RCAAP Repository

<p>Increased life expectancy of the population leads to the growing number of the elderly who need health care, mainly due to complications caused by chronic diseases. Diabetes mellitus is a disease of high prevalence in the elderly, characterized by a metabolic disorder resulting from the lack of insulin and/or its inability to act appropriately. The disease promotes the appearance of macrovascular (cardiovascular, cerebrovascular and peripheral vessels), microvascular (retinopathy, nephropathy and neuropathy) and musculoskeletal (osteoarthritis and rheumatoid arthritis) complications that affect the quality of life of seniors and their occupational performance (self-care, work and leisure). This study consists of a literature research that investigates the role of the occupational therapist following the elderly with diabetes mellitus, enclosing the two last decades, in order to identify possible interventions in the face of medical complications. It was noted the importance of the professional in the prevention of the disability and in the maintenance of the functionality during the various stages of the disease. The intervention stimulates the recovery of self-care autonomy, guides the individual in in the glycemic control, and in the face of complications, it contributes to the improvement of functional performance. The role of the therapist following the diabetic elderly enables the maintenance of a satisfactory performance of daily life activities such as eating, getting dressed, personal hygiene, mobility as well as improves the elderly's family and social relationships.</p>

<p>Increasingly healthy people are looking for preventive health care. These includes periodic medical consults for investigation of some grievance or risk factor.To provide scientific basis for such research were created recommendations on what and how often exams should be performed . However, it has become frequent diagnostic checkup exams without notecing such recommendations. As a result, "treatments" are started in asymptomatic patients based only on exams alterations. This especially occurs in the evaluation of thyroid function, when people become labeled as suffering from hypothyroidism, even if it is subclinical. Subclinical hypothyroidism is defined by the presence of elevated levels of Thyroid Stimulating Hormone with normal levels of Triiodotironine and Tiroxine. Its treatment is controversial, especially in the most prevalent population, women over sixty years, in which the risk-benefit must be carefully evaluated. The causes are diverse, and the main one is Hashimoto's thyroiditis. Among the possible associated risks is included hypertension, dyslipidemia, atherosclerosis, neuropsychiatric symptoms, changes in mood, cognition, muscle mass, bone density and quality of life. Due to the high prevalence of Subclinical hypothyroidism, studies seek information about the benefits and consequences of treatment, but the benefits are not being fully observed. A literature review with a survey of studies published in indexed journals in databases such as: SCIELO, Dynamed, Cochrane and uptodate. No improvement in survival or reduction of cardiovascular morbidity with the use of levothyroxine. Regarding quality of life and the other symptoms, treatment revealed no significant differences.</p>

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<p><b>OBJECTIVE:</b> Identify the prevalence of somatotype and analyze the association with lipids and glucose levels in elderly women.<br> <b>METHODS:</b> Anthropometric data were collected and calculated the endomorph somatotype (ENDO), mesomorph (MESO) and ectomorph (ECTO). The analysis of fasting plasma glucose (FPG) and postprandial glucose (PPG) were made with an enzymatic colorimetric glucose oxidase, glycated hemoglobin (HbA₁C) was determined using the method modified Trivelli, triglycerides (Tg), total cholesterol (TC) and HDL-cholesterol were analyzed with the enzymatic colorimetric method and LDL-cholesterol calculated by the method of Friedewald.<br> <b>RESULTS:</b> Association between ECTO x PPG (rs = -0.25; p = 0.05) and ECTO x Tg (rs = -0.27; p = 0.03) in the age group 60-69 years and between ENDO x PPG (rs = 0.33; p = 0.03), ENDO x Tg (rs = 0.41; p = 0.006) and ENDO x TC (r = 0.41; p = 0.007) in the group above 70 years. The results of multiple regression analysis were significant between ECTO x PPG (p = 0.04) in the group aged 60-69 years and between ENDO x Tg (p = 0.02) and ENDO x CT (p = 0.006) for the elderly over 70 years old.<br> <b>CONCLUSION:</b> Plasma lipids showed positive associations only with the component in the ENDO group of elderly aged over 70 years and may have different role in relation to age, perhaps because body fat exert a protective factor in the elderly.</p>

<p><b>OBJECTIVE:</b> To analyze how the elderly population in the metropolitan area of Belo Horizonte perceive their own health situation.<br> <b>METHOD:</b> This is a transversal descriptive study that was made after an analysis of the database of PAD (Household Sample Survey) conducted by Funda&ccedil;&atilde;o Jo&atilde;o Pinheiro in 2009 surveyed 17.000 households distributed by the Minas Gerais State. In such research were analyzed the variables self-perceived health status; presence of illnesses that require constant care; smoking; regular physical activities; working; education and pension benefits for people aged 60 years and over from Belo Horizonte city.<br> <b>RESULTS:</b> The study interviewed 963 people aged 60 years and over. Fifty eight point two percent of the sample are women, mean age of 69.4 years and 44% reported health status as "very good or good" and 10.7% "bad or very bad". From the subjects who reported having health problems that require constant monitoring (n = 960), 42% suffer of arterial hypertension. Seventy eight point five percent can be considered illiterate; 67.9% received retirement or pension in the reference month of the survey; 25% reported performing regular physical activity; 10.7% declared their health state as being "bad or very bad".<br> <b>CONCLUSION:</b> The self-perception of health status is worse among the elderly has reported chronic diseases, poor education, lack of working habits and reducing physical activity (p &lt; 0,05). These results can be considered as crucial information to help in the search for implementing better government funded programs to assist the elderly population of Minas Gerais.</p>

<p><b>INTRODUCTION:</b> The presence of elderly in racing background are increasingly attracting more interest in knowing what are the benefits obtained through this sport, and one of these interests is to know the effect of race on postural balance of these individuals.<br> <b>OBJECTIVE:</b> The objective of this study was to evaluate the influence of long-distance race on postural balance of older people active and healthy.<br> <b>METHODS:</b> We conducted a study of 35 elderly men and women, mean age 67 ± 5 years (60-79) years, without complaints of imbalance, divided into groups of runners and a control group. Balance assessment was conducted by the Sensory Organization Test of computerized dynamic posturography.<br> <b>RESULTS:</b> Referring to sensory systems (somatosensory, visual and vestibular) and the evaluation of the overall index of balance the results were similar between the two groups.<br> <b>CONCLUSION:</b> The race background does not influence the improvement of postural balance when compared to healthy elderly non-runners. The sensory organization test is a means of evaluation that was not sensitive to identify changes in the balance of healthy elderly.</p>

<p><b>OBJECTIVES:</b> To assess the perception of aging and finitude in the late adulthood in the elderly group Project Golden Age of the municipality of Para&iacute;so do Tocantins.<br> <b>METHODS:</b> Investigative process developed in the group for senior citizens of the City Office of the city of Para&iacute;so do Tocantins/TO, known as Project Golden Age, through exploratory field study with a qualitative approach, with the completion of semi-structured interviews. Also been developed and applied a questionnaire as part of a scale measuring symptoms of anxiety and hopelessness of them, regarding their perception of death, where the result of 1 means: I fully agree, and 3 means completely disagree.<br> <b>RESULTS:</b> The results showed that the idea of the fear of dying, most respondents said they are unnerved by the possibility, even with the knowledge that this phase of their lives, the risk of death is increasing. Fear of death is not simply the completion of the human existence of matter in its physical aspect, but also on several other issues, particularly the risk of being affected by serious illness that generates large physical and psychic dependence. The age of the elderly ranged from 75 to 89 years, and 67% of respondents were female and 33% male. It was observed that most of these have specific religion and are married or widowed.<br> <b>CONCLUSION:</b> The results showed, based on tests developed and the theoretical discussion, that old age generates uncertainty and fear for the elderly, but not by death itself, but for fear of being alone and prostrate, depending on other people to get around or carry out their daily activities.</p>

<p><b>OBJECTIVE:</b> To estimate the prevalence of anemia in an institutionalized geriatric population.<br> <b>METHODS:</b> Cross-sectional descriptive study among older adults nursing home residents, aged 60 years or older. Anemia was defined using World Health Organization criteria (hemoglobin &lt; 13 g/dl for men and hemoglobin &lt; 12 g/dl for women). Demographic, clinical and laboratory data obtained from medical records were analyzed by SPSS for Windows, version 17.0.<br> <b>RESULTS:</b> Of the 75 nursing home residents, 64 meet all inclusion criteria. Anemia prevalence was 29.7%: 26.1% in the women and 38.9% in the man. The major characteristics of anemia were normochromia with normocytosis, which occurred in 64.7% of cases. The mean age was 80.2 ± 8.9 years, 71.9% were women and 62.5% had dementia. The average time of living in the institution was around 37.5 months. Almost half of the subjects were underweight and 74.2% were malnourished or at risk of malnutrition.<br> <b>CONCLUSION:</b> Anemia is a common condition in institutionalized elderly patients, and although generally mild, can be associated with adverse clinical outcomes. Future studies should evaluate the causes and the potential benefits of treatment in terms of quality of life, reduced morbidity and health economics.</p>

<p><b>INTRODUCTION:</b> The violence against the elderly is an ongoing public health problem in the society that needs to be investigated.<br> <b>OBJECTIVE:</b> This study aims to analyse the sociodemographic profile of the elderly victims of violence reported in 2009 at the Elderly Police Station, in Porto Alegre city, RS.<br> <b>METHODS:</b> It was used the simple frequency, percentage and standardized rate per age.<br> <b>RESULTS:</b> In the overall 904 reports were checked, from which 836 were considered valid. It was found a higher incidence of violence victims in white elderly (85.1% based on 778 victims), who were 70 to 79 years old (&#8773; 486 cases per 100.000 people ), married (46%), with primary school (54.4%) and female (69.3%). Psychological violence was the most practiced, followed by financial and physical assault. There was predominance of "unfamiliar" as authors of aggressions (57.4%).<br> <b>CONCLUSION:</b> The found data confirm the importance of restructuring policies and strategies for preventing violence and strengthening the network support for older people.</p>

<p><b>OBJECTIVE:</b> Evaluate the characteristics of scientific medical studies including patients over 80 years old, from january 2000 to october 2009.<br> <b>METHODS:</b> We searched the eletronic database MEDLINE, and two regional databases (Scielo and Lilacs). We used search terms "octogenarians" or "nonagenarians" at the title, and filter to identify articles in english language, with abstracts and articles with patients over 80 years old. Data were extracted from articles and studies were classified according to level of evidence based on Oxford Center for Evidence-Based Medicine classification.<br> <b>RESULTS:</b> Three hundred ninety-five studies were found at MEDLINE database, the number of studies increased fourfold from 2000 to 2008, 18 studies in 2000 and 63 studies in 2008. The majority of studies were classified as clinical research (291 studies, 73,7%), observational (339 studies, 85,8%) and retrospective (260 studies, 65,8%). Only 6 studies (1,5%) evaluate interventions. Cardiac surgery departments published more among the articles found (106 studies, 26,8%), followed by cardiology (62 studies, 15,7%). American studies wer the most common (128 studies, 32,4%). Only 6,7% were produced by Geriatric departments.<br> <b>CONCLUSION:</b> The number of scientific evidence with very old patients increased in the last years. Clinical research, obsertational studies and retrospectives were the main characteristics found. The best level of evidence found was 1B. Cardiac surgery and cardiology produced more studies. In regional database we found more national studies.</p>

<p><b>INTRODUCTION:</b> The benefits of practicing strength training (bodybuilding) at an old age are well described in literature. However, little is known about the elderlies understanding of how important practicing strength training regularly is.<br> <b>OBJECTIVE:</b> To investigate and discuss the knowledge of physically active elderlies, about the benefits of bodybuilding's practice.<br> <b>METHODS:</b> The research was qualitative. An episodic interview, constructed by the researchers, was used to collect data.<br> <b>RESULTS:</b> Thirty-nine elderlies have participated, 25 were bodybuilders in gyms, 10 were walkers, two practiced both bodybuilding and walking, and two although were not bodybuilders, frequented a gym. Most of the elderlies have shown a few knowledge about bodybuilding and its benefits. This knowledge was less significant among those who never had access to that kind of physical activity. The main benefits associated to strength training were better mobility, aesthetic results, reduction of pain, muscular strengthening and physical conditioning.<br> <b>CONCLUSION:</b> The Knowledge of the elderly about benefits of strength training is related to physiological and biological dimension. This result is influenced both by individual questions and socio cultural context.</p>

<p><b>OBJECTIVE:</b> Compare and verify the agreement of measurements of blood pressure systolic (SBP) and diastolic (DBP) obtained by auscultatory methods (mercury column) and oscillometric (Omron - 412C), in elderly women.<br> <b>METHODS:</b> Three blood pressure (BP) measurements by two minutes intervals were measured from 47 elderly (66.8 ± 5.3 years). The oscillometric device was connected in "Y" with the mercury sphygmomanometer and the SBP and DBP values were recorded by two evaluators "blinded".<br> <b>RESULTS:</b> For each device, significant differences were not observed (P &lt; 0.01) between measurements (1, 2 and 3) SBP and DBP Except for the second measure of PAD, statistically significant differences (P &gt; 0.01) were identified from the mean SBP and DBP, estimated by different methods. Although significant positive correlations (P &lt; 0.01) e high magnitude were identified between the two methods investigated for SBD (r = 0.891) and DBP (r = 0.813), concordance analysis indicated relatively large limits. The SBP was underestimated by up to 23.1 mmHg or overestimated of up to 12.8 mmHg and in DBP was underestimated by up to 13.4 mmHg or overestimates of up to 9.0 mmHg for oscillometric method in the face of auscultation.<br> <b>CONCLUSION:</b> The results of this study suggest that SBP and DBP appear to be influenced by using different methods of evaluating BP</p>

<p>The literature has shown the importance of preserving cognitive functions and components of functional capacity with aging, and programs that offer physical activity for the population are low-cost alternatives, and have positive impact on these aspects. The Physical Activity Program for Seniors is a program offered by Unesp, and aims to offer a physical activity program for older adults, in addition to providing undergraduate students the opportunity to apply academic knowledge in the community. Among the activities offered, which give the participants an improvement and / or maintenance of autonomy, health and social interaction, is the Square Stepping Exercise, an activity created in Japan to improve the balance of the elderly, but also requires great cognitive performance of its practitioners. Studies have shown that older people participation in physical and cognitive exercise collaborates for a healthy aging, so programs that promote the healthiness of the population are necessary.</p>

<p>The pressure ulcers (PU) are defined as "An area of localized lesion of the skin and underlying tissues caused by pressure, shear stress, friction and / or a combination of factors". The UP is a major health problem, particularly in hospitals, resulting in increased costs, commitment to health and prolongation of hospitalization, with the individual elder group most susceptible to the onset of PU. This review aimed to analyze the factors that lead to the onset of UP in the elderly and identify strategies appropriate to the nutritional treatment. Several original papers and review articles, published since 2004, were searched in the databases Medline, PubMed and Lilacs, and used the following terms: pressure ulcer, treatment, elderly, malnutrition and nutritional status. Most published studies shows that the high prevalence of older people presenting this injury is in his most malnourished, or being hospitalized in geriatric institutions. Malnutrition affects both the formation of the lesion where there is a reduction of body tissue and the healing process. Malnutrition can predict the development of UP, one should note some causes such as persistent lack of appetite, dietary restrictions, dependence on assistance for eating, cognitive impairment, use of medications that interfere with appetite and psychosocial factors. Therefore, it is necessary to adopt strategies for prevention of pressure ulcers, including those related to recovery and maintenance of nutritional status.</p>

<p>The present essay intends to examine the human aging through Erik Erikson's psychosocial development theory. It is postulated that the consolidation of identity includes the individual and the culture as well. Coping with old age losses and facing death with serenity demand life revision and acceptance of past mistakes. In this way, previous conflicts may reappear, overcome or not, and the despair with finitude may emerge. However, if the aged person achieves wisdom and life involvement, ego integrity will be consolidated and despair will vanish. In this sense, the psychosocial environment is essential. The article brings a new comprehension on Erik Erikson's essays about old age and enhance some of his main concepts. Moreover, the authors present counterpoints to theories on aging, as well as proposals for actions towards the elderly.</p>

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<p><b>INTRODUCTION:</b> The diagnosis of frailty in complex and difficult. The phenotype of Fried is a tool used to classify the elderly according to his or her profile of frailty. Among its five items, the reduction of grip strength, level of physical activity and slow gait speed may suffer influence of anthropometric characteristics of the population.<br> <b>OBJECTIVE:</b> Compare the frequency of frailty using cutoff points of Fried <i>et al.</i> (2001) and others adjusted for this sample.<br> <b>METHODS:</b> 125 elderly community (70.4% women, average age 73.77 ± 5.65 years) were assessed by the Phenotype of Frailty. After application of the phenotype, the elderly were classified as frail, pre-frail and non-frail, initially using the cutoff points used by Fried <i>et al.</i> (2001) in CHS. After that, they were reclassified using cutoffs adjusted by samples percentil 20, for grip strength, physical activity level and slow gait speed. We analyzed the frequency of frailty in each classification and the comparison made by the chi-square test (X²), using &#945; = 0.05.<br> <b>RESULTS:</b> The distributions of frailty were distinct when used different cutoff points, but the pre-frail group was the biggest in both situations. The exhaustion criterion was score positive for 28% of the elderly in both classifications. There was no significant difference between the distributions according to X² test (p = 0.356).<br> <b>CONCLUSION:</b> There was not significant difference in the distribution of frailty using the two cutoff points proposed. Exhaustion criterion was frequent and does not change its cutoff point, justifying the result.</p>

<p><b>INTRODUCTION:</b> Population aging is a world-wide phenomenon. Increasing number of elderly elevate rates of chronic degenerative diseases, with loss of functionality and immobility. The causes of impaired mobility are multifactorial, predominantly neurological and musculoskeletal. Management and prevention of immobility syndrome is interdisciplinary.<br> <b>OBJECTIVE:</b> To determine the prevalence of the immobility syndrome in Hospital do Servidor P&uacute;blico Estadual geriatric ward.<br> <b>MATERIALS AND METHODS:</b> From August 24 to September 24 of 2009, all patients admitted in geriatric ward were evaluated, in order to identify which of them fulfilled diagnostic criteria for the immobility syndrome.<br> <b>RESULTS:</b> Of 47 patients, twelve of them (12/25.53%) met criteria for the immobility syndrome. Eleven (11/91.6%) were females, with mean age of 85.3 years. Regarding the reason for admission at the geriatric ward, 75% were infectious etiologies: pneumonia (5/41.66%) and urinary tract infection (4/33%).<br> <b>CONCLUSION:</b> When comparing patients with immobility syndrome and general population of this geriatric ward, there was little difference in age, 85.3 and 83.1 years, and the hospitalization stay, 12.08 and 12.47 days, respectively. Mortality observed was 50% for those patients with immobility syndrome and 25% for the general population geriatric ward. Further studies addressing this issue are important to choose its priorities, with lower rates of iatrogenic, promoting improvements in clinical and familiar approaches of this population.</p>

<p><b>OBJECTIVE:</b> Verify the effects of the practice of an aquatic exercise program resisted in the resistivity carotid, life quality and functional autonomy of elderly.<br> <b>METHOD:</b> The sample was taken based on 35 women with 68.67 ± 4.52 years old, allocated in intervention group (HG = 22) and control group (CG = 13). The carotid arterial resistance was availed by the method of Doppler ultrasound, the life quality through the questioner WHOQOL-100 and the functional autonomy through four experiences which simulate day a day activities. The proposed exercise program lasted 12 weeks with moderate intensity controlled for the OMNI-RES effort perception scale.<br> <b>RESULTS:</b> The carotid resistivity and the life quality didn't suffer significant changes. Significance was obtained on the functional autonomy in the procedure C10m with the reduction in the execution time, p = 0.002 after intervention. Correlation between the general functional autonomy index and the carotid resistivity index, p = 0,000 at before procedure and positive correlation between the standing up from the ventral decubiti position procedure and the domains 2 and 6 of life quality after procedure.<br> <b>CONCLUSION:</b> The proposed resisted aquatic exercise program wasn't capable of reduce the carotid arterial resistivity and cause significant improvement on elderly life quality when singly aviated. However there was correlation between functional autonomy and elderly life quality after aquatic resisted exercise regular practice.</p>

<p><b>OBJECTIVE:</b> To assess the effect of water aerobics exercise on the functional autonomy of the elderly.<br> <b>METHODS:</b> Thirty-eight elderly subjects (aged 60-75 years) were randomly selected and divided into two groups: sedentary elderly subjects (GIS N = 19) and elderly subjects who practiced water aerobics three times a week, 50 minutes per session, for six months (GIH; N = 19). The subjects in GIS did not participate in any activity during this period. Physical aptitude was assessed using a battery of tests from the Latin American Development Group for the Elderly (LADGE), which measure activities of daily life: a 10-min walk (10mW), getting up from a seated position (GSP), getting up from the prone position (GPP), getting up from a chair and moving around (GCM), and putting on/taking off a shirt (PTS). All data are expressed in seconds. Differences between groups were analyzed using descriptive and inferential statistics (SPSS software, version 16.0 for Windows).<br> <b>RESULTS:</b> The level of functional autonomy was higher in G1 than in G2 (p &lt; 0.05).<br> <b>CONCLUSION:</b> We found that practice of water aerobics contributes to the improvement and maintenance of functional autonomy of the elderly. Increased autonomy positively affects self-esteem and ultimately enhances the quality of life of the elderly.</p>