Frailty Syndrome in Association with Depressive Symptoms and Functional Disability among Hospitalized Elderly.

We sought to examine the frailty association with depression and functional disability in hospitalized older adults. In particular, we compared non-frail, pre-frail, and frail elderly hospitalized individuals. We performed a cross-sectional study with 255 hospitalized Brazilian elderly patients. We used a structured instrument to assess socio-economic data, the Fried frailty phenotype and used morbidity scales (Geriatric Depression; Katz; Lawton and Brody). The adjusted analysis revealed that frail elderly exhibit increased odds ratios (OR) for depressive symptoms (OR = 2.72, 95% CI: 1.12-6.62), disability related to basic activities (OR = 3.50, 95% CI: 1.26-9.60), and instrumental daily living (OR = 2.70, 95% CI: 1.12-6.44). Frailty in hospitalized older adults is associated with depressive symptomatology and functional disability.

[Prevalence and factors associated with the rates of depression among elderly residents in rural areas]. / Prevalência e fatores associados ao indicativo de depressão entre idosos residentes na zona rural.

This study aimed to determine the prevalence of elderly patients with an indication of depression by sex and age group and to identify the factors associated with the indication of depression. Analytical, observational and cross studies were conducted with 850 elderly residents in the rural areas of the municipality of Minas Gerais. For data analysis, we applied the prevalence formula and logistic regression model (p<0.05). The project was approved by the Ethics in Research Human of the Triângulo Mineiro Federal University (Protocol No. 1477). The prevalence of the indicators of depression accounted for 22%, with a greater occurrence among females and individuals aged 60├70 years. In females, a higher number of comorbidities and higher functional disability with respect to performing the activities of daily living remained associated with the indication of depression. These results reinforce the need to implement actions to promote health and disease prevention, focusing on depression.

[Morbidity and quality of life of elderly individuals with diabetes mellitus living in urban and rural areas]. / Morbidades e qualidade de vida de idosos com diabetes mellitus residentes nas zonas rural e urbana.

This study aimed to describe the socio-demographic variables and to compare the morbidities and the quality of life (QoL) of elderly individuals with diabetes mellitus (DM) residing in urban and rural areas. The sample consisted of 271 elderly individuals from urban areas and 104 from rural areas with self-reported DM. A descriptive analysis was used, and in the location comparison, an age adjustment was employed through linear and logistic multiple regression models (p<0.05). The elderly individuals from the rural area were younger, more educated, earned a higher income and were more often married in relation to the urban residents. Furthermore, the rural residents presented a higher QoL score in the physical and social relationships domains and in the autonomy, past, present and future activities, and intimacy facets compared to the urban residents. The elderly individuals residing in the urban area displayed a larger number of verified comorbidities. The elderly DM patients residing in the rural area generally presented better health conditions than those who lived in the urban area.

Analysis of the vaccination status of older adults.

OBJECTIVE: To describe the sociodemographic characteristics, functional capacity and vaccination status of older adults, and to verify the factors associated with the incomplete vaccination status and the absence of the vaccination card. METHOD: Cross-sectional and analytical study conducted with older adults living in the city of Uberaba (MG). The following analyzes were carried out: descriptive, bivariate and multinomial logistic regression (p<0.05). RESULTS: A total of 576 older adults participated. Most of them were women, in the 70-80 age group, with partner, low education and income, living with someone, independent in basic activities of daily living and with partial dependence on instrumental activities. The highest percentage was for older adults who had incomplete vaccination status, especially regarding the absence of immunization for Hepatitis B. Individual monthly income < 1 minimum wage (p=0.002) and single-person housing arrangement (p=0.010) were associated with the incomplete vaccination status, and the absence of the vaccination card, with the lowest level of education (p=0.039). CONCLUSION: Low income and education, as well as living alone, are factors associated with inadequate vaccination status among older adults in the community. The need for primary care nurses to develop strategies to increase vaccination coverage among older adults with these characteristics is emphasized.

Overweight in rural elderly: association with health conditions and quality of life. / Excesso de peso em idosos rurais: associação com as condições de saúde e qualidade de vida.

This study aimed to verify the association of overweight with functional disability, self-reported morbidities and quality of life (QoL) among rural elderly dwellers. This is a domestic and cross-sectional survey conducted in the rural region of a municipality of Southeast Brazil. Three hundred seventy non-overweight elderly people and 192 overweight elderly people were evaluated with the following tools: semi-structured; Katz and Lawton and scales; World Health Organization Quality of Life - BREF and World Health Organization Quality of Life Assessment for Older Adults. Overweight was associated with morbidities arthritis/osteoarthritis (p = 0.002), systemic arterial hypertension (p < 0.001), varicose veins (p = 0.009), heart problems (p = 0.028), diabetes mellitus (p = 0.001), cerebrovascular accident (p = 0.044) and urinary incontinence (p = 0.032). Overweight elderly had lower scores in the physical realm (p = 0.005) and higher scores in social relationships (p = 0.033) compared to those without this condition. Results point to the importance of monitoring the nutritional status of rural elderly to prevent comorbidities and improve the quality of life.

O objetivo deste estudo é verificar a associação do excesso de peso com a incapacidade funcional, morbidades autorreferidas e qualidade de vida (QV) de idosos residentes em área rural. Trata-se de um inquérito domiciliar e transversal realizado na área rural de um município do Sudoeste do Brasil. Foram avaliados 370 idosos sem excesso de peso e 192 com, por meio dos instrumentos: semiestruturado, escalas Katz e Lawton e, World Health Organization Quality of Life ­ BREF e World Health Organization Quality of Life Assessment for Older Adults. O excesso de peso associou às morbidades: artrite/artrose, hipertensão arterial sistêmica (p < 0,001), varizes (p = 0,009), problemas cardíacos (p = 0,028), diabetes mellitus (p = 0,001), acidente vascular encefálico (p = 0,044) e incontinência urinária (p = 0,032). Não identificou associação entre a incapacidade funcional e o excesso de peso (p = 0,729). Os idosos com excesso de peso apresentaram menores escores no domínio físico (p = 0,005) e maiores nas relações sociais (p = 0,033) comparados aos sem essa condição. Os resultados remetem à necessidade do acompanhamento do estado nutricional de idosos rurais na prevenção de comorbidades e na melhoria da qualidade de vida.

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil.

BACKGROUND: The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome. DESIGN AND SETTING: Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil. METHODS: The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation. RESULTS: The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals. CONCLUSIONS: The condition of frailty was associated with greater chances of violence against the elderly.

Domínios e facetas da qualidade de vida de pessoas idosas segundo a prática sexual / Domains and facets of the quality of life of olders adults according to sexual practice

A pesquisa objetivou comparar os domínios e facetas da qualidade de vida de idosos segundo a prática de relação sexual nos últimos seis meses. Estudo quantitativo, transversal e observacional realizado com 219 idosos de um município do Estado de Minas Gerais. Aplicaram-se os instrumentos WHOQoL-Bref e WHOQoL-Old para a coleta de dados referentes à qualidade de vida, e o teste Mann-Whitney (p < 0,05) para análise. Os domínios físico (p = 0,002), psicológico (p < 0,001) e relações sociais (p < 0,001), e as facetas atividades passadas, presentes e futuras (p = 0,013), participação social (p = 0,007) e intimidade (p = 0,018) estiveram associados à prática de relação sexual nos últimos seis meses, com maiores escores entre aqueles que referiram ser ativos sexualmente.

The objective of this study was to compare the domains and facets of quality of life of older adults, according to the practice of sexual intercourse in the last six months. Quantitative, cross-sectional and observational study, carried out with 219 elderly from a municipality in the State of Minas Gerais. The WHOQoL-Bref and WHOQoL-Old instruments were used to collect data regarding quality of life and the Mann-Whitney test (p < 0.05) for analysis. In the physical (p = 0.002), psychological (p < 0.001) and social relations (p < 0.001) domains, and in the facets past, present and future activities (p = 0.013), social participation (p = 0.007) and intimacy (p = 0.018) were associated with the practice of sexual intercourse in the last six months, with higher scores among those who reported being sexually active.

Quality of life and self-esteem among the elderly in the community. / Qualidade de vida e autoestima de idosos na comunidade.

This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

Quality of life and accession to the pharmacological treatment among elderly hypertensive.

OBJECTIVE: to compare variables obtained in adherence and non-adherence to drug treatment for hypertension, according to socioeconomic situation, time of diagnosis, self-reported morbidities, indicative of depression and quality of life. METHOD: cross-sectional analytical study of 524 elderly with adherence and 505 non-adherence to the treatment. A descriptive analysis, Chi-square test and Student t test (p < 0.05) were held. RESULTS: there was higher proportion of older subjects, indicative of morbidity and depression among those with adherence. Non-adherence subjects had lower scores in all domains and quality of life facets. CONCLUSION: actions favoring the adherence to pharmacological treatment should be recommended, to minimize the impact of comorbidities and improve quality of life.

Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study.

CONTEXT AND OBJECTIVE:: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING:: Observational cross-sectional study in a public teaching hospital. METHODS:: The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). RESULTS:: A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). CONCLUSION:: States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.

Analysis of the vaccination status of older adults / Análisis de la situación vacunal de los adultos mayores / Análise da situação vacinal de idosos

ABSTRACT Objective: To describe the sociodemographic characteristics, functional capacity and vaccination status of older adults, and to verify the factors associated with the incomplete vaccination status and the absence of the vaccination card. Method: Cross-sectional and analytical study conducted with older adults living in the city of Uberaba (MG). The following analyzes were carried out: descriptive, bivariate and multinomial logistic regression (p<0.05). Results: A total of 576 older adults participated. Most of them were women, in the 70-80 age group, with partner, low education and income, living with someone, independent in basic activities of daily living and with partial dependence on instrumental activities. The highest percentage was for older adults who had incomplete vaccination status, especially regarding the absence of immunization for Hepatitis B. Individual monthly income < 1 minimum wage (p=0.002) and single-person housing arrangement (p=0.010) were associated with the incomplete vaccination status, and the absence of the vaccination card, with the lowest level of education (p=0.039). Conclusion: Low income and education, as well as living alone, are factors associated with inadequate vaccination status among older adults in the community. The need for primary care nurses to develop strategies to increase vaccination coverage among older adults with these characteristics is emphasized.

RESUMEN Objetivo: Describir las caracteristicas sociodemograficas, la capacidad funcional y la situacion vacunal de los adultos mayores y comprobar los factores asociados con la situacion vacunal incompleta y la ausencia del carnet de vacunacion. Método: Se trata de un estudio transversal y analitico llevado a cabo con adultos mayores residentes en el area urbana de Uberaba, Minas Gerais, mediante un analisis descriptivo, bivariado y de regresion logistica multinomial (p<0,05). Resultados: Participaron 576 adultos mayores. Predominaban las mujeres de edad avanzada, 70├80 anos, con pareja, bajo nivel de escolaridad e ingresos, que vivian solas, independientes en las actividades basicas de la vida diaria y parcialmente dependientes de las actividades instrumentales. El porcentaje mas alto correspondia a los adultos mayores que tenian un estado de vacunacion incompleto, especialmente en lo que respecta a la ausencia de inmunizacion contra la hepatitis B. Los ingresos mensuales individuales ≤ 1 salario minimo (p=0,002) y la disposicion de una vivienda unifamiliar (p=0,010) estaban asociados con el estado de vacunacion incompleta, y la ausencia del carnet de vacunacion, con un nivel de escolaridad bajo (p=0,039). Conclusión: Los ingresos bajos y la educacion, asi como el hecho de vivir solo, son factores que estan asociados a un estado de vacunacion inadecuado en adultos mayores de la comunidad. Es importante que el enfermero de atencion primaria desarrolle estrategias para aumentar la cobertura de vacunacion entre los adultos mayores con dichas caracteristicas.

RESUMO Objetivo: Descrever as caracteristicas sociodemograficas, a capacidade funcional e a situacao vacinal de idosos, e verificar os fatores associados a situacao vacinal incompleta e a ausencia do cartao de vacinas. Método: Estudo transversal e analitico conduzido com idosos residentes na zona urbana de Uberaba (MG). Procedeu-se as analises descritiva, bivariada e regressao logistica multinomial (p<0,05). Resultados: Participaram 576 idosos. Predominaram os idosos do sexo feminino, na faixa etaria de 70├80 anos, com companheiro, baixa escolaridade e renda, que moravam acompanhados, independentes nas atividades basicas da vida diaria e com dependencia parcial nas atividades instrumentais. O maior percentual foi para os idosos que possuiam situacao vacinal incompleta, sobretudo em relacao a ausencia da imunizacao para Hepatite B. Foram associados a situacao vacinal incompleta a renda individual mensal ≤ 1 salario minimo (p=0,002) e o arranjo de moradia unipessoal (p=0,010); e a ausencia do cartao de vacinas, a menor escolaridade (p=0,039). Conclusão: As baixas renda e escolaridade, bem como residir sozinho, sao fatores associados as situacoes vacinais inadequadas dos idosos da comunidade. Ressalta-se a necessidade de que o enfermeiro da atencao primaria desenvolva estrategias para aumentar a cobertura vacinal entre os idosos com essas caracteristicas.

[Differences in the indicators of quality of life for older adults with hypertension living in urban and rural areas of Minas Gerais, Brazil]. / Diferencias en los indicadores de calidad de vida del adulto mayor con hipertensión arterial que vive en el área urbana y rural de Minas Gerais, Brasil.

OBJECTIVES: To compare socioeconomic, illnesses, and quality of life variables for older adults with arterial hypertension who are residents of urban and rural areas of Minas Gerais, Brazil. MATERIALS AND METHODS: Cross-sectional study comprised of 1,302 older adults from the urban area and 463 from the rural area who reported suffering from arterial hypertension. Descriptive analysis was performed, as well as the chi square test, t-test, and multiple and logistic regression. RESULTS: In urban areas, females were more prevalent (66.5%; p<0.001) and older adults aged 75 and over (34.3%; p<0.001) were the most prevalent age group. In rural areas there was a higher prevalence of individuals living with a partner (65%; p<0.001), living alone (16.2%; p=0.021) and a lower prevalence of diseases such as arthritis/osteoarthritis (p<0.001), osteoporosis (p<0.001), asthma/bronchitis (p=0.028), stroke (p<0.001), heart problems (p<0.001), poor circulation (varices) (p<0.001), constipation (p<0.001 ), cataracts (p<0.001), benign tumors (p=0.002) and vision problems (p<0.001). Older adults in urban areas had lower averages in the physical (p<0.001), psychological (p<0.001) and social (p<0.001) domains, aspects of autonomy (p<0.001), activities in the past, present and future (p<0.001), social participation (p<0.001) and intimacy (p<0.001).Older adults living in rural areas showed lower scores on aspects of the functioning of the senses (p<0.001) and death and dying (p<0.001). CONCLUSIONS: It is necessary for health professionals to promote the monitoring of the elderly, taking into account the conditions of the location where they live.

Acesso e utilização dos serviços de saúde por idosos segundo microrregionais de saúde / Health services access and use by older adults, by health micro-regions / Acceso y uso de servicios de salud por adultos mayores, según microrregiones de salud

Objetivo: descrever e comparar as características sociodemográficas e clínicas dos idosos, e o acesso e a utilização dos serviços de saúde, segundo três microrregionais de saúde de Minas Gerais. Método: inquérito domiciliar transversal realizado com 1.635 idosos residentes nas Microrregionais de Saúde do Triângulo Sul, em Minas Gerais. Procederam-se às análises descritivas e teste qui-quadrado (p<0,05). Resultados: na comparação entre os grupos obteve-se diferença significativa em relação à faixa etária (p<0,001), número de morbidades (p<0,001), uso contínuo de medicamentos (p<0,001) e não realizar consulta com dentista no último ano (p=0,005). Conclusão: as políticas públicas devem considerar os fatores sociodemográficos e as condições clínicas dos idosos, mediante o contexto da territorialização e regionalização em saúde, para proposição de estratégias de ação que favoreçam o acesso e uso dos serviços por essa população.

Objective: to describe and compare the older adults' sociodemographic and clinical characteristics, and their access to, and use of, health services, by three health micro-regions in Minas Gerais. Method: this cross-sectional household survey interviewed 1,635 older adults living in the Health Micro-regions of the Southern Triangle of Minas Gerais. Descriptive analyses and chisquare test were performed (p<0.05). Results: comparisons among the groups revealed significant differences by age group (p < 0.001), number of morbiditie (p<0.001), continuous medication use (p<0.001) and no dental appointment in the prior year (p = 0.005). Conclusion: in the context of health care territorialization and regionalization, public policies should consider older adults' sociodemographic characteristics and clinical conditions, in order to propose action strategies to favor service access and use by this population.

Objetivo: describir y comparar las características sociodemográficas y clínicas de los adultos mayores y su acceso y uso de los servicios de salud por parte de tres microrregiones de salud en Minas Gerais. Método: esta encuesta de hogares de corte transversal entrevistó a 1.635 adultos mayores residentes en las Microrregiones de Salud del Triángulo Sur de Minas Gerais. Se realizaron análisis descriptivos y prueba de chi-cuadrado (p<0.05). Resultados: as comparaciones entre los grupos revelaron diferencias significativas por grupo de edad (p<0.001), número de morbilidades (p<0.001), uso continuo de medicación (p<0.001) y ausencia de consulta dental en el año anterior (p = 0,005). Conclusión: en el contexto de territorialización y regionalización asistencial, las políticas públicas deben considerar las características sociodemográficas y las condiciones clínicas de los adultos mayores, con el fin de proponer estrategias de acción que favorezcan el acceso y uso de los servicios por parte de esta población.

Excesso de peso em idosos rurais: associação com as condições de saúde e qualidade de vida / Overweight in rural elderly: association with health conditions and quality of life

Resumo O objetivo deste estudo é verificar a associação do excesso de peso com a incapacidade funcional, morbidades autorreferidas e qualidade de vida (QV) de idosos residentes em área rural. Trata-se de um inquérito domiciliar e transversal realizado na área rural de um município do Sudoeste do Brasil. Foram avaliados 370 idosos sem excesso de peso e 192 com, por meio dos instrumentos: semiestruturado, escalas Katz e Lawton e, World Health Organization Quality of Life - BREF e World Health Organization Quality of Life Assessment for Older Adults. O excesso de peso associou às morbidades: artrite/artrose, hipertensão arterial sistêmica (p < 0,001), varizes (p = 0,009), problemas cardíacos (p = 0,028), diabetes mellitus (p = 0,001), acidente vascular encefálico (p = 0,044) e incontinência urinária (p = 0,032). Não identificou associação entre a incapacidade funcional e o excesso de peso (p = 0,729). Os idosos com excesso de peso apresentaram menores escores no domínio físico (p = 0,005) e maiores nas relações sociais (p = 0,033) comparados aos sem essa condição. Os resultados remetem à necessidade do acompanhamento do estado nutricional de idosos rurais na prevenção de comorbidades e na melhoria da qualidade de vida.

Abstract This study aimed to verify the association of overweight with functional disability, self-reported morbidities and quality of life (QoL) among rural elderly dwellers. This is a domestic and cross-sectional survey conducted in the rural region of a municipality of Southeast Brazil. Three hundred seventy non-overweight elderly people and 192 overweight elderly people were evaluated with the following tools: semi-structured; Katz and Lawton and scales; World Health Organization Quality of Life - BREF and World Health Organization Quality of Life Assessment for Older Adults. Overweight was associated with morbidities arthritis/osteoarthritis (p = 0.002), systemic arterial hypertension (p < 0.001), varicose veins (p = 0.009), heart problems (p = 0.028), diabetes mellitus (p = 0.001), cerebrovascular accident (p = 0.044) and urinary incontinence (p = 0.032). Overweight elderly had lower scores in the physical realm (p = 0.005) and higher scores in social relationships (p = 0.033) compared to those without this condition. Results point to the importance of monitoring the nutritional status of rural elderly to prevent comorbidities and improve the quality of life.

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil

ABSTRACT BACKGROUND: The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome. DESIGN AND SETTING: Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil. METHODS: The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation. RESULTS: The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals. CONCLUSIONS: The condition of frailty was associated with greater chances of violence against the elderly.

Discapacidad y morbilidad entre los ancianos, de acuerdo con las condiciones sociodemográficas e indicativo de la depresión / Incapacidade e morbidades entre idosos, segundo condições sócio-demográficas e indicativo de depressão / Functional disability and morbidities among the elderly people, according to socio-demographic conditions and indicative of depression

Objectives. To investigate the association of functional incapacity and the number of morbidities with sociodemographic, economic and health variables. Methods. This is a household survey, quantitative and transversal approach, conducted with 1,693 elderly in Uberaba-MG in 2012. We used the Mini-Mental State Examination, Katz Scale, Lawton and Brody Scale; Geriatric Depression Scale abbreviated and semi-structured instrument for evaluation of demographic data, economic and morbidities. Results. Functional incapacity in basic activities of daily living was associated with older age, a greater number of morbidities and presence of indicative of depression. Regarding the instrumental activities of daily living, functional incapacity was related to age, lower education and income, the greater number of morbidities and have indicative of depression. The largest number of comorbidities was associated with female sex, older age, lower income and indicative of depression. Conclusion. This study highlights the need for health actions directed to the oldest old, with less education and income, and indicative of depression to minimize the dependency on the performance of functional capacity and impact on morbidities.

Objetivos. Investigar la asociación de la incapacidad funcional y el número de morbilidades con variables sociodemográficas, económicas y de salud entre los ancianos. Métodos. Se trata de una encuesta de hogares, de enfoque cuantitativo y transversal, realizado con 1 693 personas mayores en Uberaba-MG en 2012. Se utilizaron los instrumentos: Mini Examen del Estado Mental, Escala de Katz, Escala de Lawton y Brody y la Escala de Depresión Geriátrica Abreviada. También, se recolectó información sobre datos demográficos, económicos y de morbilidad. Resultados. La incapacidad funcional en actividades básicas de la vida diaria se asoció con la edad, el número de comorbilidades y la presencia de depresión. En cuanto a las actividades instrumentales de la vida diaria, la incapacidad funcional se relaciona con la edad, la educación y los ingresos más bajos, además del mayor número de comorbilidades y de probable depresión. El mayor número de comorbilidades se asoció con el sexo femenino, la edad avanzada, menores ingresos y probable depresión. Conclusión. Este estudio pone de relieve la necesidad de que las acciones de salud dirigidas a los más ancianos, con menos educación e ingresos, e indicativa de la depresión, con el fin de reducir al mínimo la dependencia de las prestaciones de la capacidad funcional y el impacto en la morbilidad.

Objetivo. Verificar a associação da incapacidade funcional e do número de morbidades com variáveis sócio-demográficas, econômicas e de saúde. Métodos. Trata-se de inquérito domiciliar, de abordagem quantitativa e transversal, realizado com 1 693 idosos em Uberaba-MG no ano de 2012. Utilizou-se o Mini Exame de Estado Mental, Escala de Katz, Escala de Lawton e Brody, Escala de Depressão Geriátrica Abreviada e instrumento semiestruturado para avaliação dos dados sócio-demográficos, econômicos e morbidades. Resultados. A incapacidade funcional para atividades básicas da vida diária esteve associada à maior faixa etária, maior número de morbidades e presença de indicativo de depressão. Em relação às atividades instrumentais de vida diária, a incapacidade funcional relacionou-se à maior idade, menor escolaridade e renda, maior número de morbidades e ter indicativo de depressão. O maior número de morbidades esteve associado ao sexo feminino, maior idade, menor renda e indicativo de depressão. Conclusão. Este estudo evidencia a necessidade de ações em saúde direcionadas aos idosos mais velhos, com menor escolaridade e renda e indicativo de depressão, visando minimizar a dependência para o desempenho da capacidade funcional e impacto sobre as morbidades.

Homens idosos residentes na zona rural: aspectos relacionados à qualidade de vida / Elderly men living in rural areas: quality of life-related aspects / Hombres mayores que viven en la zona rural: aspectos relacionados con la calidad de vida

Objetivo: verificar os fatores socioeconômicos e de saúde associados à qualidade de vida (QV) de homens idosos rurais. Método: estudo descritivo, quantitativo com inquérito domiciliar e analítico realizado com 449 homens idosos da zona rural. Os dados foram coletados no período de junho de 2010 a março de 2011, em Uberaba-MG. Utilizaram-se os questionários: estruturado, Índex de Katz, Escala de Lawton e Brody, World Health Organization Quality of Life ­ BREF e World Health Organization Quality of Life Assessment for Older Adults. Realizou-se análise descritiva e regressão linear múltipla (p<0,05). Resultados: os menores escores nos domínios e facetas de QV apresentam diferentes preditores socioeconômicos e de saúde, a saber: as incapacidades funcionais; o uso de equipamentos de apoio; a insatisfação com o lazer; a renda inferior a um salário mínimo, e; a ausência de companheira. Conclusão: devem ser priorizadas ações que minimizem o impacto à QV relacionada aos fatores socioeconômicos e incapacidades.

Objective: to ascertain the socioeconomic and health-related factors associated with quality of life (QOL) of elderly men in rural areas. Method: quantitative, descriptive study based on an analytical home survey of 449 elderly rural men. Data were collected between June 2010 and March 2011 in Uberaba, Minas Gerais, using the following questionnaires: structured, Katz Index, Lawton and Brody Scale, World Health Organization Quality of Life (BREF) and World Health Organization Quality of Life Assessment for Older Adults. Descriptive analysis and multiple linear regression were performed (p<0.05). Results: the lowest QOL domains and facet scores show different socioeconomic and health predictors, viz.: functional disabilities; use of support equipment; dissatisfaction with leisure; income of less than one minimum wage; and lack of a companion. Conclusion: priority should be given to measures to minimize impact on QOL related to socioeconomic factors and disabilities.

Objetivo: evaluar la calidad relacionada con la salud socio-económico y de vida (QOL) de los hombres mayores. Método: estudio analítico de 449 ancianos del campo. Los datos fueron recolectados en el período junio 2010 hasta marzo 2011 en Uberaba-MG. Resultados: se utilizaron cuestionarios: estructura, índice de Katz, Lawton y Brody escala, Calidad Mundial de la Salud Organización de la Vida - BREF y la Organización Mundial de la Salud de Calidad de la Evaluación de la Vida de los Adultos Mayores. Se realizó un análisis descriptivo y de regresión lineal múltiple (p<0,05). Resultados: las puntuaciones más bajas de dominios y facetas QV tienen diferentes predictores socioeconómicos y de salud, a saber: la incapacidad funcional; el uso de equipos de apoyo; la insatisfacción con el ocio; menos de un salario mínimo, y; ningún compañero. Conclusión: deben ser priorizadas acciones que minimicen el impacto en la QOL relacionada con factores socioeconómicos y la discapacidad.

Qualidade de vida e autoestima de idosos na comunidade / Quality of life and self-esteem among the elderly in the community

Resumo Objetivou-se verificar a associação entre os escores de qualidade de vida e autoestima em idosos na comunidade. Inquérito domiciliar, transversal, observacional e analítico, conduzido com 1.691 idosos residentes em área urbana de um município no interior de Minas Gerais. Foram utilizados os instrumentos World Health Organization Quality of Life Bref (Whoqol-Bref), World Health Organization Quality of Life Old (Whoqol-Old) e a Escala de Autoestima de Rosenberg. Procedeu-se à análise estatística descritiva e modelo de regressão linear (p < 0,05). Constatou-se que o domínio relações sociais (71,19) e a faceta morte e morrer (74,30) apresentaram os maiores escores médios entre os idosos; enquanto os menores foram observados no domínio meio ambiente (60,39) e na faceta participação social (63,06). Os escores de autoestima apresentaram média de 9,36 ± 4,09. Os menores escores de qualidade de vida em todos os domínios do Whoqol-Bref e das facetas do Whoqol-Old (exceto morte e morrer) associaram-se com os piores níveis de autoestima (p < 0,001). Os resultados encontrados fornecem informações para a elaboração de ações em saúde a partir da compreensão dos aspectos que influenciam na QV de idosos devido à redução da autoestima.

Abstract This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study / Fatores de risco cardiovasculares associados à síndrome de fragilidade em idosos hospitalizados: um estudo transversal

ABSTRACT CONTEXT AND OBJECTIVE: Identification of frailty syndrome and its relationship with cardiovascular risk factors among hospitalized elderly people is important, since this may contribute towards broadening of knowledge regarding this association within tertiary-level services. This study aimed to evaluate the cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people. DESIGN AND SETTING: Observational cross-sectional study in a public teaching hospital. METHODS: The participants were elderly patients admitted to clinical and surgical wards. The cardiovascular risk factors assessed were: body mass index (BMI), waist circumference, systemic arterial hypertension (SAH), blood glucose, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL) and triglycerides. To identify frailty syndrome, the method proposed by Fried was used. The data were analyzed through descriptive statistics, chi-square test (P < 0.10) and multinomial logistic regression (P < 0.05). RESULTS: A total of 205 individuals were evaluated. It was found that 26.3% (n = 54) of the elderly people were frail, 51.7% (n = 106) were pre-frail and 22% (n = 45) were non-frail. The preliminary bivariate analysis (P < 0.10) for the regression model showed that frailty was associated with BMI (P = 0.016), LDL cholesterol (P = 0.028) and triglycerides (P = 0.093). However, in the final multivariate model, only overweight remained associated with the pre-frail condition (odds ratio, OR = 0.44; 95% confidence interval, CI = 0.20-0.98; P = 0.045). CONCLUSION: States of frailty were highly present in the hospital environment. The pre-frail condition was inversely associated with overweight.

RESUMO CONTEXTO E OBJETIVO: A identificação da síndrome de fragilidade em idosos hospitalizados em interface com fatores de risco cardiovascular é relevante, pois pode contribuir para a ampliação do conhecimento sobre essa relação no nível de serviço terciário. Este estudo objetivou avaliar os fatores de risco cardiovascular associados à síndrome de fragilidade em idosos hospitalizados. TIPO DE ESTUDO E LOCAL: Estudo observacional transversal em hospital público de ensino. MÉTODOS: Participaram idosos internados nas clínicas médica e cirúrgica. Os fatores de risco cardiovascular avaliados foram: índice de massa corporal (IMC), circunferência abdominal, hipertensão arterial sistêmica (HAS), glicemia, colesterol total, lipoproteínas de alta densidade (HDL), lipoproteínas de baixa densidade (LDL) e triglicérides. Para identificar a síndrome de fragilidade, utilizou-se o método proposto por Fried. Os dados foram analisados por estatística descritiva, teste qui-quadrado (P < 0,10) e regressão logística multinomial (P < 0,05). RESULTADOS: Foram incluídos 205 indivíduos. Constatou-se que 26,3% (n = 54) dos idosos eram frágeis, 51,7% (n = 106) pré-frágeis e 22% (n = 45) não frágeis. A análise bivariada preliminar (P < 0,10) para o modelo de regressão indicou associações da fragilidade com as variáveis IMC (P = 0,016), colesterol LDL (P = 0,028) e triglicérides (P = 0,093). Entretanto, no modelo multivariado final, apenas a variável excesso de peso permaneceu associada à condição de pré-fragilidade (odds ratio, OR = 0,44; intervalo de confiança, IC 95% = 0,20-0,98; P = 0,045). CONCLUSÃO: Os estados de fragilidade apresentaram-se elevados em ambiente hospitalar. A condição de pré-fragilidade foi inversamente associada ao excesso de peso.

Qualidade de vida e adesão ao tratamento farmacológico entre idosos hipertensos / Calidad de vida y adhesión al tratamiento farmacológico entre personas mayores hipertensiva / Quality of life and accession to the pharmacological treatment among elderly hypertensive

RESUMO Objetivo: comparar as variáveis obtidas em situação de adesão e não adesão ao tratamento farmacológico para hipertensão arterial sistêmica, segundo condições socioeconômicas, tempo de diagnóstico, morbidades autorreferidas, indicativo de depressão e qualidade de vida. Método: estudo transversal realizado com 524 idosos aderentes e 505 não. Realizou-se análise descritiva, testes Qui-quadrado e t-Student (p<0,05). Resultados: observou-se entre os aderentes maior proporção de idosos mais velhos, morbidades e indicativo de depressão. Aqueles não aderentes obtiveram escores inferiores em todos os domínios e facetas de qualidade de vida. Conclusão: devem-se preconizar ações que favoreçam a maior adesão ao tratamento farmacológico, visando minimizar o impacto das comorbidades e melhorar a qualidade de vida.

RESUMEN Objetivo: comparar las variables obtenidas en el estado de cumplimiento y la no adhesión a al tratamiento farmacológico de la hipertensión, de acuerdo con las condiciones socioeconómicas, momento del diagnóstico, morbilidades auto-reporte, indicativo de la depresión y la calidad de vida. Método: estudio transversal con 524 miembros y 505 ancianos no. Una prueba de la t análisis descriptivo, prueba de Chi-cuadrado y Student (p <0,05). Resultados: se observó entre los abonados mayor proporción de sujetos de edad avanzada, indicativos de la morbilidad y la depresión. No conforme con puntajes más bajos en todas las áreas y facetas de la calidad de vida. Conclusíon: se debe promover acciones que favorezcan el más alto es el tratamiento farmacológico para reducir al mínimo el impacto de las comorbilidades y mejorar la calidad de vida.

ABSTRACT Objective: to compare variables obtained in adherence and non-adherence to drug treatment for hypertension, according to socioeconomic situation, time of diagnosis, self-reported morbidities, indicative of depression and quality of life. Method: cross-sectional analytical study of 524 elderly with adherence and 505 non-adherence to the treatment. A descriptive analysis, Chi-square test and Student t test (p < 0.05) were held. Results: there was higher proportion of older subjects, indicative of morbidity and depression among those with adherence. Non-adherence subjects had lower scores in all domains and quality of life facets. Conclusion: actions favoring the adherence to pharmacological treatment should be recommended, to minimize the impact of comorbidities and improve quality of life.