INTRODUCTION: 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.
OBJECTIVE: Compare the frequency of frailty using cutoff points of Fried et al. (2001) and others adjusted for this sample.
METHODS: 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 et al. (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 α = 0.05.
RESULTS: 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).
CONCLUSION: 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.
Keywords: Frail elderly, phenotype, diagnose criteria.
INTRODUCTION: 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.
OBJECTIVE: To determine the prevalence of the immobility syndrome in Hospital do Servidor Público Estadual geriatric ward.
MATERIALS AND METHODS: 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.
RESULTS: 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%).
CONCLUSION: 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.
Keywords: Prevalence, aged, terminal care, dementia.
OBJECTIVE: Verify the effects of the practice of an aquatic exercise program resisted in the resistivity carotid, life quality and functional autonomy of elderly.
METHOD: 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.
RESULTS: 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.
CONCLUSION: 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.
Keywords: Arterial resistance, life quality, elderly, aquatic exercise.
OBJECTIVE: To assess the effect of water aerobics exercise on the functional autonomy of the elderly.
METHODS: 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).
RESULTS: The level of functional autonomy was higher in G1 than in G2 (p < 0.05).
CONCLUSION: 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.
Keywords: Elderly, functional autonomy, water aerobics.
INTRODUCTION: 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).
OBJECTIVES: 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.
METHODS: Data were collected using an interview protocol during the period of October to December 2010, in those USFs.
RESULTS: 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.
CONCLUSION: 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.
Keywords: Aged, primary health care, hypertension, health services accessibility, health of the elderly.
INTRODUCTION: 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.
OBJECTIVE: To evaluate clinical and laboratory characteristics of patients with EORA.
PATIENTS AND METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
Keywords: Rheumatoid arthritis, arthritis, aged.
INTRODUCTION: 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.
OBJECTIVE: To review the major cellular and molecular changes in immunosenescence.
METHODS: Literature review between 1996-2011 employing the PubMed and SciELO databases.
RESULTS: With advancing age, the cells of the innate and adaptive immune system exhibit worsening of generalized function and a reduced number of naïve 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.
CONCLUSION: 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.
Keywords: Aging, immunosenescence.
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.
Keywords: Posture, aged, health of the elderly.
INTRODUCTION: 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.
OBJECTIVE: This review examined the currently available evidence supporting the use of acupuncture to treat low back pain.
METHODS: The following databases were searched: PubMed and Lilacs with keywords: "low back pain" and "acupuncture".
RESULTS: 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.
CONCLUSION: 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.
Keywords: Low back pain, acupuncture.