RCAAP Repository

<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>

<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>