Comparação da quantidade de atividade física diária em idosos com e sem infarto do miocárdio

Abstract

Introduction and background: The aging process and cardiovascular diseases are often reported as factors that contribute to reduction of daily physical activity, which is an important aspect to be considered in assessing the health of elderly. Although heart disease apparently is an additional factor limiting physical activity in older adults, few studies have identified this condition, especially in individuals who have suffered myocardial infarction (MI) without developing heart failure. Considering the cultural fears related to physical activity for individuals with heart disease, it is important to identify if indeed this fact affects the level of daily physical activity fo r older adults. Objectives: 1) to compare the amount of daily activity of elderly who have had myocardial infarction (MI) with the healthy elderly, 2) to determine the association between socio demographic and clinical factors with the amount of daily physical activity and 3) to evaluate the relationship between physical activity measured and self-reported, and between performance and capacity measures. Materials and methods: The study included elderly individuals who were diagnosed with MI confirmed by medical record (GPIM group) and elderly with no history of heart disease or other illness that would compromise the physical capacity (GC group). Daily physical activity was measured by using an accelerometer for seven days of use. The amount of daily physical activity was measured by variables counts (number of records) and steps, considering an average of seven days of collection. In addition, there were identified clinical and demographic characteristics and applied the questionnaire Human Activity Profile (HAP), the Geriatric Depression Scale (GDS) and a progressive effort test, the Shuttle Walk Test (SWT). The values of demographic, clinical, counts/day and steps/day of both groups were compared and analyzed by the independent t test or Mann-Whitney U test depending on the normality of the data. The multiple linear regression model was used to identify factors that are associated with daily physical activity (counts/day). Based on normal distribution Pearson or Spearman test was used to verify the correlation between counts/day and HAP, as well as the correlation between counts/day and the distance walked in SWT. Values of = 5% were considered significant. Results: There were 20 elderly in GPIM (72.50±1.55 years) and 16 in the CG (70.00±1.93 years). There were no statistical differences in the amount of physical activity between groups (GPIM = 232496 ± 30937 counts/day vs. GC = 256339 ± 24879 counts/day, p = 0.441) as the step/day (GPIM = 6780±3462 steps/day vs GC = 7791±2839 p = 0.301). The age and number of risk factors for cardiovascular disease explained 48% of the amount of daily physical activity (R2= 0.48, p <0.0001). Moderate correlation was found between counts/ day and adjusted score of PAH (r = 0.56, p <0.0001) and a good correlation between the distance walked in SWT and counts/day (r = 0.71, p <0.0001). Conclusion: In elderly subjects the presence of IM caused no additional impact on the amount of physical activity performed. It was identified a significant association of risk factors for coronary disease, including age and the level of physical activity independent of the existence of previous MI. Furthermore, it was found that self-reported activity level and functional capacity are good indicators of the level of daily physical activity.