INTRODUCTION: The Healthcare Program for Alzheimer's Disease Carriers established in 2002 that anticholinesterasic drugs should be provided on a free basis in Brazil.
OBJECTIVES: To evaluate the estimates for the program coverage based on data regarding the delivery of anticholinesterasics in several regions and states of Brazil.
METHODOLOGY: It was estimated the number of elderly individuals with dementia per state based on Brazilian epidemiological studies (7.1%). It was predicted that 60% of these individuals had probable or possible Alzheimer's disease (AD), and the delivery of anticholinesterasics (IChEs) to 50% of this population was established as the major goal by the Brazilian program. Brazilian Health System as well as the Superintendence of Pharmaceutical Aid of Minas Gerais State Secretary of Health and IBGE provided data on outpatient care.
RESULTS: The prevalence of dementia symptoms was of 1,332,034 cases. Of these, 799,220 patients had AD. In 2008, the Ministry of Health provided IChEs to 47,886 patients at a yearly cost of R$ 99.747.356,53. The program coverage reached only 12% of the patients who were eligible for receiving IChEs. This rate varied from 1.2% in Amazon state to 22.3% in São Paulo state. The most prescribed anticholinesterasic drug was Rivastigmine (71.4%).
CONCLUSION: The program coverage was found to be low and extremely variable in 2008, possibly because of both poor diagnosis of AD and regional differences in the access to the program.
Keywords: Anticholinesterasics, Alzheimer's disease, dementia
OBJECTIVE: The aim of this study is to evaluate if people who assist UNITAI is representative in general population related to the sociodemographic characteristics and functional capacity.
METHOD: This is a transversal study with a sample of 115 elderly women. The functional performance was measured through the instruments Mini-Mental State Examination (MMSE); the Brazilian Older American Resources and Services Multidimensional Functional Assessment questionnaire (BOMFAQ) and International Physical Activity questionnaire (IPAQ). Descriptive analysis, chi-square, and Fischer's exact test were used, and the significance level that was adopted was p < 0,05.
RESULTS: The sample consisted of elderly women; 67.16 ± 5.5 years; with good cognitive level (27.92 ± 2.3 in MMSE) and with good educational status (74.7% with > 9 years of study); 63.5% without a conjugal relationship, 64.3% with an income > 4 minimum wages; 51.4% reported only one chronic disease. The features that were more associated with moderate/severe dependency were: age over 75 years lower education, being unmarried, having lower income, report two or more chronic diseases. Related to the level of physical activity was considered active elderly women in general, however the prevalence of elderly women with insufficientactive level in leisure time was 49.6%.
CONCLUSION: The elderly women who participate in the Open University seems to be a special population, were healthy and active, with a good socio-economic status (higher income and better-educated) were health (fewer comorbidities) and able to perform daily activities without any difficulty. This profile is similar to the elderly from other universities for elderlies, while in many aspects it reflects the reality of the elderly population in the city of Maceió, Alagoas State.
Keywords: elderly, functionality, cognition, daily activities, educational status.
INTRODUCTION: With increasing aging population grows the number of elderly people with chronic diseases which generally are in slow development and long term which often influence the functional capacity and mental of the elderly, causing them taking multiple medications per day. So, this work aimed to study the index of complexity of the dependent elderly pharmacotherapy self-care.
METHODOLOGY: transversal study, developed in Dourados (MS), with elderly registered in the Family Health Strategy (FHS). Questionnaire administered for the sociodemographic data, the Functional Independence Measure (FIM) for evaluation of dependence to the self-care and the Index of Complexity of Pharmacotherapy (ICP).
RESULTS: were interviewed 302 aged from 29 FHS and identified 38 (12,6%) aged with some dependence degree. The locomotion was the most compromised dimension. The average use of medicines per day by the dependent aged was 4,1 being the maximum 10 different medicines by day. The Index of Complexity of Pharmacotherapy (ICP) among the 302 aged was obtained an average of 8.5. Analyzing the 38 aged with any dependence degree observed that the average of ICP rose to 10.3.
CONCLUSION: It was concluded that the dependent aged to the self-care have a pharmacologic scheme more complex and this evidence the nurse role as the attendance of these aged patients, as well as the orientation and the teamwork with other professionals of the team to the health education.
Keywords: Health of the elderly, pharmaceutical services, nursing care, primary health care, aged.
INTRODUCTION: 15% residents of urban areas are over 60. A part of them rely on caregivers who often need special attention themselves.
PRIMARY OBJECTIVES: To assess the profile, level of stress and needs of professional and non-professional elderly patients caregivers of 2 primary care health units of São Paulo, Brazil.
SECONDARY OBJECTIVES: To assess their morbidity, their interest in capacitation courses and discussion groups, as well as the level of disability of the patients under their care.
METHODS: 8 professional and 18 non-professional caregivers of 2 primary care units in São Paulo, Brazil, underwent an interview where 4 questionnaires where applied: Profile of participant, Inventory of Symptoms & Stress, The Brazilian Version of the Burden Interview and Functional Evaluation Scale of the Elderly Patient.
RESULTS: 85,3% of patients where women between the ages of 36-55; 40,7% of the non-professional caregivers where over the age of 60; 100% of them referred suffering from some form of disease. 88% of the professional caregivers showed interest in capacitation courses and 88,9% in belonging to support groups. Stress: Professional caregivers where mostly under light burden, non-professional caregivers where subjected to light/moderate burden. Inventory of Symptoms & Stress: 44,4%, 14,8% and 40,8% of nonprofessional caregivers where in the alert, resiliency and exhaustion phases, respectively. Functional Evaluation Scale of the Elderly Patient: 77,8% and 75-100% of the professional and non-professional caregivers patients were classified as highly dependent.
CONCLUSIONS: The care of elderly patients is stressful and debilitating for caregivers, especially for nonprofessional ones. Most of the caregivers showed interest in capacitation courses and support groups.
RECOMMENDATION: It is recommended that a better attention be paid to elderly patients caregivers.
Keywords: Elder/ill caretaker. Stress, health profile.
OBJECTIVE: To characterize the profile of elderly patients in the elderly health attention program in municipal health units and health care center for the elderly in Belém, Pará, Brazil.
METHOD: Descriptive, cross-sectional and retrospective study. The sample consisted of 1.433 copies of The Health Book of the Elderly Person, of elderly who were consulted in the municipal health between January and December 2010. Statistical analysis was performed with BioEstat software version 5.2.
RESULTS: There was a prevalence of elderly people aged 60 to 69 years (53.3%), female (70.4%), low education (43.8%) and married (41.8%). Most seniors reported not to smoke (94.5%), not to consume alcohol (90.9%), to have family support/caregiver (84.7%) and to be independent in daily care (90.2%). Futhermore, 85.8% of the elderly had no fall-related events and 91.8% reported not having a history of hospitalization in the last six months. There was a higher prevalence of cardiovascular diseases (58.6%) and endocrine, nutritional and metabolic diseases (24.2%). The most important diseases were hypertension (53.1%) and diabetes mellitus (17.2%).
CONCLUSION: According to the results obtained, this study allowed to profile healthy elderly in Belém, indicating the need to implement preventive and healing actions in health, in order to promote an active aging in this population.
Keywords: Health profile. Health of the elderly. Aging. Epidemiology. Health program. Public health.
OBJECTIVE: The objective of this study was to investigate the accuracy of a glomerular filtration rate (GFR) estimation equation based upon serum cystatin C (Hojs) and the abbreviated Modification of Diet in Renal Disease (MDRD) study and the Cockcroft-Gault (CG) corrected for body surface area (CG-BSA) estimation equations for detecting moderate chronic kidney disease against 51Cr-EDTA clearance (taken as the gold standard) in southern elderly Brazilians.
METHOD: An Observational prospective study in which GFR estimates via CG without BSA correction were performed in 160 community patients 60 aged or more. The ones with estimated GFR < 60/ml/min underwent GFR determination using 51Cr-EDTA clearance. The GFR obtained with this method was compared with GFR estimates obtained via CG-BSA, MDRD and Hojs.
RESULTS: 69,1% of the patients were female. Forty of the 160 studied elderly studied had an estimated GFR < 60/ml/min and underwent GFR determination using 51Cr-EDTA. Of the forty patients with an estimated GFR < 60 ml/min, only 18 presented GFR values < 60 ml/min/1.73 m2 using 51Cr-EDTA clearance. The accuracy within 30% was 78% for MDRD, 75% for CG-BSA and 45% for Hojs, with a trend towards superiority of the first two equations over the last one.
CONCLUSIONS: Either CG-BSA or MDRD can be used for GFR estimation in southern elderly Brazilians until larger studies about the subject are available. The common practice of using CG without BSA correction for chronic kidney disease screening led to overdiagnosis of the condition in our study.
Keywords: Aged, chronic kidney disease (CKD), cystatin C, 51Cr-EDTA, Glomerular filtration rate (GFR)
INTRODUCTION: The use of questionnaires for the evaluation of auditory prosthesis output is very important in the clinical practice of speech-language pathology because it supplies the professional with important data that aids in patient follow-up. In Brazil and the rest of world there are many proposed models.
OBJECTIVE: The objective of this paper is to study the International Questionnaire for the Evaluation of Individual Sound Amplification Devices to verify if its application by the researcher interferes in the quality of the patient's answer.
METHODS: The results of the questionnaire were evaluated in 400 elderly, literate patients, who used auditory prostheses; this was applied at two moments - first the patient answered the questions by himself (self-application) and secondly the researcher reapplied the questionnaire asking the questions himself.
RESULTS: The results revealed that there was no significant difference statistically among the answers given by the patients during self-evaluation or during the application by the professional.
CONCLUSION: The instrument has similar results when applied by the patient or by the speech therapist.
Keywords: Speech, language and hearing sciences, deafness, aged, hearing aids, satisfaction.
The foundations elaborated and systematized in this review deal with the effects of fitness on the immune system of elderly front of immunosenescence, since currently the aging and health issues have received special attention due to the exponential increase of the elderly population in the world. This work aims to conduct a systematic literature review on the main effects of physical conditioning on the expression of cytokines and cells of the immune system of elderly people. In order to contextualize this analysis, we performed a literature search in MEDLINE, SciELO, BIREME, and LILACS. We selected studies that included the keywords in the title: immunosenescence, aging, older aldults or elderly, exercise, physical therapy or exercise therapy and its equivalent in Portuguese. The contribution of this study is to investigate whether a simple and low cost, physical activity, can be effective also in the immune system, whereas already well elucidated the benefits of regular exercise in other body systems as well as in younger populations. In general, prolonged physical activity and customized for the elderly has been identified as an important predictor of human longevity therefore affects all body systems and especially in the immune system, aiding in the regulation of immune responses by enhancing the activity of NK cells, balancing the balance of pro-inflammatory and anti-inflammatory cytokines (de acordo), orchestrating a better response to antigens, and, under a global point of view, helping to reverse or minimize the deleterious effects of aging on the immune system.
Keywords: Aging, physical fitness, immune system, immune system.
The objective of this study was to review, survey and analyze the construction of RUG's (Resource Utilization Groups) in use in various countries. It was found that since its creation in the U.S., several countries have tested this system of classification in the context of institutional care for the elderly. The system has proven to be valid and reliable with good results, explaining the variance of resources used especially for the institutions providing long-term health care and social support.
It was concluded that this classification system has considerable potential for its implementation in Portugal and in many Portuguese-speaking countries.
This system will help to understand the characteristics and true needs of its users by providing evidence-based information for the heads of institutions and policy makers alike. It will also further justify the allocation of resources as well as improve the strategic planning of institutions and quality of care.
Keywords: Aging, physical fitness, immune system, immune system.