INTRODUCTION: Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.
OBJECTIVE: To analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's Disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.
METHOD: Survey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.
RESULTS: Healthy older people showed greater capacity for abstraction than those with AD. There was significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3 (p = 0.090), with the biggest sentence. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.
CONCLUSION: Elderly people with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD. As lesser sentence, the better the capacity for abstraction.
Keywords: Executive functions, language, abstraction, Alzheimer's disease, occupational therapy.
OBJECTIVE: The objective of this study was to identify the physiological response of multiple trauma elderly with chronic constipation to the use of a symbiotic compost.
METHODS: It was characterized as a non-controlled experimental study, which included 12 elderly patients, with multiple trauma and chronic constipation as a secondary disease and that were hospitalized in a public trauma referral hospital in Pará, Brasil.
RESULTS: At the initial evaluation there was an average of 5.5 days of time off defecation. At the end of the intervention with the symbiotic held for eight days, 100% of patients had experienced episodes of defecation, especially for the type 4 stool (shaped, smooth and soft faeces - ideal type), according to the Bristol Stool Scale, present in 75% o the sample. The average of days to the first bowel movement after the use of symbiotic was 2.58 ± 1.72.
CONCLUSION: The use of symbiotic was shown to cause a positive physiological response in the multiple trauma elderly, through the improvement of the constipation.
Keywords: Constipation, aged, multiple trauma, probiotics.
OBJECTIVE: To determine the prevalence of malnutrition in elderly inpatients in a public hospital of the Northeastern region (São Luís/MA) and its association to depression.
METHODS: In 2009, a prospective cross-sectional study evaluated elderly patients admitted through the application of a questionnaire containing variables for socioeconomic aspects, gender, race and marital status. Nutritional status was established by the Mini Nutritional Assessment (MNA) applied with less than 72 hours after admission. The Geriatric Depression Scale (GDS) was used to assess symptoms suggestive of depression. Statistical analysis was performed using SPSS (Statistical Package for Social Sciences). Differences were considered significant when p < 0.05.
RESULTS: 92 elderly inpatients have been evaluated, 53.3% were men, 43.5% were mulatto, 52.2% were married, 88.0% retired, 55.4% were illiterate and 85.9% reported personal income of one minimum salary. The total score of the average MNA was 17.6 ± 5.8 points. The prevalence of risk of malnutrition and malnutrition was respectively of: 37.8% and 43.3%. The average GDS score was 6.9 ± 3.0 points. The prevalence of depression was of 56.3%. There was a significant association between malnutrition and female sex, widowhood and depression.
CONCLUSION: The prevalence of malnutrition and depression were high with a significant association in elderly inpatients in the Northeastern region (São Luís/MA).
Keywords: Elderly, malnutrition, depression, hospital.
INTRODUCTION: Functional capacity is an important component of quality of life and health marker that reflects the overall condition of the elderly. Together with functional capacity assessment, nutritional and anthropometric evaluations are also used to estimate health in this population. Observed association between these parameters.
OBJECTIVE: To study the relationship among anthropometric and nutritional data and functional capacity in the senior population of a long permanence institution (LPI) located in Botucatu - SP, Brazil, analyzed the relationship between anthropometric data and the functional capacity in elderly.
MATERIALS AND METHODS: Design: Cross-sectional. We evaluated 54 individuals, and measured anthropometric data with calculation of body mass index (BMI). We evaluated the functional capacity by the Basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). We analyzed the association between dependence and anthropometric variables obtained.
RESULTS: Of the institutionalized individuals assessed (19 males and 35 females with mean age of 76.1 ± 9.9 years), 46.3% showed BMI < 22 kg/m2. Dependence for ADL was directly associated with low weight (BMI < 22 kg/m2) in 33.3% of the cases (p < 0.05).
CONCLUSION: Most LPI elderly residents showed low weight associated with reduced functional capacity for ADL.
Keywords: Elderly, anthropometry, activities of daily life.
OBJECTIVE: This research aims at identifying the physician's considerations regarding the terminal patient and evaluating his attitude towards the end of life.
METHOD: The method chosen was the qualitative-descriptive type, with methodological frame based upon Collective Subject Discourse. Twenty physicians were interviewed, who were responsible for the terminal patients' treatment at the regional hospital, Pouso Alegre city, in Brazil. Data was reached through a semi-structured questionnaire, with two questions that were recorded and transcribed in full.
RESULTS: The discussion of the considerations about terminal patient and the observation of the development of the physician-terminal patient relationship, allows the results to reinforce that the conflict between the professional personality and the medical reality orientates the physician-terminal patient relationship, inducing the physician to judge his embarrassing presence, and even useless, near the patient's bedstead. However, the bioethical principles about the end of life do not limit themselves only to the patient's right of knowing the truth, but also establish the right to the dialogue with his physician and reinforce the necessity of a relationship based on reciprocity.
CONCLUSION: Most of the physicians interviewed believe to be their mission to cure. However, according to Hippocrates, the physician's obligation is to treat when that's possible and always take care. This care is defended on the bioethical principles as the physician's presence near the patient, respecting his desire to speak, to be heard, to get answers, at a time when every event, word, thought, purpose, decision and action assume a new meaning.
Keywords: Physician-patient relations, terminally ill, bioethic.
In this text we describe a case report of a 60 years old patient with a 12 hour anterograde memory disturbance and a complete resolution of this symptom after. The presenting symptom, a complete and spontaneous recovery and the exclusion of other neurologic conditions were consistent with the diagnosis of transient global amnesia (TGA). Transient global amnesia generally causes profound upset in the patients and their families although it is considered a benign condition. The physiopathology is yet to be elucidaded and the incidence is higher in the elderly. Memory complaints are very much discussed in this age group although the TGA is not much debated in geriatrics.
Keywords: Memory disorder, transient global amnesia, aged. íntrodução
The occurrence and the development of progressive, symptomatic manifestations of dementia of Alzheimer's type (AD) are questions that researchers in different disciplinary and clinical fields must be concerned. This paper discusses the specifities of how the patients should be treated, both in the diagnostic phase and the treatment itself. The objective of this study was to identify ways of obtaining the cooperation of people with Alzheimer's disease during the odontological treatment; also the involvement of family/caretaker to achieve better results in clinical intervention. During 24 months between February 2004 and February 2006, 51 patients with AD - age group between 60 and 90 years old were examined/followed in the outpatient clinic (Hospital do Servidor Público Municipal de São Paulo) or at home. They were inserted in three distinct odontological treatment plans, according to the early, moderate or late stages of the disease, based on Alzheimer's disease guide from Associação Brasileira de Alzheimer (ABRAz). The results were: Treatment plan I - 39 patients all of them treated in the outpatient clinic with the optional presence of a family member/caretaker and no sedation; Treatment plan II - 8 patients all of them treated in the outpatient clinic with the presence of a family member in all appointments and no need for sedation; Treatment Plan III - 4 patients were assisted at their homes. In two of these cases, there were needs for sedation. The results showed that the effective participation of the caretaker; as well as the commitment to the relationship work with the patient, constitute an essential requirement for therapeutic success in all stages of the disease.
Keywords: Alzheimer's disease, geriatric dentistry, dental care for the chronically ill.
It has been happening an important change in the world population with increasing number of older people, life expectancy and prevalence of chronic diseases mainly the cardiovascular disorders. To manage this condition is important to have efficient methods of diagnosis and cardiovascular prevention. Aging promotes physiologic changes which influence the normal parameters of the tests. It may also alter the associated enfermities and the wishes of the patients for less invasive procedures. To update the bibliography about treadmill test in the elderly, the research was carried out with the keywords: "exercise test", "treadmill stress test X elderly" and "aged" on the Medline, SciELO and Lilacs. Authors which have evaluated older patients during the test showed the efficacy and security of this method as well as its indication. The examination should be applied to clinical evaluation and mainly evaluation of the functional capacity, with important prognostic value.
Keywords: Treadmill test, elderly, exercise, aging.
This article presents initial reflections of the author in his doctoral research on aging and sexuality, and weighs about a "new" old conceived in light of the transformations of modern society, conceptualizing it and bring out some expressions of this phenomenon. Discusses miscellaneous provisions that characterize today being old and the discovery of new social roles.
Keywords: Old age, modern, arrangements, sexuality.