RCAAP Repository

<p><b>OBJECTIVE:</b> The aim of this article is to investigate the association between the mobility standard in the daily activities and the cognitive decline. 131 elderly individuals participated in the study (77.5 ± 9.15 years).<br> <b>METHODS:</b> Several aspects were assessed such as functional decrease (Katz and Lawton-Brody Indexes), Mini Mental State Examination, sociodemographical variables and mobility conditions.<br> <b>RESULTS:</b> There was significant association between cognitive impairment of activities in daily living and instrumental activities of daily living, cognitive decline and caregivers needs.<br> <b>CONCLUSION:</b> Mobility is an easy instrument and may be useful for preventive actions to reduce functional disability in elderlies.</p>

<p><b>OBJECTIVES:</b> Verify the possible correlation between the responses obtained by "The Hearing Handicap Inventory for the Elderly - HHIE" questionnaire and the hearing thresholds measured in a group of institutionalized elderly.<br> <b>METHODS:</b> The sample consisted of people resident in a long-term institution for elderly who had results from the HHIE questionnaire and an audiometric evaluation. The study included 41 individuals, of which 30 were females, aged between 63 and 92 years old.<br> <b>RESULTS:</b> All participants in this study presented some degree of hearing loss being the most with mild degree. Only 34% of the participants had a hearing handicap resulting in a weak positive correlation and statistically not significant with hearing loss.<br> <b>CONCLUSION:</b> The frequency of hearing loss was high in the sample studied, but less than half of study participants presents auditory handicap. We hypothesize that nursing home residents with mild hearing loss perceive more intensely their hearing handicap than those with more severe loss. Nursing home residents with severe hearing loss would restrict their daily life activities and social participation, not perceiving the hearing handicap.</p>

<p><b>OBJECTIVE:</b> This study sought to identify, through the Defense Style Questionnaire (DSQ-40), the defensive style and protection of greater intensity in 15 caretakers of cancer patients in palliative care who were admitted to the <i>"Programa de Interna&ccedil;&atilde;o Domiciliar Interdisciplinar (Pidi)"</i> in the period from August to October 2011.<br> <b>METHODS:</b> This is a cross sectional study of quantitative approach.<br> <b>RESULTS:</b> This study showed that caretakers have greater intensity of defenses belonging to the mature defensive style, as anticipation.<br> <b>CONCLUSION:</b> It indicates that a good deal with the situation in progress, demonstrating resilience and suggesting the mature of the caretakers in the adaptive process as individual who provides care to their family in the process of the end of life.</p>

<p><b>OBJECTIVE:</b> To verify the association between religiosity and the feelings of loneliness in elderly widowers.<br> <b>METHODS:</b> A group of 200 elderly windowers aged <u>&gt;</u> 60 years attending the outpatient clinic of the Institute of Geriatrics and Gerontology of PUCRS participated. The instruments used were the scale of the Ucla Loneliness Scale and Frequency of Religious Practices and Religiosity Scale of Intrinsic/Extrinsic.<br> <b>RESULTS:</b> The results showed a high level of loneliness in the sample, with an average of 48.4%. For the estimative of the scale of solitude, the results indicated that 36.7% of the variations occurred in scale score of solitude can be explained by the incomes, the highest is the income the highest is the level of solitude. Still it was found significance in the correlation between loneliness and sex, for it came out that widowers demonstrate greater social satisfaction than widows. Most elderly presented tendency to intrinsic religiosity (<i>Md</i> = 25.5). Another significant relationship was found between religiosity and the age range of participants, the oldest the person is, the greatest is the tendency for the practice of intrinsic religiosity. Significant difference was found only in the relationship between the scale of loneliness and social religiosity scale.<br> <b>CONCLUSION:</b> As a general overview it was found that income is a predictive factor for the feeling of loneliness and the age range is a predictive factor for the practice of intrinsic religiosity among elderly widows. Furthermore, the practice of social religiosity can decrease the feeling of loneliness in elderly widowers.</p>

<p><b>OBJECTIVE:</b> Investigate the ideal pattern of body image (BI) ideal established for older women and identify the relationship between the dissatisfaction degree with their BI and the variables of anthropometric and aerobic fitness.<br> <b>METHODS:</b> A total of 47 elderly women (66.12 ± 3.4 years; VO² peak 20.3 mL.kg.min-1) were submitted to body fat percentage (%BF) evaluation using Dexa and a cardiopulmonary exercise test. Body image was evaluated through the nine silhouette scale proposed by Sorensen and Stunkard.<br> <b>RESULTS:</b> Volunteers presented a significant dissatisfaction grade in relation to their real body image (p &lt; 0,001). The dissatisfaction grade presented a positive and significant correlation with BMI (r = 0.56) and %BF (r = 0.39) but not with the peak oxygen consumption (p &gt; 0.05).<br> <b>CONCLUSION:</b> The findings suggest that the highest the body fat is the highest the degree of dissatisfaction. There was no distortion of body image among the elderly surveyed.</p>

<p><b>OBJECTIVES:</b> The objective of this study was to evaluate its frequency and impact on mortality in three years of monitoring in Nursing Home residents.<br> <b>METHODS:</b> A prospective study in 65 aged people in Nursing Home, located in Cariacica, ES, for three years (2005-2008). For data evaluation we used the Board survival Kaplan Meier and Cox regression with adjustment for comorbidities. Values of &#961; <u>&lt;</u> 0.05 were considered significant.<br> <b>RESULTS:</b> Sixty-five subjects (51.5% men), 79 ± 8 (60-97) years, 62.1% (41) hypertensive, 24% (16), immobility syndrome, 16.7% (11) with senile dementia and 12.1% (8) with diabetes <i>mellitus</i>. 18 (27.3%) had anemia. There were 16 deaths from different causes, as follows: group without anemia (9.09% women and 20% men), anemia (44.4% women and 55.5% men), LogRank 0.004. Analysis of Cox regression adjusted for comorbidities (age, senile dementia, immobility, diabetes), RR 3.21 (95% CI 1.05 to 19.76).<br> <b>CONCLUSIONS:</b> The aged presented a high frequency of anemia in this Nursing Home and it was an important independent risk factor for mortality in both sexes.</p>

<p><b>OBJECTIVE:</b> Evaluate the effects of training on balance and motor coordination applied to users of a cardiopulmonary and Metabolic Rehabilitation (CMR) project.<br> <b>METHODS:</b> It is randomized and controlled clinical trial, with the participation of sixteen elderlies (<u>&gt;</u> 60 years), Senador Jos&eacute; Erm&iacute;rio de Morais Medical Centre patients in 2011. They were blinded sorted and divided into two groups: a control group, which performed the routine protocol of the project; and, an experimental group, which was added to a regular protocol of the training program in balance and coordination. The participants completed 12 weeks of intervention, performing it three times a week. They were evaluated by the tests: Tinetti, Adapted Romberg, Time Up and Go and coordination test (AAHPERD).<br> <b>RESULTS:</b> Comparing the two groups, the experimental one presented a better performance in Tinetti, Time Up and Go and coordination (AAHPERD) tests.<br> <b>CONCLUSION:</b> A balance and coordination training in elderly patients of the CMR, held for 12 weeks, proved efficiency in decreasing the falls probability in this group.</p>

<p>Brazilian population is fastly growing older, and it is being foreseen that, in 2020, the elderly population will reach 16,2 million. The event of fall in those individuals can mean a great decline in functional independence and great losses in In their life quality. About 28% to 35% of the aged ones above of 65 years had suffered, at least, one fall in the period of one year. The etiologies generally are multifactorial; extrinsic and intrinsic factors, being these last one related to the static disequilibrium, difficulty of postural, dynamic control, deficit of muscular force and power.<br> Some studies suggest that training programs of muscular force or balance can reduce, the risk of falling, while others suggest that only multifactorial programs are effective in this reduction. Objectifying to evaluate the effect of the physical resisted exercises and/or muscular force training as an only intervention in the improvement of the balance and the prevention of fall in aged people, a bibliographical revision of current literature was done.<br> The only intervention with resisted exercise traditional showed to improve the muscular force in aged people, however, it had a limited effect in the improvement of balance, and also, in their functional capacity; this way, it had a limited effect in the reduction of the risk of falling. However, in recent studies, the training of muscular power shows benefits for balance and functional capacity in aged people.Thus, it is suggested that programs that promote balance and prevent falls in aged people must be multisensorial, enclosing the multiples and important factors important factors of the risk of falling population.</p>

<p>The Brazilian population is progressively becoming elderly and the number of elderly who has suffered some kind of fall has increased. Changes that occur with the body of an elderly individual should be observed to assess and prevent the fall. Falls can occur by intrinsic and extrinsic factors. The Poma test - Brazilian Evaluation of the Performance Oriented Mobility (Performance Oriented Mobility Assessment) is used for the purpose of evaluating the risk factors of falls in elderly. This research aims to demonstrate how the Poma test is applied in Brazil and to classify the physical changes that most influence the risk of a fall in an elderly. The method used was through a survey of the literature. The method used was through in the literature. This article is of paramount importance for the multidisciplinary team that works directly with elderly that are living in communities, institutionalized or not, to assess and prevent a possible fall, as well as, for the general population.</p>

<p><b>OBJECTIVE:</b> Assess the frequency of orthostatic hypotension and its symptoms in outpatients and identify possible risk factors for the patient's profile.<br> <b>METHOD:</b> A hundred elderly aged 65 years old or over it of both sexes that sought outpatient care at "Hospital do Servidor P&uacute;blico Estadual", had their the blood pressure measured in the supine position after a resting of 3 minutes in this position and in a standing position after 1 - 3 minutes, when the patient was asked about the symptoms. The risk factors for orthostatic hypotension were asked previously.<br> <b>RESULTS:</b> Frequency of orthostatic hypotension was 38% and of these only 11% had symptoms. The association of changes in systolic and diastolic blood pressure was more frequent, 24%, compared to isolated changes. One or more risk factors were found in all patients of the sample, and the use of medications and hypertension were the most common.<br> <b>CONCLUSION:</b> There is a high frequency of orthostatic hypotension in ambulatory elderly, especially chronic users of drugs and hypertense elders.</p>

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<p><b>OBJECTIVE:</b> To trace the profile of frail elderly who are attended in a reference outpatient service considering the associated diseases and the use of medicines.<br> <b>METHODS:</b> The criteria of Fried et al. (2001) had been used in association with the diagnosis of confirmed chronic disease, as well as the effectively used medicines in 151 elders of the Geriatric Outpatients Service of the Clinic Hospital of the State University of Campinas (Brazil), throughout the period of two years. It was used the univariate and multivariate logistic regression to study the factors associated with the fragility syndrome.<br> <b>RESULTS:</b> It was verified association between fragility and the diagnosis of chronic respiratory diseases (p = 0,043) and with the use of (p = 0,036).<br> <b>CONCLUSION:</b> Even if this study does not allow a cause - effect association it was verified that the chronic respiratory diseases and the use of medicines for cardiovascular system can be related to fragility condition, as they contribute to maintain or to increase this morbid condition.</p>

<p><b>OBJECTIVE:</b> Population aging is a global reality and is happening mainly due to improved sanitary conditions and quality of life. Because the elderly consume most of the world's production of drugs and are more sensitive to the effects of certain drug classes, tools were developed to identify inappropriate drugs for this population class or whose use should be evaluated. One of these instruments is the Beers-Fick Criteria, used to assess and intervene in the use of medications in the elderly. There are few publications related to drug therapy in the elderly in Brazil, which demonstrates the need for more researches.<br> <b>METHODS:</b> This is a quantitative, cross-sectional, retrospective, descriptive study, aimed to identify which are the inappropriate drugs prescribed for seniors over 65 years old in an oncology hospital and how often are they prescribed. The instrument used for the selection of the drugs studied was the Beers-Fick criteria.<br> <b>RESULTS:</b> We analyzed 8,860 prescriptions containing inappropriate drugs for seniors made to 1,448 patients, of whom 451 (31,1%) were elderly and the rate of use of these drugs was 28%.<br> <b>CONCLUSION:</b> We conclude that the frequency of prescriptions containing inappropriate drugs for the elderly is high, which leads us to realize the need for development of clinical protocols for prescribing for the elderly to ensure patient safety and rational use of medication.</p>

<p><b>OBJECTIVE:</b> The aim was to analyze the reliability and the adhesion of medicine therapy in elders. Elderlies, in their majority, present chronic disease such as hypertension and, because of this, take a lot of medicines. A large number is retired and benefit themselves with health programs and medicines given by government health.<br> <b>METHODS:</b> The data were gotten through an interview and of a visual choice among three different diur&eacute;tico hidroclorotiazida 25 mg packages. The data were analyzed through analysis of Bardin content.<br> <b>RESULTS:</b> We checked that the medicine manufactured by the government industry was the first choice, showing that it has a great reliability. The arguments were: efficacy, custom and gratuitousness. The reference medicine was the second choice due to the cost, and the similar medicine was the last option because it is an unknown brand.<br> <b>CONCLUSIONS:</b> The results assume that the government industry needs to account for the demand and maintain the supply in the health units.</p>

<p><b>OBJECTIVE:</b> To identify the actions taken by the family health teams on prevention of falls in the elderly, as well the use of the Handbook of Health of the Elderly as a tool for identification of falls in the elderly.<br> <b>METHODS:</b> Descriptive study with a quantitative approach developed in the city of Fortaleza, with professionals from the Family Health Teams of the Regional Executive Office VI. Data collection was conducted from June to November 2011. Data was collected through a questionnaire and the sample consisted of 16 doctors and 42 nurses.<br> <b>RESULTS:</b> 43.75% of doctors and 26.9% of nurses said they had received some form of action aimed at preventing falls in the elderly. Regarding risk factors for falls: 100% of doctors refer to meet them and cite at least one risk factor, however 7.69% of nurses are still unaware of these factors, even when working daily with vulnerable groups. Among doctors, 12.5% recognized the existence of book of health of the elderly as a means of identifying older people who fall more frequently and 15.38% of the nurses recognized the existence of the instrument, but only 11.53% knew that that this tool was the book of the elderly.<br> <b>CONCLUSIONS:</b> The professional must question the occurrence and frequency of falls recorded in the Handbook of Health of the Elderly, hence the importance of knowing and using these tools, since the information contained in there are sufficient to identify the risk.</p>

<p><b>OBJECTIVE:</b> To analyze the range of motion and function of the knee, in addition to evaluating the quality of life and identify if there is improvement in overweight elderly patient sunder going aquatic therapy.<br> <b>METHODS:</b> This is a quantitative, cross-sectional, retrospective, descriptive study, aimed to identify which are the inappropriate An evaluation of quality of life and function, using the SF 36, and Lequesne knee goniometry in six women aged between 58 and 82 years, BMI <u>&gt;</u> 25 kg/m2, diagnosis of knee OA who reported pain in the last month. Later were submitted to the aquatic physical therapy twice a week, 50 minutes for eight sessions. By completing these were reassessed.<br> <b>RESULTS:</b> We observed significant improvements in the questionnaires and goniometry.<br> <b>CONCLUSIONS:</b> A protocol aquatic therapy can assist in improving pain, range of motion and quality of life of older overweight.</p>

<p><b>OBJECTIVE:</b> The aim of this study was to assess the effect of a functional exercise program, associated with the entertainment component, depressive symptoms, the ability to perform activities of daily living (ADL) and pain symptoms of elderly living in a nursing home.<br> <b>METHODS:</b> Ten elderly (age = 72.6 ± 5.2) participated of this study. For data collection we used the Geriatric Depression Scale (GDS-15), the Katz Index, to assess the ADL and a numeric pain scale. The exercise program lasted 3 months (60 min, 2 times/week).<br> <b>RESULTS:</b> The Wilcoxon test indicated a significant difference between the two moments to: depression (z = -2.388, p = 0.017), ADL items in the "dressing" (z = -2.000, p = 0.046) and "housework" (Z = -2.236, p=0.025) and pain intensity (Z = -2.121, p = 0.034).<br> <b>CONCLUSIONS:</b> The functional exercise program was effective in minimizing the symptoms of depression and pain and improves the elderly ability to the ADL.</p>

<p><b>OBJECTIVE:</b> To identify the nutritional status and compare the methods of nutritional assessment in the elderly residents in geriatric institutions.<br> <b>METHODS:</b> The sample was composed of elderly in three geriatric institutions of Porto Alegre. The methods used to assess nutritional status were body mass index, calf circumference, grip strength of dominant hand and non-dominand, and of adductor pollicis muscle thickness.<br> <b>RESULTS:</b> 89 elderly with a mean age of 78.6 ± 7.30 years was evaluated and 52.8% were female. Aged 80 years or older represent 51.7% of the sample Regarding the classification of nutritional status by body mass index, 12.3% of subjects were classified as underweight, normal weight 55% and 32.5% overweight. The method of nutritional assessment that identified more malnourished was hangrip strength, followed by calf circumference (13.5%), body mass index (12.4%) e adductor pollicis muscle thickness (10.1%). There was a correlation between body mass index and calf circumference (r=0.328) and body mass index and adductor pollicis muscle thickness (r=0.307).<br> <b>CONCLUSIONS:</b> The method of nutritional assessment identified that more malnutrition was grip strength, however this measure was not correlated with other measures of nutritional assessment. There was a correlation between body mass index and calf circumference and adductor pollicis muscle thickness.</p>

<p><b>OBJECTIVE:</b> To associate neuroimages from elderly patients with a risk factor for vascular dementia with cognitive assessment test for detecting whether these findings are able to presuppose a cognitive disorder compatible to vascular dementia.<br> <b>METHOD:</b> Were tested 31 patients older than sixty years old, from both sexes, with a risk factor for vascular dementia, hospitalized during the year 2011 in Funda&ccedil;&atilde;o Santa Casa de Miseric&oacute;rdia do Par&aacute;. The following cognitive assessment tests were used: the Mini-Mental State Examination (MMSE), the Cerard scale, the watch test and verbal fluency test. As a complement it was used Magnetic Nuclear Resonance (MNR); such exams were analyzed by the same radiologist according to the Fazekas modified classification. Later on the data were statically analyzed by the Chi-square test.<br> <b>RESULTS:</b> the systemic arterial hypertension (71%), diabetes mellitus (58.1%), sedentariness (58.1%), and smoking (41.9%) were the main risk factors for vascular dementia. From Fazekas classification the most common findings were Fazekas 1 and 2 in 64.5% of the cases, 90% of the total presented cognitive disorder positive for vascular dementia. From the cognitive tests the ones who had greater sensibility for the dementia evaluation were the MMSE and Cerard scale.<br> <b>CONCLUSION:</b> Thus, for tracking vascular dementia in elderly people it is necessary the use of at least two cognitive tests and a neuroimaging evaluation, emphasizing the fact that controlling and preventing risk factors for cardiovascular diseases it also contributes to the control of vascular dementia.</p>

<p>This study describes Brazilian caregiver burden in the case of demented aged people, through an integrative review, from 1999 to 2009, published in Portuguese and English. Data were collected through the electronic databases Pubmed, CINAHL and LILACS. The keywords used in CINAHL and Pubmed databases were: "dementia" OR "cognitive impairment""aged"OR "older people", "Brazil", "caregiver burden" OR "caregiver stress"OR "caregiver strain". A total of 14 papers were found. The keywords used in LILACS in the field <i>DeCS</i> category were "aged", "caregivers" and "dementia" combined with AND, which resulted in 25 studies. About 39 papers were selected, which were then reduced to 19, after unrelated themes, the Spanish language, duplicate papers, reviews, theses/dissertations and books. The studies were organized into three categories: 11 (57,9%) focused the correlation between caregiver burden and the characteristics of the caregivers and the demented elderly individuals; six (31,6%) reported the experiences and feelings reported by the caregivers; only one (5,3%) exclusively focused on the definition of burden and one (5,3%) even reported the reliability of a specific instrument directed to the Brazilian population addressing caregiver burden. The Brazilian government and city health services, universities, non-governmental organizations and other agencies and networks urgently need to organize in order to devise formal and informal intervention proposals directed to informal caregivers.</p>