Comportamentos de movimento e mobilidade no espaço de vida e suas associações com características da moradia durante a pandemia da COVID-19 em idosos com hipertensão: um estudo longitudinal

Abstract

The aim of this thesis was to investigate the movement behavior and life-space mobility and their associations with housing characteristics during different moments of the coronavirus disease (COVID-19) pandemic in older adults with hypertension. In this exploratory longitudinal study, 35 participants were included. The evaluations occurred at three moments over 18 months: i) before the first case of COVID-19 in Natal-RN (January‒March, 2020); ii) during the social distancing policy and without vaccination (June, 2020); iii) ~2 months after the vaccination (July, 2021). Physical activity (PA) and sedentary behavior (SB) were measured by accelerometry. Life-space mobility was assessed by the Life-Space Assessment Questionnaire. The following housing characteristics were assessed: housing type, housing surface area, and household size. Generalized linear mixed model was used for data analyses, with adjustment for age, sex, education, income, employment status and/or accelerometer wear use. During the social distancing policy without vaccination there was a decrease in steps/day (β = –886, p = 0.018), in moderate-vigorous PA (β = –0.4 %, p = 0.001), and in light PA (β = –3.7 %, p = 0.004), in addition to an increase in SB (β = 4.1 %, p = 0.001) in relation to the period before the pandemic. The magnitude of changes was greater on the weekend, mainly for steps/day (β= –1,739, p < 0.001) and SB pattern (more time in prolonged bouts and less breaks). Older adults who resided in apartment and row housing showed a greater decrease in PA and a greater increase in SB compared to those who resided in detached house (p < 0.05). After the vaccination, older adults who resided in apartment and row housing showed an increase in life-space mobility and light PA, in addition to a decrease in SB in relation to the period of social distancing policy (p < 0.05). In conclusion, the movement behavior and life-space mobility of older adults with hypertension seem to change during the COVID-19 pandemic, especially in those who reside in limited houses. While the social distancing policy without vaccination is associated with a reduction in PA and an increase in SB, the immunization is associated with an increase in life-space mobility and PA, in addition to a reduction in SB.