INTRODUCTION AND OBJECTIVE: This study evaluates the prevalence of health problems in the elderly, an index of successful aging and considers its relationship with sociodemographic factors and functional capacity, in a random sample representative of the residents in Ouro Preto.
METHODS: Association between functional capacity and sociodemographic and clinical variables was assessed by multiple logistic regression.
RESULTS: The mean age was 67 years old; 59% were of low socioeconomic level and 50% with low education level. There was high prevalence of urinary incontinence, falls, depression, disability and problems with vision, hearing, immunization and cancer screening. Association was observed between functional dependence and female, age, cognitive impairment and vision problems. The probability of presenting successful aging profile was lower among women, for 75-79 years old and low education level.
CONCLUSION: Althoung being young-elderly, they have presented a higher prevalence of health problems. The expectancy of a longer life in women is not associated with a life expectancy free of disability. Successful aging could be a privilege of higher social classes.
Keywords: Geriatric assessment, functional capacity, disease's impact profile, epidemiological surveys, elderly health.
OBJECTIVES: The present study aimed (1) to assess the functional capacity, (2) to identify factors associated with dependency in the achievement of instrumental activities of daily living (IADL) and (3) to describe the sociodemographic and health profiles of the elderlies.
METHODS: A cross-sectional study was carried with elderly people who live at Joinville (SC). A questionnaire was applied in order to obtain sociodemographic data, health condition and functional capacity evaluated by Lawton's scale. Statistical analysis was performed using the Chi Square test at significance level of 0.05.
RESULTS: The sample was composed of 935 elderly people: 57.3% females, 57.9% aged between 60 and 69 years old, 26.2% illiterate, 57.4% living in stable union, 84.3% without exerting remunerated activity and 98.1% with some self-referred health problem. It was noted that 73.2% of them lack any health plan. And 49.2% presented some degree of dependency to accomplish the IADL. The factors associated with the dependency were illiteracy, not being married, age, hypertension, diabetes, heart disease, cancer, respiratory disease, memory problems, urinary incontinence, fecal incontinence, falls and quality of life.
CONCLUSION: These results suggest that the studied group is characterized by a population of elderly people, users of the health system, with multiple comorbidities, nearly half presented some reduction of functional capacity. So the health system needs to be aware of the reality of these elderly people, in order to identify the potential risk situations for dependency and adequately plan a comprehensive care.
Keywords: Health of the elderly, aging, activities of daily living.
OBJECTIVES: Evaluation of the association between social status and access to the cancer treatment of elderly patients with cancer.
METHODS: This study evaluated some sociodemographic characteristics (age, sex, HDI, the distance between hometown and Campinas) of elderly patients with cancer who were assisted in three units of Unicamp Hospital Complex (Campinas, SP), in order to profile this class of disease in the region, and to evaluate, indirectly, the quality of the assistance offered to them. The sociodemographic data were compared with the period between the first appointment at Unicamp and the beginning of the treatment. The elderly's registers were analyzed, both sexes, with a diagnosis of cancer, assisted at Gastrocentro, Hemocentro, or Unicamp Clinical Hospital, between January 2000 and July 2010. The data came from the Service of Statistics of the Cancer linked to the São Paulo Oncocentro Foundation.
RESULTS: Of all the 5,891 evaluated registers, 66.3% were men; 48.8% had between 60 and 69 years old; 67.1% came from cities situated lesser than 51 km from Campinas; 65.3% came from cities with HDI between 0.707 and 0.740. HDI (p = 0,003) and distance between hometown and Campinas (p = 0,019) had shown an association with the period between the first appointment and the beginning of the treatment.
CONCLUSION: This study showed the relevance of social factors in the access to the cancer treatment in elderly people.
Keywords: Aged, neoplasms, therapeutics, clinical evolution, social class.
INTRODUCTION: Malnutrition affects the patient's clinical conditions, and increases the risk of complications in elderly people, this is also responsible for the increase in the hospital stay length and mortality rate in this age group.
OBJECTIVE: To study the association between nutritional risk and clinical outcomes in elderly patients hospitalized at a medicine unit at a private hospital in Rio de Janeiro.
MATERIALS AND METHODS: A prospective study with 116 elderly patients. In the first 72 hours after hospital admission the Nutritional Risk Screening (NRS-2002) was applied, and anthropometric data such as weight and height and clinical diagnosis was collected; at the end of hospitalization, clinical outcomes (death, infection and length of stay) were also collected. Data was analyzed by SPSS and significance was considered less than 5%.
RESULTS: It was found that 39.6% of the patients were at nutritional risks in admission time. Patients at nutritional risk were older, had a body mass index (BMI) lower (p <0.05) and with a chance of death three times higher. Patients who were hospitalized longer periods (>13 days) have had a chance of developing infection or of dying three times higher.
CONCLUSION: Patients at nutritional risks had a higher risk of complications such as longer hospitalization, infection and death.
Keywords: Elderly, nutritional risk, clinical outcomes.
OBJECTIVES: Checking the profile of elderly patients with AIDS through some variable such as gender, race, education level and age, reported in southern Brazil and in Chapecó in the period from 1980 to 2009, who acquired AIDS through sexual transmission.
METHODS: This was an observational, descriptive and cross study, whose data were obtained by consulting the Datasus, and then arranged in sheets through the operational program Excel, and a cross was made with this data.
RESULTS: During the period between 1980 and 2009 there was an increase in AIDS diagnoses in elderly people in the studied region, and that those who had a higher prevalence of infection were men, heterosexuals, whites, aged between 60 and 69 years old and education level between 1 and 3 years (low education). This same behavior was repeated in Chapecó however, there were only elderly people contaminated by AIDS in 1995 and in the period between 2005 and 2009, the education level with the highest prevalence was 4-7 years followed by 8 to 11 years, although in this period there was a higher prevalence of elderly people between aged 70 and 79 years old.
CONCLUSIONS: The sexual transmission of human immunodeficiency virus (HIV), in elderly population in southern Brazil and Chapecó, had an increase in the number of diagnoses during the studied period, especially in the males, heterosexual, white, between 60 and 69 years old and low education level.
Keywords: Elderly, acquired immunodeficiency syndrome, infectious disease transmission.
INTRODUCTION: HIV infection is a global phenomenon, extremely prevalent worldwide and it is currently considered a pandemic. Since the prevalence of this infection in elderly population has increased, it may be assumed an increase of sexual activity in this population, so it is essential the knowledge about it in this population.
OBJECTIVES: To determine the degree of knowledge about HIV/AIDS in a group of elderly people in Criciúma, Santa Catarina, Brazil, in the first semester of 2013, which included basic concepts, transmission and prevention.
METHODOLOGY: The study was a cross-sectional observational, descriptive, predominantly with a quantitative approach, using as a study area a health center at Criciúma/SC neighborhood, where the elderly people's meetings took place. The sample was composed by elderly individuals who attended the elderlies' meeting during the days that the questionnaires were applied and that fulfilled the inclusion criteria.
RESULTS: The study population was composed predominantly by women, constituting 90.4%. The education level most common was 1-3 years of education (43.2%). Regarding the transmission, 33% of the population believed that transmission occurred through a mosquito bite. Nearly half of the interviewees, 47.7% thought that the person with the AIDS virus always shows symptoms of the disease. Only 12% of sexually active interviewees answered affirmatively wearing condoms during sexual intercourse.
CONCLUSION: Although the population has already been in touch with informations about this disease, it is notable the not knowing of basic aspects important to the prevention, demonstrating the need for a corrective action in this way.
Keywords: HIV, elderly, prevention.
INTRODUCTION: Pulmonary tuberculosis (TB) is a global health problem, especially when associated with HIV infection. TB is prevalent in older adults whose late diagnosis occurs because of poor clinical manifestation. In Brazil, approximately 6,000 deaths from TB are reported annually. Coinfection with Mycobacterium tuberculosis and HIV increases by 10% the annual risk of tuberculosis.
METHODS: we collected data from Datasus (Department of the Brazilian Unified Health System) and Sinan (Information System for Notifiable Diseases) covering a period from 2004 to 2010 in order to compare the death rate from tuberculosis in individuals with and without HIV.
RESULTS: There was an increase in the mortality rate from TB in older adults without HIV compared to adults from 20 to 59 years old. Comparing the mortality rate from TB in older adults with and without HIV we found that the mortality rate is higher in those without HIV. In the period from 2004 to 2010 there was an increase in the mortality rate from TB in older adults comparing to younger adults.
CONCLUSION: The increase in the mortality rate from TB in older adults may warrant the need for preventive health policies for patients over 60 years old.
Keywords: Pulmonary tuberculosis, acquired immunodeficiency syndrome, aged, mortality rate.
OBJECTIVE: Investigation of effects of supervised resistance training program on functional fitness in elderly type 2 diabetic patients.
MATERIAL AND METHODS: The study included 51 patients from both genders, aged between 60 and 80 years old, diagnosed with type 2 diabetes. Measurement of body mass index (IMC), waist circumference (PC) and hip circumference (PQ) was evaluated according to previous guidance. Moreover, with measures to PC and PQ waist-hip ratio (WHR) could be calculated. Functional fitness was assessed by some tests to achieve motor evaluation of these elderly people, the tests were five: sit and reach test with the Wells' bank, strength endurance of the arms, agility and dynamic balance, sitting-rising, single-foot balance, and ergospirometry on treadmil.
RESULTS: The exercise training did not induce changes in anthropometric parameters, but improved performance in the sitting-rising test and agility and dynamic balance test. Considering other physical abilities tested (flexibility, balance and aerobic capacity) the sixteen weeks of training were not able to induce significant changes in the diabetic elderly people.
CONCLUSION: The ondulatory resistance training has a positive effect to functional fitness in elderly type 2 diabetic patients, with a higher pronounced effect in the lower limbs.
Keywords: Elderly, diabetic, resistance training, functional fitness.
OBJECTIVES: To evaluate cognitive and motor skills of elderly with Parkinson disease who had been submitted to video game training, including six different activities.
METHOD: Longitudinal study involving nine subjects with Parkinson disease of both genres. After having their detailed clinical anamneses taken, they were submitted to seven training sessions using the following games on the console Nintendo Wii - Wii Fit Plus: Soccer, Ski Slalom, Table Tilt Plus, Snowball Fight, Balance Bubble Plus and Big Top Juggling. To compare the performance of the participating individuals during the first and last sessions, the Wilcoxon test was chosen as the statistical analysis tool.
RESULTS: Results showed improvement in the cognitive and motor skills. Most games showed statistically significant differences between the first and last sessions: Soccer (Z = -2.207; p = 0.027), Snowball Fight (Z = -2.692; p = 0.007), Table Tilt Plus (Z = -2.428; p = 0.015), Balance Bubble Plus (Z = -2.547; p = 0.011) e Big Top Juggling (Z = -2.549; p = 0.011).
CONCLUSION: The training using video game proved to be relevant for improving cognitive and motor skills of the subjects. Once conventional games exercises can have limited results in improving those skills, it is desirable to test video games stimulating double task activities to better offer a new type of treatment.
Keywords: Elderly, virtual reality exposure therapy, video game, Parkinson disease.
OBJECTIVE: To analyze the perception of violence by elderly residents of Juazeiro (BA) and how they react to the situation.
METHODS: This qualitative study, with the participation of 10 elderly people between 64 and 84 years old, with evidence of violence and attending a Family Health Unit. The bioecological theory of human development of Bronfenbrenner (1998) was the theoretical framework used and allowed the study of the elderly within the family microsystem and its integration within this ecological environment. The data was collected through semi-structured interviews with open questions. The analysis was performed after the transcription of the interviews.
RESULTS: The results indicate the following forms of violence: psychological (90%), neglect (100%), financial (50%), physical (30%) and abandon (30%). The violence was perceived in the actions and circumstances experienced daily, such as confusion, drink, fight, disagreement, brutality, physical aggression and disobedience. The reaction of elderly people facing situations of violence seemed as nonexistent, timid, fearful and fragile. Some seniors responded by pathological manifestation. The support of family, friends and religion were the coping strategies used.
CONCLUSION: The violence is perceived by the elderly resident of Juazeiro, but they have presented no reaction to the situation. There is a need to articulate a support network to form partnerships to combat violence.
Keywords: Domestic violence, elderly and coping.
OBJECTIVE: The assessment of the feet in geriatric patient is of great importance, since it can detect problems that could cause some disabilities in this age group. In this article, we'll focus on diagnostic and therapeutic aspects.
METHODS: Retrospective study done through a critical systematic review of the literature.
RESULT: The metatarsals are the most common site of pain, predominantly in females. Among the most frequent causes: plantar fasciitis, hallux valgus, claw toes, hammer or mallet, cavus foot, flat feet, heel spur syndrome, tendinitis, onychomycosis, osteoarthritis, rheumatoid arthritis, and acute gouty crisis, diabetes, and so on. During the diagnosis, we must do a proper anamnesis and look for some specific points in the physical examination, such as: vascular, neurological, biomechanical and dermatological evaluation; and complementary exams. Indexes could be used to assess the disability associated with foot pain in elderly people. The treatment consists in changing some habits, with physical therapy, and specific approaches according to the cause of foot pain.
CONCLUSION: From this study was possible to conclude that this disease is often preventable and, when it is combined investigation and treatment, enabling the improvement of patient's quality of life.
Keywords: Foot, elderly.
The use of probiotcs, prebiotcs and synbiotics are called functional foods. The use of them stimulate the proliferation of beneficial bacteria, rather than the proliferation of harmful bacteria, the strengthen of the natural defense mechanisms of the host maintaining the balance, they can directly stimulate immunity, protection against pathogens and prevention of infection by Clostridium resulted of the using of antibiotics. It is common for patients to proceed with gastrointestinal tract disorders are able to increase the lenght of hospital stay causing other complications, such as respiratory infections and pressure ulcers. The aim of study was to identify aspects concerning the use of synbiotics, prebiotcs and probiotcs in adults and/or elderly people and to describe the advantages and disadvantages of their use. A literature review was performed by nurses of a semi-intensive of a large hospital in the city of São Paulo between the years 2011 and 2012. The following question was used as a guideline: Is it possible to benefit hospitalized patients with the use of prebiotics, probiotics and synbiotics, thus preventing the complications of the gastrointestinal tract? It was concluded that many complications of inpatients were resulted from changes in the GI tract, such as anorexia, eletrolyte imbalance, dehydration, susceptibility to the formation of pressure ulcers, dermatitis, and so on. Continued use of these products could prevent these situations, thereby reducing the length of stay, hospital costs and time spent by nursing staff in preventable situations. It is not clear the disadvantages of using these products.
Keywords: Dietary supplements; gastrointestinal tract, length of stay, constipation/control and prevention, functional food, hospital costs, elderly.
The increasing elderly population provides significant challenges to maintaining quality of life and health status. One of these challenges includes the dimension of the physical space and accessibility for the elderly in nursing care. The aim of this paper is to discuss through a narrative review of the literature, the implications of the physical environment and the design of spatial accessibility for the prevention of falls in older adults. A search was performed in the databases: Lilacs, Medline and Bireme. We identified 159 publications, selecting in the end 18 publications that met the inclusion criteria. Falls in the elderly are often related to the physical environment and spatial accessibility. Nurses should pay attention to this aspect, taking into account the notion of spatial accessibility in their home visits, becoming an agent capable of intervening in the environment to prevent falls in the elderly.
Keywords: Spatial accessibility, elderly, geriatric nursing, physical environment, nursing care.
OBJECTIVE: To report the case of a patient who suffered bullying in a long-term care facilities.
METHOD: The needed data was obtained by a medical chart review, interview with the patient, and literature review.
RESULTS: The reported case and the data reviewed bring to focus violence suffered by elderly people, especially, about the bullying that is a form of violence too little researched in elderly people. There is a need of further researches about the topic, focusing on prevention and early detection.
Keywords: Bullying, aged, violence.