Aging of the lungs in asymptomatic lifelong nonsmokers: findings on HRCT.

PURPOSE: To report lung parenchymal findings on high-resolution computed tomography (HRCT) in a population of asymptomatic, never-smoker urban dwellers aged 65 years and older. MATERIALS AND METHODS: After institutional approval, asymptomatic older patients from the Geriatrics Outpatient Clinic aged 65 years and older (older group) and healthy volunteers aged 30-50 years (younger group) were invited to participate in the study. Asymptomatic, never-smoker subjects considered free of relevant disease after spirometry and echocardiography underwent chest HRCT. Three researchers reviewed every scan, noting the absence/presence and distribution of pre-specified parenchymal findings. Statistical comparisons between groups were performed using appropriate tests with the aid of software. RESULTS: Forty-seven older and 24 younger subjects were included in this analysis. A higher proportion of women and a longer history of urban dwelling were present in the older group. Parenchymal findings were more prevalent in the older group (78.7 vs. 25% in the younger group; p < 0.001). Parenchymal bands (59.6 vs. 25%; p = 0.007), ground-glass opacities (25.5 vs. 0%; p = 0.006), and septal lines (21.3 vs. 0%; p = 0.013) were more prevalent in the elderly. When only subjects aged 75 years and older were considered as the older group, micronodules, reticular opacities, cysts, and bronchiectases (19.1 vs. 0 % for all comparisons; p = 0.04) were also more frequently found among the elderly. CONCLUSION: Parenchymal bands, ground-glass opacities, septal lines, bronchiectasis, micronodules, reticular opacities, and lung cysts were more prevalent among the elderly.

Translation, cross-cultural adaptation, and validity of the Brazilian version of the Cognitive Function Instrument.

Subjective cognitive decline (SCD) is defined as a self-perception of a progressive cognitive impairment, which is not detected objectively through neuropsychological tests. The Alzheimer's Disease Cooperative Study developed the Cognitive Function Instrument (CFI) to evaluate individuals with SCD. The CFI consists of two versions, namely, a self-report and a partner report. Objective: This study aimed to translate CFI into Brazilian Portuguese, perform a cross-cultural adaptation, and validate the Brazilian version. Methods: The translation and transcultural adaptation process consisted of six stages, and the preliminary version was answered by a sample of individuals recruited among the patients' caregivers from a cognitive neurology outpatient clinic. Finally, the final Brazilian version of the CFI was applied to a sample of nondemented older adults to validate the instrument, which was divided into with and without SCD, according to the answer "yes" for the question: "Do you feel like your memory is becoming worse?". Results: The final version of CFI showed a high level of acceptability as an assessment tool in nondemented older adults. Participants with SCD had higher scores in the CFI self-report compared with those without complaints. In the receiver operating characteristic curve analysis, the area under the curve of the CFI self-report was 0.865 (95% confidence interval 0.779-0.951), and the cutoff score of 2.0 was the one that best distinguished the SCD group from the control group, with a sensitivity of 73.3% and a specificity of 81.5%. Conclusions: CFI proved to be an instrument with good accuracy and easy applicability to identify older adults with SCD.

O declínio cognitivo subjetivo (DCS) é definido como uma autopercepção de um comprometimento cognitivo progressivo, não detectado objetivamente por meio de testes neuropsicológicos. O Alzheimer's Disease Cooperative Study desenvolveu o instrumento de função cognitiva (IFC) para avaliar indivíduos com DCS. O IFC existe em duas versões, uma do paciente e outra do acompanhante. Objetivo: O objetivo deste estudo foi traduzir para o português brasileiro, fazer uma adaptação transcultural e validar a versão brasileira do IFC. Métodos: O processo de tradução e adaptação transcultural consistiu em seis etapas, e a versão preliminar foi respondida por uma amostra de voluntários recrutados entre os cuidadores de pacientes de um ambulatório de Neurologia Cognitiva. Por fim, a versão brasileira final do IFC foi aplicada a idosos sem demência, que foram divididos naqueles com e sem DCS de acordo com a resposta "sim" à questão: "Você sente que a sua memória está piorando?". Resultados: A versão final do IFC mostrou alto nível de aceitabilidade como ferramenta de avaliação em idosos sem demência. Os participantes com DCS tiveram pontuações mais altas na versão do paciente em comparação com aqueles sem queixas. Nas análises da curva característica de operação do receptor (ROC), a área sobre a curva da versão do paciente foi de 0,865 (intervalo de confiança [IC95%] 0,779­0,951) e a pontuação de corte de 2,0 foi a que melhor distinguiu o grupo com DCS dos controles, com sensibilidade de 73,3% e especificidade de 81,5%. Conclusões: O IFC mostrou-se um instrumento de boa acurácia e de fácil aplicabilidade para identificar idosos com DCS.

Nutritional status of selenium in Alzheimer's disease patients.

Studies have shown that various antioxidants are decreased in different age-related degenerative diseases and thus, oxidative stress would have a central role in the pathogenesis of many disorders that involve neuronal degeneration, including Alzheimer's disease (AD). The present study aimed to assess the nutritional status of Se in AD patients and to compare with control subjects with normal cognitive function. The case-control study was carried out on a group of elderly with AD (n 28) and compared with a control group (n 29), both aged between 60 and 89 years. Se intake was evaluated by using a 3-d dietary food record. Se was evaluated in plasma, erythrocytes and nails by using the method of hydride generation atomic absorption spectroscopy. Deficient Se intake was largely observed in the AD group. AD patients showed significantly lower Se levels in plasma, erythrocytes and nails (32.59 microg/l, 43.74 microg/l and 0.302 microg/g) when compared with the control group (50.99 microg/l, 79.16 microg/l and 0.400 microg/g). The results allowed us to suggest that AD has an important relation with Se deficiency.

Association between health literacy and glycemic control in elderly patients with type 2 diabetes and modifying effect of social support.

OBJECTIVE: To investigate the association between inadequate functional health literacy, considering the Short Assessment of Health Literacy for Portuguese-speaking Adults, and glycemic control in elderly patients with type 2 diabetes, and to examine this association in low social support settings, according to Medical Outcomes Study . METHODS: Cross-sectional study conducted at the diabetes referral center of a university hospital. Participants were recruited among type 2 diabetes patients aged 60 years or older, between May 2013 and November 2014. The primary outcome was the most recent glycated hemoglobin value measured within the last 6 months. RESULTS: A total of 398 elderly patients with type 2 diabetes were evaluated. Of these, 232 were not eligible to participate. The final sample comprised 166 participants. Hierarchical multiple linear regression was performed. The following variables were entered in three blocks: sociodemographic characteristics, clinical variables and health literacy scores. Regression analysis of the interaction between health literacy and social support as a determinant of glycemic control was also performed. Mean age of subjects was 68.0 years (standard deviation of 5.9). Mean glycated hemoglobin value was 8.5% (standard deviation of 1.4). Short assessment of health literacy for Portuguese speaking adults score was independently associated with glycated hemoglobin (B=-0.059; p=0.043). The interaction between social support and health literacy score (p=0.003) was a determinant of glycemic control. CONCLUSION: Health literacy is associated with glycemic control. Social support may modify the relation between health literacy and glycemic control.

Aging and End Stage Renal Disease Cause A Decrease in Absolute Circulating Lymphocyte Counts with A Shift to A Memory Profile and Diverge in Treg Population.

There is a growing number of elderly kidney transplant (Ktx) recipients. Elderly recipients present lower acute rejection rates but higher incidence of infection and malignancies. Aging per se seems to result in a shift to memory profile and chronic kidney disease (CKD) in premature immunological aging. Understanding aging and CKD effects on the immune system can improve elderly Ktx immunosuppression. We analyzed the effects of aging and CKD in the immune system, comparing healthy adults (HAd) (n=14, 26±2y), healthy elderly (HEld) (n=15, 79±7y), end stage renal disease (ESRD) adults (EnAd) (n=18, 36±7y) and ESRD elderly (EnEld) (n=31, 65±3y) prior to Ktx regarding their naïve, memory and regulatory T and B peripheral lymphocytes. Aging and ESRD presented additive effect decreasing absolute numbers of B and T-lymphocytes, affecting memory, naive and regulatory subsets without synergic effect. Both resulted in higher percentages of T memory subsets and opposing effects on regulatory T (TREG) subsets, higher percentage in aging and lower in ESRD. Combined effect of aging and ESRD also resulted in higher regulatory B cell percentages. In addition to global lymphopenia and TCD4+ memory shift in both aging and ESRD, aging shifts to an immunoregulatory profile, inducing a increase in TREG percentages, contrasting with ESRD that decreases TREGs. Differential immunosuppression regimens for elderly Ktx may be required. (ClinicalTrials.gov number: NTC01631058).

Quantitative sensory testing in elderly: longitudinal study.

OBJECTIVE: To evaluate elderly patients in a geriatric service, along with their sensory characteristics and their association with clinical aspects. METHODS: This was a descriptive longitudinal study. We enrolled 36 healthy participants of both sexes in this study. The following instruments were used and evaluations performed: clinical evaluation, Mini-Mental State Exam, and quantitative sensory testing. RESULTS: During the follow-up, there was reduction of mean corpuscular volume at each evaluation (p < 0.001) and significant increase in mean corpuscular hemoglobin concentration (p < 0.001). There was an increase of the olfactory (p < 0.001), salty (p = 0.024), sour (p = 0.020), bitter (p = 0.001), facial cold (p = 0.019), hand cold (p = 0.004), facial tactile (p < 0.001), hand tactile (p = 0.012) and facial vibration (p = 0.018) thresholds. Previous existing morbidities were associated with sensitivity changes in the individuals in this sample. CONCLUSION: This longitudinal study suggests that the loss of sensitivity with aging may be associated with the presence of morbidities in elders.

Trace element contents in serum of healthy elderly population of metropolitan São Paulo area in Brazil.

In this study, the elements Br, Ca, Cl, Fe, Na, Rb, Se and Zn were determined in serum of a healthy elderly population residing in the São Paulo Metropolitan area, using instrumental neutron activation analysis. Comparison studies indicated that only Se concentration was significantly lower in the elderly group aged 75-91 years than those obtained for the group aged 60-74 years. Between genders, males presented lower Br concentrations and, the females lower Fe. Mean concentrations obtained for most elements were within the values reported in the literature.

Oral infections, comorbidities and sensory evidences in elderly: Cross-sectional study.

BACKGROUND: Oral infections affect the general health and overlap with chronic diseases due to infectious-immune mechanisms. On the other side, sensory abnormalities may be symptoms of this association. OBJECTIVE: To evaluate the prevalence of oral infections, comorbidities, health parameters and sensory abnormalities in elderly patients. METHODS: Thirty (30) elderly with mean age 70.4 yo, distributed according to ages were evaluated with a protocol that included demographics, comorbidities, medications, laboratory tests, blood pressure, heart rate, mini-mental state examination, clinical oral evaluation and systematized sensory testing (gustative, olfactory, thermal, mechanical and pain thresholds). Data were tabled and statistically analyzed. RESULTS: Twenty-three (76.6%) subjects had chronic diseases that increased according to the age. Seventeen (56.7%) elderly were having medication. Mean probing pocket depth was 1.90mm±0.39mm, mean clinical attachment level was 0.76mm±0.54mm and mean gingival bleeding index was 29.10%±29.05%. All periodontal indexes increased with age (p <0.05) and were associated with comorbidities and use of medication. Patients with chronic diseases had more numbness and pricking sensations (p=0.031; p=0.000). Main sensory findings were: abnormal gustative and vibratory thresholds, which were associated with hematological parameters (blood count, cholesterol levels and glycaemia). Periodontal parameters were associated with facial cold threshold (p=0.000). CONCLUSION: This study showed an association between systemic diseases, periodontal indexes and sensory thresholds. Sensory findings were associated with blood parameters and are potential tools for periodical health evaluation. Inflammatory or neural mechanisms need further investigation.

Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly.

OBJECTIVE: To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. METHODS: A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. RESULTS: We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. CONCLUSION: This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills. OBJETIVO: Traduzir, adaptar e avaliar as propriedades de uma versão, em português do Brasil, do Spoken Knowledge in Low Literacy Patients with Diabetes, um questionário que avalia conhecimento em diabetes. MÉTODOS: Estudo transversal, em diabéticos tipo 2, com idade ≥60 anos de uma instituição pública de saúde, em São Paulo (SP). Após o desenvolvimento da versão na língua portuguesa, foram avaliadas suas propriedades psicométricas e associação com variáveis sociodemográficas e clínicas. Os modelos de regressão foram ajustados para dados sociodemográficos, alfabetismo funcional em saúde, tempo de doença, uso de insulina e controle glicêmico. RESULTADOS: Foram avaliados 129 diabéticos, com média de idade de 75,9 (±6,2) anos, escolaridade média de 5,2 (±4,4) anos, hemoglobina glicada média de 7,2% (±1,4) e valor médio do Spoken Knowledge in Low Literacy Patients with Diabetes de 42,1% (±25,8). No modelo de regressão, as variáveis associadas de forma independente ao Spoken Knowledge in Low Literacy Patients with Diabetes foram escolaridade (B=0,193; p=0,003), uso de insulina (B=1,326; p=0,004), tempo de doença (B=0,053; p=0,022) e alfabetismo em saúde (B=0,108; p=0,021). O coeficiente de determinação foi de 0,273. O a de Cronbach apresentou valor de 0,75, revelando consistência interna adequada. CONCLUSÃO: Esta versão traduzida do Spoken Knowledge in Low LiteraFcy Patients with Diabetes mostrou-se adequada para avaliar conhecimentos em diabetes em idosos de baixa escolaridade, apresentando distribuição normal, consistência interna adequada, sem a presença de efeito teto ou chão. O instrumento teve boa aplicabilidade, já que pôde ser administrado de maneira rápida e não depende da capacidade de leitura.

Quantitative sensory testing in elderly: longitudinal study / Teste sensitivo quantitativo em idosos: estudo longitudinal

ABSTRACT Objective: To evaluate elderly patients in a geriatric service, along with their sensory characteristics and their association with clinical aspects. Methods: This was a descriptive longitudinal study. We enrolled 36 healthy participants of both sexes in this study. The following instruments were used and evaluations performed: clinical evaluation, Mini-Mental State Exam, and quantitative sensory testing. Results: During the follow-up, there was reduction of mean corpuscular volume at each evaluation (p < 0.001) and significant increase in mean corpuscular hemoglobin concentration (p < 0.001). There was an increase of the olfactory (p < 0.001), salty (p = 0.024), sour (p = 0.020), bitter (p = 0.001), facial cold (p = 0.019), hand cold (p = 0.004), facial tactile (p < 0.001), hand tactile (p = 0.012) and facial vibration (p = 0.018) thresholds. Previous existing morbidities were associated with sensitivity changes in the individuals in this sample. Conclusion: This longitudinal study suggests that the loss of sensitivity with aging may be associated with the presence of morbidities in elders.

RESUMO Objetivo: Avaliar pacientes idosos em um serviço de geriatria, juntamente com as características sensitivas e sua associação com aspectos clínicos. Métodos: Este é um estudo longitudinal descritivo. Foram avaliados 36 sujeitos saudáveis de ambos os sexos. Os seguintes instrumentos e avaliações foram realizados: Avaliação clínica, Mini Exame de Estado Mental (Mini-Mental) e testes sensitivos quantitativos. Resultados: Durante o acompanhamento houve redução do volume corpuscular médio (VCM) em cada avaliação (P < 0,001) e aumento significativo das concentrações de hemoglobina corpuscular média (CHCM) (P < 0,001). Houve aumento dos limiares olfativos (p < 0,001), salgado (p = 0,024), azedo (p = 0,020), amargo (p = 0,001), frio face (p = 0,019), frio mão (p = 0,004), tato face (p < 0,001), tato mão (p = 0.012) e vibração face (p = 0,018). Morbidades prévias foram associadas às alterações de sensibilidade nos indivíduos desta amostra. Conclusão: Este estudo longitudinal sugere que a perda de sensibilidade no envelhecimento pode estar associada à presença de morbidades em idosos.

Glutathione peroxidase 1 Pro198Leu polymorphism in Brazilian Alzheimer's disease patients: relations to the enzyme activity and to selenium status.

BACKGROUND/AIMS: Oxidative stress plays a central role in Alzheimer's disease (AD). Pro198Leu cytosolic glutathione peroxidase (GPx1) polymorphism seems to be associated with a lower activity of this enzyme, but there are no studies with AD patients. Thus, the aim was to determine the frequency of the GPx1 Pro198Leu polymorphism in AD patients and to verify its relation to glutathione peroxidase (GPx) activity and selenium (Se) status. METHODS: The study was carried out in a group of AD elderly (n = 28) compared to a control group (n = 29). Blood Se concentrations were measured through hydride generation atomic absorption spectroscopy. GPx activity was determined using a commercial kit, and the polymorphism using amplified DNA sequencing. RESULTS: The distribution of genotypes was not different between groups. The variant allele frequency was 0.179 (AD group) and 0.207 (control group). Although no differences regarding GPx activity were found between individuals with different genotypes, lower blood Se levels were found in Pro/Pro AD patients compared to Pro/Pro control subjects, which was not found in the Pro/Leu groups. Moreover, the association between the erythrocyte Se concentration and GPx activity was affected by the Pro198Leu genotype. CONCLUSIONS: Results indicate that this polymorphism had apparently affected Se status in AD patients and that more studies in this field are necessary.

Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly / Aplicabilidade do Spoken Knowledge in Low Literacy Patients with Diabetes em idosos brasileiros

ABSTRACT Objective To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. Methods A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. Results We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. Conclusion This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills.

RESUMO Objetivo Traduzir, adaptar e avaliar as propriedades de uma versão, em português do Brasil, do Spoken Knowledge in Low Literacy Patients with Diabetes, um questionário que avalia conhecimento em diabetes. Métodos Estudo transversal, em diabéticos tipo 2, com idade ≥60 anos de uma instituição pública de saúde, em São Paulo (SP). Após o desenvolvimento da versão na língua portuguesa, foram avaliadas suas propriedades psicométricas e associação com variáveis sociodemográficas e clínicas. Os modelos de regressão foram ajustados para dados sociodemográficos, alfabetismo funcional em saúde, tempo de doença, uso de insulina e controle glicêmico. Resultados Foram avaliados 129 diabéticos, com média de idade de 75,9 (±6,2) anos, escolaridade média de 5,2 (±4,4) anos, hemoglobina glicada média de 7,2% (±1,4) e valor médio do Spoken Knowledge in Low Literacy Patients with Diabetes de 42,1% (±25,8). No modelo de regressão, as variáveis associadas de forma independente ao Spoken Knowledge in Low Literacy Patients with Diabetes foram escolaridade (B=0,193; p=0,003), uso de insulina (B=1,326; p=0,004), tempo de doença (B=0,053; p=0,022) e alfabetismo em saúde (B=0,108; p=0,021). O coeficiente de determinação foi de 0,273. O a de Cronbach apresentou valor de 0,75, revelando consistência interna adequada. Conclusão Esta versão traduzida do Spoken Knowledge in Low LiteraFcy Patients with Diabetes mostrou-se adequada para avaliar conhecimentos em diabetes em idosos de baixa escolaridade, apresentando distribuição normal, consistência interna adequada, sem a presença de efeito teto ou chão. O instrumento teve boa aplicabilidade, já que pôde ser administrado de maneira rápida e não depende da capacidade de leitura.

Effect of temporal lobe structure volume on memory in elderly depressed patients.

OBJECTIVE: To compare the volume of the hippocampus and parahippocampal gyrus in elderly individuals with and without depressive disorders, and to determine whether the volumes of these regions correlate with scores on memory tests. METHOD: Clinical and demographic differences, as well as differences in regional gray matter volumes, were assessed in 48 elderly patients with depressive disorders and 31 control subjects. Brain (structural MRI) scans were processed using statistical parametric mapping and voxel-based morphometry. Cognitive tests were administered to subjects in both groups. RESULTS: There were no between-group gray matter volume differences in the hippocampus or parahippocampal gyrus. In the elderly depressed group only, the volume of the left parahippocampal gyrus correlated with scores on the delayed naming portion of the visual-verbal learning test. There were also significant direct correlations in depressed subjects between the volumes of the left hippocampus, right and left parahippocampal gyrus and immediate recall scores on verbal episodic memory tests and visual learning tests. In the control group, there were direct correlations only between overall cognitive performance (as assessed with the MMSE) and the volume of right hippocampus, and between the total score on the visual-verbal learning test and the volume of the right and left parahippocampal gyrus. CONCLUSIONS: These findings highlight different patterns of relationship between cognitive performance and volumes of medial temporal structures in depressed individuals and healthy elderly subjects. The direct correlation between delayed visual-verbal memory recall scores with left parahippocampal volumes specifically in elderly depressed individuals provides support to the view that depression in elderly populations may be a risk factor for dementia.

Quality of life and multimorbidity of elderly outpatients.

INTRODUCTION: Substantial medical research has established an inverse relationship between quality of life and illness. However, there exists minimal evidence for such a connection in the context of stable and controlled diseases. OBJECTIVE: We wished to correlate multimorbidity with quality of life for elderly patients who suffer from stable chronic diseases. METHODS: We used a tool to evaluate quality of life, namely World Health Organization quality of life-BRIEF, together with a scale of multimorbidity known as the Cumulative Illness Rating Scale - Geriatric Version. Furthermore, the quality of life data were correlated with scores recorded on the Cumulative Illness Rating Scale - Geriatric Version, the number of drugs used, and individual perceptions of health and age. RESULTS: We studied 104 elderly patients who suffered from chronic diseases. The patients had exhibited neither acute events nor secondary complications, their cognition was intact, and they were functionally independent. The Cumulative Illness Rating Scale - Geriatric Version showed an inverse correlation with the physical domain (p= 0.008) and a tendency toward an inverse correlation with the psychological domain (p= 0.052). Self-perception of health showed a high correlation with the physical domain (p= 0.000), psychological domain (p= 0.000) and environmental domain (p= 0.000). The number of drugs used correlated only with the physical domain (p= 0.004). Age and social domain showed a tendency toward a positive correlation (p= 0.054). DISCUSSION: We uncovered an inverse relationship between quality of life and multimorbidity in a group of patients who suffered from stable chronic diseases, with no functional limitations, pain or complications. Our data suggest that a patient's knowledge that they have a certain clinical condition changes their subjective assessment of quality of life in the related domain. CONCLUSION: The perceived quality of life of the sample was affected by multimorbidity in the physical domain, with a tendency toward commensurate effects in the psychological domain.

Influence of education and depressive symptoms on cognitive function in the elderly.

OBJECTIVE: The purpose of the present study was to investigate the influence that education and depression have on the performance of elderly people in neuropsychological tests. METHODS: The study was conducted at the Institute of Psychiatry, University of São Paulo School of Medicine, Hospital das Clínicas. All of the individuals evaluated were aged 60 or older. The study sample consisted of 59 outpatients with depressive disorders and 51 healthy controls. We stratified the sample by level of education: low = 1-4 years of schooling; high = 5 or more years of schooling. Evaluations consisted of psychiatric assessment, cognitive assessment, laboratory tests and cerebral magnetic resonance imaging. RESULTS: We found that level of education influenced all the measures of cognitive domains investigated (intellectual efficiency, processing speed, attention, executive function and memory) except the Digit Span Forward and Fuld Object Memory Evaluation (immediate and delayed recall), whereas depressive symptoms influenced some measures of memory, attention, executive function and processing speed. Although the combination of a low level of education and depression had a significant negative influence on Stroop Test part B, Trail Making Test part B and Logical Memory (immediate recall), we found no other significant effects of the interaction between level of education and depression. CONCLUSION: The results of this study underscore the importance of considering the level of education in the analysis of cognitive performance in depressed elderly patients, as well as the relevance of developing new cognitive function tests in which level of education has a reduced impact on the results.

Avaliação da qualidade de vida: comparação entre idosos jovens e muito idosos / Assessment of quality of life: comparison between elderly young and very old

JUSTIFICATIVA E OBJETIVOS: Os idosos representam uma população heterogênea, principalmente nos extremos etários, em que há predomínio de doenças crônico-degenerativas com diferentes impactos sobre a qualidade de vida (QV). O objetivo deste estudo foi avaliar e comparar a QV de idosos jovens e muito idosos.MÉTODO: Estudo transversal constituído por idosos em seguimento ambulatorial de um hospital-escola, distribuídos por faixa etária em dois grupos: G1 - idosos jovens (60-70 anos) e G2 - muito idosos (85 anos ou mais). Utilizou-se um questionário auto-aplicativo de QV para idosos, da Organização Mundial de Saúde (WHOQOL-OLD), composto por 6 domínios: funcionamento dos sentidos, autonomia, morte e morrer, atividades passadas, presentes e futuras, participação social e intimidade. As respostas dos dois grupos foram avaliadas e comparadas.RESULTADOS: Foram avaliados 69 idosos, sendo 35 do G1 e 34 do G2. Em ambos, houve predomínio do sexo feminino, sedentários, independentes para atividades básicas de vida diária, com média de 8 comorbidades. A média do escore total do WHOQOL-OLD foi 84,08 para o G1 e 83,32 para o G2. CONCLUSÃO: Observou-se boa qualidade de vida na população estudada. A comparação entre os grupos mostrou que a QV não parece decair com a idade.

BACKGROUND AND OBJECTIVES: Elderly represents a heterogeneous population, mainly in the extreme age, in which there is a predominance of chronic-degenerative diseases with different impacts on the quality of life (QL). This study aimed to evaluate and compare the quality of life of elderly young and very old.METHOD: Cross-sectional study consisting of elderly in outpatient follow-up of a hospital, distributed into two groups: G1 - elderly young (60-70 years) and G2 - very old (85 and over). The World Health Organization questionnaire (WHOQOL-OLD) was used composed of 6 domains: sensory function, autonomy, death-dying, past-present-future activities, social participation and intimacy. The answers of two groups were evaluated and compared.RESULTS: This study evaluated 69 elderly, 35 in G1 and 34 in G2. In both, there was a predominance of females, averaging 8 comorbidity, sedentary and independent for basic activities of daily living. The total average score WHOQOL-OLD was 84.08 between G1 and 83.32 between G2.CONCLUSION: A good quality of life was observed in the studied population. The comparison between groups showed that the QF does not seem to decline with age.

Quality of life and multimorbidity of elderly outpatients

INTRODUCTION: Substantial medical research has established an inverse relationship between quality of life and illness. However, there exists minimal evidence for such a connection in the context of stable and controlled diseases. OBJECTIVE: We wished to correlate multimorbidity with quality of life for elderly patients who suffer from stable chronic diseases. METHODS: We used a tool to evaluate quality of life, namely World Health Organization quality of life-BRIEF, together with a scale of multimorbidity known as the Cumulative Illness Rating Scale - Geriatric Version. Furthermore, the quality of life data were correlated with scores recorded on the Cumulative Illness Rating Scale - Geriatric Version, the number of drugs used, and individual perceptions of health and age. RESULTS: We studied 104 elderly patients who suffered from chronic diseases. The patients had exhibited neither acute events nor secondary complications, their cognition was intact, and they were functionally independent. The Cumulative Illness Rating Scale - Geriatric Version showed an inverse correlation with the physical domain (p= 0.008) and a tendency toward an inverse correlation with the psychological domain (p= 0.052). Self-perception of health showed a high correlation with the physical domain (p= 0.000), psychological domain (p= 0.000) and environmental domain (p= 0.000). The number of drugs used correlated only with the physical domain (p= 0.004). Age and social domain showed a tendency toward a positive correlation (p= 0.054). DISCUSSION: We uncovered an inverse relationship between quality of life and multimorbidity in a group of patients who suffered from stable chronic diseases, with no functional limitations, pain or complications. Our data suggest that a patient's knowledge that they have a certain clinical condition changes their subjective assessment of quality of life in the related domain. CONCLUSION: The perceived quality of life of the sample...

Análise da dosagem sérica de elementos traço e sua correlação com aspectos clínicos de uma população de idosos saudáveis / Analysis of serum trace elements and their correlation with clinical aspects of a population of healthy elderly

O interesse sobre o papel dos elementos traço na gênese de doenças, na mortalidade e na manutenção da saúde vem sendo cada vez maior. Este trabalho tem como objetivo determinar as concentrações séricas dos elementos: Br, Ca, Cl, Fe, Na, Rb, Se e Zn e correlacioná-las com os aspectos clínicos de uma população de idosos saudáveis. Foram considerados saudáveis os idosos sem senilidade sistêmica e sintomática, sendo selecionamos 101 idosos saudáveis, 33 (32,67%) homens e 68 (67,33%) mulheres com idade média de 71,7 ± 7,1 (60-98). O nível sérico de Se foi significativamente menor em pacientes mais idosos (p < 0.001). Em comparação com os valores de referência, o Br, Cl e Na apresentaram médias menores. Em relação ao sexo, os homens tiveram menores níveis de Br (p < 0,001) e de Se (p = 0,005) com maiores níveis de Fe (p < 0,001). Menores níveis de Se foram relacionados com menor escolaridade (p= 0.013). Os valores de Br estiveram muito abaixo dos valores de referência e a prática da atividade física correlacionou-se com menores níveis de Br (p= 0,008). Poderíamos questionar se os altos níveis de Br seriam prejudiciais ao envelhecimento saudável, se níveis baixos de bromo seriam marcadores de saúde em idosos ou até se existe relação entre hábitos de vida saudáveis com os níveis de Br. A partir dos 71,2 anos, os níveis séricos de selênio começam a cair mesmo em indivíduos saudáveis. Estudos adicionais deverão determinar se o monitoramento dos níveis séricos de selênio pode ser utilizado como marcador precoce do desenvolvimento de doenças e mortalidade.

Concern about the role of trace elements in the genesis of disease, mortality and health maintenance has been increasing. This study aims to determine serum concentrations of the elements: Br, Ca, Cl, Fe, Na, Rb, Se and Zn and correlate them with clinical features of a population of healthy elderly. Were considered healthy elderly people without senile systemic symptoms. We selected 101 healthy elderly, 33 (32.67%) men and 68 (67.33%) women with a mean age of 71.7 ± 7.1 (60-98). The serum level of Se was significantly lower in older patients (p <0.001). Compared with the reference values Br, Cl and Na diminished. Longer averages about sex men had lower levels of Br (p <0.001) and Se (p = 0.005) with higher levels of Fe (p <0.001). If lower levels were associated with less education (p = 0.013). Br values were well below the reference values and physical activity correlated with lower levels of Br (p = 0.008). One might question whether high levels of Br would be detrimental for healthy aging, if low levels of bromine were markers of health in the elderly or even if there is a relationship between healthy lifestyle habits with the levels of Br. From 71.2 years, serum levels of selenium begin to fall even in healthy individuals. Additional studies will determine if monitoring of serum levels of selenium can be used as a marker of early development of disease and mortality.