Impacto do autorrelato exercício físico na mortalidade de idosos ribeirinhos de Maués-AM no período de 2009 a 2017

Abstract

A large part of human populations is experiencing the aging process, including those living in regions with little access to health services and socioecological peculiarities such as riverine people living in the Amazon rainforest. A previous study carried out in riparian elderly subjects suggested that they had satisfactory functional aptitude and a health profile with a lower prevalence of non-transmissible chronic diseases compared to populations living in more developed regions in Brazil. As great majority of the elderly living in the so-called urban area of Maués, which concentrates some basic social and health services, has moved to this place because of the difficulty of living alone in the forest, it is possible that this change has an impact on the lifestyle indicators of this population, influencing the burden of morbidity and mortality. To test this hypothesis, an 8-year prospective follow-up study was performed testing the impact of self-reported physical exercise on the mortality of these subjects. To carry out the study, information on the survival of the elderly was gathered from the original database of data collected from the Health Department of the Municipality of Maués on deaths occurring each semester, from August 2009 to July 2017 and the main cause of death identified through the International Code of Diseases (ICD-10). With these data, the survival time of each elderly person (in months) was calculated. In this case, the elderly who were alive after 8 years were identified as having 96 months of survival. From the collection of these data it was possible to calculate if self-report of exercise performance could have impact on the survival of these elderly people through Kaplan Meier survival curve analysis. The potential influence of other variables such as gender, age, previous morbidities or habitual consumption of guarana (paullinia cupana), which is highly prevalent in that population, was evaluated using a multivariate logistic regression analysis (Backward Wald method). The study included 540 individuals [72.3 ± 7.9 years, 248 (45.9%) men and 292 (54.1%) women]. In the period, 108 (20%) subjects died and 432 (80%) survived. Elderly that self-reported to perform regular physical exercise had lower mortality than the ones who didn’t (p= 0.021). Moreover, as expected, younger elderly survived more than older-elderly subjects. However, the association between regular physical exercise and survival in an 8-years follow-up was independent of sex, age and other health variables. The results suggest that the impact of physical exercise on elderly longevity is universal and does not depend on specific genetic, ethic and socioeconomic characteristics of each society.