.74; 95%CI=0.79-9.49) compared with elderly women with MV enough (<2.86s). For elderly males, the risk of death was also not significantly associated with low MV (p=0.805). The 4.57m MV test proved to be a good predictor of mortality for men, however, when analyzed for the group in general, the test did not have a good prediction for mortality. Low MV at different distances (2.44 and 4.57 m) may increase the risk of death in the older population.