OBJECTIVE: To evaluate nutritional status, health conditions, and their impact on the functional capacity of aging adults in a community center in Campo Grande, state of Mato Grosso do Sul.
METHODS: This is a cross-sectional, population-based study with 47 participants of both sexes, aged 60-96 years. Functional capacity was defined by the basic and instrumental activities of daily living, operationalized by the Katz index and the Lawton and Brody scale. A sociodemographic questionnaire and two 24-hour reminders were used to evaluate food consumption; hand grip strength and nutritional status were also evaluated. A structural equation model was used to analyze the relationship and associations between variables.
RESULTS: The sample showed good functional capacity for the basic activities of daily living, but there was a high frequency of losses in instrumental activities, especially for tasks such as managing finances, cooking, cleaning and performing small domestic repairs. Low functional capacity is in agreement with the low hand grip strength found. Most participants were classified as eutrophic (51.06%). When applying the structural equation model, a standardized coefficient of 0.45 was obtained; indicating a mean and significant effect (p = 0.02) of body mass index on dependence for basic activities, with direct effect.
CONCLUSION: Overweight negatively influences the functional capacity of older adults to perform basic activities of daily living.
OBJECTIVE: To evaluate risk factors for mortality in geriatric patients admitted to an intensive care unit (ICU).
METHODS: We studied older patients admitted to the ICU in a historical cohort study. Convenience sampling was performed for all patients aged 60 years or older, admitted to the 20 beds of an ICU of a highly complex hospital. Cox regression analysis was performed to estimate risk factors associated with mortality. The significance level used was 5%.
RESULTS: The proportion of geriatric patients represented 45% of ICU admissions in the period. In-hospital mortality was 38.4%. The postoperative emergency surgery variable and the Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) admission scores were identified as independent risk factors for in-hospital mortality.
CONCLUSION: Risk factors associated with mortality were APACHE II and SOFA scores for admission and postoperative emergency surgery.
Keywords: aged; health services for the aged; intensive care units.
OBJECTIVE: To correlate the main clinical characteristics of geriatric patients hospitalized for femur fracture with delirium incidence and mortality during hospitalization.
METHODS: Cross-sectional study in patients over 65 years old admitted to an orthopedics unit with femoral fracture. The authors interviewed patients and / or caregivers to investigate their clinical characteristics, and subsequently correlate their profiles to the rates of delirium and mortality. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS), Student’s t-test and χ2 test. Significance was established at p < 0.05.
RESULTS: Participants included 90 patients with a mean age of 83 years (65–99), 77.8% women. The mean length of stay was 19.7 days, with delirium identified in 39.9% of patients, and a mortality rate of 17.8%. Delirium was significantly associated with advanced age (p = 0.046), use of psychotropic drugs — especially quetiapine — , higher mortality rate, diabetes mellitus, dementia syndrome, and low functionality. Mortality, in turn, was associated with chronic kidney disease, lower functionality, and dementia syndrome.
CONCLUSION: We found that delirium was associated with advanced age, lower functionality, diabetes mellitus, dementia syndrome, higher death outcomes, and the use of psychotropic drugs; and mortality was associated to dementia syndrome, chronic kidney disease, and worse functionality.
Keywords: geriatrics; femoral fractures; delirium; mortality.
OBJECTIVE: To compare the applicability of the 2006 Brazilian Ministry of Health food guide questionnaire Como ter uma alimentação saudável (QGAS — How to have a healthy diet) and the 2013 National Health Survey healthy eating questionnaire (QA-PNS) for determining quality of life among the oldest-old (85 years and older).
METHODS: This descriptive, quantitative, cross-sectional and analytical study included 44 oldest-old participants from a multi-professional care project (AMPAL) in Porto Alegre, Rio Grande do Sul, Brazil, who were evaluated at home. Eating habits were assessed using two questionnaires applied by nutritionists and other health professionals. The QA-PNS score was adapted to the QGAS score to facilitate comparison.
RESULTS: Applying the QA-PNS was easier for non-nutritionists and was significantly related to the QGAS, with a correlation coefficient (r2) of 0.67. The women’s diet quality was better according to the QGAS (10 out of 18 items evaluated), but the men’s was better according to the QA-PNS (8 out of 15 items evaluated).
CONCLUSION: There was good correlation between the QA-PNS and QGAS questionnaires for evaluating diet quality in the oldest-old.
Keywords: longevity; surveys and questionnaires; healthy diet; aged, 80 and over.
INTRODUCTION: This study aimed to report the results of a Palliative Care Units first year of operation in a general hospital of medium-complexity care.
METHOD: Data on demographic and clinical characteristics, functional status, and number of in-hospital deaths were collected regarding patients admitted to the unit during its first year of operation. Descriptive statistics were used to analyze the data.
RESULTS: In total, 129 patients were treated (140 admissions and 11 readmissions). Their mean age was 80 years, and 57% were female. Patients died in 67% of unit admissions, while in 32% they were discharged. The mean length of hospital stay was 11.1 days, and the mean length of Palliative Care Unit stay was 5.5 days. Most patients had neurological J2 conditions, such as sequelae of cerebrovascular diseases and dementia syndromes, and low functional scores. Of all in-hospital deaths recorded in the period, 59% occurred in the Palliative Care Unit, with a higher proportion in older ages.
CONCLUSION: The unit met an existing demand related to increased prevalence of chronic diseases and population aging, requiring palliative care services. Expanding access to palliative care is needed for patients admitted to hospitals.
Keywords: palliative care; hospital; hospital units; humanization of assistance.
This article is part of a special series that was designed to assist authors in the process of scientific writing and communication. Among the various forms of ethical misconduct in scientific publishing, plagiarism is increasingly common. Plagiarism is defined as the presentation of a work containing parts authored by another person without due credit. One type of plagiarism that has gained prominence in recent years is self-plagiarism, in which authors themselves reuse their previous work without proper referencing. However, active discussion remains in the scientific community about this type of plagiarism, with the term being extended to some specific forms of misconduct in scientific publication. This practice leads to inauthentic work and ultimately undermines the integrity of science. The purpose of this article is to address in depth the definition of self-plagiarism, the underlying motives for this practice and its consequences for the scientific community. To do so, a non-systematic review of the literature was conducted. Guidance is provided on the major types of self-plagiarism, what can be done to avoid it and how to proceed when it is detected.
Keywords: plagiarism; ethics, research; scientific misconduct.
Common among the older population, falls are considered a public health issue, accounting for high rates of morbidity and mortality. Thus, there is a need for theoretical studies that improve the understanding of the relationship between falls and their risk factors; the pathophysiology of balance and gait disorders; and early identification of “idiopathic fall” (with no apparent cause). Based on the specialized literature, the present study provides an overview of the role of sensory systems responsible for regulating postural control, showing the main strategies that older adults use to maintain postural control and the benefits of regular physical exercise for prevention of falls in older adults. Then, a graphic model describing the sequence of strategies used by older adults to regain an upright stance in different phases of postural perturbation is presented. In conclusion, poor performance of attention, memory, and executive functions increases postural instability and reduces gait speed, thereby raising the risk of falls. In this context, regular physical exercise may significantly reduce the rate of falls in older adults. Planned exercises are recommended and should involve cognitive tasks with moderate-to-high level of instability for two to three hours/week.
Keywords: accidental falls; postural balance; cognition; aging.
The estimated average survival of people with Down syndrome (DS) is currently over 50 years of age. This demographic finding warrants attention of health professionals who will care for an increasing number of adults with DS. Clinical evaluation of adults with DS should correlate characteristics inherent to the age group, especially the peculiarities produced by the syndrome. The present article proposes the development of preventive and vaccination programs — according to gender and age — and screening of diseases and conditions associated with the syndrome: 1) endocrine diseases; 2) cardiac diseases; 3) mental health; 4) dental care; 5) sensory organs; 6) osteoarticular abnormalities; 7) skin and appendages; 8) gastrointestinal diseases; and 9) cancer. However, there is scant information on the impact of comorbidities on life expectancy and quality of life or on the social and hospital costs of adults with DS.
Keywords: Down syndrome; adults; health care.
Diabetes mellitus (DM) and its complications constitute the leading causes of early mortality in most countries. Population aging and the growing prevalence of obesity and sedentary lifestyles, in addition to spreading urbanization, are considered the main drivers of the increasing incidence and prevalence of DM worldwide. This case report describes the acute onset of movement disorder in an older woman secondary to hyperosmolar hyperglycemic state (HHS). The combination of hemichorea–hemiballismus, HHS, and evidence of basal ganglia involvement on neuroimaging is considered a unique syndrome. Movement disorders secondary to HHS respond satisfactorily to administration of neuroleptic agents and proper glycemic control. The lack of published studies on this pathologic entity may lead to clinical and laboratory underdiagnosis, with negative impacts on patient prognosis and follow-up.
Keywords: aged; hyperglycemic hyperosmolar nonketotic coma; dyskinesias; diabetes mellitus.