Quality of life and social vulnerability of older adults in the urban community: A cross-sectional study.

We aimed to investigate the association between social vulnerability and the quality of life of older adults. A cross-sectional study was conducted with 805 older adults. Quality of life was measured using the WHOQOL-BREF and WHOQOLOLD instruments. Moreover, the older adults were evaluated according to the level of social vulnerability of the sector they live in. We found that older adults living with medium and high/very high social vulnerability had lower quality of life scores in the social relationships domain and the sensory skills facet compared to those with low social vulnerability. Those who lived in medium social vulnerability sectors had lower scores in the physical domain and in the past, present, and future activities facet. Translating these results into older adult care practice is in line with the new health paradigms that aim to overcome the current biological model of health care an moves toward the active aging approach.

Factors associated with the occurrence of falls among older people with and without cataracts: Structural equation modelling analysis.

AIMS AND OBJECTIVES: To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community-dwelling older adults according to self-reported cataracts. BACKGROUND: Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis. DESIGN AND METHOD: This is a cross-sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed. RESULTS: The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls. CONCLUSION: The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts. RELEVANCE TO CLINICAL PRACTICE: The expanded understanding of the factors associated with falls among community-dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events.

Potentially inappropriate medication use and frailty phenotype among community-dwelling older adults: A population-based study.

AIMS AND OBJECTIVES: To investigate the association between potentially inappropriate medication use and frailty phenotype among community-dwelling older adults and to identify factors associated with the use of these drugs according to frailty condition. BACKGROUND: There is insufficient evidence about the association between inappropriate medication use and the condition of frailty, particularly among community-dwelling older adults. Therefore, data obtained from population surveys should be made available in order to support the development of clinical guidelines about the prevention of frailty. DESIGN: This was a cross-sectional study conducted according to the STROBE Checklist. METHODS: This population-based study was conducted on 1,607 older adults. Potentially inappropriate medication use was assessed according to Beers criteria and frailty syndrome was determined according to the phenotype proposed by Fried and colleagues. Data were analysed statistically using multinomial or binary logistic regression models. RESULTS: About 13.6% of the subjects were frail, and 36.8% used at least one inappropriate medication. The adjusted model indicated that, the more potentially inappropriate medication use, the higher the prevalence of frailty, prefrailty and the walking slowness component. Female gender, one or more years of schooling, five or more reported morbidities, and instrumental dependence regarding daily life activities were factors associated with potentially inappropriate medication use in the nonfrail group. CONCLUSION: Inappropriate medication use was prevalent among community-living older adults, and its presence was associated with the occurrence of frailty. RELEVANCE TO CLINICAL PRACTICE: Primary care nurses are the professionals with the greatest contact with the older adults in the community. Thus, the results support the inclusion of the assessment of potentially inappropriate medication use in the routine of nursing consultation. In case of a positive screening, the older person should be referred to geriatric evaluation in order to optimise drug treatment for the prevention of frailty.

Factors associated with the social, individual and programmatic vulnerability of older adults living at home.

OBJECTIVE: To verify the occurrence and factors associated to social, individual and programmatic vulnerability among older adults. METHOD: A household and cross-sectional survey conducted with 701 community-dwelling older adults. For evaluation of the individual component, we used the frailty phenotype; for the social component, the social vulnerability index was implemented; and for the programmatic component, the Index of access and use of health services. Descriptive and bivariate statistical analyzes and multinomial logistic regression were also carried out (p≤ 0.05). RESULTS: It was verified that 15.7% of the older adults lived in areas of high social vulnerability, 31.8% were physically frail and had a moderate programmatic vulnerability score. Older people of a lower age, having lower education and income levels were more likely to live in areas of high or very high social vulnerability. The female gender and the high age groups increased the chances of the frailty condition. It was also observed that the older adults in the 70├ 80-year age group and having lower education were more likely to have medium programmatic vulnerability. CONCLUSION: The importance of primary care professionals to consider the multidimensional aspect of vulnerability in identifying older adults who need to be prioritized in health care is evidenced.

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.

[Empowering a group of seniors in a rural community]. / Potencializando um grupo de terceira idade de uma comunidade rural.

OBJECTIVE: To describe the stages of the empowerment process of a group of seniors in a rural community. METHOD: Convergent care research whose foundation is to use the scope of practice. Conducted with the proposal to change the practice of 21 seniors and nine health professionals, with the aim of health promotion empowerment. Data were collected during 22 meetings, and group interviews at the end of the intervention. RESULTS: Showed that despite the initial impact of the change, the group was able to welcome the new change, taking advantage of the space to express anxieties, share joys, and build new knowledge, which led to the incorporation of changes that reflected in the development of healthy habits and improvements in interpersonal relationships. CONCLUSION: The convergent care research consisted of strategy that changed the group's lives, empowering them with health promoting actions.

Exploring the effect of the structural model of active aging on the self-assessment of quality of life among older people: A cross-sectional and analytical study.

BACKGROUND: Although studies have examined the relationship between variables associated with active aging and quality of life (QoL), no studies have been identified to have investigated the effect of a structural model of active aging on QoL in a representative sample of older people in the community. OBJECTIVE: To measure the domains and facets of QoL in older people and identify the effect of the structural model of active aging on the self-assessment of QoL. DESIGN AND SETTING: This cross-sectional analytical study included 957 older people living in urban areas. Data were collected from households using validated instruments between March and June 2018. Descriptive, confirmatory factor, and structural equation modeling analyses were performed. RESULTS: Most older people self-rated their QoL as good (58.7%), and the highest mean scores were for the social relationships domain (70.12 ± 15.4) and the death and dying facet (75.43 ± 26.7). In contrast, the lowest mean scores were for the physical domains (64.41 ± 17.1) and social participation (67.20 ± 16.2) facets. It was found that active aging explained 50% of the variation in self-assessed QoL and directly and positively affected this outcome (λ = 0.70; P < 0.001). CONCLUSION: Active aging had a direct and positive effect on the self-assessment of QoL, indicating that the more individuals actively aged, the better the self-assessment of QoL.

[Factors associated with the participation of elderly people in group educational activities]. / Fatores associados a participação de idosos em atividades educativas grupais.

This study sought to characterize the elderly and their participation in group educational activities, and to verify the sociodemographic and health factors associated with non-participation. It was a cross-sectional survey carried out with 2,142 elderly individuals, using descriptive analysis, Student's t-test and logistical regression (p<0.05). In both groups, the majority of participants were women, 60 - 70 years of age, married with an income of one minimum salary. The elderly participants predominately showed 1-4 years of education, with non-participants 4 - 8. The morbidities most cited by the elderly who participated in educational activities were: hypertension and vision problems. Among non-participants, vision and spinal problems prevailed. In both groups, the greatest percentage was 1 - 3 incapacities. The age range of 80 years and above was associated with a greater chance of non-participation in activities. It is necessary to plan actions that favor participation, thereby contributing to monitor their health conditions.

[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.

[Factors associated with the quality of life of elderly men]. / Fatores associados com a qualidade de vida de homens idosos.

This was an analytical, cross-sectional household survey study aimed at describing the sociodemographic characteristics, health and quality of life of elderly men, and to verify the socioeconomic and health factors related to quality of life. Participants in this study included 804 elderly men. Data were collected using the following instruments: Older Americans Resources and Services scale (OARS), the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). Descriptive analysis, student's t-test, Pearson correlation and multiple linear regression (p<0.05) were used. The prevalent characteristics were: individuals 60-70 years old, married, 4-8 years of education, and a minimum wage income. The lowest quality of life scores were in the physical domain and autonomy facet, and were associated with: the absence of a companion, education, low income, higher number of comorbidities, and functional disability. Functional disability had the strongest influence on the quality of life, except for the physical domain and intimacy facet.

Quality of life in older adults according to race/color: a cross-sectional study.

BACKGROUND: Increased longevity is accompanied by new social and health demands, such as the race/color social construct, indicating the need to identify the specific needs of older adults to maintain and improve their quality of life. OBJECTIVE: We aimed to verify the direct and indirect associations of demographic, economic, and biopsychosocial characteristics with self-assessed quality of life in older adults according to race/color. DESIGN AND SETTING: This cross-sectional study included 941 older adults living in the urban area of a health microregion in Minas Gerais, Brazil. METHODS: Older adults were divided into three groups: white (n = 585), brown (n = 238), and black (n = 102) race/color. Descriptive and trajectory analyses were performed (P < 0.05). RESULTS: Among the three groups, worse self-assessed quality of life was directly associated with lower social support scores and greater numbers of depressive symptoms. Worse self-assessed quality of life was also directly associated with a higher number of functional disabilities in basic activities of daily living and the absence of a partner among older adults of brown and black race/color. Lower monthly income and higher numbers of morbidities and compromised components of the frailty phenotype were observed among participants of white race/color, as well as lower levels of education in the brown race/color group. CONCLUSION: Factors associated with poorer self-assessed quality of life among older adults in the study community differed according to race/color.

[Correlation between quality of life and morbidity of the caregivers of elderly stroke patients]. / Correlação entre qualidade de vida e morbidade do cuidador de idoso com acidente vascular encefálico.

The objective of this study was to describe the sociodemographic characteristics and the quality of life of the caregivers of elderly individuals with a stroke history, and correlate morbidity with the caregivers' quality of life scores. This is a cross-sectional household survey that interviewed the caregivers of elderly individuals using the following tools: a semi-structured instrument; the World Health Organization Quality of life-BREF; and the Brazilian Multidimensional Functional Assessment Questionnaire. Descriptive analysis and Pearson's correlation (p<0.05) were performed. Most participants were female (93.5%), with a mean age of 55.4±14.17 years, married or living with a partner (58.7%), with four to eight years of education (28.3%), and an income equivalent to one minimum wage salary (34.8%). The highest quality of life score was in the social relations domain (67.57) and the lowest was in the environmental domain (54.82). The highest number of caregiver morbidities correlated with the lowest scores in all quality of life domains.

[The effects of professional factors on the quality of life of family health team nurses]. / A relação dos aspectos profissionais na qualidade de vida dos enfermeiros das equipes Saúde da Família.

The objective of this study was to identify the professional factors affecting the quality of life of nurses working in the family health teams in the Macro Health Region, referred to as the South Triangle, in the State of Minas Gerais. This is a descriptive, cross-sectional study. The participants were 90 nurses, who answered a questionnaire containing the professional variables and the Quality of Life assessment instrument - WHOQOL-100. The results showed a negative impact regarding the number of jobs, unstable jobs, excessive workload and job dissatisfaction in the nurses' Quality of Life domains. There is a need to (re)define the public policies that control the working conditions of these professionals. Actions that contribute towards improving nurses' Quality of Life are important, considering their strong influence on the quality of the healthcare that is delivered.

Health self-care practices among community older adults with morbidity.

OBJECTIVES: to describe sociodemographic and health characteristics of older adults with morbidity, identify self-care practices and verify the association of sociodemographic variables with those related to health and self-care practices. METHODS: a quantitative, analytical and cross-sectional household survey, developed in the urban area in the countryside of Minas Gerais, from 2017 to 2018. A total of 796 older adults were assessed using validated instruments, such as Geriatric Depression Scale: short form, Brazilian Questionnaire for Functional and Multidimensional Assessment, International Physical Activity Questionnaire, Instrument for Assessing Attitude Towards Taking Medications. Multiple logistic regression (p<0.05) was used. RESULTS: negative self-perceived health was associated with low income and education. As for self-care in health, being physically active associated with the age group 60 |-| 79 years and higher education. CONCLUSIONS: sociodemographic variables such as sex, age group, income, education, marital status, housing arrangement were related to health status and self-care practice.

Racial inequities and biopsychosocial indicators in older adults. / Iniquidades raciais e indicadores biopsicossociais de idosos.

OBJECTIVE: to analyze the association of self-reported skin color/race with biopsychosocial indicators in older adults. METHOD: cross-sectional study conducted with a total of 941 older adults from a health micro-region in Brazil. Data were collected at home with instruments validated for the country. Descriptive analysis and binary, multinomial and linear logistic regression (p<0.05) were performed. RESULTS: Most older adults were self-declared white color/race (63.8%). Black color/race was a protective factor for negative (OR=0.40) and regular (OR=0.44) self-rated health perception and for the indicative of depressive symptoms (OR=0.43); and it was associated with the highest social support score (ß=3.60) and the lowest number of morbidities (ß=-0.78). CONCLUSION: regardless of sociodemographic and economic characteristics, older adults of black color/race had the best outcomes of biopsychosocial indicators.

Social support among older adults understood through structural equation modeling.

OBJECTIVES: to analyze factors associated, directly and indirectly, with lower social support of older adults, according to sex. METHODS: a cross-sectional study, with 941 older adults from a health micro-region in Minas Gerais. Descriptive and trajectory analyzes were carried out (p<0.05). RESULTS: in groups of women and men, direct and significant associations were observed between a smaller social network (p<0.001;p<0.001), single-person housing (p=0.046;p<0.001), greater number of depressive symptoms (p<0.001;p=0.010) and lower participation in advanced activities (p<0.001;p=0.005) with lower social support. In women, younger age was directly and significantly associated with outcome (p<0.001). In men, older age, mediated by lower participation in advanced activities, was indirectly associated with outcome. CONCLUSIONS: men and women showed less social support associated with social network, housing arrangement, depressive symptoms and participation in advanced activities. Understanding the context of social support among older adults makes it possible to establish more effective measures to improve care.

Resilience in elderly people: factors associated with sociodemographic and health conditions.

OBJECTIVE: to describe the sociodemographic and health characteristics of elderly people, measure the score of total resilience and by sex and verify the association of sociodemographic and health variables with total resilience and by sex. METHODS: this is a household survey with 808 elderly people, assessed by validated instruments. Student's t test and multiple linear regression (p<0.05). RESULTS: most were female, 60|-|79 years old. The total resilience score was 78.06, for men 81.53 and for women, 76.32. Total resilience was associated with males; positive self-perceived health; greater participation in Advanced Activities of Daily Living; fewer morbidities; absence of depressive symptoms. Among men and women, resilience was associated with greater participation in Advanced Activities of Daily Living and absence of depressive symptoms and, specifically, among women, positive self-perceived health. CONCLUSION: these results contribute to nursing care, aiming to encourage resilience.

Association between living arrangement and quality of life for older adults in the community.

OBJECTIVE: to compare the sociodemographic and economic characteristics of the older adults in the community according to the living arrangement and to verify the association between the type of living arrangement and the quality of life scores. METHOD: a cross-sectional epidemiological study conducted with 796 older adults in the community. To assess quality of life (dependent variable), network and social support (adjustment variable), validated and applied chi-square tests, descriptive statistical analysis, multiple comparison analysis (ANOVA) and multiple linear regression model (p<0.05) were used. RESULTS: the older adults who lived only with their spouses had better quality of life scores in all domains and facets, except in the death and dying domain, which did not show any significant difference. The lowest scores for quality of life were identified in the groups with the presence of children and, exceptionally, in the domain of social relationships and, in the facets death and dying and intimacy, those who lived alone had worse assessments. In the adjusted model, there was an association between the type of living arrangement and the different domains and facets of quality of life. CONCLUSION: living arrangement was associated with quality of life scores for older adults in the community, even after adjusting for the gender, age, number of morbidities, and social support variables.

Using structural equation modeling in the understanding of functional disability in older adults.

OBJECTIVE: to analyze functional disability and its associated factors among community-dwelling older adults. METHOD: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. RESULTS: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. CONCLUSION: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.