4 aptidão fisica

Biehl-Printes, C., et al (2014) A comparative study of the functional fitness and perception of quality of life among elderly participants and non-participants of Universities of third age, Journal of Aging & Inovation, 3 (3): 39-49

ARTIGO ORIGINAL / ORIGINAL ARTICLE

DEZEMBRO, 2014

UM ESTUDO COMPARATIVO DA APTIDÃO FÍSICA FUNCIONAL E PERCEPÇÃO DA QUALIDADE DE VIDA ENTRE IDOSOS FREQUENTADORES E NÃO-FREQUENTADORES DE UNIVERSIDADE SÉNIOR A COMPARATIVE STUDY OF THE FUNCTIONAL FITNESS AND PERCEPTION OF QUALITY OF LIFE AMONG ELDERLY PARTICIPANTS AND NON-PARTICIPANTS OF UNIVERSITIES OF THIRD AGE UN ESTUDIO COMPARATIVO DE LA CONDICIÓN FÍSICA FUNCIONAL Y DE LA PERCEPCIÓN DE CUALIDAD DE VIDA ENTRE LOS ANCIANOS FRECUENTADORES Y NO-FRECUENTADORES DE UNIVERSIDAD DE LA TERCERA EDAD Autores Biehl-Printes, Clarissa 1; Teixeira, Diogo 1; Costa, Armando 1; Pinheiro, Valter1; Sousa, Paulo 1; Cruz, Joana2; Tomas-Carus, Pablo 3 1

Departamento de Ciências do Desporto. Instituto Superior de Ciências Educativas – ISCE. Lisboa. Portugal, 2 Departamento

Social e Cultural. Instituto Superior de Ciências Educativas – ISCE. Lisboa. Portugal, 3 Departamento de Ciências do Desporto e

Saúde, Universidade de Évora. Évora. Portugal Corresponding Author: cbprintes.isce@gmail.com Author contributions Biehl-Printes C. conceived of the study, participated in its design and coordination, analysed the data, contributed to the results discussion and wrote the manuscript; Teixeira D., analysed the data and contributed to the results discussion; Costa A., Pinheiro V., and Sousa P., contributed to the results discussion; Cruz J., participated in coordination and data collection. Tomas-Carus P., participated in the study design and coordination, and contributed to the results discussion. All authors read and approved the final manuscript.

Abstract - Objectives: To analyze the contributions of Universities of third age (U3A) through their proposed activities and effects in functional fitness and quality of life of elderly participants and non-participants. Methods: The sample was composed of two groups: elderly participants in U3A (EPG; n=25) and elderly non-participants (ENPG; n=25). Data collection was obtained through questionnaires: one about sociodemografic characteristics and U3A attendance (General questionnaire) and another about quality of life (WHOQOL-BREF Portuguese version). Also, were applied two test of the Fullerton Tests battery (30-second chair stand and 8-food up and go). Results: The results show statistically significant differences in attendance between women (76%) and men (24%). There is a predominance of married (68%) that attend the U3A. The educational level indicates that the EPG present more years of education (28%) and more people with higher education (24%). The main reason why the ENPG didn’t attend U3A was lack of time (44%). For lower body strength, the results showed differences between EPG and ENPG (p=0.022), in favor of EPG. No differences were observed between groups for agility/dynamic balance (p=0.977). In quality of life were observed differences between groups in the physical domain (p=0.026), with the EPG presenting higher scores that ENPG. For all the other domains, no differences were observed (all p>0.050). Conclusions: This study showed a prevalence of attendance of women to U3A and that the enrolled elderlies have more previous years of schooling. The elderly participants in U3A showed better physical domain than non-participants. However, in other domains were not found differences between participants and non-participants.

For future studies, it is proposed that the sample should encompass groups with higher age range that may produce results with new interpretations.

Keywords: active aging; university of third age, functional fitness, quality of life.

Resumo - Objetivos: Analisar as contribuições da Universidade da Terceira Idade (UTI) através de suas atividades propostas e os efeitos na aptidão funcional e qualidade de vida dos idosos participantes e não-participantes. Métodos: A amostra foi composta por dois grupos: idosos participantes na UTI (GIP; n=25) e idosos não-participantes (GINP). A coleta de dados foi obtida por meio de questionários: um sobre as características sóciodemográficas e particpação na U3A (questionário geral) e outro sobre a qualidade de vida (WHOQOL-BREF versão Portuguesa). Além disso, foram aplicados dois testes da bateria Fullerton Tests (30-chair stand and 8-food up and go). Resultados: Os resultados mostraram diferenças estatísticas significativas na participação entre as mulheres (76%) e homens (24%). Há um predomínio de casados (68%) dos idosos que participam na U3A. O nível de escolaridade indica que os idosos do GIP apresentam mais anos de escolaridade (28%), e mais idosos com ensino superior (24%). A principal razão pela qual o GINP não adere a U3A está associada à falta de tempo (44%). Para aptidão física funcional, os resultados mostraram diferenças entre o GIP e GINP (p=0.022) para uma menor força do corpo. Não foram observadas diferenças entre os grupos para a agilidade/equilíbrio dinámico (p=0.977). Na qualidade de vida foram obeservadas diferenças entre os grupos no domínio físico (p=0.026), valores mais elevados no GIP. Para todos os outros domínios não foram encontradas diferenças (todos p>0,050). Conclusões: Este estudo mostrou uma prevalência de participação das mulheres na U3A, e que os idosos inscritos têm mais anos e nível de escolaridade. Os idosos participantes mostraram melhor domínio físico que os não-participantes. No entanto nos outros domínios não foram encontradas diferenças. Para estudos futuros, propõe-se uma amostra com uma faixa etária mais elevada, de modo a possibilitar outro tipo de resultados sujeitos a novas interpretações.

Palavras chaves: envelhecimento ativo, universidade sénior, aptidão física funcional, qualidade de vida.

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Introduction

OMS, 1980; ONU, 1982). However, that socioeducative response, targeting the creation and

World population age has arisen in the

dynamization of regular social, cultural,

last decades. Despite this, several conquests

educational, physical and socializing activities

were made in modern societies as a mean to

reflect a perfect integration of the previously

adjust to this new social paradigm. It is possible

framework if the active aging concept previously

to observe that these populations are

proposed by OMS (1990), that envisions as a

experiencing the challenge of an active aging. It

major objective to create opportunities to

is commonly accepted that a person with 65 or

optimize conditions to health, participation and

more years old is considered an elderly

security, that may allow the quality of life as

individual (3rd age), but new definitions arise in

people become older (Jacob et al., 2012; WHO,

order to adjust to the prolonged life expectancy

2002).

and to better distinguish among the vast

Data from Portuguese senses tends to

amplitude previously existing. For this matter, a

show a crescent trend in the number of people

new stratification now seems to be consensual,

with more than 65 years (19.1% of the

4th

population), surpassing that of young (15%),

ranging between 80-85 or more years (i.e. age) ( Formosa, 2012; Stathi & Simey, 2007).

accentuating the verified trend in 2001 senses

In Europe changes in this age group has

(Carrilho & Patrício, 2010). Due to the evidence

been a matter of concern and interest for more

that elderly people are increasing, it becomes

than 40 years, in which France stood as one of

even more relevant to stimulate programs and

the countries to boost successful aging trough

politics of healthy aging, assuring the

higher education institutions (Cachioni, 2012;

continuities of a productive, healthy and quality

Lemieux, Boutin, Snachez & Riendeau, 2003). In

life. Therefore, the concept of quality of life in the

the 70’s Portugal, alongside France,

advanced age is considered as one of main

implemented the concept and practice of free

indicators to evaluate the condition of life of the

time associations denominated Universities of

elderly, involving different dimensions that

3rd

Age (U3A) or Senior Universities (SU), but

encompass the optimum level of physical,

adopted an English structured model based in

mental, social, performance functioning, and

non-profit associations or self-organized groups,

satisfaction with life and their well-being (Fleck

with non-formal education, differing from the

et al., 2000; Fonseca, 2005). Corroborating the

French model associated with formal

perspective of a comprehensive concept of

Universities (Jacob, Jesus & Sampaio, 2012;

quality of life that involve a wide array of

Lemieux et al., 2003; Pinto, 2003).

multidisciplinary perspectives (e.g. sociologic,

Gradually, the chronologic concept

biomedical, psychological, economical and

adopted by U3A and SU in the 60’ and 70’

environmental) (Walker, 2005), interested

decades that referred this association as a

investigate the contribution that the social

socio-educative response to individuals starting

support networks that allow organization of 3rd

50 years of age, has been weakened by the

age activities (i.e. U3A/SU) brings to functional

senescence age attributed in the 80’ decade by

health, independent life, social relations and to

OMS of 60 and 65 years (Jacob et al., 2012; JOURNAL OF AGING AND INOVATION (EM LINHA) ISSN: 2182-696X / (IMPRESSO) ISSN: 2182-6951

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psychological well-being of these people. As an

activities and effects in physical fitness and

example, previous studies show that adherence

quality of life elderly people.

to these organizations influence physical and psychological well being. In this sense, an

Material and Methods

association between the participation in U3A and

Sample selection

a lower intensity depression was found (Irigaray

For this exploratory cross-sectional study

& Schneider, 2007). The interest in physical

were used posters and verbal communication to

activities practices and the pursuance of well-

call for voluntary participants in Senior University

being was demonstrated as a determinant

of Odivelas (SUO), integrated in Superior

indicator of the U3A participants, as for a better

Institute of Educational Sciences (ISCE).

perception of the factors related to the

Selection criteria were: men and women >65

environmental and psychological domains and

years, elderly participants of SUO (EPG; n=25)

global perception of quality of life and health in

and elderly non- participants (ENPG; n=25 -

middle age and elderly people (Castro et al.,

elderly friends and family of the participants of

2007; Fenalti & Swartz, 2000).

SUO - we asked participants of U3A to bring to

To the extent of our knowledge, it seems

the evaluation day a friend or family member)

to exist a discrepancy between the high number

without cognitive and locomotors problems (we

of U3A/SU in Portugal (over 200 registered in

allowed the participation of elderlies that used a

2012) and scientific work published within this

canadian cane). Exclusion criteria: elderly that

approach (5). Several studies are unanimous to

already attending another U3A or other social

assume the influence of an active life style with

organization for 3rd age (i.e. sports club, social

some variability of physical and cognitive

solidarity association, inhabitant association) or

activities to the promotion of the quality of the

those that participate in entities or organizations

lived years (Colombe & Krower, 2003; Chou,

directed to this population (i.e. day centers,

Hwang & Wu, 2012). In these sense, the

recreational collectivities, municipal services).

multidisciplinary set offered by U3A in physical

The participants were informed of study

activities, such as physical education, walking,

procedures and given the informed consent to

dancing, yoga and senior bocce are normally

voluntary participate in the research. All were

available to elderly students.

approved by the Ethics Committee of Health and

Thus, assuming U3A as a prepared

Welfare of the University of Évora (Document Nº

organization with a wide array of

13020) and were in accordance with the 1975

multidisciplinary opportunities with continuous

Helsinki Declaration.

and regular formation, we ought to explore these contexts and develop scientific knowledge to

Procedures and instruments

ensure the promotion and valorization required to continue a healthy and active aging.

Sociodemographic characteristics, cognitive

Therefore, in this study we propose to analyze

problems and adherence to the U3A

the contributions of U3A through their proposed

All participants were asked about the age, civil status and education level.

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Immediately, the Watch Design Test

calculated by a syntax that considers answers in

(Freitas & Simões, 2010) was used as exclusion

each question composing the domain, resulting

criteria for cognitive problems in the elderly.

in final scores in a scale of 4 to 20, comparable

Each participant was asked to make a clock (no

to dose of WHOQOL-100, which can be

pre-defined time), making a circle and putting

transformed in a 0 to 100 scale.

the numbers in the correct position, without looking in to his watch. When finished, it is

Functional fitness

asked to put the indicators marking 10 minutes

For assess lower body strength and

to 2 o’clock. This test is used to evaluate: visual

agility/dynamic balance were applied two test of

perception, construction praxis, right hemisphere

Fullerton Functional Fitness Test Battery (Rikli &

dysfunction and left hemisphere negligence. For

Jones, 1999): 30-Second Chair Stand and 8-

example: small watch indicates lack of planning

Foot Up and Go. The 30-Second Chair Stand

and inadequate positioned numbers point to

Test assess lower body strength, needed for

executive deficit. Additionally, was analyzed the

numerous tasks such as climbing stairs, walking

characteristics of adherence to the U3A by the

and getting out of a chair, tub or car. The elderly

senior participants. Only the EPG were asked

people should perform the maximum number of

about years attends U3A, times per week,

full stands that can be completed in 30 seconds

motivational factors, intent of leaving and

with arms folded across chest. The 8-Foot Up

number of disciplines attended. The ENPG were

and Go Test assess agility/dynamic balance,

asked about the reasons why they didn’t attend

which is important in tasks that require quick

U3A.

manoeuvring, such as getting off a bus in time or getting up to attend to something in the kitchen,

Quality of Life

to go to the bathroom or to answer the phone.

The Portuguese version of World Health

The elderly people should to get up from a

Organization Quality of Life Group (WHOQOL-

seated position, walk 2.44 metres (8 foot) and

Bref) (Fleck et al., 2000) was applied to assess

return to seated position.

quality of life. This instrument has 26 questions divided in four domains of quality of life: physical

Statistical analysis

capacity, psychological well-being, social

Normality of data was initially tested

relations and the environment where the

using the Kolmogorov-Smirnov test. Differences

individual is inserted. Besides these four

between groups were tested using Kruskal-

domains, WHOQOL-Bref it is also composed by

Wallis test for continuous variables (age,

a domain that assesses global quality of life.

functional fitness and quality of life) and Chi-

Each domain is composed by questions where

square test for categorical variables (sex, civil

higher scores (between 1 and 5) represent

status, educational level). For all tests the

better quality of life. Some characteristics,

significance level was set at p<0.05. These

designed as facets are not formulated in a

analyses were performed in SPSS 22.0

positive sense. In these cases higher scores do not mean better quality of life. Scoring is JOURNAL OF AGING AND INOVATION (EM LINHA) ISSN: 2182-696X / (IMPRESSO) ISSN: 2182-6951

software.

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Results Sociodemographic characteristics

educational level. The results showed that the women’s attend more U3A than men. Also was showed that there is a predominance of married

Were observed significant differences between

elderly that attend the institution. The

EPG and ENPG in sex, civil status and

educational level indicates that the elderly in the EPG present more years of education and more people with higher education (Table 1).

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Additionally, we have analyzed the characteristics of adherence to the U3A by the EPG. We observed that our sample attends U3A for 3,88 ± 1,76 years with a frequency of 3,48 ± 1,12 times per week; the three more motivational factors were 1) own will – 18 (72%), 2) refer of a friend – 4 (16%) and 3) refer of family – 2 (8%); the intent of leaving U3A 1) Yes - 1 (4%) and No - 24 (96%); number of disciplines attended was 4,44 ± 1,63; the five more attended disciplines were 1) Music – 13 (52%), 2) English – 12 (48%), 3) Painting – 11 (44%), 4) Informatics – 10 (40%) and 5) Spanish – 8 (32%). We also asked the ENPG the reasons why they didn’t attend U3A, being that the three main reasons were 1) lack of time – 11 (44%), 2) does not consider an adequate ambient for themselves –

Functional fitness and Quality of life Were showed significant differences between EPG and ENPG in lower body strength. The EPG showed more strength in the lower body.

No differences were observed between groups in agility/dynamic balance. In addition, were observed differences between groups in the physical domain (p=0.026), with the EPG presenting higher scores that the ENPG. For all the other domains, no differences were observed between groups. Nonetheless, the EPG presents marginally higher scores in three other of the five non-statistically significant variables (perception of overall quality of life, psychological domain and social relationships domain) (Table 2).

8 (32%),3) financial limitations – 3 (12%) and 4) locomotors difficulties – 1 (4%).

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Discussion

interactions with the elderly people. The range of

This comparative study showed that the

disciplines provided promotes an interaction that

more women go to U3A and that elderly enrolled

allows the training and development of physical,

have more previous years of schooling. The

social, cultural and psychological domains. The

frequency engage in activities was of 3 times/

combination of disciplines attended by the

week and there is no report of intention the leave

elderly will ultimately define the benefits

the U3A after enrolling. Non-enrolled elders

obtained (Pinto, 2003). As seen in ours results,

consider the lack of time the main cause

the participants in U3A tend to enrolled in the

preventing them to start in U3A. The participants

institution by self-initiative, of the thirty

in U3A showed better strength and quality of life

disciplines they attend in average 4, were the

in physical domain that non-participants in U3A.

most frequented are music, painting, informatics,

However, in all domains they present a “good”

English and Spanish, all promoters of sedentary

classification in quality of life.

or light physical activity during class time.

The data presented in the

However, these activities are promoters of a high

sociodemographic analysis supports previous

cognitive and motor-cognitive function, marked

findings. The age, sex and level of education

today as important to this population. Several

distribution in our EPG is in accordance with

studies have indicated that cognitive training

studies done in other countries that have

have advantages to retard the cognitive decline

functioning U3As and have demographic

in the process of healthy aging, were new

similarities with Portugal (Alfageme, 2007;

technologies like computers and video games

Formosa, 2012; Mindwinter, 1996). In our study,

present themselves as alternatives of

the mean age is clearly within the

3rd

age group

intervention to be expanded (Kueide, Parisi,

for elderly men and women, women are the

Gross, & Rebok, 2012). Additionally, it is

highest percentage of members in U3A and the

suggested that cognitive domain practices may

participants have higher levels of education. This

bring gains in the cognitive performance of

is an expected trend repeatedly presented in

healthy elderlies that may manifest 5 years after

previous studies. This generally represents the

training (Willis et al., 2006). Moreover, previous

retirement age of this population, the absence of

studies support the efficacy of the practice of

similar services in this age group, higher life

motor coordination activities, trough gross and

expectancies for women, and a set of secondary

fine motor abilities activation, that act positively

and post-secondary education experiences that

in executive functions that may seem to be

may have influenced the motivations and

independent of gains obtain by cardiovascular

pleasure associated with learning in the past,

and strength training (Voelcker-Rehage, Godde

contrasting with the heavy class baggage

& Staudinger, 2011; Yan & Zhou, 2009). Physical

associated with the name “university” for the

activities are presented in several disciplines

owners of lower education levels (Formosa,

and by different modalities, where students

2012).

presented their preference in boccia (20%), The U3A provides a space that has

dance (20%) and physical activities (12%),

multidimensional and multidisciplinary

which in general shows an adherence as

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significant as music, languages, painting and

health benefits for their members (Formosa,

informatics. However, bearing in mind the

2012; Ordonez, Lima-Silva & Cachioni, 2011;

several possible ways to promote a healthy and

Sonati, Modeneze, Vilarta, Maciel & Boccalett,

active aging, it is suggested and supported the

2011), and that there is a positive relationship

pertinence of each filed of intervention, either by

between psychological wellbeing and

cognitive abilities, motor-cognitive associated

participating in U3A with extension to other

with physical exercise, physical activities, social

areas of life (Maniecka-Bryłaemail, Gajewska,

relation, nutrition, etc., all contributing to retard

Burzyńska, & Bryla, 2013). Additionally, EPG

the cognitive decline associated to the loss of

shows a sustained connection to U3A with the

functional independence, autonomy and quality

duration of 4 years, assuming a frequency of 3

of life (Williams & Kemper, 2010).

times per week, reflecting the capability for

The participants in U3A showed better quality of life in physical domain that nonparticipants. This domain explores pain and discomfort, energy and fatigue and stress and rest facets (Fleck et al., 2000). From the data collected it is not possible to clearly identify the reasons behind this result. One factor that may be influencing the higher results presented in physical domain by the EPG is the lower body strength score. It is possible to observe that there were differences between groups in this parameter, in favor of EPG. However, all domains quality of life showed a classification of “good” (score ≈75 in scale 0-100), this could be due to the age (years) of the attendees 66,6 (EPG) and 67,2 (ENPG), functional and mental conditions adequate to an independent and active life that may have a low interference in quality of life. This, associated with the concept that aging is a dynamic and progressive process that involve physical, functional, biochemical, psychological and social changes that, when associated with an active healthy life style, results in a bigger longevity, described in

retaining for a long period elderlies in activities.

Continuous adherence of elderly in health promoting activities is the question of interest in this research, considered as problematic for the shift in the healthy life style (Caetano & Raposo, 2005). For this matter, it seems interesting to point out that U3A is a promoter of this change.

The present study also included limitations, which require further discussion.

First, the age in the group studied may have influenced the results, regarding that they already enjoy good functional, mental and physical health, associated with quality of life.

Besides, ENPG considers that they do not attended U3A mainly because of lack of time (44%), maintaining themselves active and involved in other activities, being, this way, equally active to EPG, condition that influence directly in the evaluation of quality of life.

Another possible analysis to be considered on sociodemographic variables is labor situation (i.e. working; retired). The association with work and health is well documented, where labor activities are seen as having a positive role in

previous studies (Castro et al., 2007; Chodzko-

preservation some health variables, whereas

Zajko & Schwingel, 2009; Ferreira, Maciel,

unemployment is associated with higher rates of

Costa, Silva & Moreira, 2012). Several studies

mortality, psychiatric symptoms and worst health

pointed out the importance of U3A in promoting

conditions (Arber, 1987; Janlert, 1997). Few

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studies had addressed this theme with elderly.

2. Stathi, A & Simey, P. (2007). Quality of life in

Findings described on the relation of the

the Fourth Age: exercise experiences of

capacity of sustaining a healthy living associated

nursing home residents. Journal of Aging and

with non-formal work, sociodemographic

Physical Activity, 15 (3), 272-286.

characteristics, higher levels of schooling, health

3. Lemieux, A. Boutin, G. Sanchez, M. &

condition, autonomy and independence (Giatti, &

Riendeau, J. (2003). The faculties of

Barreto, 2003; Marmot & Shipley, 1986).

education in the traditional universities and

However, and in U3A context, we consider this

the third age universities: A model of

study as pioneer in elderly and quality of life

partnership. Versão policopiada. 9: 2.

characterization.

4. Cachioni, M. (2012). Universidade da Terceira Idade: história e pesquisa. Revista

Conclusion

Temática Kairós Gerontologia, 15 (7), 01-08.

This study showed a higher adherence of

5. Jacob, L. Jesus, A. & Sampaio, J. (2012).

women to U3A and that elderly enrolled have

Universidades Seniores: criar novos projetos

more previous years of schooling. Additionally,

de vida. Lisboa: Ed. Rutis.

the participants in U3A engage in activities with

6. Pinto, M. (2003). As Universidades da

a weekly frequency on average of 3 times and

Terceira Idade em Portugal: das origens aos

there is no report of intention the leave the U3A

novos desafios no futuro. Revista da

after enrolling. The ENPG considered the lack of

Faculdade de Letras – Línguas e Literaturas,

time the main cause preventing them to start in

20(2), 467-478.

U3A. Moreover, were observed higher levels in

7. Organización Mundial de la Salud (1980).

lower body strength and physical domain in

Informe de la conferencia preparatoria de la

participants of U3A. However, in all domains

OMS para a asamblea mundial de las

they present a good classification in quality of

naciones unidas sobre el envejecimiento.

life. We propose the development of studies with

México.

higher age groups, mainly because they may

8. Organização das Nações Unidas (1982).

possess different characteristics and present

Asamblea mundial sobre el envejecimiento.

results worthy of new interpretations.

Viena 9. World Health Organization (2002). Active

Acknowledgements We would like to thank Direction of

ageing: A policy framework. Geneva.

10. Carrilho, M. J. & Patrício, L. (2010). The

Senior University of Odivelas for allow us to

demographic Changes in Portugal. Lisboa:

develop this study, and to the elderly that

National Institute of Statistics.

collaborate voluntary in this study.

11. Fonseca, A. M. (2005). O envelhecimento bem sucedido. In

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