OBJECTIVE: To evaluate the use of 10-g monofilament in the diagnosis of diabetic neuropathy (NPD) in elderly comparing it to two validated screening instrument scores.
METHODS: A descriptive cross-sectional study with a convenience sample in which 50 patients diagnosed with NPD by the instruments score of neuropathic symptoms (ESN), score neuropathic commitments (ECN), and protective sensation plant using the 10-g Semmes-Weinstein monofilament (orange) were evaluated.
RESULTS: 50 olders were diagnosed with NPD by ESN and ECN instruments and the presence or absence of the 10-g monofilament was compared. There was no statistically significant correlation using the Kruskal-Wallis test including. In many patients the monofilament were preserved.
CONCLUSION: The isolated 10-g monofilament was not able to indicate the diagnosis of diabetic neuropathy. It is possible that elderly diabetics with neuropathy have the feeling plant preserved.
Keywords: aged; diabetic neuropathies; diagnosis.
OBJECTIVES: Evaluate cognitive impairment and associated factors in institutionalized elders.
METHOD: Transversal studying, analytical, with sample composed by 213 elders. In order to evaluate data it was measured the confidence recess to the scoring average in each domain and it was performed hypothesis tests to verify the association between dependents variable, cognitive impairment, according to the Mini Exam of Mental Illness and independents variable (socio-demographic and health conditions).
RESULTS: Dominance of female genre (69.5%); age group from 70 to 79 years old (35.7%); singles (53.5%); school educated (74.6%), although 28.6% haven't concluded elementary education, retired workers (75.8%), with personal income up to one minimum wage (73.2%), and residents in ILPI from one to three years (31.6%). In relation to health conditions approximately 77% of elders had illness with medical diagnostic, 28.6% using from 3 to 4 medicines and 73.7% were independents. Cognitive impairment was identified in 67% of evaluated sample. In univariate evaluation was verified substantial statistically association between variables: genre, number of child, school educated, education level, length of stay in ILPI and functional capacity. At logistic binary model the most precision presented variable was years of education and the most influential was genre due to show the highest estimated coefficient.
CONCLUSION: The percentage of cognitive impairment at studied institutions is alarming, notably the education level associated with cognitive impairment, mainly in female genre.
Keywords: elder; cognitive; long-stay institutions for elderly.
OBJECTIVE: To describe the structural implementation of a pharmaceutical services model to homes for the aged.
METHODS: The study delineates the structural implementation of a pharmaceutical service model in a home for the aged in the city of Aracaju, Sergipe, Brazil, which was conducted from January 2010 to December 2012. A researcher-pharmacist and an auditor-pharmacist, based on the adaptation of the Anvisa Resolution and recommendations on the international literature, evaluated structure quality indicators. In the end of the study, a comparison was conducted between the indicators before and after implementation.
RESULTS: According to the instrument of such organ, after pharmaceutical interventions, there were modifications in seven of the 13 quality indicators in the homes for the aged. The second instrument showed changes in two of the ten quality indicators in such places. However, in the third, there was a modification in six of 11 quality indicators after pharmaceutical interventions. Although the assessments were focused on the structural characteristics of the medication system, some of the modified indicators were associated with activities that characterize "processes" such as storage and inventory control. The main intervention was the implementation of a medication dispensary in homes for the aged, which allowed the proper storage of drugs and allowed the disclosure of information sources.
CONCLUSION: The implementation of pharmaceutical services in homes for the aged enabled the alteration of structural characteristics from the medication system in the institution.
Keywords: homes for the aged; pharmaceutical care; quality indicators, health care.
OBJECTIVE: To identify the prevalence of benzodiazepine use in the elderly of Pelotas, Brazil, and associated factors.
METHODS: A cross-sectional study was undertaken with a representative population from a Family Primary Health Unit and an Outpatient Service.
RESULTS: The sample was comprised by 389 elder people within 60 and 96 years. The prevalence was of 10.3%. Multivariate Analysis identified the female gender (RR = 2.75; CI95% 1.33 - 5.68), related depression (RR = 2.10; CI95% 1.07 - 4.14) and anti-depressive use (RR = 1.91; CI95% 1.01 - 3.61) as the independent factors associated with benzodiazepine's use in this population.
CONCLUSION: The study showed a low prevalence of Benzodiazepine's use within elderly, in the inferior limit of values seen in studies in Brazil and other countries.
Keywords: aged; drug utilization; benzodiazepines; epidemiology.
OBJECTIVE: The presence of peripheral arterial disease (PAD) increases the risk and vulnerability to adverse clinical outcomes in the elderly. Therefore, we investigated the relationship between functional performance and indicators of PAD in elderly women.
METHODS: Cross-sectional study in which 54 elderly were assessed by means of the Mini Mental State Examination (MMSE), Short Physical Performance Battery (SPPB), Ankle-Brachial Index (ABI), Human Activity Profile (HAP) and Edinburgh questionnaire. Statistical analysis was performed using ANOVA, Student's t test and Pearson correlation. We considered p < 0.05 as the significance level.
RESULTS: The mean age, SPPB and ABI were 69.2 (± 6.9) years, 9.42 (± 2.55) and 1.04 (± 0.14), respectively. The prevalence of PAD was of 16.3%. There was a significant correlation between ABI and gait speed (r = 0.75, p = 0.001) and between PAH and SPPB (p = 0.001).
CONCLUSIONS: It is suggested that the decline in functional performance in the elderly, expressed in the gait velocity component of SPPB, is related to the presence of PAD.
Keywords: peripheral arterial disease; elderly; lower extremity.
OBJECTIVE: Conduct a systematic review about the body exposure to vibration training and the effects on bone tissue of postmenopausal women.
METHODS: The search for the material was made through research at the database: CAPES, LILACS, MEDLINE, PubMed and SciELO, in all languages, from 2000 to 2015. The descriptors used in combination were: whole body vibration, osteoporosis and vibrating platform. All the searches had their methodological quality assessed by the PEDro scale and only articles with a score above 70% were reviewed. The analysis consisted of 532 articles, but only 11 were eligible.
RESULTS: The analyzed studies show divergent results of vibration effects on bone of postmenopausal women. However, it is observed that the most positive results are osteogenic resulting from exposure to low and medium frequencies, with rest periods between sets and training days.
CONCLUSION: There is no scientific evidence to support the benefit of body vibration in increasing bone mass in post-menopausal women.
Keywords: vibration; osteoporosis; bone density; physical therapy modalities.
This text deals with citizenship rights, conquered in Brazil in the 1980s, and registered in the current Federal Constitution, promulgated in 1988. Focusing on the elderly, it emphasizes the social rights of this segment, governed by the principles of equality, equity and social justice, whose guarantee requires specific legislation and government commitment to the effectual provision of public policies under effective control of society.
Keywords: aged; social rights; public policies.
O problema da incapacidade e da deficiência em idosos tem relevância no âmbito da saúde pública, embora a situação da assistência a essas pessoas no Brasil ainda apresente um perfil de fragilidade, desarticulação e descontinuidade de ações na esfera pública e privada. O estudo, de abordagem qualitativa e de caráter descritivo, teve como objetivo principal: investigar a acessibilidade de idosos com deficiência física aos serviços de saúde na Atenção Primária no município de Florianópolis (SC), na perspectiva destes usuários, dos profissionais de saúde e dos gestores. Foram realizadas 18 entrevistas com os idosos com deficiência(as) física(s) por meio de roteiro semiestruturado, além da aplicação de questionários a 17 gestores da Secretaria Municipal de Saúde de Florianópolis e 3 profissionais de saúde atuantes nos centros de saúde ao qual os idosos estavam vinculados. Para análise dos dados, utilizou-se a hermenêutica dialética, a qual permitiu a apreensão de elementos constitutivos de dois grandes eixos temáticos: 1) Perspectivas da deficiência física no envelhecimento: vulnerabilidades em saúde; 2) Atenção à saúde do idoso com deficiência física: a busca de novos paradigmas. Conclui-se que, no âmbito da atenção à saúde do idoso, há uma fragilidade na formação acadêmica e escassez de capacitações para as equipes de Estratégia de Saúde da Família. Ressalta-se a deficiente rede de suporte em saúde para os idosos e a vigência do modelo biomédico na Atenção Primária. As fragilidades encontradas no atendimento dos idosos com deficiência física na Atenção Primária contrariam os princípios do Sistema Único de Saúde (SUS). Os cuidados aos idosos implicam em ofertar serviços que propiciem o acesso e o acolhimento de maneira ordenada e adequada, respeitando suas limitações. Nesse processo, a Atenção Primária à saúde deve configurar a porta de entrada desses idosos ao sistema de saúde, no qual será prestada uma assistência de qualidade e de resolutividade.
Keywords: envelhecimento, idoso, atenção primária à saúde, pessoas com deficiência.