Enfermedades cronicas y limitacion funcional en adultos mayores: estudio comparitivo en siete ciudades de America Latina y el Caribe / Chronic diseases and functional limitation in older adults: a comparative study in seven cities of Latin America and the Caribbean

OBJECTIVE. To identify the relationship between selected chronic diseases and the presence of disability in inhabitants 60 years old or older in seven cities of Latin America and the Caribbean. METHODS. In 2000 and 2001 a descriptive cross-sectional study was conducted with a sample of 10 891 persons 60 or older in seven cities: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and Sao Paulo, Brazil. This research was part of the Salud, Bienstar y Envejecimiento (Health , Well-Being, and Aging) project (known as the "SABE project"). The dependent variables in the study were difficulty in performing basic activities of daily living, and difficulty in performing instrumental activities of daily living. Compiled from self-reports, the independent variables were : age, sex, educational level, living alone or with other person (s), self-assesed health, and the presence or not of hypertension, diabetes mellitus, cancer, chronic obstructive pilmonary disease, ischemic heart disease, cerebrovascular diseases, and osteoarthritis. The presence of depression and cognitive impairment in the participants was evaluated, and body mass index was also calculated. To compare the degree of influence of the different variables on disability, a standardized coefficient for each association was calculated. RESULTS. In the seven cities studied, the variables that showed a direct association with difficulty in carrying out basic activities of daily living and instrumental activities of daily living were: suffering from a higher number of noncommunicable diseases, from cerebrovascular diseases, from osteoarthritis, or from depression; being older; being female; rating one's own health as bad, and the presence of cerebrovascular diseases, osteoarthritis, or cognitive impairment. CONCLUSIONS. Our research provides the first systematized description of the associations between disability and chronic noncommunicable diseases in older adults in Latin America and the Caribbean. Difficulties that older adults have in carrying out instrumental activities of daily living are the first ones to appear. Therefore, follow-up mechanisms should be established that make possible the early detection of this disability (AU)

Hearing aids and services for developing countries

Of the estimated 250 million people around the world who have hearing loss and could benefit from having a hearing aid, two-thirds of them live in developing countries. In adults hearing loss affects their ability to obtain, perform, and keep a job. Throughout life, hearing loss causes people to be isolated and stigmatized. And while hearing loss is generally associated with aging, people in the developing world are more susceptible to this problem at a young age. Hearing loss in children affects language formation and cognitive and social development, and it can lead to lifelong disability. In spite of the pressing needs in the developing world, the supply of hearing aids fall far short of the demand. Of the hearing aids that are manufactured in the world, only a tiny proportion of them end up going to developing countries-only about one out of every eight units produced. Further, there is a major shortage of services in developing countries to fir hearing aids correctly, and with very few trained personnel to help that process. In response to this situation, the World Health Organization (WHO) has taken a number of steps. For example, representatives at a 1998 workshop organized by WHO and the Christian Blind Mission recommended that a small working group draw up guidelines for requirements for hearing aids and their accesories and services so that they would be appropriate and affordable for developing countries (AU)

Situational analysis of disabilities and rehabilitation in the English-speaking Caribbean

A situational analysis of the status of persons with disabilities and rehabilitation services in the english-speaking Caribbean was carried out during a three month period, March-May 1993 and was updated in February, 1994, by Dr. M. J. Thorburn and Mrs Geraldine Maison-Halls, PAHO/WHO short term consultants ... The analysis revealed that although rehabilitation services are in operation in all the countries, there is a great disparity between needs and available resources resulting in a serious deficit in services. The study highlighted a number of issues which have implications for effective planning and programming in rehabilitation. Included in the list of issues are the following; disability statistics, rehabilitation policies, rehabilitation service needs, manpower development, public education, community networking, CBR delivery models and research