RCAAP Repository

<p><b>INTRODUCTION:</b> Population aging is a worldwide phenomenon that brings with it an increase in chronic noncommunicable diseases (NCDs) with particular attention to cardiovascular diseases (CVDs), among which stands out arterial hypertension (high blood pressure - HBP).<br> <b>OBJECTIVES:</b> To identify factors that may interfere with the accessibility of the elderly population to antihypertensive medication in the context related to the patient and their interpersonal relationships, the physical structure of the family health units (USFs) and the flow distribution and dispensing of medications in the USFs of Recife and Paulista, Pernambuco.<br> <b>METHODS:</b> Data were collected using an interview protocol during the period of October to December 2010, in those USFs.<br> <b>RESULTS:</b> The profile of the population studied were: mean age 67.6, most females, the factors that most affect are: difficulty reading the doctors prescription and the name on the package, displacement of the USF, lack of infrastructure, lack of medicine.<br> <b>CONCLUSION:</b> The state must invest in improving the service of primary health care in order to improve and achieve the goals of geriatric patients blood pressure and prevent complications of CVDs.</p>

<p><b>INTRODUCTION:</b> About one third of patients develops rheumatoid arthritis (RA) after 65 years of age, a condition named EORA (elderly-onset rheumatoid arthritis). It is postulated that EORA has different features of RA in adults.<br> <b>OBJECTIVE:</b> To evaluate clinical and laboratory characteristics of patients with EORA.<br> <b>PATIENTS AND METHODS:</b> Retros-pective analysis of 35 patients with EORA. Variables: gender, age at diagnosis, initial presentation, affected joints, rheumatoid factor (RF), constitutional symptoms, ESR, response to initial treatment and comorbidities.<br> <b>RESULTS:</b> Of 35 patients, 26 (74%) were female and 9 were (26%) men, with 74 years on average. Thirty (86%) had polyarticular onset and 5 (14%), oligoarticular. Main joints involved were hands and wrists, with involvement of shoulders in 11 (32%). Constitutional manifestations occurred in 9 (26%). RF was positive in 27 (77%), and it was greater than 100 UI/ml in 23. The mean ESR was 62 mm/h. As for the initial treatment, 26 (74%) showed satisfactory response and 5 (14%) unsatisfactory. Methotrexate was used as the first drug in 28 and in 7 we used anti-malarial drugs. All who used anti-malarial responded satisfactorily. It was impossible to evaluate the response of 4 patients due to the recent diagnosis.<br> <b>CONCLUSION:</b> In this study, the relationship between women and men was similar to that found in young people, and most showed positive RF. Most had polyarticular presentation and elevated ESR, and many had constitutional symptoms and involvement of shoulders. The recognition of EORA becomes difficult in the face of many different possible diagnoses in this age group, which explains the heterogeneity of the literature data.</p>

<p><b>INTRODUCTION:</b> Aging involves various complex cellular and molecular changes, including a general decline in immunological functions known as immunosenescence. The clinical consequences of immunosenescence include increased susceptibility to respiratory infections, neoplasias and cardiovascular diseases.<br> <b>OBJECTIVE:</b> To review the major cellular and molecular changes in immunosenescence.<br> <b>METHODS:</b> Literature review between 1996-2011 employing the PubMed and SciELO databases.<br> <b>RESULTS:</b> With advancing age, the cells of the innate and adaptive immune system exhibit worsening of generalized function and a reduced number of na&iuml;ve T cells. In addition, there is an expansion of certain clones of T lymphocytes (mainly CD8 +CD28- cells) that correlate with morbidity and mortality in the elderly. Besides the age-related impairments in cellular immune responses, aging is also associated with high serum inflammatory molecules and increased counts of circulating NK cells which is characterized by inflammaging. This framework can contribute to the pathogenesis and pathophysiology of inflammatory diseases such as atherosclerosis, Alzheimer's disease among others. In addition, during immunosenescence is also present a poor response to vaccines and increase in infectious diseases, tumors and autoimmunity.<br> <b>CONCLUSION:</b> Understanding the relationship between the immune system and aging is of great importance to human health particularly on the impact of age-related diseases. It also helps to promote more effective and specific interventions for the elderly diseases.</p>

<p>Correct posture is considered to be the alignment of the body with physiological efficiency and maximum biomechanics that minimizes the stress and overload on the support system caused by gravity. Posture is related to coordination, equilibrium and posture control. One of the main problems associated with human aging is the reduce ability to control the posture and the walk. Studies have shown an association between posture control and equilibrium alteration related to those over the age of 75. It is estimated that prevalence of equilibrium complains in this age group is 85% generating sible for approximately 70% of the accidentally deaths among the elderly. To arrive at an advanced age in life with functional independence is certainly a common desire of the individual to enjoy accomplishing his tasks. In this way, this article proposes to analyses the posture alterations emanate to aging and its clinical implications as a relevant factor for the elderly individuals quality of life and also an alert to plan preventative actions and cares for functional health. The topic is justifiable as an awakening to look at the necessary care regarding factors that intervene on posture alignment in the sense of preventing future repercussions.</p>

<p><b>INTRODUCTION:</b> Low back pain is a very prevalent condition in the elderly. It causes significant morbidity and cost to society. Considering the search for effective, safe and affordable treatments, especially in the elderly, who are more susceptible to medications side effects, acupuncture has been widely used as a primary or complementary treatment option for low back pain.<br> <b>OBJECTIVE:</b> This review examined the currently available evidence supporting the use of acupuncture to treat low back pain.<br> <b>METHODS:</b> The following databases were searched: PubMed and Lilacs with keywords: "low back pain" and "acupuncture".<br> <b>RESULTS:</b> Some studies suggest better efficacy of acupuncture compared to treatment with anti-inflammatory. Others studies showed similar superiority between real acupuncture and sham acupuncture compared to conventional drug therapy, while others studies suggest superior benefit of real acupuncture compared to sham. However, systematic reviews have highlighted the lack of well-designed studies to assess properly the true role of acupuncture in low back pain.<br> <b>CONCLUSION:</b> The evidence of acupuncture for low back pain was demonstrate and it is better than the conventional treatment. However the sham and real acupuncture had haven the some evidence in this review.</p>

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<p><b>OBJECTIVE:</b> To execute the process of translation and cultural adaptation of the Minnesota Leisure Time Activities Questionnaire for the Portuguese-Brazil and to verify its intra and inter-rater reliability in community-dwelling elderly.<br> <b>METHODS:</b> Thirty-nine elderly were evaluated (71.2 ± 6.8 y.), irrespective of gender, race and/or social class, being excluded those who had cognitive impairment (Mini-Mental State Exam, the Brazilian version). The process of translation and cultural adaptation followed the criteria proposed by Beaton <i>et al</i>. (2000). The data analysis was done to the intra-class coefficient correlation in the annual and the last two weeks activities. The visual analysis was done for the Bland and Altman graphics'.<br> <b>RESULTS:</b>: There was a strong significant intra and inter-rater concordance for the application concerning the last two weeks (ICC = 0.911, p = 0.000, ICC = 0.777, p = 0.000), and for the information concerning the annual activities (ICC = 0.969, p = 0.000, ICC = 0.791, p = 0.000) performed by the elderly. The validity analyses had a satisfactory result considering the average of differences seen through Bland-Altman graphics, with a little variability between measures.<br> <b>CONCLUSION:</b> The results found allow to state that the Portuguese-Brazil version of the Minnesota Leisure Time Activities Questionnaire can be used as a tool to verify the weekly and/or annual calorie consumption in community-dwelling elders.</p>

<p><b>OBJECTIVE:</b> To investigate the association between functional disability for basic and instrumental activities of daily living and behavioral aspects of health in the elderly and residents of neighborhoods Restinga and Far southern city of Porto Alegre.<br> <b>METHODS:</b> A cross-sectional study, including 638 individuals aged greater than or equal to 60 years. For the evaluation of basic and instrumental activities of daily living, Katz's Index and Lawton Scale, were used respectively. Defined as functional disability for each area needing help in at least one activity investigated. The independent variables were: smoking, physical activity, excessive alcohol consumption, hypertension, depression, diabetes, hypercholesterolemia, osteoporosis, hospitalizations in the previous year, number of physician visits in the last three months and self-rated health. We used the Wald test for heterogeneity and trend in the crude analysis and Poisson regression with robust variance in the adjusted analysis.<br> <b>RESULTS:</b>: The prevalence of disability for basic and instrumental activities was 15.8% (95% CI: 12.9-18.6) and 25.9% (95% CI: 22.5-29.3), respectively. It was observed that elderly patients with osteoporosis (PR = 1.64) and greater number of physician visits in the last three months had higher occurrences of failure to basic activities. As for instrumental activities, the elderly diagnosed with depression had greater functional disability (PR = 1.39). Both the functional and basic activities for instrumental activities were associated with physical inactivity and poor self-rated health.<br> <b>CONCLUSION:</b> Functional disability for basic and instrumental activities were associated with several behavioral and health. Physical inactivity and poorer perceptions of health were the factors most strongly associated with disability in both areas investigated.</p>

<p><b>OBJECTIVE:</b> The present study has as objective evaluates the balance, the trunk mobility and the risk of falls in patients with Parkinson's disease.<br> <b>METHODS:</b> They were appraised six senior of both sexes with age same or larger than 60 years bearers of the Parkinson's disease. The research used an evaluation record for collection of the data of the history, a scale for evaluation of the corporal balance (scale of Berg), other scale (Downton) to evaluate fall risk and the test of functional reach to measure the mobility of the trunk and static balance. The statistical analysis used was the Pearson's test correlation with level of significance of 5% and 1%.<br> <b>RESULTS:</b>: There is a correlation between the corporal balance and the risk of falls with r -0,8083, the correlation between the age and the risk of falls with r -0,7394, there is no correlation between the functional reach and the risk of falls with r -0,3593 and the time of lesion with risk of falls with r equal the -0,2292.<br> <b>CONCLUSION:</b> The decrease of the static balance is directly related with the largest risk of falls and that the test of functional reach doesn't allow to predict on the risk of falls among the studied population.</p>

<p><b>INTRODUCTION:</b> With increasing life expectancy, interest is growing in the elderly remain independent and quality of life. In this context, sexual activity is an important part and the exercise has shown protective effect on the sexual health in aging.<br> <b>OBJECTIVE:</b> The objective of this study was to explore the relationship between physical fitness and sexual activity in men 55 to 72 years.<br> <b>METHODS:</b> The participants underwent an exercise test and were interviewed about risk factors and cardiovascular aspects of life such as sexual satisfaction, desire and frequency. The data collected was used Spearman correlation tests for nonparametric variables and chi-square for categorical variables.<br> <b>RESULTS:</b>: The physical fitness and aspects of sexual activity were lower in older subjects. Adjusted for age, seniors with higher functional ability had better scores for sexual desire and frequency, but with no correlation to satisfaction. The lowest satisfaction scores were justified by the difficulty in maintaining an erection during the sexual act, and was associated with the high cholesterol risk factors.<br> <b>CONCLUSION:</b> Although physical fitness is associated with better scores for sexual desire and frequency, the use of medications for erection and sexual counseling with a therapist can help the elderly increase in sexual satisfaction.</p>

<p><b>OBJECTIVES:</b> Parkinson's disease is related to the decline in daily functional activities, favoring reduced quality of life. Because of it, the aim of this study was to analyze the balance and gait agility of parkinsonian and their correlation on the functional activities.<br> <b>METHODS:</b> It was evaluated 21 volunteers: 10 parkinsonian and 11 clinically healthy individuals. All the volunteers were assessed using the Berg Balance Scale (BBS), the Time Up and Go Test (TUGT) and a pedometer during 48 hours.<br> <b>RESULTS:</b> It was observed that the values obtained by BBS and TUGT were significantly different between the groups (p &lt; 0.05). For the number of steps it was not observed the same, the steps/48 hours were equivalent for both groups. Furthermore, it was observed great correlation between the number of steps and the BBS.<br> <b>CONCLUSION:</b> Individuals with Parkinson disease showed a deficit of balance and gait agility, but there was no interference in the independence of gait, since the subjects evaluated had similar number of steps in relation to the control group during the evaluation period.</p>

<p><b>OBJECTIVE:</b> To describe the distribution of hospitalizations in the Unified Health System (SUS) of elderly in Recife, with respect to cost and length of hospitalization, according to gender, age and major causes from 1998 to 2005.<br> <b>METHODS:</b> A study of descriptive and cross-sectional nature were performed, using data obtained from the Bank of the Hospitalization System of the SUS, focusing on the analysis of Hospitalization Authorizations (AIHs) issued for elderly patients (aged 60 and over) in the referred period. Gender, age and primary diagnosis were studied as independent variables while cost and length of hospitalization were the dependent variables. The statistical analysis were performed by means of Pearson's chi-square test and linear regression.<br> <b>RESULTS:</b> A total number of 137,546 hospitalizations with cost of R$ 101,019,926.20 have been described throughout the study period. Of this total, R$ 49,661,829.38 was allocated for males (49.2%) and R$ 51,358,096.77 for females (50.8%). The ratio between the proportion of funds paid for hospitalizations and the proportional size of the population increases gradually with age for both sexes. The average cost and length of hospitalization decrease with increasing age. 70.6% of total expenditures (R$ 71,480,950.14) were for circulatory diseases, mental disorders, respiratory diseases, digestive tract, and neoplasms. The mean length of hospitalization was longer for the mental and behavioral disorders.<br> <b>CONCLUSION:</b> Knowing the profile of hospitalizations has shown to be very important for monitoring and evaluating the health care system and the outcome of this study reinforces the need for implementing prevention activities and health programs throughout the life course.</p>

<p>Gerontology is the elderlys study that includes the relation between biological, psychological and social aspects. It's a dynamic e personal process. The song "foster child" is a classic regional Brazilian song that shows a lot of aspects about elderly; the family and her relationships since of children education until their responsibility to take care of the parents when they became older. Themes like violence, asylum, to be father in law and others will be discuss in this song. The regional Brazilian song is so popular and it can be used to get information and paradigms changes in the society</p>

<p>In Brazil, the elderly population presents the fastest growing segment in proportional terms and according to World Health Organization, the global impact of cancer more than doubled in 30 years. National estimates of 2010, which will be also valid for 2011, show the occurrence of 489,270 new cases. Although the link between cancer and senectude be complex and fundamental questions remain unanswered, it is expected that these indicators will increase even more with the progressive aging of the population. In this context, it is necessary to develop an interaction between oncology and geriatrics, in order to promote the evaluation of elderly patients with cancer individually, in its multiple dimensions, focusing on their comorbidities, functional status, level of dependence and the physiological factors related to senescence that limit treatment to develop the best therapeutic regimen for each patient in an interdisciplinary way, ensuring equal access to quality care.</p>

<p>Human cytomegalovirus (HCMV) is associated with important cause of morbidity and mortality in immunocompromised individuals, but their action in immunocompetent individuals has gained prominence in the field of geriatrics, in immunosenescence's works, with numerous studies revealing a significant association between HCMV chronic infection and increase of functional limitations and mortality in the population after 60 years. Research has demonstrated that HCMV chronic infection is directly related to immunological changes of aging, specifically with changes in lymphocyte T cell response, this set of changes was called immune risk profile (IRP), which is associated with the limitation on the ability of the immune system to organize an effective response to pathogenic microorganisms, resulting in increased susceptibility to infections, among other consequences. This article aims to review the role of HCMV in the aging, the immune risk profile markers and their consequences for the health of elderly population.</p>

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<p><b>INTRODUCTION:</b> Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.<br> <b>OBJECTIVE:</b> To analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's Disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.<br> <b>METHOD:</b> Survey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.<br> <b>RESULTS:</b> Healthy older people showed greater capacity for abstraction than those with AD. There was significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3 (p = 0.090), with the biggest sentence. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.<br> <b>CONCLUSION:</b> Elderly people with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD. As lesser sentence, the better the capacity for abstraction.</p>

<p><b>OBJECTIVE:</b> The objective of this study was to identify the physiological response of multiple trauma elderly with chronic constipation to the use of a symbiotic compost.<br> <b>METHODS:</b> It was characterized as a non-controlled experimental study, which included 12 elderly patients, with multiple trauma and chronic constipation as a secondary disease and that were hospitalized in a public trauma referral hospital in Par&aacute;, Brasil.<br> <b>RESULTS:</b> At the initial evaluation there was an average of 5.5 days of time off defecation. At the end of the intervention with the symbiotic held for eight days, 100% of patients had experienced episodes of defecation, especially for the type 4 stool (shaped, smooth and soft faeces - ideal type), according to the Bristol Stool Scale, present in 75% o the sample. The average of days to the first bowel movement after the use of symbiotic was 2.58 ± 1.72.<br> <b>CONCLUSION:</b> The use of symbiotic was shown to cause a positive physiological response in the multiple trauma elderly, through the improvement of the constipation.</p>

<p><b>OBJECTIVE:</b> To determine the prevalence of malnutrition in elderly inpatients in a public hospital of the Northeastern region (S&atilde;o Lu&iacute;s/MA) and its association to depression.<br> <b>METHODS:</b> In 2009, a prospective cross-sectional study evaluated elderly patients admitted through the application of a questionnaire containing variables for socioeconomic aspects, gender, race and marital status. Nutritional status was established by the Mini Nutritional Assessment (MNA) applied with less than 72 hours after admission. The Geriatric Depression Scale (GDS) was used to assess symptoms suggestive of depression. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences). Differences were considered significant when p &lt; 0.05.<br> <b>RESULTS:</b> 92 elderly inpatients have been evaluated, 53.3% were men, 43.5% were mulatto, 52.2% were married, 88.0% retired, 55.4% were illiterate and 85.9% reported personal income of one minimum salary. The total score of the average MNA was 17.6 ± 5.8 points. The prevalence of risk of malnutrition and malnutrition was respectively of: 37.8% and 43.3%. The average GDS score was 6.9 ± 3.0 points. The prevalence of depression was of 56.3%. There was a significant association between malnutrition and female sex, widowhood and depression.<br> <b>CONCLUSION:</b> The prevalence of malnutrition and depression were high with a significant association in elderly inpatients in the Northeastern region (S&atilde;o Lu&iacute;s/MA).</p>