Efeito da atividade física na função cognitiva, depressão e satisfação com a vida: um estudo em idosos de Salvador, Bahia, Brasil
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2016
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A prática regular de atividade física é considerada uma estratégia de promoção a saúde, de fácil acesso, baixo custo e raros efeitos colaterais. Diversos estudos têm indicado que o efeito da prática de atividade física pode ser benéfico na saúde mental dos idosos. Neste contexto, o objetivo principal do presente estudo foi verificar o efeito da prática de atividade física na saúde mental de idosos brasileiros, tendo por objetivos específicos, verificar o efeito das variáveis sociodemográficas, dos diferentes programas de atividade física e dos níveis de atividade física na função cognitiva, depressão e satisfação com a vida, e também determinar os fatores de risco associados ao declínio cognitivo e à depressão. O presente estudo pode ser caracterizado como quasi experimental, descritivo, de abordagem quantitativa, transversal e longitudinal. Este trabalho foi organizado em 04 estudos, nomeadamente, Estudo 1: O efeito das variáveis sociodemográficas na função cognitiva, depressão e satisfação com a vida em idosos; Estudo 2: O efeito de diferentes programas de atividade física na função cognitiva, depressão e satisfação com a vida em idosos; Estudo 3: O efeito e a interação dos diferentes níveis de atividade física na função cognitiva e depressão em idosos; Estudo 4: Fatores de risco associados ao declínio cognitivo e à depressão em idosos. O delineamento metodológico nos Estudos 1 e 4 foi de caráter transversal, os estudos 2 e 3, de caráter longitudinal, realizados por um período de 35 semanas.
Foi utilizada uma amostra de conveniência constituída por 465 idosos provenientes de uma amostra inicial de 500 idosos, residentes na cidade de Salvador, capital da Bahia, Brasil, sendo 29,5% dos participantes do gênero masculino e 70,5% do gênero feminino. As idades foram compreendidas entre 60 e 93 anos (média de 69,93±6,63). Os instrumentos utilizados para identificação das variáveis independentes (variáveis sociodemográficas, tipos e níveis de atividade física), foram um questionário sociodemográfico e o International Physical Activity Questionnaire (IPAQ) versão longa. Para avaliação das variáveis dependentes (função cognitiva, depressão e satisfação com a vida) foram utilizados o Mini Exame do Estado Mental (MEEM), o Beck Depression Inventory 2nd version (BDI-II) e a Escala de Satisfação com a Vida (ESV), respectivamente.
Para verificar o efeito das variáveis sociodemográficas (Estudo 1), foi aplicado o modelo geral linear (GLM) introduzindo no modelo a idade, como covariável e realizou-se uma MANCOVA; para verificar o efeito dos diferentes programas de atividade física (Estudo 2) e o efeito e interação dos diferentes níveis de atividade física (Estudo 3) nos três momentos avaliativos foi aplicado o modelo geral linear (GLM) introduzindo no modelo a idade, como covariável e realizou-se uma MANCOVA de medidas repetidas. E para identificar os fatores de risco ao declínio cognitivo e depressão (Estudo 4) foi realizado o teste qui quadrado (χ2) e assim verificar a associação entre as variáveis independentes e dependentes, posteriormente, foi aplicado um modelo de regressão logística binária para identificar os fatores de risco associados ao declínio cognitivo e à depressão.
Os resultados indicaram no Estudo 1 que os níveis mais elevados de escolaridade demonstraram melhor desempenho na função cognitiva e reduzidos valores na depressão, enquanto que ter companheiro/a revelaram níveis superiores de satisfação com a vida. No Estudo 2, foi evidenciado que os diferentes programas de atividade física não apresentaram efeito significativo na função cognitiva, depressão e satisfação com a vida, mas a prática regular de atividade física demonstrou efeito significativo nestas variáveis. No Estudo 3, os resultados sugeriram que o nível ativo de atividade física revelou efeito significativo na função cognitiva e na depressão. No Estudo 4, evidenciou-se que pertencer ao gênero feminino foi fator de risco à depressão, enquanto que o nível ativo de atividade física demonstrou efeito protetor à função cognitiva.
Concluímos que no presente estudo, as variáveis sociodemográficas, nomeadamente, a escolaridade exerceu efeito significativo na função cognitiva e depressão; a situação conjugal foi significativa para satisfação com a vida; e pertencer ao gênero feminino foi fator de risco para a depressão. Também foi evidenciado que indepententemente do tipo de programa de atividade física, a prática regular de atividade física exerceu efeito significativo benéfico na função cognitiva, depressão e satisfação com a vida e foi fator protetor da função cognitiva dos idosos brasileiros. Então, em oposição ao sedentarismo, a prática de atividade física moderada, independentemente do tipo de atividade, potencia a saúde mental do idoso.
Portanto, implementar programas de atividade física para idosos deve ser uma das maiores prioridades das políticas públicas de promoção à saúde da população idosa no Brasil, uma vez que manter um indivíduo idoso ativo pode significar a promoção de um envelhecimento saudável para a população brasileira.
The regular practice of physical activity is considered a strategy of health promotion, easy access, low cost and rare side effects. Several studies have indicated that the effect of physical activity can be beneficial in the mental health of the elderly. In this context, the main objective of the present study was to verify the effect of the practice of physical activity on the mental health of Brazilian elderly, with specific objectives, to verify the effect of sociodemographic variables, different physical activity programs and physical activity levels in the cognitive function, depression, and life satisfaction, as well as determining the risk factors associated with cognitive decline and depression. The present study can be characterized as quasi experimental, descriptive, of quantitative, transversal and longitudinal approach. This study was organized in four studies, namely, Study 1: The effect of sociodemographic variables on cognitive function, depression and satisfaction with life in the elderly; Study 2: The effect of different physical activity programs on cognitive function, depression and life satisfaction in the elderly; Study 3: The effect and interaction of different levels of physical activity on cognitive function and depression in the elderly; Study 4: Risk factors associated with cognitive decline and depression in the elderly. The methodological design in Studies 1 and 4 was cross-sectional, studies 2 and 3, of a longitudinal nature, performed for a period of 35 weeks. A convenience sample consisted of 465 elderly individuals from an initial sample of 500 elderly people living in the city of Salvador, Bahia, Brazil, 29.5% of the male participants and 70.5% of the female. The ages ranged from 60 to 93 years (mean of 69.93 ± 6.63). The instruments used to identify the independent variables (sociodemographic variables, types and levels of physical activity) were a sociodemographic questionnaire and the International Physical Activity Questionnaire (IPAQ) long version. The Mental State Mini Exam (MMSE), the Beck Depression Inventory 2nd version (BDI-II) and the Satisfaction With Life Scale (SWLS) were used to evaluate the dependent variables (cognitive function, depression and life satisfaction), respectively. In order to verify the effect of the sociodemographic variables (Study 1), the general linear model (GLM) was introduced introducing into the model the age, as covariate and a MANCOVA was performed; To verify the effect of the different physical activity programs (Study 2) and the effect and interaction of the different levels of physical activity (Study 3) in the three evaluative moments was applied the general linear model (GLM) introducing in the model the age, as covariate, and a MANCOVA of repeated measurements was performed. In order to identify the risk factors for cognitive decline and depression (Study 4), the chi-square test (χ2) was used to verify the association between the independent and dependent variables. Later, a binary logistic regression model was used to identify the risk factors associated with cognitive decline and depression. The results indicated in Study 1 that higher levels of formal education demonstrated a better performance in cognitive function and reduced values in depression, while having a spouse revealed higher levels of satisfaction with life. In Study 2, it was shown that the different physical activity programs had no significant effect on cognitive function, depression and life satisfaction, but the regular practice of physical activity showed a significant effect on these variables. In Study 3, the results suggested that the active level of physical activity revealed a significant effect on cognitive function and depression. In Study 4, it was shown that to be of the female gender was a risk factor for depression, while the active level of physical activity demonstrated a protective effect on cognitive function. We conclude that in the present study, sociodemographic variables, namely, schooling had a significant effect on cognitive function and depression; The marital situation was significant for life satisfaction; And belonging to be of female gender was a risk factor for depression. It was also evidenced that, independently of the type of physical activity program, the regular practice of physical activity had a significant beneficial effect on cognitive function, depression and satisfaction with life and was a protective factor of the cognitive function of the Brazilian elderly. Thus, in opposition to the sedentary lifestyle, the practice of moderate physical activity, regardless of the type of activity, enhances the mental health of the elderly. Therefore, implementing physical activity programs for the elderly should be one of the highest priorities of the public health promotion policies of the elderly population in Brazil, since maintaining an active elderly individual can mean the promotion of a healthy aging for the Brazilian population.
The regular practice of physical activity is considered a strategy of health promotion, easy access, low cost and rare side effects. Several studies have indicated that the effect of physical activity can be beneficial in the mental health of the elderly. In this context, the main objective of the present study was to verify the effect of the practice of physical activity on the mental health of Brazilian elderly, with specific objectives, to verify the effect of sociodemographic variables, different physical activity programs and physical activity levels in the cognitive function, depression, and life satisfaction, as well as determining the risk factors associated with cognitive decline and depression. The present study can be characterized as quasi experimental, descriptive, of quantitative, transversal and longitudinal approach. This study was organized in four studies, namely, Study 1: The effect of sociodemographic variables on cognitive function, depression and satisfaction with life in the elderly; Study 2: The effect of different physical activity programs on cognitive function, depression and life satisfaction in the elderly; Study 3: The effect and interaction of different levels of physical activity on cognitive function and depression in the elderly; Study 4: Risk factors associated with cognitive decline and depression in the elderly. The methodological design in Studies 1 and 4 was cross-sectional, studies 2 and 3, of a longitudinal nature, performed for a period of 35 weeks. A convenience sample consisted of 465 elderly individuals from an initial sample of 500 elderly people living in the city of Salvador, Bahia, Brazil, 29.5% of the male participants and 70.5% of the female. The ages ranged from 60 to 93 years (mean of 69.93 ± 6.63). The instruments used to identify the independent variables (sociodemographic variables, types and levels of physical activity) were a sociodemographic questionnaire and the International Physical Activity Questionnaire (IPAQ) long version. The Mental State Mini Exam (MMSE), the Beck Depression Inventory 2nd version (BDI-II) and the Satisfaction With Life Scale (SWLS) were used to evaluate the dependent variables (cognitive function, depression and life satisfaction), respectively. In order to verify the effect of the sociodemographic variables (Study 1), the general linear model (GLM) was introduced introducing into the model the age, as covariate and a MANCOVA was performed; To verify the effect of the different physical activity programs (Study 2) and the effect and interaction of the different levels of physical activity (Study 3) in the three evaluative moments was applied the general linear model (GLM) introducing in the model the age, as covariate, and a MANCOVA of repeated measurements was performed. In order to identify the risk factors for cognitive decline and depression (Study 4), the chi-square test (χ2) was used to verify the association between the independent and dependent variables. Later, a binary logistic regression model was used to identify the risk factors associated with cognitive decline and depression. The results indicated in Study 1 that higher levels of formal education demonstrated a better performance in cognitive function and reduced values in depression, while having a spouse revealed higher levels of satisfaction with life. In Study 2, it was shown that the different physical activity programs had no significant effect on cognitive function, depression and life satisfaction, but the regular practice of physical activity showed a significant effect on these variables. In Study 3, the results suggested that the active level of physical activity revealed a significant effect on cognitive function and depression. In Study 4, it was shown that to be of the female gender was a risk factor for depression, while the active level of physical activity demonstrated a protective effect on cognitive function. We conclude that in the present study, sociodemographic variables, namely, schooling had a significant effect on cognitive function and depression; The marital situation was significant for life satisfaction; And belonging to be of female gender was a risk factor for depression. It was also evidenced that, independently of the type of physical activity program, the regular practice of physical activity had a significant beneficial effect on cognitive function, depression and satisfaction with life and was a protective factor of the cognitive function of the Brazilian elderly. Thus, in opposition to the sedentary lifestyle, the practice of moderate physical activity, regardless of the type of activity, enhances the mental health of the elderly. Therefore, implementing physical activity programs for the elderly should be one of the highest priorities of the public health promotion policies of the elderly population in Brazil, since maintaining an active elderly individual can mean the promotion of a healthy aging for the Brazilian population.
Descrição
Tese de Doutoramento em Ciências do Desporto
Palavras-chave
Envelhecimento , Idosos , Atividade física , Depressão , Variáveis sociodemográficas , Função cognitiva , Satisfação com a vida