OBJECTIVE: To evaluate the nutritional status and quality of life of elderly nursing home residents in Florianópolis, State of Santa Catarina, and to investigate their diseases.
METHODS: A cross-sectional study was performed in three institutions. Nutritional status was evaluated using the Mini Nutritional Assessment questionnaire and quality of life using WHOQOL-OLD. Diseases were identified from medical records. Individuals presenting incapacitating mental disease, uncommunicativeness or inability to walk or remain standing for anthropometric evaluations were excluded. The data were analyzed descriptively and the Kolmogorov-Smirnov test, One-way ANOVA and the chi-square or Fisher test were applied, using the Statistical Package for the Social Sciences software, version 12.0.
RESULTS: Twenty-eight elderly people (33%) aged 63 to 93 years (77±9 years) took part; 93% were women. Normal nutritional status predominated (85,7%), without statistically significant difference between age groups (p=0,558) or sexes (p=0,174). The "Autonomy" facet of quality of life presented the worst score, without significant difference between age groups (p=0,170). The "Death and dying" facet had the best score, with a significant difference between age groups (p=0,008). 50% of the sample presented three to four different diseases, and chronic-degenerative diseases prevailed, particularly systemic arterial hypertension (70%) and heart disease (39%). There was no significant difference between disease presence and age groups (p=0,166).
CONCLUSIONS: It was observed that women and multiple diseases predominated and that 14.3% of the sample presented nutritional deficits. A low quality-of-life score was only seen in the facet "autonomy". The need for further studies on institutionalized elderly people, using these assessment instruments to better characterize this group, is highlighted.
Keywords: Aged people, mini nutritional assessment, quality of life, WHOQOL-OLD, diseases.
INTRODUCTION: The main caregiver is the one in charge of tasks, among others, of helping the dependent elderly person with his daily activities and is, in general, a member of his family nucleus. The role of the caregiver falls into his hands, without him being prepared for that.
OBJECTIVE: Verify the caregivers preparation regarding the basic care of the elderly inpatients prone to hospital discharge.
METHODS: The study was carried out at the Geriatric Ward of Hospital do Servidor Público Estadual Francisco Morato de Oliveira in September and October 2007. It is a descriptive transversal study, with quantitative approach. Identification questionnaires were applied to the caregivers and elderly patients and a semi-structured questionnaire to the caregivers.
RESULTS: The study sample was composed of 17 caregivers, being 94% female and 76% daughters. In relation to the preparation to carry out the elderly persons' Daily Living Basic Activities, 65% of the caregivers stated that they feel prepared. It was observed that 59% of the caregivers didn't have doubts before the admission and all the research's participants mentioned they didn't need to receive further orientations.
CONCLUSION: It was observed that, in agreement with previous studies, the majority of the caregiver was female and daughters, who did not report doubts with regard to the basic cares before the admission and also affirmed they were prepared for providing care of hospital discharge. This can be a pointer of positive impact of the work of orientation exerted by the interdisciplinary team throughout hospitalization, being objectified one better care of the elderly person in the domicile.
Keywords: Caregivers, preparation for the care, aged.
OBJECTIVE: To asses information level and preventive attitudes toward Aids, as well as the risk perception regarding the disease among elderly people attending the Health Family Program.
METHOD: Descriptive cross-sectional study. The sample was composed by 60 individuals, aged 60 years or older attending, and assisted by the Family Health Public Program (PSF) through September 2005 and residents in Ibura, Recife, PE. For data collection a semi-structured questionnaire was applied using the interview technique, with 14 questions, being 5 open questions and 9 closed ones.
RESULTS: Most investigated seniors reported some knowledege on Aids and how to protect themselves against the disease; however 100% of the interviewed reported not using any preventive strategy; 83% of the interviewed reported to be aware that an aged person can be contaminated with Aids and 80% of elderly knowed that and apparently healthy individual might be contaminated with the HIV virus. Regarding risk perception, 60% of respondents believed that they were not at risk to be infected by HIV virus and 48% head already been tested for HIV virus.
CONCLUSION: The results from this study highligth the need for educational policies towards Aids prevention among elderly people.
Keywords: Knowledge, Aids, elderly, prevention.
OBJECTIVE: Analyze the interference of the chronic pain in the functional capacity of community-dwelling elderly
METHODS: Cross sectional study with 111 noninstitutionalized elders, resident in the area of local Unit of Health in the city of Londrina, PR. The functional capacity was analyzed through the observation of the basic activities of daily living (ADL) and instrumental activities of daily living (IADL). Chronic pain was identified through the continuous or recurring reference of pain in a most minimum period of 6 months.
RESULTS: We were studied 111 elders with median age of 70 years and predominance of women (65,8%). The elderly people referred that the pain presented interference mainly in the sleep, humor and leisure activities. The activities of daily life that presented significant association with the presence of the pain were walking around the house, transferring from bed to chair, transportation, shopping, cooking, house working and managing money.
CONCLUSIONS: The chronic pain present negative interference in the functional capacity of elderly, mainly in the instrumental activities of daily living, so can restrict the autonomy or become the elderly disability.
Keywords: Aged, pain, health of the elderly
Considering the difficulty that some people have in the intake of adequated quantities of food that fit their nutritional needs, the supplement prescription has been done in order to correct nutritional deficiency manifestation and to assure adequate food intake by a person with insufficient diet on macro and micronutrients. This study has been based on literature researches about the nutritional supplement embracing the period from 1987 to 2006, intending to identify its use on several clinical events. It was evidenced that nutritional supplement use increases according to age, being greater for women and for people with low Body Mass Index (BMI). Among the groups, elderly trends to greater food deficiency, and their health gets 2 or 3 time worse than the other groups. But about the hospitalized elderly it was verified that 40% of them are considered under nutrition and the clinical state recovery is influenced by the long hospitalization period, and mainly of these patients show weight reduction. In this sense, the nutritional supplement has been a satisfactory alternative that influences the nutritional treatment indication. The studies about the hospitalized elderly nutritional supplement consider taste, touch, appearance and variety as essential factors, as well as they show differences of application according to the different clinical events (chronic, pointed and cathabolic), seeking for the guarantee of use, acceptance and the product efficiency on each analyzed study.
Keywords: Elderly, hospitalization, nutritional supplement, nutritional deficiency.
Frailty in the elderly is associated with several negative health outcomes in this population. However, lack of consensus among experts with regard to its etiology, definition, and operational features makes difficult the pro-gress in research area and its clinical implications. Moreover, one of the most frequently feature associated with frailty is physical inactivity. In despite of this, influence of physical exercise on frailty development and evolution is unknown. The purpose of this review study is to discuss 1) the main points of debate regarding etiology and definition of frailty, the criteria of classification for frail elders, as well as 2) the role played by physical exercise in this debate. By several kinds of search and selection, articles in French, Spanish, Portuguese, and English were selected. In general, they were published between 2002 and January 2008. Based on currently scientific evidence, frailty advances (provided by genetical, physiological and nutritional areas, as well as by researches on functional limitations/disability and co-morbidities) and obstacles for research and clinical areas are exposed and discussed. The influence of physical exercise in preventing or delaying frailty, as well as in stopping or reversing its negative effects, was not confirmed, specially because research absence in this field.
Keywords: Frailty, frail elders, physical exercise, physiologic decline, public health.
Influenza has a great impact on elderly morbidity and mortality rates. Vaccination is the most effective measure to prevent these diseases complications. It is effective preventing hospital admission for influenza and pneumonia and all-cause mortality. Moreover, it is associated with reductions in the risk of hospitalization for cardiovascular disease. Although ageing has consequences that diminish vaccine effectiveness, the great benefits of vaccination occur in this population. Even though, there are some groups with characteristics associated with lower rates of vaccination. The leading reasons given worldwide for not vaccinating are: fear of adverse effects, lack of credibility in the vaccine and beliefs that it is unnecessary. However, the vaccine causes few adverse effects. Nevertheless non vaccinated elderly say they would have been vaccinated if a doctor had proposed this to them, the vaccine isn't part of medical routine. The whole health team should be more active to elucidate the real benefits of vaccination. Then, more elderly people would beneficiate from this and achieve a better quality of life.
Keywords: Influenza vaccines, adverse effects, aged, quality of life.
The increase in life expectancy has lead to the proportional increase in the number of elderly people who need surgical treatment. The perioperatory assessment aims to identify and quantify the possible risk factors in order to prevent postoperative adverse events. The perioperatory care is particularly important in the old individuals as they are more vulnerable to postoperatory clinical complications as a result of comorbidities and poor functional status. A good clinical history, physical examination and some complementary tests can accurately predict which elderly patients are most likely to have postoperatory adverse outcomes. Although many tools to assess surgery risks are proposed, this review highlights those that are applied in the Perioperatory Assessment Program of the Division of Geriatrics, Hospital das Clínicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP).
Keywords: aged, preoperative evaluation, preoperative tests.