INTRODUCTION: Vaccination coverage against influenza has been monitored to evaluate the access, the adherence to the vaccine and the disease burden after the annual vaccination of the elderly in Brazil, State of Rio de Janeiro and its capital city.
OBJECTIVE: To analyze the trend in vaccination coverage with influenza vaccine, separated for State of Rio de Janeiro, its capital and Brazil over a period of 12 years.
METHODS: Rates were calculated through secondary data from Datasus. Vaccination coverages for influenza vaccine for Rio de Janeiro, State of Rio de Janeiro and Brazil were performed in the period of 1999-2010. Trends were analyzed through polynomial regression.
RESULTS: Analysis of trends in influenza vaccination coverages showed a decrease in the three levels analyzed. It was observed that the capital city constantly maintains coverages at lower levels than the state, as the same behavior of the national vaccination coverage.
CONCLUSION: The results showed a decrease in the country, State of Rio de Janeiro and especially in the state capital in the period analyzed. Many factors may be associated with this fall, highlighting the quality of the registration of doses, the imprecision of estimates of population data provided by the IBGE for groups with more than 60 years old and increasing population heterogeneity.
Keywords: Vaccination, influenza, time series analysis, epidemiology of communicable diseases, immunization coverage.
OBJECTIVE: To identify whether religiousness/spirituality are predictors of quality of life in elderly individuals.
METHODS: A cross-sectional, descriptive and analytical study in a sample of 158 elderly socially active, participating in social groups in different religious communities in Porto Alegre city.
RESULTS: Mean age was 70.6 years with a variation range between 60 and 92 years. There was a predominance of females and married marital status. Regarding the education of the studied group. There was a prevalence of higher education and, about the socioeconomic status, the majority had incomes between 1 to 4 minimum wages. When asked about the religious services assiduity, 63% attend more than once a week. The result of the religiosity/spirituality impact analysis, on the different quality of life domains, showed that this can be positively associated with most of their domains.
CONCLUSION: Religiosity and spirituality variables are predictors of quality of life in this elderly sample.
Keywords: Elderly, religion, spirituality, quality of life.
INTRODUCTION: Chronic diseases and mental disorders are common causes of hospitalization in the elderly. These clinical conditions make these patients require drug therapy on large scale. The use of drugs can cause adverse health effects in the elderly, with oral or systemic repercussions.
OBJECTIVES: To identify the presence of signs and symptoms of salivary gland hypofunction in elderly patients admitted to Santa Maria University Hospital, and relate this to the medicines prescribed during hospitalization.
METHODS: This was a descriptive cross-sectional study, in which an oral examination and a consultation to the patient's chart was performed. The data related to signs and symptoms of xerostomia and the medical record data were registered in the patient's own card.
RESULTS: It was observed that 59% of the elderly complained of dry mouth during most of the day and that 11 of the 20 most prescribed drugs have side effects like xerostomia and/or other characteristic manifestations of salivary gland hypofunction.
CONCLUSIONS: The results of the study indicate that the signs and symptoms of salivary gland hypofunction seen in hospitalized elderly people may be associated with the consumption of drugs that predispose this condition. Therefore, the multidisciplinary approach, with the inclusion of the dentist in the hospital is required to monitor the oral conditions of patients, in order to reduce and control the effects of this dysfunction in oral health.
Keywords: Elderly, hospital, drugs, xerostomia.
OBJECTIVES: To describe the degree of dependence of elderly according to the Patient Classification System (PCS) proposed by Fugulin et al. in order to analyse the difference at the time of admission and discharge.
METHODS: A descriptive, exploratory, quantitative cross-sectional search.
RESULTS: All together 105 records were evaluated, 54 men and 51 women, with the mean age of 83 years. Relating the results of elderly dependence of admission and exit 61 maintained dependence (58%), 8 progressed to lower dependence (7.6%) and 36 to greater dependence (34.2%). Those who maintained the degree of dependence between entry and output, 50 were discharged (81%) and 11 died (18%). Those who improved 100% (8) were discharged. But among the worsened 20 (55.5%) were discharged and 16 died (41.4%).
CONCLUSIONS: The results corroborate with other studies that also relate to greater dependency of elderlies when there is a need of hospitalization. In order to this reality to be controlled, it is needed an extra care in elderly hospitalization admission, preventing that in a moment of weakness, they could lose their independence, autonomy and quality of life.
Keywords: Hospitalization, health of older persons, dependency-independency area
OBJECTIVES: Investigating the socio-demographic profile and the main factors that affect the quality of life of elderly individuals enrolled in a family health unit in Ipatinga city (MG).
METHODS: A descriptive and quantitative study, whose sample consisted of 181 patients aged over 60 years. We applied a form containing questions about socio-demographic variables, and subsequently conducted a multidimensional assessment quickly through the table adopted by the Ministry of Health.
RESULTS: The general characteristics of the 181 subjects interviewed were as follows: 51.9% were women, 33.7% were between 60-65 years old, 63.5% were married, 56.4% Catholic, 65.2% retired, 60.2% had only primary as study, 93.9% with income between 1-5 monthly salaries, 42% live with their spouses. Among the changes in health, the most prevalent disease was hypertension and as the geriatric change the most recurrent was the urinary incontinence the most recurrent urinary incontinence (21.5%).
CONCLUSION: This study supplied indicators for disease prevention action planning and for elderly healthy promotion.
Keywords: Acidental falls, aged, frequency.
OBJECTIVE: This study assesses the prevalence of hyperparathyroidism secondary to vitamin D deficiency and its association with functional decline in elderly patients above 65 years old, hospitalized at a geriatric ward at Hospital do Servidor Público Estadual.
METHODS: The elderly people were evaluated through a questionnaire as an interview, prepared highlighting the most common factors leading to the hypovitaminosis D. It was analyzed using appropriate scales of functional losses in basic and instrumental activities of daily living and a possible correlation with the laboratory diagnosis of hypovitaminosis D and secondary hyperparathyroidism.
RESULTS: The elderlies were evaluated at the end of summer and autumn (March,April and May), 62 patients were admitted in the geriatric ward, which 60 patients were considered valid. It was observed a positive association of hyperparathyroidism secondary to deficiencies of vitamin D in 46.77% of the cases, with a mean age of 84.75 years. No positive correlation was demonstrated between the degree of functional loss with the increase of parathyroid hormone or vitamin D deficiency.
CONCLUSION: The data shows a significant prevalence of hyperparathyroidism secondary to vitamin D deficiency in hospitalized patients and the importance of further investigations and the introduction of diagnostic and treatment strategies appropriate for the under-diagnosed population, however it was not possible to associate functional loss and hyperparathyroidism in the sample studied.
Keywords: Elderly, secondary hyperparathyroidism, vitamin D deficiency, loss of function.
Parkinson's disease (PD) is a slowly progressive disease, characterized by four basic components: bradykinesia, resting tremor, rigidity and postural instability.
OBJECTIVE: To correlate the functionality and severity of PD patients enrolled in a public service of the Federal District and the School of Physiotherapy Clinic of the University Center Unieuro.
METHODS: We recruited 27 patients with PD and residents of the Federal District, the gathering information was through the Hoehn and Yahr (HY) scale of degrees of disability and functional tests: Functional Reach (AF), Timed Up and Go (TUG), timed sit and stand (SL), gait speed (VM) and wall-occiput distance (OP).
RESULTS: Whereas the Pearson correlation test, and significant correlations were statistically significant between the HY scale and test OP (R = 0.47, p = 0.013), TUG (R = 0.63, p = 0.0001) and AF (R = - 0.66, p = 0.0001). It is a low rate of linear relationship between the variables and the results that were a little significant correlation between the scale of HY and the test SL (R = 0.25, p = 0.20) and VM (R = - 0.26, p = 0.17).
CONCLUSION: There is an association between severity and functionality in PD, since when the severity of the patient clinical condition occurs there is also a loss of functionality, mobility and postural stability.
Keywords: Parkinson disease, disability and healthy, mobility limitation
OBJECTIVES: The objective of this research was to associate complaint of dizziness, fear of falling and occurrence of falls in elderly people.
METHODS: We evaluated 38 elderlies by applying an interview and a scale to measure fear of falling (FES-I-Brazil).
RESULTS: Of the 38 elderly interviewed, 68,4% reported complaint of dizziness, 97,4% showed fear of falling and 57,9% had suffered a fall after 60 years old. The mean age of the elderlies who fell was significantly higher than of those who didn't (p = 0.015). The elderly people who reported dizziness utilize significantly higher number of medicines than those who did not report dizziness (p = 0.030). The score on the FES-I-Brazil was statistically significant when associated with the number of falls (p = 0.003).
CONCLUSIONS: The study showed high prevalence of dizziness, fear of falling and occurrence of falls among elderly people evaluated and significant correlation between increasing age and the occurrence of falls, the dizziness complaints and the number of medications used and the FES-I-Brazil score and the number of falls.
Keywords: Dizziness, accidental falls, aging.
OBJECTIVE: Evaluation of the frequency and characteristics of falls in older adults, in order to identify the context and possible prevention.
METHODS: A questionnaire about the frequency of falls in 201 elderly outpatients of cardiology, internal medicine, endocrinology and geriatrics from Hospital Servidor Público Estadual of São Paulo was applied. The questions were about number of falls, context, consequences and habits changes after the event.
RESULTS: The patients who reported fall were 83.9% with a higher number of those aged between 60 and 79 years (61.6%), predominantly women (76.5%). Those with 80 years or more, the percentage of events were 37.1% and 51.7% in men. Street is the most frequent place (40%).
CONCLUSION: Data revealed the importance of implementing screening tools for fall risk as well as the development of educational and prevention activities.
Keywords: Acidental falls, aged, frequency.
The evaluation of health interventions in frail elderly people was always a challenge due to the nature of its multiple and complex problems. Once it has been adequate with the use of questionnaires to evaluate quality of life, a review of the literature on this topic is needed. Thus, a review was conducted using key words such as "frail elderly" and "questionnaire" and "quality of life" and adding "Brazil" in the second search, with the final result the inclusion of 63 articles. The combination of a generic questionnaire for assessing quality of life for a specific disease or condition to be evaluated is the tactic used by the authors to access this dimension of knowledge. Although there are no specific questionnaires for the frail elderly, the questionnaires that have been tested have shown to be valid, and the development of a specific tool for this population is strongly recommended by the authors studied.
Keywords: Frail elderly, questionnaire, quality of life, Brazil.
INTRODUCTION: Depression is a health problem that is frequent among elderly people. Most of the time it is difficult to identify in clinical practice. It results in the loss of autonomy, aggravation of a preexistent pathological state and it is also associated with a bigger risk of morbid-mortality, suicide and negligence in self-care. The diagnosis and the treatment are still deficient.
OBJECTIVES: To identify the selected range used, to know epidemiological data in Brazil and risk factors related to elderly people's depression. Method: Explanatory study using bibliography research from books, documents and articles that are related to the theme from the basis MEDLINE, SCIELO, LILACS published from 2006 to 2011.
RESULTS: Depressive syndromes are psychiatric disturbance more prevalent among elderly people with 5% of depression and significant depressive symptoms up to 15%. The prevalence of hospitalized or institutionalized elderly people reaches 22%. The prevalence in literature varies between 6.4 to 59.3% in the community. Among the main risk factors are: female sex, widowhood, low schooling, chronic physical diseases and stressful events of life. The main methods of selection identified for diagnosis have been: the level of geriatric depression, center of epidemiological studies and DSM-IV-TR.
DISCUSSION AND CONCLUSION: Depression in elderly people is a problem of public health that can't be seen as a manifestation of physiological aging. The use of routine instruments of selection helps the diagnosis in many cases that may be unnoticeable and may influence in these patients quality of life.
Keywords: Aged, depression, geriatric psychiatry, psychiatric status rating scales, risk factors.
A síndrome de Sjögren é uma doença inflamatória sistêmica de natureza autoimune caracterizada pela infiltração linfocitária progressiva de vários órgãos exócrinos e não exócrinos. Acomete preferencialmente as glândulas salivares e lacrimais, determinando prejuízo estrutural e disfunção secretória. A referida síndrome afeta principalmente mulheres, na proporção de 9:1. Ocorre em todas as idades, especialmente entre a quarta e a quinta décadas de vida, afetando cerca de 3% da população geriátrica.
A proposta deste trabalho é apresentar o caso clínico de uma paciente de 72 anos que permaneceu com quadro compatível com a síndrome durante aproximadamente 10 anos. As queixas em diversas consultas não foram valorizadas, permanecendo assim até que em consulta geriátrica de rotina foi aventada a hipótese de síndrome de Sjögren.
Procuramos enfatizar a importância clínica e a necessidade da realização do diagnóstico precoce para proporcionar melhora na qualidade de vida dos pacientes acometidos.
Keywords: Idoso, vacinação, vacinas contra influenza.