RCAAP Repository

<p><b>OBJECTIVE:</b> Frailty is characterized by increased vulnerability to stressors that results from decreased physiological reserves due to increased disability in multiple systems. This process, coupled with the decrease in the individual's ability to meet the demand imposed, culminating in the appearance of fragility. To identify, among the five items on the phenotype of frailty, which were more frequent in the investigation of Rede Fibra in Belo Horizonte- MG.<br> <b>METHODS:</b> This study is a subproject of Rede Fibra and used a random sample of 199 elderly from the database center of Belo Horizonte. This study was performed descriptive statistics for all study variables. For this, we used the Statistical Package for Social Science (SPSS), version 15.0.<br> <b>RESULTS:</b> The prevalence of frailty in our sample was 14%, and the most frequent item of the sample was running at low speed in both, the frail elderly (93.6%) as in the pre-frail (88.4%).<br> <b>CONCLUSION:</b> The low-speed running was most common among frail and pre-frail elderly. So, this should be an item that deserves careful observation by health professionals for better conditions to identify possible frailty in the elderly.</p>

<p><b>OBJECTIVE:</b> To evaluate the association between frailty and self-rated health in community-dwelling elderly.<br> <b>METHODS:</b> 79 male and female subjects, aged 65 years or older, living in Belo Horizonte-MG, volunteered for the study. It was administered "rede Fibra" questionnaire from December 2008 to may 2009, by interviewers previously trained. Self-rated health was measured through five questions: self-rated general health, health care, health compared to people with same age, actual health compared to last year and activity level compared to last year. Frailty criteria was the five items of frailty phenotype. Statistic analyses was performed using Kruskal Wallis and chi-squared, with &#945; = 0.05.<br> <b>RESULTS:</b> Sample was composed of 78% female and 28% male with mean age 75.15 ± 6.77 years. Prevalence of frailty was 22% frail, 48% pre-frail and 30% not frail. There was significant statistic association between questions about health compared to people with same age and actual health compared to last year and frailty profile. Only the last question was significant to identify frail elderly with answer "worst health".<br> <b>CONCLUSIONS:</b> Results suggested significant association (p &lt; 0,03) between self-rated health and frailty when evaluated by the question: "Compared to last year, how do you consider your health now?" And the proportion of answers "worst" was higher in the frail elderly group.</p>

<p><b>OBJECTIVE:</b> The aim of this study was to investigate the static and dynamic balance after a training session on the vibration platform in elderly women with different loads.<br> <b>METHODs:</b> Participated in this study fifteen subjects (67.0 ± 4.7 years, 69.1 ± 10.5 kg, 155.4 ± 4.5 cm) underwent eight sessions in which the vibrating platform on separate days, in different frequencies and amplitudes (2 mm/30 Hz; 2mm/50 Hz, 4 mm/30 Hz, 4 mm/50 Hz), were evaluated after the first four sessions, the static balance test by one foot and in four subsequent sessions by the dynamic balance test "timed up and go", checked in the pre, post, twenty minutes and forty minutes later.<br> <b>RESULTS:</b> The data were tested using the analysis of variance ANOVA for repeated measures following by Scheff&eacute; post hoc when p &lt; 0,05. No statistically significant difference was found between the times for any of the protocols for the dynamic and static equilibrium.<br> <b>CONCLUSIONS:</b> The results suggest that acute exercise on vibratory platform does not affect the post-balance in older women.</p>

<p><b>OBJECTIVE:</b> The high number of elderly fallers raises, among other issues, the importance of proper use of assistive devices (DAM): crutches, canes and walkers. Despite DAM aim the improvement in functional independence, balance and the reduction of disability, most patients are not instructed on their proper use and they often use inadequate/damaged models or unsuitable height. Few studies have confirmed the efficacy of isolated prescription of DAM to reduce the risk of falls and few studies have shown the proper way to indicate and adjust them individually. Thus, in order to describe, inform and guide about the proper use of DAM, a literature review was conducted using the databases Medline, Lilacs, Scielo and PubMed, literary references and book chapters wich approached the topic. A total of nine articles and three book chapters were identified. The results showed, for each type of DAM, its indication, use, variations and its characteristics, guidance about walk and transfers and height adjustments. In addition, other relevant issues have been described such as patients' features and limitations, their environment, their social and economic conditions and mostly their functional capacity. The prescription, guidance and proper follow up of DAM by a physical therapist provide better confidence, skill and adherence regarding their use. Possibly, such gain will interfere on patient's daily activities performance and it will act on falls prevention.</p>

<p><b>OBJECTIVE:</b> To present the ongoing researches for biomarkers in Alzheimer disease<br> <b>METHODS:</b> Bibliographic review, starting from 2000, utilizing PubMed data bank.<br> <b>RESULTS:</b> This revision presents the actual evidences of the main markers involved in Alzheimer disease including the molecular (presented in blood and cerebrospinal fluid), the associated with image (p&oacute;sitron emission tomography, single photon emission computed tomography and magnetic ressonance) and neural networks.<br> <b>CONCLUSIONS:</b> Finding an efficient biomarker will enable significative progress in the clinic evaluation and in the disease development approaches, also, will contribute to the increment of new therapeutic estrategies.</p>

<p><b>Objective:</b> Identify and characterize population-based studies using the SF-12 as a means of evaluating the elderly's quality of life related to health (HRQoL). Integrative literature review about population-based studies that used the SF-12 as a means of evaluating the HRQoL of individuals aged sixty years or older in the last five years.<br> We selected eighteen articles that used the SF-12 to assess prediction of hospitalization and mortality in elderly community, program evaluation and health services, assessments and treatments for health conditions and evaluation of psychometric measures. The population-based studies were composed of community elders. The SF-12 instrument was considered a short, understandable, quick and with good psychometric measures. We recommend their application as an interview to ensure the assessment of HRQOL in the elderly.</p>

<p><b>OBJECTIVE:</b> Frailty is a high vulnerability state and adverse health effects common to the elderly, but it is also strongly associated with chronic kidney disease (CKD). The causes of this association may be inflammation, vitamin D deficiency and anemia. However, as the patient with CKD presents these events independent of age, worrying about the fragility in CKD patients should be a standard practice for patient care.</p>

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<p><b>OBJECTIVE:</b> Evaluation of the population aged 60 years and older in the city of Arapongas - Paran&aacute; state - according to the sociodemographic and health variables.<br> <b>METHOD:</b> A descriptive and exploratory, quantitative, using a semi-structured questionnaire and Katz Index.<br> <b>RESULTS:</b> 9,295 elderlies participants of the study were in the range of 60 to 79 years old, where the females were more often than the males. About the marital status, most of them are married, with schooling less than three years, living with a family composition of two people. Although all of them are retired, a significant portion assumes an alternative source of income. In the health profile, the study subjects did not use tobacco or alcohol, they are independent, do not practice regular physical activity and noticed their health as good or regular. Indicators of morbidity: most subjects reported no falls, and when they occurred, did not cause fractures. The conditions established, the chronic degenerative diseases were the most reported. Regarding the profile of hospitalization causes diseases of the circulatory system were the most frequent, followed by diseases from the digestive system and external causes.<br> <b>CONCLUSION:</b> The subjects' profile is similar to the findings in the literature, but the discrepancies found suggest a possible need of an improvement in the accessibility of elderly to health services.</p>

<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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