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		<property:Field_data rdf:datatype="http://www.w3.org/2001/XMLSchema#string">##$a Tese (doutorado) – Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, 2022.</property:Field_data>
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		<property:Field_data rdf:datatype="http://www.w3.org/2001/XMLSchema#string">##$a Inclui referências.</property:Field_data>
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		<property:Field_data rdf:datatype="http://www.w3.org/2001/XMLSchema#string">##$a Este estudo teve o objetivo de identificar padrões de comportamentos de risco à saúde e sua associação com o comprometimento cognitivo e funcional em pessoas idosas, ao longo de 10 anos, residentes no município de Florianópolis/SC, Brasil. Foi conduzido estudo longitudinal com dados provenientes de três ondas da coorte de base populacional e domiciliar, EpiFloripa Idoso. Participaram do estudo 743 pessoas com 60 anos ou mais, residentes na área urbana do município de Florianópolis/SC, entrevistadas em 2009/2010 (onda 1), 2013/2014 (onda 2) e 2017/2019 (onda 3). Quatro comportamentos de risco à saúde (consumo de frutas, legumes e verduras insuficiente [FLVi], inatividade física [IF], consumo de álcool de risco [A] e tabagismo [T]) foram utilizados para identificar os padrões de comportamentos através da análise de cluster em duas etapas (Two Steps Cluster). O comprometimento cognitivo foi identificado pelo Mini Exame do Estado Mental com ponto de corte ajustado para escolaridade. O comprometimento funcional foi avaliado pelo Questionário Brasileiro de Avaliação Funcional Multidimensional, que considera a dificuldade em realizar 15 atividades de vida diárias (AVD), sendo oito atividades básicas de vida diárias (ABVD) e sete atividades instrumentais de vida diárias (AIVD). Qualquer grau de dificuldade em quatro ou mais atividades foi considerado comprometimento funcional nas ABVD, AIVD e na escala geral das AVD. Para identificar os fatores associados aos padrões de comportamentos de risco à saúde, bem como investigar a associação entre estes padrões com o comprometimento cognitivo e funcional, foram utilizados modelos de Equações de Estimativa Generalizadas, investigando a relação dos preditores na onda 1 sobre os desfechos nas ondas seguintes. Quatro grupos de comportamentos de risco foram criados nas três ondas do estudo: “FLVi” (onda 1: 11,2%; onda 2: 10,3%; Onda 3: 9,5%); “IF” (onda 1:19,3%; onda 2: 27,9%; onda 3: 32,8%); “FLVi + IF” (onda 1:55,4%; onda 2: 49,6%; onda 3:47,9%) e “IF + FLVi + T + A” (onda 1: 13,6%; onda 2: 12,2%; onda 3: 9,8%). O aumento da idade reduziu a chance do padrão “FLVi” e pessoas com 12 anos ou mais de estudo apresentaram cerca de três vezes mais chance do padrão “FLVi” comparado aos demais padrões. Mulheres e indivíduos com maior escolaridade possuíam, em média, maior chance do padrão “IF”, enquanto as pessoas mais velhas foram mais prováveis de apresentar padrão “FLVi + IF”, e maior escolaridade foi negativamente associada a este padrão. Ainda, mulheres, indivíduos com maior escolaridade e com três ou mais morbidades tiveram menor chance de apresentar padrão “IF + FLVi + T + A”. A prevalência de comprometimento cognitivo foi de 17,2% na onda 1 e 24,5% na onda 3. Observou-se aumento na frequência de comprometimento funcional nas AVD (onda 1: 23,9%; onda 3: 37,9%), AIVD (onda 1: 10,5%; onda 3: 23,4%) e ABVD (onda 1: 6,6%; onda 3: 15,6%) entre a onda 1 e 3. Análise de associação entre os padrões de comportamentos e o comprometimento cognitivo e funcional, mostrou que indivíduos com padrão “FLVi + IF” apresentaram maior chance de comprometimento cognitivo (OR=1,57; IC95%=1,03-2,42; p=0,039) e comprometimento funcional nas AVD (OR=1,65; IC95%=1,12-2,43; p=0,012) na onda posterior, quando comparados com o grupo “FLVi”. Não foi observada associação entre os padrões de comportamentos de risco à saúde com o comprometimento funcional nas AIVD e ABVD após ajuste do modelo. Conclui-se que pessoas idosas apresentam padrões de comportamentos de risco à saúde complexos, os quais são determinados por fatores sociodemográficos e de saúde. Ainda, o padrão “FLVi + IF” é um importante preditor de subsequente comprometimento cognitivo e comprometimento funcional nas atividades de vida diárias.</property:Field_data>
		<property:Field_data rdf:datatype="http://www.w3.org/2001/XMLSchema#string">8#$a Abstract: This study aimed to identify patterns of health risk behaviors and their association with cognitive and functional impairment in older adults, over 10 years, living in the city of Florianópolis/SC, Brazil. A panel-type cohort study was conducted with data from three waves of the population-based and household EpiFloripa Idoso Cohort. The study included 743 people aged 60 years or older, living in the urban area of the city of Florianópolis/SC, interviewed in 2009/2010 (wave 1), 2013/2014 (wave 2) and 2017/2019 (wave 3). Four health risk behaviors (insufficient consumption of fruits and vegetables [FLVi], physical inactivity [IF], risky alcohol consumption [A] and smoking [T]) were used to identify behavioral patterns through the TwoStep Cluster Analysis. Cognitive impairment was identified by the Mini Mental State Examination with cutoff adjusted for schooling. Functional impairment was assessed using the Brazilian Multidimensional Functional Assessment Questionnaire, which considers the difficulty in performing 15 activities of daily living (ADL), eight of which are basic activities of daily living (BADL) and seven instrumental activities of daily living (IADL). Any degree of difficulty in four or more activities was considered functional impairment in BADL, IADL and on the general ADL scale. To identify factors associated with patterns of health risk behaviors, as well as investigate the association between health risk behaviors with cognitive and functional impairment, models of Generalized Estimating Equations were used, investigating the relationship of predictors in wave 1 on outcomes in waves following. Four groups of risk behaviors were created in the three waves of the study: “FLVi” (wave 1: 11.2%; wave 2: 10.3%; Wave 3: 9.5%); "IF" (wave 1:19.3%; wave 2: 27.9%; wave 3: 32.8%); “FLVi + IF” (wave 1:55.4%; wave 2: 49.6%; wave 3:47.9%) and “IF + FLVi + T + A” (wave 1: 13.6%; wave 2: 12.2%; wave 3: 9.8%). Increasing age reduced the chance of the “FLVi” pattern and people with 12 years or more of schooling were about three times more likely to have the “FLVi” pattern compared to the other patterns. Women and individuals with higher schooling were, on average, more likely to have the “IF” pattern, while older people were more likely to have the “FLVi + IF” pattern, and higher schooling was negatively associated with this pattern. Also, women, individuals with higher education and those with three or more morbidities had a lower chance of presenting the “IF + FLVi + T + A” pattern. The prevalence of cognitive impairment was 17.2% in wave 1 and 24.5% in wave 3. There was an increase in the frequency of functional impairment in ADL (wave 1: 23.9%; wave 3: 37.9% ), IADL (wave 1: 10.5%; wave 3: 23.4%) and ABVD (wave 1: 6.6%; wave 3: 15.6%) between wave 1 and 3. Analysis of association between behavioral patterns and cognitive and functional impairment, showed that individuals with “FLVi + IF” pattern were more likely to have cognitive impairment (OR=1.57; 95%CI=1.03-2.42; p=0.039) and functional impairment in general ADL (OR=1.65; 95%CI=1.12-2.43; p=0.012) in the posterior wave, when compared with the “FLVi” pattern. No association was observed between patterns of health risk behaviors and functional impairment in IADL and BADL after adjusting the model. In conclusion, older adults have complex health risk behavior patterns, which are determined by sociodemographic and health conditions. Furthermore, the “FLVi + IF” pattern is an important predictor of subsequent cognitive impairment and functional impairment in activities of daily living.</property:Field_data>
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		<property:Field_data rdf:datatype="http://www.w3.org/2001/XMLSchema#string">2#$a Universidade Federal de Santa Catarina. $b Programa de Pós-Graduação em Saúde Coletiva</property:Field_data>
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