Psychometric properties of the falls efficacy scale-international and validating the short version among older Brazilians.

OBJECTIVES: The aim of this study was to: (1) confirm the reliability and validity of a single factor structure for the 16-item FES-I within a Brazilian context; and (2) confirm the reliability and validity of the abbreviated Short FES-I (7 items) within a Brazilian context. METHODS: We compared the reliability and construct validity of the unidimensional FES-I and the Short FES-I among older Brazilians. Our analyses included confirmatory factor analyses, and discriminatory validity and internal reliability consistency comparisons. RESULTS: The unidimensional FES-I (α = 0.94; CFI = 0.98; RMSEA = 0.08) and the Short FES-I (α = 0.87; CFI = 0.98; RMSEA = 0.07) are equally valid and reliable measures. CONCLUSION: The FES-I is best represented as a unifactorial structure yielding a total Fear of Falling score. Researchers and healthcare professionals can also use the equally robust Short-FES-I to best minimize responder burden.

Prevalence of Polypharmacy of Older People in a Large Brazilian Urban Center and its Associated Factors.

BACKGROUND: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. OBJECTIVE: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. METHODS: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. RESULTS: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. CONCLUSION: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC.

The role of spirituality and religiosity on suicidal ideation of homeless people in a large Brazilian urban center.

BACKGROUND: Suicidal ideation is an important mental health issue among homeless people. Despite the fact that spirituality and religiousness (S/R) have been associated with lower levels of suicide behavior, there is little evidence on this relationship among homeless individuals. Thus, this study aims to investigate the association between S/R and suicidal ideation among homeless people living in a large Brazilian city. METHODS: This cross-sectional study included 456 homeless individuals living in Sao Paulo, Brazil. Logistic and linear regression models were used to determine the role of religious and spiritual beliefs (Duke Religion Index, FACIT SP-12 and Brief-RCOPE) on suicidal ideation, after adjustements. RESULTS: Most participants were male (75%) with a mean age of 44.53(SD 12.62) years. A total of 49.6% had significant depressive symptoms and the prevalence of suicidal ideation was 29.8%. In the adjusted logistic regression, higher levels of religiousness (organizational, nonorganizational and intrinsic), positive religious/spiritual coping, peace and meaning were associated with a lower suicidal ideation. The same results were found when using linear regression models. LIMITATIONS: Long questionnaires can be factors of inhibition and fatigue for the participants. Suicidal ideation was based on a single question. CONCLUSION: Our results revealed a high prevalence of suicidal ideation and depression in our sample. Religiousness and spirtuality were important factors in the life of homeless individuals, being negatively associated with suicidal ideation. These results could make healthcare professionals aware of the importance of addressing S/R issues in this vulnerable population.