Frailty syndrome among older adults after hospitalization: A structural equation modeling analysis.

AIM: To analyze the association of demographic, clinical, health and functional capacity variables as predictors of frailty in older adults after one year of hospital discharge. BACKGROUND: There is still insufficient research with older persons after hospital discharge that evaluated the predictive variables for an increase in the frailty score. Identifying the characteristics that result in greater risk helps to guide care and interventions. METHODS: Longitudinal study involving 129 older adults who completed the follow-up. The Frailty Phenotype was used according to Fried and sociodemographic, clinical, health and functional capacity variables. Analysis was performed using structural equation modeling. RESULTS: At admission, the highest percentage (53.4%) of older adults were pre-frail, followed by frail (23.3%) and non-frail (23.3%). After a year of discharge, there was a decrease in the frail condition (22.5%) and pre-frail (52.7%); and an increase in non-frail (24.8%). At baseline, 29.5% showed impairment in only one component, with an increase in the percentage at follow-up (37.2%). The highest number of morbidities and hospital readmissions and lower IADL scores were predictors of an increase in the frailty score during follow-up. CONCLUSION: The prevalence of frailty was high among hospitalized older adults and after follow-up. Identifying the risk factors allows early and individualized interventions with reduction of negative outcomes. During hospitalization, a multidimensional assessment of older adults should be performed, especially with regard to frailty. The recognition of frailty predictors directs the care of older persons considering their individual needs and allows the improvement and/or stability of the frailty condition.

Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence.

BACKGROUND: Research on quality of life QOL is limited in Brazil and few studies have examined the association between smoking status and quality of life. This study addresses this gap and also examines the association between smoking, nicotine dependence, and duration of smoking cessation on (QOL) among older adults in an urban area in Brazil. METHODS: Data are from a household survey conducted in urban areas of Uberaba, Brazil, in 2012 (n = 980). Multivariable linear regressions were used to evaluate the association between smoking, nicotine dependence based on Fageström test, and smoking cessation on the World Health Organization Quality of Life WHOQOL-BREF and Quality of Life Assessment for Older Adults WHOQOL-OLD. RESULTS: The mean age of older adults in the study was 74.0 (SD = 6.9 years) and 64% of participants were women. The majority, 55% had never smoked, 12.4% were current smokers, and 32.7% were past-smokers. Current smokers had lower scores for social participation (ß = - 2.6) and intimacy (ß = - 3.8) than never smokers. Smokers with high or very high dependence reported higher levels of fear and concern about death and pain before death than those with low or very low dependence (ß = - 10.6). However, smokers with medium levels of nicotine dependence had higher scores on social relationship. Longer cessation time was positively associated with higher scores for psychological health. CONCLUSIONS: Except for the positive association between medium levels of nicotine dependence and better social relationships, smoking and higher levels of nicotine dependence were associated with worse QOL among older adults in Brazil. Nonetheless, smoking cessation had positive effects in QOL. Campaigns targeting older adults should point to the negative impact of tobacco use on QOL and the benefits of smoking cessation.

[Socioeconomic characteristics and quality of life of urban and rural elderly people with heart disease]. / Características socioeconômicas e qualidade de vida de idosos urbanos e rurais com doenças cardíacas.

OBJECTIVE: To compare the socioeconomic variables and quality of life scores (QOL) of elderly residents with heart diseases in urban and rural areas. METHOD: household survey with 829 urban and 220 rural elderlies. The data were collected using: Brazilian Questionnaire for Functional and Multidimensional Assessment, WHOQOL-BREF and WHOQOL-OLD. The collection in the urban area was from June to December of 2008 and, in the rural area, from June 2010 to March 2011. Chi-square, t-student and multiple linear regression (p <0.05) tests were used. RESULTS: The proportion of women and elderlies with 75 years of age and over was higher in urban areas. Lower scores among urban elderlies physical and social relations were observed, and; facets autonomy, past, present and future activities and intimacy; for the rural elderlies, the environment, sensory abilities, death and dying. CONCLUSION: the urban elderlies showed a lower QOL score in most areas and facets compared to rural elderlies.

Transition and factors associated with the level of physical activity combined with sedentary behavior of the elderly: A longitudinal study. / Evolución y factores asociados con los niveles de actividad física y comportamiento sedentario en ancianos: estudio longitudinal

INTRODUCTION: Physical activity and sedentary behavior are emerging issues in public health, especially in developing countries. OBJECTIVE: To verify transition and factors related to physical activity combined with sedentary behavior among the elderly followed for 24 months. MATERIALS AND METHODS: We conducted a longitudinal observational study with people aged 60 years or over living in the urban area of Uberaba, Brazil. We collected the data from sociodemographic, health, and physical tests in 2014 and 2016 using the Mini-Mental State Examination (MMSE), the Katz Index, the Lawton and Brody Scale, the Short Physical Performance Battery (SPPB), and the International Physical Activity Questionnaire (IPAQ). For the combined evaluation we considered a cutoff point of 150 minutes of physical activity per week and the percentile 75 (420 minutes/day) for sedentary behavior constituting the groups: Unsatisfactory (insufficient sum of physical activity and sedentary behavior), intermediate (loss of only one of the two components) and satisfactory (sufficient sum of physical activity and sedentary behavior). The statistical descriptive and inferential analysis was performed using the Statistical Package for Social Sciences™, version 21.0, considering p<0.05. RESULTS: Of the 374 elderly, 61 (16.3%) improved their physical activity and sedentary behavior condition, 226 (60.4%) remained in the same category and 87 (23.3%) got worse. Unsatisfactory levels of physical activity and sedentary behavior were related to the eldest group (p=0.031), the absence of professional activity (p<0.001), the dependence for instrumental activities of daily living (p=0.013), and a worse physical performance (p<0.001). CONCLUSION: Our results showed a relationship between sociodemographic and health factors with physical activity and sedentary behavior, reiterating the need for further research on the subject.

Introducción. La actividad física y el comportamiento sedentario son temas emergentes de salud pública, especialmente en los países en desarrollo. Objetivo. Verificar la transición y los factores relacionados con la actividad física y el comportamiento sedentario entre ancianos durante un seguimiento de 24 meses. Materiales y métodos. Se llevó a cabo un estudio longitudinal y observacional en ancianos de 60 años o más residentes en Uberaba, Minas Gerais, Brasil. Los datos sociodemográficos, de salud y de los exámenes físicos se recolectaron en el 2014 y el 2016 utilizando el Mini-Mental State Examination (MMSE), el índice de Katz, la escala de Lawton y Brody, la Short Physical Performance Battery (SPPB) y el International Physical Activity Questionnaire, (IPAQ). Para la evaluación combinada se consideró el punto de corte de 150 minutos semanales de actividad física y el percentil 75 (420 minutos/día) para el comportamiento sedentario, lo que arrojó los siguientes grupos: insatisfactorio (suma insuficiente de actividad física y comportamiento sedentario), intermedio (pérdida en uno solo de los dos componentes) y satisfactoria (suma suficiente de actividad física y comportamiento sedentario). El análisis estadístico descriptivo e inferencial se hizo con el Statistical Package for Social Sciences™, versión 21.0, p<0,05. Resultados. De los 374 ancianos, 61 (16,3 %) mejoraron su condición de actividad física y comportamiento sedentario, 226 (60,4 %) permanecieron en la misma categoría y 87 (23,3 %) empeoraron. Los niveles insatisfactorios de actividad física y comportamiento sedentario se asociaron con una mayor edad (p=0,031), la ausencia de actividad profesional (p<0,001), la dependencia para las actividades instrumentales de la vida diaria (p=0,013) y un peor rendimiento físico (p<0,001). Conclusiones. Los resultados evidenciaron una relación entre los factores sociodemográficos y de salud con la actividad física y el comportamiento sedentario, lo que reitera la necesidad de nuevos estudios sobre la salud del anciano.

[Profile of patients submitted to amputation related to diabetes mellitus]. / Perfil de clientes submetidos a amputações relacionadas ao diabetes mellitus.

Retrospective study that aimed at describing the clinic and socio- demographical characteristics of 141 individuals which were interned in Teaching Hospital of Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil, who were submitted to amputations related to diabetes and compare the number of amputations considering the variables sex, age, co-morbidity, the type of treatment and then associated the number of amputations with the duration of internments and diagnosis. Data were collected from patient health records, totalizing 208 amputations. Major percentage of masculine individuals (58,9%), and a major occurrence of amputation among the elderly (70.2%); the cause: diabetic foot (35.7%); the most of patients (75.0%) went through internment at least twice; most frequent co-morbidity: arterial hypertension (74.0%); median in the number of amputations was two. It was not observed any significant difference between the variables of study.

[Falls in older adults: predictors and space distribution]. / Queda entre idosos: preditores e distribuição espacial.

OBJECTIVE: This work seeks to calculate the prevalence of falls in the last 12 months among the elderly from the community of the city of Uberaba; verify the occurrence of falls in the elderly of the community according to sociodemographic and health characteristics; and identify and group the types of falls among the older individuals in the city of Uberba. METHODS: Cross-sectional study carried out with 612 elderly people living in the urban area of Uberaba. Descriptive and bivariate analyzes were performed using the chi-square test (p<0.05). The kernel density estimation was used to estimate the intensity of the events. This project was approved by the Research Ethics Committee through Protocol No. 573.833. RESULTS: It was found that 24.7% of the elderly had falls in the last 12 months. The highest proportion of the elderly who suffered falls was female (p=0.004); aged 80 years or more (p=0.001); illiterate (p=0.026); who lived alone (p=0.049); without partner (p=0.002); with negative self-perception of health (p<0.001); dependent for BADL (p=0.049) and IALD (p=0.027); with a lower participation in AADL (p=0.003); pre-fragile/fragile (p<0.001); and with low/poor physical performance (p<0.001). The clusters with the most frequently reported falls were in the center-west region of the city, followed by the southeast region. CONCLUSION: To know the profile and the factors associated with the occurrence of falls among the elderly allows health professionals to develop actions directed to prevent, monitor and control these factors.

Qualidade da assistência de enfermagem ao idoso na atenção primária à saúde no interior de minas gerais

Objetivos: Avaliar a confiabilidade, viabilidade, usabilidade e a utilidade dos indicadores de qualidade da assistência ao idoso na Atenção Primária à Saúde e descrever a qualidade da assistência de enfermagem ao idoso nesse nível de atenção. Material e Métodos: Estudo transversal, com abordagem quantitativa, desenvolvido em uma Estratégia de Saúde da Família de um município no interior de Minas Gerais. A população do estudo foi composta pelos profissionais de enfermagem (indicadores coletados por meio de entrevista), prontuários de idosos (indicadores coletados por meio de supervisão), gestores municipais da secretaria de saúde (avaliação da utilidade e usabilidade) e avaliador de campo (avaliação da confiabilidade e viabilidade/disponibilidade). Utilizaram-se 22 indicadores (5 gerenciais e 17 relacionados ao cuidado de enfermagem), disponíveis on-line no Harvard Dataverse. Foram utilizadas análise descritiva por meio de frequências absolutas e percentuais. A confiabilidade dos dados foi mensurada por análise de concordância entre as coletas por meio do índice Kappa. A viabilidade de coleta dos dados foi dada em escala de um a nove, quanto maior melhor a viabilidade; para utilidade e usabilidade foi utilizada escala variando de 1 ponto (não recomendado), a 9 pontos (altamente recomendado). Resultados: A confiabilidade dos indicadores mensurados por meio de entrevistas e análise dos prontuários obteve 100% de respostas concordantes, sendo considerada substancial. Sobre a viabilidade sete indicadores não estavam disponíveis e dentre estes dois foram considerados inviáveis; a utilidade e usabilidade obtiveram avaliação positiva; observou-se baixo percentual de cumprimento dos indicadores, demonstrando baixa qualidade da assistência de enfermagem prestada ao idoso. Conclusões: Os resultados apontaram confiabilidade substancial na coleta, viabilidade na maioria dos indicadores, utilidade e usabilidade com avaliação positiva e baixo percentual de cumprimento dos indicadores.

Objectives: To evaluate the reliability, feasibility, usability and usefulness of the indicators of quality of care for the elderly in primary health care, and to describe the quality of nursing care for the elderly. Materials and Methods: Cross-sectional study with a quantitative approach, developed in the context of the Family Health Strategy program in a municipality of the State of Minas Gerais. The study population consisted of nursing professionals (indicators collected through interviews), elderly medical records (indicators collected through supervision), managers of municipal health departments (assessment of usefulness and usability) and field evaluators (assessment reliability and feasibility/availability). 22 indicators (5 managerial and 17 related to nursing care), available online at the Harvard Dataverse repository, were used. Descriptive analysis was used through absolute and percentage frequencies. Reliability was measured by concordance analysis between the collected data using the Kappa index. Feasibility was measured on a scale of one to nine: the higher the better the feasibility; for usefulness and usability a scale ranging from 1 point (not recommended) to 9 points (highly recommended) was used. Results: The reliability of the indicators, measured through interviews and analysis of medical records, showed 100% of concordant responses, so that it was considered relevant. Seven indicators were not available and, among these, two were considered unfeasible: usefulness and usability had a positive evaluation; there was a low percentage of compliance with the indicators, which shows low quality of nursing care provided to the elderly. Conclusions: The results showed substantial reliability in the collection, feasibility in most of the indicators, usefulness and usability with positive evaluation and low percentage of compliance with the indicators.

Objetivos: Evaluar la confiabilidad, factibilidad, usabilidad y utilidad de los indicadores de calidad del cuidado a la persona mayor en la Atención Primaria de Salud y describir la calidad del cuidado de enfermería a la persona mayor en este nivel de atención. Material y Método: Estudio transversal con enfoque cuantitativo, desarrollado en una Estrategia de Salud de la Familia de un municipio del interior de Minas Gerais, Brasil. La población de estudio estuvo compuesta por profesionales de enfermería (indicadores recolectados a través de entrevistas), prontuarios de personas mayores (indicadores recolectados a través de la supervisión), gestores de departamentos de salud municipales (evaluación de utilidad y usabilidad) y evaluadores de campo (evaluación de confiabilidad y factibilidad/disponibilidad). Se utilizaron 22 indicadores (5 gerenciales y 17 relacionados con el cuidado de enfermería), disponibles en línea en Harvard Dataverse. Se utilizó análisis descriptivo a través de frecuencias absolutas y porcentuales. La fiabilidad se midió mediante el análisis de concordancia entre colecciones utilizando el índice Kappa. La factibilidad se dio en una escala de uno a nueve, cuanto más alta, mejor factibilidad; para la utilidad y usabilidad se utilizó una escala que va desde 1 punto (no recomendado) hasta 9 puntos (muy recomendable). Resultados: La confiabilidad de los indicadores, medidos a través de entrevistas y análisis de historias clínicas, obtuvo el 100% de repuestas concordantes, considerándose sustancial. Siete indicadores no estaban disponibles y, entre estos, dos se consideraron inviables; la utilidad y usabilidad tuvo evaluación positiva; hubo bajo porcentaje de cumplimiento de los indicadores, lo que demuestra baja calidad de la atención de enfermería brindada a las personas mayores. Conclusiones: Los resultados mostraron una fiabilidad sustancial en la recogida, viabilidad en la mayoría de los indicadores, utilidad y usabilidad con evaluación positiva y bajo porcentaje de cumplimiento de los indicadores.

Frailty syndrome and socioeconomic and health characteristics among older adults.

OBJECTIVE: To investigate the association of frailty syndrome with socioeconomic and health variables among older adults. METHODS: This is a cross-sectional, observational and analytical household research conducted with a sample of 1,609 urban elderly. We used: semi-structured questionnaire, scales (Katz, Lawton and shortened version of Geriatric Depression Scale) and Fragility Phenotype proposed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p <0.05). RESULTS: The prevalence of pre-frailty condition was 52.0% and the fragility corresponded to 13.6%. Pre-frailty and frailty associated factors were, respectively: age range between 70-79 years and ≥80 years; one to four morbidities and five or more morbidities categories; functional disability for basic and instrumental activities of daily life and depression indicative; whilst lack of a companion or income and female gender were only associated to pre-frailty. CONCLUSION: The conditions of pre-frailty and frailty levels were elevated with negative effects on the health of the elderly.

OBJETIVO: Investigar la asociación del síndrome de fragilidad con variables socioeconómicas y de salud de los adultos mayores. MÉTODOS: encuesta domiciliaria transversal, observacional y analítico realizado con una muestra de 1,609 personas mayores urbano. Fueron utilizados: cuestionario semi-estructurado, escalas (Katz, Lawton y depresión geriátrica acortado) y Fragilidad Fried fenotipo. Se realizaron los siguientes análisis: descriptivo, bivariado y modelo de regresión logística multinomial (p <0.05). RESULTADOS: La prevalencia de la condición pre-fragilidad fue del 52.0% y la fragilidad correspondió a 13.6%. Los factores asociados a la prefragilidad y fragilidad fueron, respectivamente: a los intervalos de edad de 70-79 años y ≥80 años; una a cuatro morbilidades y cinco o más categorías de morbilidad; incapacidad funcional para actividades básicas e instrumentales de la vida diaria y indicativo de depresión; en cuanto que la ausencia de compañero y ingreso y el género femenino se asociaron a la prefragilidad. CONCLUSIÓN: Las condiciones de los niveles previos a la fragilidad y la fragilidad fueron elevados con efectos negativos sobre la salud de los ancianos.

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. CONCLUSIONS: 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.

Correlation of quality of life with knowledge and attitude of diabetic elderly.

OBJECTIVE: To describe the quality of life (QL), knowledge and attitude of the elderly with diabetes mellitus (DM) and to correlate the QL with the knowledge and the attitude of the elderly. METHOD: It is a cross-sectional study of household inquiry type and developed with 296 elderly with DM. The used instruments were: World Health Organization Quality of Life Bref (WHOQOL-BREF), World Health Organization Quality of Life Old (WHOQOL-OLD), Diabetes Knowledge Scale Questionnaire (DKN-A) and Diabetes Attitudes Questionnaire (ATT-19). RESULTS: The female were predominant (68.2%), aged from 70 - 79 years old (43.9%), married or living with a partner (41.6%), living with their children (43.2%), with income of one minimum wage (52.4%), had 4 - 7 years of education (32.8%), on diet use and oral hypoglycemic (68.6%) and less than five years diagnosis (29.1%). The greater the knowledge and the attitude the higher QL scores in physical, psychological, social relationships and environment domains; and facets of sensory works, autonomy, and intimacy. CONCLUSION: Educational activities need to be worked improving the knowledge and attitude of the elderly about the DM.

Transition and factors associated with the level of physical activity combined with sedentary behavior of the elderly: A longitudinal study / Evolución y factores asociados con los niveles de actividad física y comportamiento sedentario en ancianos: estudio longitudinal

Introduction: Physical activity and sedentary behavior are emerging issues in public health, especially in developing countries. Objective: To verify transition and factors related to physical activity combined with sedentary behavior among the elderly followed for 24 months. Materials and methods: We conducted a longitudinal observational study with people aged 60 years or over living in the urban area of Uberaba, Brazil. We collected the data from sociodemographic, health, and physical tests in 2014 and 2016 using the Mini-Mental State Examination (MMSE), the Katz Index, the Lawton and Brody Scale, the Short Physical Performance Battery (SPPB), and the International Physical Activity Questionnaire (IPAQ). For the combined evaluation we considered a cutoff point of 150 minutes of physical activity per week and the percentile 75 (420 minutes/day) for sedentary behavior constituting the groups: Unsatisfactory (insufficient sum of physical activity and sedentary behavior), intermediate (loss of only one of the two components) and satisfactory (sufficient sum of physical activity and sedentary behavior). The statistical descriptive and inferential analysis was performed using the Statistical Package for Social Sciences™, version 21.0, considering p<0.05. Results: Of the 374 elderly, 61 (16.3%) improved their physical activity and sedentary behavior condition, 226 (60.4%) remained in the same category and 87 (23.3%) got worse. Unsatisfactory levels of physical activity and sedentary behavior were related to the eldest group (p=0.031), the absence of professional activity (p<0.001), the dependence for instrumental activities of daily living (p=0.013), and a worse physical performance (p<0.001). Conclusion: Our results showed a relationship between sociodemographic and health factors with physical activity and sedentary behavior, reiterating the need for further research on the subject.

Introducción. La actividad física y el comportamiento sedentario son temas emergentes de salud pública, especialmente en los países en desarrollo. Objetivo. Verificar la transición y los factores relacionados con la actividad física y el comportamiento sedentario entre ancianos durante un seguimiento de 24 meses. Materiales y métodos. Se llevó a cabo un estudio longitudinal y observacional en ancianos de 60 años o más residentes en Uberaba, Minas Gerais, Brasil. Los datos sociodemográficos, de salud y de los exámenes físicos se recolectaron en el 2014 y el 2016 utilizando el Mini-Mental State Examination (MMSE), el índice de Katz, la escala de Lawton y Brody, la Short Physical Performance Battery (SPPB) y el International Physical Activity Questionnaire, (IPAQ). Para la evaluación combinada se consideró el punto de corte de 150 minutos semanales de actividad física y el percentil 75 (420 minutos/día) para el comportamiento sedentario, lo que arrojó los siguientes grupos: insatisfactorio (suma insuficiente de actividad física y comportamiento sedentario), intermedio (pérdida en uno solo de los dos componentes) y satisfactoria (suma suficiente de actividad física y comportamiento sedentario). El análisis estadístico descriptivo e inferencial se hizo con el Statistical Package for Social Sciences™, versión 21.0, p<0,05. Resultados. De los 374 ancianos, 61 (16,3 %) mejoraron su condición de actividad física y comportamiento sedentario, 226 (60,4 %) permanecieron en la misma categoría y 87 (23,3 %) empeoraron. Los niveles insatisfactorios de actividad física y comportamiento sedentario se asociaron con una mayor edad (p=0,031), la ausencia de actividad profesional (p<0,001), la dependencia para las actividades instrumentales de la vida diaria (p=0,013) y un peor rendimiento físico (p<0,001). Conclusiones. Los resultados evidenciaron una relación entre los factores sociodemográficos y de salud con la actividad física y el comportamiento sedentario, lo que reitera la necesidad de nuevos estudios sobre la salud del anciano.

Quality of life of elderly. Comparison between urban and rural areas.

OBJECTIVE: Comparing the scores of quality of life according to place of residence (urban and rural areas). METHODS: A cross-sectional study involving 2142 elderly in urban area and other 850 in rural area of the municipality of Uberaba (Minas Gerais, Brazil). Instruments used: Olders Americans Resources and Services, World Health Organization Quality of Life--BREF (WHOQOL-BREF) and World Health Organization Quality of Life Assessment for Older Adults (WHOQOL-OLD). RESULTS: We found that in urban area predominated women and men in rural areas. It was common in two areas: 60â±µ70 years old, married marital status, schooling of 4 to 8 years of study and the income of a minimum wage. The elderly residing in the urban area with their children and in rural areas did so with the spouse. In the evaluation of the quality of life, rural elders presented scores significantly higher than the urban area in the domains of physical, psychological, and social relations in the WHOQOL-BREF; and in the facets of autonomy, past, present and future activities, social participation and intimacy of the WHOQOL-OLD. For the latter instrument facets sensory ability and of death and dying the elderly's urban area had higher scores than the rural area. CONCLUSION: The elders of the urban area showed a greater involvement of the quality of life than the residents in the rural area. Nurses who work in primary care should address health strategies according to the specific needs of the urban and rural areas.

Frailty syndrome and socioeconomic and health characteristics among older adults / Síndrome de fragilidad y características socioeconómicas y de salud de los adultos mayores

Abstract Objective: To investigate the association of frailty syndrome with socioeconomic and health variables among older adults. Methods: This is a cross-sectional, observational and analytical household research conducted with a sample of 1,609 urban elderly. We used: semi-structured questionnaire, scales (Katz, Lawton and shortened version of Geriatric Depression Scale) and Fragility Phenotype proposed by Fried. Descriptive analysis was performed along with a bivariate and multinomial logistic regression model (p <0.05). Results: The prevalence of pre-frailty condition was 52.0% and the fragility corresponded to 13.6%. Pre-frailty and frailty associated factors were, respectively: age range between 70-79 years and ≥80 years; one to four morbidities and five or more morbidities categories; functional disability for basic and instrumental activities of daily life and depression indicative; whilst lack of a companion or income and female gender were only associated to pre-frailty. Conclusion: The conditions of pre-frailty and frailty levels were elevated with negative effects on the health of the elderly.

Resumen Objetivo: Investigar la asociación del síndrome de fragilidad con variables socioeconómicas y de salud de los adultos mayores. Métodos: encuesta domiciliaria transversal, observacional y analítico realizado con una muestra de 1,609 personas mayores urbano. Fueron utilizados: cuestionario semi-estructurado, escalas (Katz, Lawton y depresión geriátrica acortado) y Fragilidad Fried fenotipo. Se realizaron los siguientes análisis: descriptivo, bivariado y modelo de regresión logística multinomial (p <0.05). Resultados: La prevalencia de la condición pre-fragilidad fue del 52.0% y la fragilidad correspondió a 13.6%. Los factores asociados a la prefragilidad y fragilidad fueron, respectivamente: a los intervalos de edad de 70-79 años y ≥80 años; una a cuatro morbilidades y cinco o más categorías de morbilidad; incapacidad funcional para actividades básicas e instrumentales de la vida diaria y indicativo de depresión; en cuanto que la ausencia de compañero y ingreso y el género femenino se asociaron a la prefragilidad. Conclusión: Las condiciones de los niveles previos a la fragilidad y la fragilidad fueron elevados con efectos negativos sobre la salud de los ancianos.

Aspectos sociodemográfícos e desempenho cognitivo de idosos residentes na zona rural / Socio-demographic aspects and cognitive performance of elderly adults living in rural areas

Resumo Objetivo: Comparar as variáveis sociodemográficas e o percentual de erros nos itens do Mini-Exame do Estado Mental (MEEM) entre idosos com e sem declínio cognitivo. Metodologia: Estudo analítico, transversal, realizado com 955 idosos residentes na zona rural de um município de Minas Gerais, Brasil. Realizou-se uma análise descritiva e aplicou-se o teste qui-quadrado (p < 0,05). Resultados: Não houve associação entre sexo e declínio cognitivo; o declínio cognitivo foi associado a maior faixa etária, menor grau de instrução, e viuvez. Os itens mais impactados no MEEM foram Atenção e cálculo, Capacidade construtiva visual e Memória de evocação. Conclusão: Evidencia-se a necessidade de desenvolvimento de ações de saúde para a prevenção do declínio cognitivo e a melhoria dos aspectos cognitivos em indivíduos já acometidos.

Resumen Objetivo: Comparar las variables sociodemográficas con el porcentaje de errores en los ítems del Mini Examen del Estado Mental (MEEM) entre adultos mayores con y sin deterioro cognitivo. Metodología: Estudio analítico y de corte transversal, el cual se realizó con 955 adultos mayores residentes en la zona rural de un municipio de Minas Gerais, Brasil. Se llevó a cabo un análisis descriptivo y se aplicó la prueba chi-cuadrado (p < 0,05). Resultados: No se encontró asociación entre el sexo y la presencia de deterioro cognitivo, el cual, a su vez, se relacionó con un mayor grupo etario, un menor nivel educativo y la viudez. En cuanto al MEEM, los ítems más afectados fueron Atención y cálculo, Capacidad constructiva visual y Memoria de evocación. Conclusión: El estudio pone de relieve la necesidad de desarrollar acciones de salud enfocadas en prevenir el deterioro cognitivo y en mejorar las funciones relacionadas con la cognición de los afectados.

Abstract Objective: To compare sociodemographic variables to error rate in categories of Mini-Mental State Examination (MMSE) among elderly adults both with and without cognitive impairment. Methodology: This is an analytical, cross-sectional study, conducted with 955 elderly adults living in rural areas of Minas Gerais municipality, Brazil. A descriptive analysis was carried out and the chi-square test was applied (p < 0.05). Results: No association was found between sex and cognitive impairment. For its part, cognitive impairment was associated with a wider age range, a lower educational level, and widowhood. With regard to MMSE, categories most affected were Attention and Calculation, Visual Capacity Building and Memory Recall. Conclusion: The results from our study put emphasis on the need to carry out health activities in order to prevent cognitive impairment, and to improve functions related to patients' cognitive performance.

Enfermedades autoreportadas en el adulto mayor: diferencias entre las áreas urbana y rural / Self-reported diseases of the aged adult: differences between the urban and rural areas

Introducción: las poblaciones rurales presentan una realidad que puede contribuir a mayores dificultades en el cuidado de su salud y subdiagnóstico de las enfermedades crónicas. Objetivo: comparar las enfermedades autoreportadas en el adulto mayor por lugar de domicilio. Métodos: estudio transversal, realizado con entrevistas en el domicilio a 2 142 adultos mayores que viven en la zona urbana y 850 en la rural. Se utilizó la estadística descriptiva y regresión logística (p<0,001). Resultados: predominaron el sexo femenino en el área urbana y el masculino en la rural; en ambos grupos las edades comprendidas entre 60-70 años, viudo, 4-8 años de estudio y el ingreso de un salario mínimo. Los adultos mayores del área urbana presentaron mayor proporción de artritis (p<0,001), osteoporosis (p<0,001), mala circulación (p<0,001), problemas cardíacos (p<0,001), de columna (p=0,006); de visión (p<0,001), estreñimiento (p<0,001), catarata (p<0,001); secuela por accidente/trauma (p=0,003) y los tumores benignos (p <0,001). La proporción de la embolia fue mayor entre la zona rural (p<0,001). La mediana del número de enfermedades fue mayor en el área urbana (p<0,001). Conclusiones : en general, la proporción de morbilidad entre los ancianos fue mayor entre los que residen en el zona urbana en comparación con la rural(AU)

Introduction: rural populations have a reality that can contribute to greater difficulties in the health care and poor diagnosis of chronic diseases. Objective: to compare self-reported diseases of the aged adults by dwelling place. Methods: cross-sectional study carried out with home interviews to 2142 aged adults living in urban areas and 850 living in rural areas. Descriptive statistics and logistic regression (p <0.001) was used. Results: there was a predominance of females in urban areas and of males in rural; also in both groups aged between 60-70 years, widowed, 4-8 years of study and income of a minimum wage predominated. Aged adults in urban areas had a higher proportion of arthritis (p<0.001), osteoporosis (p<0.001), poor circulation (p<0.001), heart problems (p<0.001), spine problems (p=0.006); sight problems (p<0.001), constipation (p<0.001), cataract (p<0.001); sequel accident/trauma (p=0.003) and benign tumors (p<0.001). The proportion of stroke was higher among rural aged adults (p<0.001). The average number of diseases was higher in urban areas (p<0.001). Conclusions: general speaking, morbidity proportion between the elderlies was higher among those who dwell in the urban zone in comparison to the rural one(AU)

Correlation of quality of life with knowledge and attitude of diabetic elderly / Correlación de la calidad de vida con el conocimiento y la actitud en ancianos diabéticos / Correlação da qualidade de vida com conhecimento e atitude de idosos diabéticos

Objective.To describe the quality of life (QL), knowledge and attitude of the elderly with diabetes mellitus (DM) and to correlate the QL with the knowledge and the attitude of the elderly. Method. It is a cross-sectional study of household inquiry type and developed with 296 elderly with DM. The used instruments were: World Health Organization Quality of Life Bref (WHOQOL-BREF), World Health Organization Quality of Life Old (WHOQOL-OLD), Diabetes Knowledge Scale Questionnaire (DKN-A) and Diabetes Attitudes Questionnaire (ATT-19). Results. The female were predominant (68.2%), aged from 70 - 79 years old (43.9%), married or living with a partner (41.6%), living with their children (43.2%), with income of one minimum wage (52.4%), had 4 - 7 years of education (32.8%), on diet use and oral hypoglycemic (68.6%) and less than five years diagnosis (29.1%). The greater the knowledge and the attitude the higher QL scores in physical, psychological, social relationships and environment domains; and facets of sensory works, autonomy, and intimacy. Conclusion. Educational activities need to be worked improving the knowledge and attitude of the elderly about the DM.

Objetivo.Describir la calidad de vida (CV), el conocimiento y la actitud de los ancianos con diabetes mellitus (DM), y correlacionar la CV con el conocimiento y la actitud de los ancianos. Métodos. Estudio transversal del tipo encuesta de hogares en el que participaron 296 ancianos con DM. Se utilizaron los instrumentos: World Health Organization Quality of Life Bref (WHOQOL-BREF), World Health Organization Quality of Life Old (WHOQOL-OLD), Diabetes Knowledge Scale Questionnaire (DKN-A) y Diabetes Atitudes Questionnaire (ATT-19). Resultados. Predominó el sexo femenino (68.2%), la edad de 70 a 79 años (43.9%), los casados o con compañero (41.6%), que vivían con los hijos (43.2%), con renta de un salario mínimo (52.4%), con 4 a 7 años de estudio (32.8%), tratados con dieta e hipoglicemiante oral (68.6%) y con tiempo de diagnóstico inferior a cinco años (29.1%). Cuanto mayor fue el conocimiento y la actitud, los puntajes de la CV fueron mayores en los dominios físico, psicológico, relaciones sociales y medio ambiente; y en los aspectos de funcionamiento de los sentidos, autonomía e intimidad. Conclusión. Deben desarrollarse actividades educativas direccionadas hacia el mejoramiento del conocimiento y de la actitud de los ancianos acerca de la DM.

Objetivo.Descrever a qualidade de vida (QV), o conhecimento e a atitude dos idosos com diabetes mellitus (DM), e correlacionar a QV com o conhecimento e a atitude dos idosos. Métodos. Estudo transversal do tipo inquérito domiciliar em que participaram 296 idosos com DM. Foram utilizados os instrumentos: World Health Organization Quality of Life Bref (WHOQOL-BREF), World Health Organization Quality of Life Old (WHOQOL-OLD), Diabetes Knowledge Scale Questionnaire (DKN-A) e Diabetes Atitudes Questionnaire (ATT-19). Resultados. Predominaram o sexo feminino (68,2%), idade de 70 a 79 anos (43,9%), casados ou com companheiro (41,6%), que viviam com os filhos (43,2%), com renda de um salário mínimo (52,4%), com 4 a 7 anos de estudo (32,8%), em uso de dieta e hipoglicemiante oral (68,6%) e com tempo de diagnóstico inferior a cinco anos (29,1%). Quanto maior o conhecimento e a atitude maiores foram os escores de QV nos domínios físico, psicológico, relações sociais e meio ambiente; e facetas funcionamentos dos sentidos, autonomia e intimidade. Conclusão. Devem ser desenvolvidas atividades educativas direcionadas a melhoria do conhecimento e atitude dos idosos acerca do DM.