Aplicabilidade do instrumento "Screening of Activity Limitation and Safety Awareness" em idosos com hanseníase / Aplicabilidad del instrumento "Screening of Activity Limitation and Safety Awareness" en personas de edad avanzada con lepra / Applicability of the instrument "Screening of Activity Limitation and Safety Awareness" in elderly with leprosy

RESUMO Objetivo Analisar a aplicabilidade da Screening of Activity Limitation and Safety Awareness (SALSA) para a avaliação da capacidade funcional de idosos com hanseníase. Método Pesquisa descritiva, transversal, desenvolvida com 77 idosos com hanseníase acompanhados no Centro de Referência em Dermatologia, em Fortaleza, Ceará, de junho a agosto de 2015, por meio da aplicação da SALSA e de outras duas escalas já validadas para uso em idosos. Para a análise, utilizou-se estatística descritiva e inferencial. Resultados Houve convergência entre as escalas (p=0,0000) na avaliação da capacidade funcional. As variáveis idade e sexo apresentaram maior número de associações com as atividades avaliadas, ao passo que, nas variáveis clínicas relacionadas à hanseníase, apenas o grau de incapacidade física apresentou relação com mais de duas atividades. Conclusão A SALSA contribuiu para a avaliação eficaz da capacidade funcional na população estudada, sendo mais influenciada pela idade do que pela hanseníase. Implicações para a prática: Assim, recomenda-se a sua aplicação nas consultas iniciais como instrumento de rastreio da capacidade funcional de idosos com hanseníase.

RESUMEN Objetivo Analizar la aplicabilidad del Screening of Activity Limitation and Safety Awareness (SALSA) para evaluación de la capacidad funcional de personas mayores con lepra. Método Investigación descriptiva, transversal, desarrollada con 77 personas mayores con enfermedad de Hansen acompañadas por el Centro de Referencia en Dermatología, en Fortaleza, Ceará, desde junio hasta agosto de 2015, mediante la aplicación de la SALSA y otras dos escalas ya validadas para uso en personas de edad avanzada. Para el análisis, se utilizó estadística descriptiva e inferencial. Resultados Hubo convergencia entre las escalas (p=0,0000) en la evaluación de la capacidad funcional. Los variables edad y sexo mostraron mayor número de asociaciones con las actividades evaluadas, mientras que en las variables clínicas relacionadas con la lepra, apenas el grado de incapacidad física presentó relación con más de dos actividades. Conclusiones La SALSA ha contribuido a la efectiva evaluación de la capacidad funcional en la población estudiada, siendo influenciada más por edad que por la enfermedad de Hansen. Implicaciones para la práctica: Su aplicación se recomienda en las consultas iniciales como una herramienta para la detección de la capacidad funcional de personas mayores con lepra.

ABSTRACT Objective To analyze the applicability of Screening of Activity Limitation and Safety Awareness (SALSA) for the evaluation of the functional capacity of the elderly with leprosy. Method Descriptive and transversal research, developed with 77 elderly people with Hansen's disease accompanied at the Reference Center in Dermatology, in Fortaleza, Ceará, from June to August 2015, through the application of SALSA and two other scales already validated for use in elderly. For the analysis, descriptive and inferential statistics were used. Results There was convergence between the scales (p=0.0000) on the evaluation of functional capacity. The variables age and gender showed a larger number of associations with the activities evaluated, whereas, in the clinical variables related to leprosy, just the grade of disability presented a relationship with more than two activities. Conclusion and Implications for practice The SALSA has contributed to the effective evaluation of functional capacity in the population studied, being more influenced by age than by leprosy. SALSA's application is recommended in the initial consultations as a tool for screening of the functional capacity of older people with leprosy.

Association between the degree of physical impairment from leprosy and dependence in activities of daily living among the elderly in a health unit in the State of Minas Gerais.

INTRODUCTION: In addition to the common alterations and diseases inherent in the aging process, elderly persons with a history of leprosy are particularly vulnerable to dependence because of disease-related impairments. OBJECTIVE: determine whether physical impairment from leprosy is associated with dependence among the elderly. METHODS: An analytical cross-sectional study of elderly individuals with a history of leprosy and no signs of cognitive impairment was conducted using a database from a former leprosy colony-hospital. The patients were evaluated for dependence in the basic activities of daily living (BADL) and instrumental activities of daily living (IADL), respectively) and subjected to standard leprosy physical disability grading. Subsequently, descriptive and univariate analyses were conducted, the latter using Pearson's chi-squared test. RESULTS: A total of 186 elderly persons were included in the study. Of these individuals, 53.8% were women, 49.5% were older than 75 years of age, 93% had four or less years of formal education, 24.2% lived in an institution for the long-term care of the elderly (ILTC), and 18.3% had lower limb amputations. Among those evaluated, 79.8% had visible physical impairments from leprosy (grade 2), 83.3% were independent in BADL, and 10.2% were independent in IADL. There was a higher impairment grade among those patients who were IADL dependent (p=0.038). CONCLUSIONS: The leprosy physical impairment grade is associated with dependence for IADL, creating the need for greater social support and systematic monitoring by a multidisciplinary team. The results highlight the importance of early diagnosis and treatment of leprosy to prevent physical impairment and dependence in later years.

Association between the degree of physical impairment from leprosy and dependence in activities of daily living among the elderly in a health unit in the State of Minas Gerais

Introduction In addition to the common alterations and diseases inherent in the aging process, elderly persons with a history of leprosy are particularly vulnerable to dependence because of disease-related impairments. Objective determine whether physical impairment from leprosy is associated with dependence among the elderly. Methods An analytical cross-sectional study of elderly individuals with a history of leprosy and no signs of cognitive impairment was conducted using a database from a former leprosy colony-hospital. The patients were evaluated for dependence in the basic activities of daily living (BADL) and instrumental activities of daily living (IADL), respectively) and subjected to standard leprosy physical disability grading. Subsequently, descriptive and univariate analyses were conducted, the latter using Pearson's chi-squared test. Results A total of 186 elderly persons were included in the study. Of these individuals, 53.8% were women, 49.5% were older than 75 years of age, 93% had four or less years of formal education, 24.2% lived in an institution for the long-term care of the elderly (ILTC), and 18.3% had lower limb amputations. Among those evaluated, 79.8% had visible physical impairments from leprosy (grade 2), 83.3% were independent in BADL, and 10.2% were independent in IADL. There was a higher impairment grade among those patients who were IADL dependent (p=0.038). Conclusion s: The leprosy physical impairment grade is associated with dependence for IADL, creating the need for greater social support and systematic monitoring by a multidisciplinary team. The results highlight the importance of early diagnosis and treatment of leprosy to prevent physical impairment and dependence in later years. .

The prevalence of dementia and depression in Taiwanese institutionalized leprosy patients, and the effectiveness evaluation of reminiscence therapy--a longitudinal, single-blind, randomized control study.

OBJECTIVE: This study investigated the prevalence of depression and dementia in long-term institutionalized older leprosy patients in Taiwan. We then examined the effectiveness of reminiscence group therapy on depressive symptoms and cognitive function in this population. METHODS: We recruited 129 long-term institutionalized older leprosy patients in Taiwan and used the Geriatric Depression Scale-Short Form (GDS-SF), the mini mental state examination (MMSE), and the Clinical Dementia Rating (CDR) scale for outcome measurement. We then conducted a single-blind, randomized, longitudinal quasi-experimental analysis comparing the pre-test and post-test results of two equivalent groups at a 24-week intervention interval. The intervention in the experimental group was three sessions of reminiscence group therapy per week, whereas that in the control group was weekly individual supportive interviews. RESULTS: The prevalence of dementia was 45.7-50.4% according to a CDR score ≥ 0.5 and an MMSE score < 25, and the prevalence of depression was 25% based on a GDS-SF score ≥ 7. According to the Wilcoxon signed-rank test, the GDS-SF scores in the experimental group decreased significantly (p = 0.02) after intervention as compared with that in the control group (p = 0.22), whereas the MMSE scores in both groups remained steady. CONCLUSIONS: The prevalence of dementia and depression in long-term institutionalized older leprosy patients in Taiwan is high. Reminiscence group therapy has been confirmed effective on depression in this population, but its effectiveness on cognitive function requires further verification.