Dear editor: In view of the publications that have observed a high prevalence of dissatisfaction with their image among elderly individuals, it is important to consider that biopsychosocial factors interfere in the perception that the elderly have of their image and that this can interfere in the quality of life of individuals.

Understanding body image can be defined as a multidimensional construct that individuals make about their physical attributes due to the complex involvement of biopsychosocial factors that influence the way people think, feel and behave in relation to the characteristics of their body.¹1. Rocha LM, Terra N. Body image in older adults: a review. Scientia Medica. 2013;23(4):255-61. https://doi.org/10.15448/1980-6108.2013.4.15357
https://doi.org/10.15448/1980-6108.2013....

In this context, and knowing that the perception of body image can influence the adoption of behaviors directly related to the way they perceive themselves externally, this study sought to evaluate, among elderly people living in the city of Campina Grande/Paraíba/Brazil and attended by Family Health Strategy, the perception of the body image and the cognitive factors that influence its construction.

The nine silhouetted scale of Stunkard and colleagues ²2. Stunkard AJ, Sorenson T, Schlusinger F. Use of the Danish Adoption Register for the study of obesity andthinness. In: Kety SS, Rowland LP, Sidman RL, Matthysse SW (eds). The genetics of neurological and psychiatric disorders. New York: Raven, 1983. was used to evaluate the perception of body image among the elderly, and those who identified their current silhouette as they would like to have were considered satisfied with the body image. To obtain information regarding cognitive factors, we used variables related to cognitive impairment, depression and memory.

In order to detect the global cognitive impairment of the elderly, the Mini-Exam of the Mental State ³3. Almeida OP. Mini Exame do Estado Mental e o diagnóstico de demência no Brasil. Arq Neuropsiquiatr. 1998;56(3B):605-12. https://doi.org/10.1590/S0004-282X1998000400014
https://doi.org/10.1590/S0004-282X199800... was used, which classified the elderly, according to the influence of schooling on the performance in the exam, in: with cognitive impairment, and without cognitive impairment. For the identification of depression, the Geriatric Depression Scale ⁴4. Almeida OP, Almeida AS. Short versions of the Geriatric Depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry. 1999;14(10):858-65. https://doi.org/10.1002/(SICI)1099-1166(199910)14:10<858::AID-GPS35>3.0.CO;2-8
https://doi.org/10.1002/(SICI)1099-1166(... was used. From the obtained score, the subjects were classified with depression and without depression. For the identification of the memory variable, the Subjective Perception of Memory Complaints ⁵5. Crook TH, Feher EP, Larrabee GJ. Assessment of memory complaint in age-associated memory impairment: the MAC-Q. Int Psychogeriatr. 1992;4(2):165-76. https://doi.org/10.1017/S1041610292000991
https://doi.org/10.1017/S104161029200099... was used, which identifies the memory decline among these subjects and the elderly were classified as follows: without loss of memory; with memory loss.

A total of 409 elderly were included in this study, 68.2% of them women. During simple logistic regression analysis, a statistically significant association was identified between body image dissatisfaction and the presence of depression and memory loss (p<0.001). It was observed that elderly people with depression and memory loss were more likely to have dissatisfaction with body image compared to those without depression and memory loss. Similar results were found in the literature1 and indicate that the presence of problems related to mental health can make the individual more demanding with his body image.

After testing the models during multiple logistic regression, elderly people with depression, with or without memory loss, were identified as being more likely to be dissatisfied with their body image. In a review study it was found that the pressure from the media may result in body image dissatisfaction and an incessant search for an ideal body, which in turn can generate anxiety and depression.⁶6. Marshall C, Lengyel C, Utioh A. Body dissatisfaction among middle-aged and older women. Can J Diet Pract Res. 2012;73(2):241-7. https://doi.org/10.3148/73.2.2012.e241
https://doi.org/10.3148/73.2.2012.e241...

It is important to emphasize that the presence of anxiety and depression can impact the quality of life of the individuals and, therefore, the behaviors attributed to the psychological distress must be investigated and treated so that its effects do not interfere in the healthy aging.

The results verified by the present study reinforce the need to identify the aspects that would be associated to the construction of the body image in the elderly, in order to evaluate if the construction of the body image is related to pressures related to beauty or to a concern with the corporal functionality.

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