[Nurses' interventions in the management of urinary incontinence in the elderly: an integrative review]. / Atuação do enfermeiro no manejo da incontinência urinária no idoso: uma revisão integrativa.

The objective of this study was to verify the strategies that nurses use to manage urinary incontinence (UI) in the elderly. An integrative literature review was performed on the following databases: WEB OF SCIENCE, MEDLINE, SCOPUS and CINAHL, in the period from 2006 to 2010. A total of 186 articles were located, and after excluding duplicates and performing a careful reading of the full articles, the sample was comprised of seven articles. Most studies utilize an overall approach to urinary incontinence, without characterizing the type or the subjects' claims. Only one study addressed the management of urinary incontinence in the elderly with dementia; another specified the type (hyperactive bladder). Therefore, there is a need for further clinical nursing studies regarding the management of urinary incontinence, aiming to provide scientific evidence to support this practice.

[Urinary incontinence and the criteria of frailness among the elderly outpatients]. / Incontinência urinária e os critérios de fragilidade em idosos em atendimento ambulatorial.

The objectives of this study were to verify the occurrence of urinary incontinence (UI) and its characteristics in pre-frail and frail elderly patients of a geriatrics outpatient clinic, compare the presence of frailness criteria among the elderly with and without UI and identify among the frailty criteria the chance of risk for UI among those elderly outpatients. Participants were 100 elderly individuals, with an average age of 76.2 years; 65 participants reported UI, 71.3% of which presented three or more frailness criteria. The occurrence of UI was greater in frail participants (p=0.0011). Multivariate analysis showed that the criteria slowness (OR=4.99) and exhaustion (OR=4.85) has a statistically significant relation with UI. The occurrence of UI was high and participants who presented slowness have a risk almost five times greater to presenting UI while those reporting exhaustion have a risk five times greater for UI compared to those without these criteria.

Lack of anticipated support for care for community-dwelling older adults. / Ausência de expectativa de suporte para o cuidado aos idosos da comunidade.

OBJECTIVE: to identify the factors associated with lack of anticipated support for care for community-dwelling older adults. METHOD: this study presents comparison and logistic regression analyses of data from 671 individuals who took part of the multicentric study entitled "Frailty in older Brazilians" - a quantitative, epidemiologic and transversal investigation carried out between 2008 and 2009. RESULTS: the subjective evaluation of anticipated support for care for community-dwelling older adults was a good indicator of risk for lack of anticipated support for care in women, older adults who live alone and those with poor self-rated health. CONCLUSION: it is necessary to reflect upon the formal support system currently available for older people in Brazil, considering that those who most frequently presented lack of anticipated support for care are an increasing population. The study also highlights the importance of using subjective methods for the evaluation of the adequacy of older adults' support network.

Violência contra a pessoa idosa no município de Campinas, São Paulo, nos últimos 11 anos: uma análise temporal / Violence against old people in the city of Campinas, São Paulo, in the last 11 years: a temporal analysis

Resumo Objetivo Analisar as notificações dos casos de violência contra a pessoa idosa, no período de 2009 a 2019, através de dados obtidos no Sistema de Notificação de Violência (SISNOV) no município de Campinas, Estado de São Paulo, Brasil. Método Trata-se de uma pesquisa epidemiológica de abordagem quantitativa, descritiva e tendência temporal. Para as análises das notificações seguiu-se a observação das informações de acordo com as variáveis sociodemográficas, característica da violência e de seu agressor; e no tocante a análise temporal anual: faixa etária, tipos de violência, meio de agressão e sexo do autor. Resultados 1.217 idosos sofreram agressões, sendo que deste total (69,5%) eram do sexo feminino, com predomínio na faixa etária entre 60 a 69 anos (35,8%), viúvas (37,7%) e de cor branca (64,4%). O tipo mais prevalente de violência foi a negligência (33,1%), sendo a residência (92.9%) o local de maior ocorrência. O principal autor das agressões era do sexo masculino (55,6%), o meio utilizado para praticá-la foi a força corporal (24,4%). A análise de tendência temporal evidenciou aumento de: faixa etária: 60-69 anos, violência física, meios utilizados para a sua prática: força corporal, objetos e envenenamento, e sexo do agressor: ambos. Conclusão Os resultados obtidos foram ao encontro de outras pesquisas, indicando uma tendência no perfil das vítimas e agressão, salienta-se ainda a importância desse grupo conhecer os seus direitos e serem incentivados a realizar as denúncias, bem como os profissionais de saúde, para que se elaborem políticas públicas cada vez mais eficazes para o enfrentamento dessa questão.

Abstract Objective To analyze the notifications of cases of violence against old people in the period from 2009 to 2019 using data obtained from the Violence Notification System (SISNOV) in the city of Campinas, State of São Paulo, Brazil. Method This is an epidemiological research with a quantitative, descriptive approach and temporal trend. For the analysis of the notifications, information was observed according to the sociodemographic variables characteristic of violence and its aggressor, and according to the annual temporal analysis: age group, types of violence, means of aggression, and gender of the author. Results 1,217 old people suffered aggression, (69.5%) of which were female, with a predominance of the age group between 60 and 69 years (35.8%), widows (37.7%), and whites (64.4%). The most prevalent type of violence was neglect (33.1%), with the residence (92.9%) being the place of greatest occurrence. Most of the aggressors were male (55.6%), and the way to do it was with body strength (24.4%). The temporal trend analysis showed an increase in the age group: 60-69 years, physical violence, means used for that - body strength, objects, and poisoning -, and gender of the aggressor - both. Conclusion The results obtained were in line with other studies, indicating a trend in the profile of victims and aggression, and it is important for this group to know their rights and be encouraged to make complaints, as well as health professionals so that increasingly effective public policies are developed to address this issue.

Effect of cycle ergometer and conventional exercises on rehabilitation of older patients with total hip arthroplasty: study protocol for randomized controlled trial.

BACKGROUND: Total hip arthroplasty (THA) is an increasingly common treatment for older patients with hip osteoarthritis. The best strategy for a physiotherapy intervention for older people after THA is not clear in the literature. The purpose of this protocol study is to test the feasibility of undertaking a full trial clinical to evaluate the effect of ergometer cycling-associated conventional exercises on functional results and health-related quality of life (HRQOL) of older patients with THA. METHODS/DESIGN: This study protocol is a prospective, single center, randomized controlled pilot clinical trial. Older patients (≥60 years) in the postoperative phase after primary unilateral THA for hip osteoarthritis will be consecutively recruited for this study and randomly allocated to 2 treatment groups. Group I will perform cycle ergometer and conventional exercises, and group II will perform only conventional exercises. The sessions will be conducted twice a week for 8 weeks. Assessments will be made at baseline (2 weeks postoperatively: the moment that the patients receive a referral for physical therapy, which will start after suture removal), after intervention (10 weeks postoperatively), and at 6 months of follow-up (24 weeks postoperatively). The primary outcomes are the function, evaluated using the Harris Hip Score (HHS) and the Short Physical Performance Battery (SPPB). The secondary outcome is HRQOL, measured using 2 evaluation instruments: the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data collectors will be blinded and will not have contact with participants during the interventions. DISCUSSION: This randomized controlled trial will provide evidence regarding the effect of this exercise therapy on physical function and quality of life in older patients after THA. If our hypothesis is correct, both interventions will be effective, but the exercises on the cycle ergometer conferring better results in function, physical performance and quality of life. The study follows Consolidated Standards of Reporting Trials (CONSORT) guidelines, and the approval of the local ethics committee has been obtained. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01622465 (14 June 2012).

WOMAC and SF-36: instruments for evaluating the health-related quality of life of elderly people with total hip arthroplasty. A descriptive study.

CONTEXT AND OBJECTIVES: Quality-of-life results have increasingly been evaluated among patients undergoing joint replacements. The objective of this study was to compare two assessment instruments for health-related quality of life (one generic and the other specific), among elderly patients undergoing total hip arthroplasty. DESIGN AND SETTING: Cross-sectional descriptive study in a reference hospital in the region of Campinas. METHODS: The subjects were 88 elderly outpatients aged 60 years or over who underwent primary total hip arthroplasty. Two instruments for assessing health-related quality of life were applied: the generic Medical Study 36-item Short-Form Health Survey (SF-36) and the specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Cronbach's alpha and the ceiling and floor effects of the instruments were evaluated. RESULTS: The scores from both instruments showed that issues of a physical nature affected these elderly people's quality of life most. The pain and stiffness dimensions of WOMAC showed ceiling effects and only the functional capacity and pain dimensions of the SF-36 did not show the ceiling effect. The SF-36 presented floor effects in the dimensions of physical and emotional aspects. Cronbach's alpha was considered satisfactory in both instruments (α > 0.70). CONCLUSIONS: The floor and ceiling effects that were observed suggest that these instruments may present some limitations in detecting changes to the majority of the SF-36 dimensions, except for functional capacity and pain, and to the pain and stiffness dimensions of WOMAC, when applied to elderly people with total hip arthroplasty.

Suporte social e expectativa de cuidado de idosos: associação com variáveis socioeconômicas, saúde e funcionalidade / Social support and expectation of elderly care: association with sociodemographic variables, health and functionality

RESUMO Este estudo tem como objetivo avaliar a associação entre suporte percebido e recebido e a expectativa de cuidado com as variáveis sociodemográficas, condições de saúde e funcionalidade dos idosos da comunidade do município de Várzea Grande, no estado de Mato Grosso. Trata-se de uma pesquisa transversal, realizada com 348 idosos. A coleta de dados foi efetivada por entrevistas, utilizando-se de um instrumento com questões sociodemográficas; estado de saúde; funcionalidade; e rede de suporte percebido e recebido. As análises foram realizadas pelos testes do Qui-quadrado ou Exato de Fisher. O suporte social foi avaliado positivamente entre os idosos, reconhecendo a família como principal provedora, principalmente as mulheres. A expectativa do cuidado foi associada ao cônjuge, por gênero, idade, estado civil e arranjo familiar, principalmente às filhas ou noras, enquanto os irmãos e o profissional pago foram pouco mencionados. Na velhice, há uma dependência maior do suporte, em razão da saúde e da incapacidade, entretanto, há uma tendência da redução da rede de apoio na idade avançada. É importante desenvolver estratégias de atenção aos idosos e cuidadores familiares. Espera-se que este estudo subsidie a implementação de ações de cuidados aos idosos.

ABSTRACT This study aims to evaluate the association between perceived and received support and the expectation of care with the sociodemographic variables, health conditions and functionality of the elderly in the community of the municipality of Várzea Grande, Mato Grosso state. It is a cross-sectional study carried out with 348 elderly people. The data collection was carried out by interviews, using an instrument with sociodemographic questions; health condition; functionality; and perceived and received support network. Analyzes were performed using Chi-square or Fisher's Exact tests. Social support was evaluated positively among the elderly, recognizing the family as the main provider, especially women. The expectation of care was associated to the spouse, by gender, age, marital status and family arrangement, especially to daughters or daughters-in-law, while siblings and paid professional were little mentioned. In old age, there is a greater reliance on support, due to health and disability, however, there is a tendency to reduce the support network in old age. It is important to develop care strategies for the elderly and family caregivers. It is hoped that this study will subsidize the implementation of elder care actions.

Idosos mais idosos: uma revisão da literatura / Older senior: a review of literature / Ancianos Ancianos: una revisión de la literatura

O objetivo é revisar os artigos científicos publicados nos últimos cinco anos sobre idosos longevos (≥80 anos) e identificar o perfil dessas publicações. Foi realizada uma revisão da literatura, utilizando-se a Biblioteca Virtual em Saúde. A busca resultou na seleção de 36 artigos nacionais e internacionais. Observou-se que a maioria dos estudos era do tipo transversal, realizados em países da Europa e com maior participação de idosos do sexo feminino. Câncer e doenças cardíacas foram os temas mais abordados.

The objective is to review the scientific articles published in the last five years on long-lived elderly (≥ 80 years) and to identify the profile of these publications. An review of literature was carried out, using the Virtual Health Library. The search results in the selection of 36 national and international articles. It was observed that most of the studies were of a cross-sectional type, in countries of Europe and a greater participation of the elderly women. Cancer and heart disease were the topics most covered.

El objetivo es revisar los artículos científicos publicados en los últimos cinco años sobre personas mayores de larga vida (≥ 80 años) e identificar el perfil de estas publicaciones. Se realizó una revisión de literatura utilizando la Biblioteca Virtual en Salud. La búsqueda resultó en la selección de 36 artículos nacionales e internacionales. La mayoría de los estudios fueron estudios transversales realizados en países europeos con una mayor participación de mujeres mayores. El cáncer y las enfermedades cardíacas fueron los temas más discutidos.

Relationship between lower-limb muscle strength and functional independence among elderly people according to frailty criteria: a cross-sectional study.

CONTEXT AND OBJECTIVE: Muscle strength and functional independence are considered to be determinants of frailty levels among elderly people. The aim here was to compare lower-limb muscle strength (LLMS) with functional independence in relation to sex, age and number of frailty criteria, and to ascertain the influence of these variables on elderly outpatients' independence. DESIGN AND SETTING: Quantitative cross-sectional study, in a tertiary hospital. METHODS: The study was conducted on 150 elderly outpatients of both sexes who were in a cognitive condition allowing oral communication, between October 2005 and October 2007. The following instruments were used: five-times sit-to-stand test (FTSST), Functional Independence Measurement (FIM) and Lawton's Instrumental Activities of Daily Living Scale (IADL). Descriptive, comparative, multivariate, univariate and Cronbach alpha analyses were performed. RESULTS: The mean time taken in the FTSST was 21.7 seconds; the mean score for FIM was 82.2 and for IADL was 21.2; 44.7% of the subjects presented 1-2 frailty criteria and 55.3% > 3 criteria. There was a significant association between LLMS and functional independence in relation to the number of frailty criteria, without homogeneity regarding sex and age. Functional independence showed significant influence from sex and LLMS. CONCLUSION: Elderly individuals with 1 or 2 frailty criteria presented greater independence in all FTSST scores. The subjects with higher LLMS presented better functional independence.

[Satisfaction with life and functionality among elderly patients in a geriatric outpatient clinic]. / A satisfação com a vida e a funcionalidade em idosos atendidos em um ambulatório de geriatria.

Aging is often accompanied by functional limitations that affect self esteem, lowering the level of satisfaction with life. Studies highlight satisfaction with life as a predictor of quality of life and has a marked correlation with a decrease in functionality. Therefore, this study sought to examine the relationship between satisfaction with life and functional independence and performance of the lower limbs (muscle strength, gait speed and balance) among the elderly in outpatient care with respect to age groups and genders. A total of 125 elderly men and women aged 60 years and above, attending a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; 3) Satisfaction with life. The sample was random, with a predominance of females, in which the older participants had greater functional impairment. In univariate logistic regression analysis and multivariate analysis, overall self reported and comparative satisfaction with life was more satisfactory among the oldest elderly. The results suggest that older individuals have better satisfaction with life even though they have greater functional impairment.

Variables related to the anticipated support for care in community-dwelling older adults.

OBJECTIVE: to compare the anticipated support for care, living arrangements and variables related to health as functions of gender and age in older adults in the community. METHOD: data was used from the Research network "Frailty in Brazilian Older Adults" (FIBRA network), sample for Campinas (n=671) analyses of data description and comparison were made. RESULT: compared to the men, the women are in worse socio-demographic conditions and have poorer perception of their health and dependency and lower expectations of support for care; those who have expectations anticipate receiving help from only one person. Advanced age was related to lower incapacity percentages and the majority of the older adults assess their health as good or very good, irrespective of their age, although the women predominate in the group composed of those who assess their own health as bad or very bad. CONCLUSION: this study guides the nurse in identifying older adults in situations of risk of lack of support for care and indicates the need for interventions aiming at giving support to this group.

Instituições de Longa Permanência para Idosos no Brasil: revisão integrativa da literatura / Long-stay Institutions in Brasil: an integrative literature review / Instituciones de largo plazo para ancianos en Brasil: una revisión integradora de literatura

Objetivou-se levantar e analisar a produção científica acerca do delineamento dos trabalhos publicados e temas estudados sobre as instituições de longa permanência para idosos no Brasil, produção essa arrolada no LILACS, MEDLINE, BDENF e SciELO no período de 2013 a 2017. O corpus constitui-se por 88 artigos. Nota-se um número insipiente de pesquisas com intervenções, visto que os pesquisadores ainda buscam descrever o perfil dos idosos institucionalizados, segundo critérios de saúde e doença.

It was aimed to review the literature about Brazilian nursing homes for seniors published at LILACS, MEDLINE, BDENF and SciELO between 2013 and 2017. The corpus consists of 90 articles. There is an incipient amount of papers about intervention research, as long as the researchers still seek to describe the profile of the resident seniors, according to health and disease criteria.

El objetivo fue encuestar y analizar la producción científica sobre la delineación de los trabajos publicados y los temas estudiados sobre las instituciones de atención a largo plazo para ancianos en Brasil. El corpus consta de 88 artículos. Existe un número incipiente de investigaciones con intervenciones, ya que los investigadores todavía buscan describir el perfil de los ancianos institucionalizados, de acuerdo con los criterios de salud y enfermedad.

Elderly outpatient profile and predictors of falls.

CONTEXT AND OBJECTIVES Falls are a serious public health problem and are one of the biggest reasons for hospitalization, morbidity and mortality among elderly people. Moreover, few studies on predictors of falls have been conducted in low and middle income countries. The aim here was to identify elderly outpatient profiles according to sociodemographic, clinical, physical and functional variables and correlate them with occurrences of falls among these subjects. DESIGN AND SETTING Cross-sectional descriptive study forming part of the project "Quality of Life of Frail Elderly People", carried out in Campinas, Brazil. METHODS The subjects were 145 elderly individuals (76.3 ± 7.8 years old), of whom 65% were women, who were living in the city of Campinas or nearby and were attended at the geriatric outpatient clinic of a University Hospital. Sociodemographic, clinical, physical and functional data, as well as fall occurrence data, were gathered. Cluster analyses and comparisons between groups were carried out. RESULTS Cluster analysis identified two distinct groups related to the study variables, and the determinants for this distinction were: gender, marital status, physical performance, handgrip strength and functional independence. These groups were compared according to occurrences of falls over the last year, and significant differences between them were found. CONCLUSIONS The results showed that greater occurrences of falls were associated with a profile of elderly people comprising female gender, single status, lower muscle strength and physical performance regarding balance and gait, and lower independence in motor tasks for activities of daily living.

Elder abuse in Brazil: an integrative review / Maus-tratos a idosos no Brasil: uma revisão integrativa

Objective: the present study aimed to carry out an integrative review of literature on the scientific knowledge relating to the occurrence of elder abuse produced in Brazil between the years of 2013 to 2017. Method: a bibliographic survey was carried out through publications indexed in the Virtual Health Library (VHL) database: the Scientific Electronic Library Online (SCIELO), Latin American Literature in Health Sciences (LILACS) and the CAPES Portal of Periodicals (CAPES). The data collection instrument, created by the authors, included characteristics such as: year of publication, main journals, research design, topics covered, main areas of knowledge, sampling and study objectives. Results: 28 publications were analyzed. The main types of violence were psychological (28%), physical (28%), unspecified (16%), financial (12%), self-abandonment (8%), neglect and verbal violence (4%). The majority of the victims were female (64%), of unspecified gender (28%) and male (8%). Conclusion: the present integrative review found that the main violence suffered was psychological together with physical, with the elderly the main victims. The main place of maltreatment was in the home. The research also found that there are gaps in information about the reasons that triggered the aggressions. It is therefore necessary to investigate this subject further and carry out new studies that seek to identify these factors.

Objetivo: o presente estudo objetivou a realização de uma revisão integrativa da literatura sobre o conhecimento científico produzido no Brasil entre os anos de 2013 a 2017, enfatizando a ocorrência de maus-tratos contra idosos. Método: o levantamento bibliográfico foi realizado através de publicações indexadas na base de dados da Biblioteca Virtual de Saúde (BVS): Scientific Electronic Library Online (SCIELO), Literatura Latino-Americana em Ciências de Saúde (LILACS) e Portal de Periódicos CAPES (CAPES). O instrumento de coleta de dados, elaborado pelos autores, abrangeu características como: ano de publicação, principais periódicos, delineamento de pesquisa, temas abordados, principais áreas de conhecimento, amostragem e objetivos dos estudos. Resultados: foram analisadas 28 publicações. Os principais tipos de violência evidenciados foram: psicológica (28%), física (28%), não especificou (16%), financeira (12%), autoabandono (8%), negligência e violência verbal (4%), sendo o principal gênero da vítima do sexo feminino (64%), não especificou o gênero (28%) e do sexo masculino (8%). Conclusão: a presente revisão integrativa evidenciou que as principais violências sofridas foram à psicológica juntamente com a física, sendo as idosas as principais vítimas. O principal local de ocorrência de maus-tratos foi na própria residência. A pesquisa concluiu ainda que há lacunas de informação quanto aos motivos que desencadearam as agressões. Diante disso, faz-se necessária uma maior investigação nesse contexto e realização de novos estudos que busquem identificar esses fatores.

[National studies on family caregivers of older persons: integrative review]. / Estudos nacionais sobre cuidadores familiares de idosos: revisão integrativa.

It is an integrative literature review of Brazilian scientific production on elderly family caregivers, which sought to highlight the profile of papers published in national and international, from January 2005 to September 2010, indexed in MEDLINE, CINAHL and LILACS. It was found 76 studies, published in Portuguese, Spanish or English. Twenty five were selected; most of them were published in 2009 in nursing and public health journals. The sample was divided into the following topics, according to the theme: "building the caregiver's role", "caregivers' quality of life and burden", "caregiver's knowledge about the issues involved in care". The authors found high levels of burden, significant worsening of caregivers' quality of life, lack of support for caregivers, lack of information and preparation for care and lack of instrumentation and studies within this theme.

Relationship between lower-limb muscle strength and frailty among elderly people.

CONTEXT AND OBJECTIVE: Sarcopenia is the main factor involved in the development of frailty syndrome. The aims here were to investigate relationships between lower-limb muscle strength and the variables of sex, age and frailty criteria; compare lower-limb muscle strength with each frailty criterion; and assess the power of each criterion for estimating the risk of frailty among elderly outpatients. DESIGN AND SETTING: Cross-sectional study at the Geriatrics Outpatient Clinic of a university hospital in Campinas. METHOD: A non-probabilistic convenience sample of 150 elderly people of both sexes who were followed up as outpatients was assessed. Sociodemographic data (sex and age) and physical health data (frailty criteria and the five-times sit-to-stand test) were gathered. Descriptive, comparative and multivariate logistic regression analyses were performed. RESULTS: The majority of the elderly people (77.3%) were 70 years of age or over, with predominance of females (64.2%) and had a low score for the five-times sit-to-stand test (81.4% scored 0 or 1); 55.3% of the elderly people presented three or more frailty criteria. A significant association was found between lower-limb muscle strength and the variables of age and number of frailty criteria. CONCLUSIONS: Lower levels of lower-limb muscle strength were associated with advanced age and greater presence of signs of frailty. Moreover, lower-limb muscle strength was also associated with the criteria of reduced walking speed criteria and hand-grip strength.

Ausência de expectativa de suporte para o cuidado aos idosos da comunidade / Falta de expectativas de ayuda para el cuidado de adultos mayores residentes en la comunidad / Lack of anticipated support for care for community-dwelling older adults

RESUMO Objetivo: identificar fatores associados à ausência de expectativa de suporte para o cuidado aos idosos da comunidade. Método: foram utilizados parte dos dados do estudo multicêntrico "Fragilidade em Idosos Brasileiros", pesquisa quantitativa, epidemiológica e transversal desenvolvida no período de 2008 a 2009. Foram realizadas análises de comparação e regressão dos dados de 671 idosos. Resultados: a avaliação da expectativa de suporte para o cuidado aos idosos mostrou-se um bom indicador de risco para ausência de expectativa de suporte em mulheres, idosos que residiam sozinhos e com percepção ruim da própria saúde. Conclusão: conclui-se que é preciso refletir sobre o sistema de suporte oferecido aos idosos no Brasil, visto que o perfil destes que estão em risco é cada vez maior na população. Ressalta-se também a importância da inserção de métodos subjetivos para avaliação da percepção dos idosos sobre suporte para o cuidado.

RESUMEN Objetivo: identificar los factores asociados a la falta de expectativas de ayuda para el cuidado de adultos mayores residentes en la comunidad. Método: este estudio presenta un análisis de comparación y regresión logística de 671 individuos que tomaron parte del estudio multicentro titulado "Fragilidad en ancianos brasileños" - una investigación cuantitativa, epidemiológica y transversal llevada a cabo entre 2008 y 2009. Resultados: la evaluación subjetiva de expectativas de ayuda para el cuidado de adultos mayores residentes en la comunidad ha sido un buen indicador de riesgo para la falta de expectativas de ayuda para el cuidado en mujeres, adultos mayores que viven solas y aquellos con una mala auto percepción de su salud. Conclusión: es necesario reflexionar sobre el sistema de apoyo formal que actualmente existe disponible para las personas mayores en Brasil, considerando que aquellos que presentan más frecuentemente una falta de expectativas de ayuda son una población creciente. El estudio señala además la importancia de usar métodos subjetivos para la calidad de la red de apoyo adecuada para adultos mayores.

ABSTRACT Objective: to identify the factors associated with lack of anticipated support for care for community-dwelling older adults. Method: this study presents comparison and logistic regression analyses of data from 671 individuals who took part of the multicentric study entitled "Frailty in older Brazilians" - a quantitative, epidemiologic and transversal investigation carried out between 2008 and 2009. Results: the subjective evaluation of anticipated support for care for community-dwelling older adults was a good indicator of risk for lack of anticipated support for care in women, older adults who live alone and those with poor self-rated health. Conclusion: it is necessary to reflect upon the formal support system currently available for older people in Brazil, considering that those who most frequently presented lack of anticipated support for care are an increasing population. The study also highlights the importance of using subjective methods for the evaluation of the adequacy of older adults' support network.

The influence of sociodemographic, clinical and functional variables on the quality of life of elderly people with total hip arthroplasty.

OBJECTIVES: To evaluate the health-related quality of life (HRQOL) of elderly people with total hip arthroplasty (THA) and to investigate the relationships and influences of the sociodemographic, clinical and functional variables of these subjects. METHODS: The HRQOL was evaluated by means of the Brazilian versions of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), a general instrument, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a specific instrument. Eighty-eight elderly people of both genders with primary unilateral THA were recruited. The data were subjected to descriptive analysss, univariate analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) to investigate the influences of the variables studied in the dimensions of the SF-36 and WOMAC; and the Mann-Whitney and Kruskal-Wallis tests to compare instrument scores between the variables. RESULTS: There was a predominance of women in the study sample, and their mean age was 68.8 (+/- 7.4) years. Hip function, as assessed by the Harris Hip Score, had a significant influence on HRQOL from the perspective of both the general and the specific instruments. The use of accessories for locomotion, hip functions and satisfaction with the surgery were the main variables that demonstrated significant differences in the dimensions of the SF-36 and the WOMAC. CONCLUSIONS: Investments in functional and rehabilitation programs aimed towards the peculiarities of elderly people with THA can benefit this population.

Resiliência psicológica: fator de proteção para idosos no contexto ambulatorial / Psychological resilience: protector factor for elderly assisted in ambulatory

INTRODUÇÃO: Em idosos, a resiliência psicológica associa-se a depressão, saúde física, atividades da vida diária e saúde percebida. OBJETIVO: Descrever as relações entre funcionalidade, sintomatologia depressiva e cognição em grupos de idosos resilientes e não resilientes. MÉTODO: Estudo descritivo, com 59 pacientes do Ambulatório de Geriatria/HC-Unicamp, idade 69-91 anos. Instrumentos: escalas de atividades básicas e instrumentais da vida diária ABVD, AIVD, sintomas depressivos EDG, Miniexame do Estado Mental MEEM e escala de resiliência. Foram feitas medidas de frequência, posição e dispersão, comparações entre variáveis categóricas Qui-quadrado e Exato de Fisher e numéricas teste de Mann-Whitney, Krushal-Wallis, correlações entre variáveis e análise multivariada de regressão linear. RESULTADOS: Maioria mulheres 80,4%, 70-89 anos, renda ≤ 2 salários mínimos, 43,1% analfabetos, 57% apresentaram AIVD preservadas independência em seis ou sete itens; 43% não preservadas ajuda total ou parcial em ao menos dois itens; 31,4 % apresentaram sintomatologia depressiva sugestiva de depressão. Os mais resilientes >66 em 75 pontos apresentaram média de 5,2±2,1 AIVD, em relação aos menos resilientes 3,6±2,4; p=0,017. Os menos resilientes apresentaram média de 6,4±4,2 sintomas depressivos, os mais resilientes média de 2,6±2,6; p=0,001. Correlação negativa entre resiliência e sintomatologia depressiva r=-0,688; p<0,01. Idosos com frequência >5 sintomas depressivos tenderam a apresentar baixos escores em resiliência análise de regressão linear multivariada. CONCLUSÃO: A resiliência constitui importante fator de proteção para idosos ambulatoriais com relativo grau de dependência e evidência de sintomas depressivos.

INTRODUCTION: Among elderly, psychological resilience is associated with depression, physical health, daily living activities and self-perceived health. OBJECTIVE: To describe the relationships between functionality, depressive symptomatology and resilience between resilient and non resilient groups. METHOD: Descriptive study, 59 patients from the Geriatric Ambulatory/HC Unicamp, age 69-91 years. Instruments: scales of activities of daily living ADL, instrumental activities of daily living IADL, depressive symptoms GDS, Mini-Mental Exam MEEM and resilience. Measurements used were: frequency, position and dispersion, comparisons among categorical variables Chi-square and Fisher Exact, numerical variables Mann-Whitney, Krushal-Wallis, co-relations among variables and linear regression multivariate analysis. RESULTS: Mostly women 80.4%, 70-89 years, income ≤ 2 minimum wage, 43.1% illiterate, 57% showed preserved IADL independence in six or seven items, 43% not preserved partial or total help in at least 2 items, 31.4% showed depressive symptomatology suggestive of depression. The most resilient >66 within 75 scores showed average of 5.2±2.1 IADL, in relation to the least resilient 3.6±2.4; p=0.017. The least resilient showed average of 6.4±4.2 depressive symptoms, the most resilient showed average of 2.6±2.6;p=0.001. Negative co-relation between resilience and depressive symptomatology r=-0.688; p<0.01. Elderly with frequency >5 depressive symptons tended to show low scores in resilience linear regression multivariate analysis. CONCLUSION: Resilience is an important protector factor for elders assisted in ambulatory, with a relative degree of dependency and evidence of depressive symptoms.

Perfis de funcionalidade e relação com óbito em idosos assistidos em Serviço Ambulatorial de Geriatria / Functionality profiles related to mortality in elders assisted in a Geriatric Outpatient Service

Buscou-se avaliar o perfil funcional de idosos atendidos em nível ambulatorial (Ambulatório de Geriatria do Hospital de Clínicas da Universidade Estadual de Campinas), relacionando-o com ocorrência de óbito. Foram avaliados os dados de 120 idosos (≥60 anos), através de critérios sociodemográficos, cognição pelo Mini Exame do Estado Mental, Atividades de Vida Diária (AVD), Atividades Instrumentais de Vida Diária (AIVD), autoavaliação de memória, sintomas depressivos, número de consultas e evolução para óbito em um ano. Utilizou-se a análise de conglomerados, os testes qui-quadrado ou exato de Fischer e o teste de Mann-Whitney para análise comparativa das variáveis entre os grupos (p < 0,05). A média de idade foi de 76,81 (±7,56) anos; 66,7% eram mulheres; 63,33% eram independentes para as AVD e 68,33% eram dependentes para as AIVD; 31,67% tinham sintomas depressivos; 30% apresentavam déficit cognitivo; 56,67% referiram dificuldade para lembrar fatos recentes; 83,33% não tinham dificuldade para lembrar fatos antigos; 6,67% morreram no primeiro ano. Evidenciou-se um perfil constituído predominantemente de idosos mais jovens, mais escolarizados, com dificuldade para lembrar fatos recentes e antigos, pior autoavaliação de memória e que evoluíram para óbito em maior proporção. O segundo perfil constituiu-se predominantemente de idosos mais velhos, mais analfabetos, com menos queixas de memória e que não evoluíram para óbito. Houve um grupo de idosos que sobreviveram até idade mais avançada e com melhor desempenho cognitivo. Considera-se a possibilidade de esse achado associar-se a maior capacidade de resiliência.