Effect of the use of potentially inappropriate medications on the mortality of Brazilian older adults: SABE cohort study.

OBJECTIVE: Investigate the association between potentially inappropriate medication (PIM) use and the risk of death among community-dwelling older Brazilian adults. METHODS: Participants from the Health, Well-Being, and Aging Cohort Study (SABE) in São Paulo, Brazil, between 2000 and 2016 were included. The dependent variable was all-cause mortality, measured as the time elapsed until death. The exposure of interest was the use of PIM according to the Beers Criteria 2019 version. All covariates, except for sex and education, were considered time-varying. RESULTS: PIM use was not associated with mortality after adjusting for covariates (HR = 0.99; 95 % CI: 0.88-1.12). There was a significant interaction between PIM use and age (HR = 0.98; 95 % CI: 0.96-0.99). CONCLUSION: The association between PIM use and the risk of death was moderated by age. Future studies should consider the impact of necessary medication omissions when assessing the mortality risk associated with PIM use.

Urinary incontinence in female athletes with inadequate eating behavior: a case-control study.

INTRODUCTION AND HYPOTHESIS: Female athletes can develop symptoms of urinary incontinence (UI) as well as risk behaviors for eating disorders owing to the type of training and sports modality. Such symptoms are intensified by the demands for results and an idealized body composition. Our aim is to investigate the possible association between urinary incontinence and risk behaviors for eating disorders in female athletes. METHODS: A case-control study was conducted with 270 female athletes who answered the International Consultation on Incontinence Questionnaire (ICIQ-SF) and the Eating Attitudes Test (EAT-26). Different sports modalities and their respective impact levels were considered in the study. Female athletes were divided into two groups, i.e., athletes with UI (case group) and those without UI (control group). Multiple logistic regression was used to calculate associated factors. RESULTS: From all variables included in the study, only abnormal eating behavior was found to be associated with UI according to the multiple logistic regression test. Participants with UI were 2.15-fold more likely to have risk behaviors for eating disorders. CONCLUSIONS: Female athletes with UI were more likely to have risk behaviors for eating disorders. Multidisciplinary teams that provide care for these athletes should be attentive to symptoms that may not appear to be associated at first glance but may reflect a condition that needs to be treated.

Excess mortality in a cohort of Brazilian patients with a median follow-up of 11 years after the first psychiatric hospital admission.

PURPOSE: To estimate the mortality rates of a cohort of Brazilian patients after their first psychiatric admission and determine the possible risk factors associated with excess mortality. METHODS: The study included a cohort of psychiatric patients hospitalised from Jan 1, 2002 to Dec 31, 2007 in the catchment area of Ribeirão Preto, São Paulo state, Brazil. Data were linked to deaths that occurred between Jan 1, 2002 and Dec 31, 2016 from the SEADE Foundation (state data analysis system of São Paulo). The mortality rate (MR), age-sex-standardised mortality ratio (SMR), life expectancy at birth, and years of life lost (YLL) were computed. The factors associated with mortality were analysed by survival analysis using a Cox proportional hazards regression model. RESULTS: Of 4019 patients admitted (54.76% male), 803 died (69.74% male) during the follow-up (median = 11.25 years). Mortality rates were approximately three-fold higher than expected (SMR = 2.90, 95% CI 2.71-3.11). The highest mortality rate was noted in men with alcohol-related disorders (SMR = 5.50, 95% CI 4.87-6.19). Male sex (adjusted hazard ratio (aHR) = 1.62, 95% CI 1.37-1.92), higher age (aHR = 21.47, 95% CI 13.48-34.17), and unemployment (aHR = 1.22, 95% CI 1.05-1.43) significantly increased the mortality risk from all causes. The average YLL was 27.64 years with the highest YLL noted in nonalcohol substance-related disorders (39.22 years). The life expectancy at birth in this cohort was 47.27 years. Unnatural causes of death were associated with nonwhite skin colour and substance-related disorders. CONCLUSION: An excess of mortality and a significant reduction in life expectancy of mentally disordered patients who were first admitted to psychiatric beds was noted, particularly patients admitted for substance-related disorders, which should represent a priority in mental health policies.

Urinary incontinence, overactive bladder, and quality of life in women submitted to total hip replacement.

INTRODUCTION AND HYPOTHESIS: Hip osteoarthritis (OA) compromises functioning. Total hip replacement (THR) is the indicated treatment and may improve urinary incontinence (UI) and symptoms of overactive bladder (OAB). OBJECTIVES: Assess UI, OAB symptoms, and quality of life (QoL) impact in preoperative and postoperative periods of women submitted to THR and investigate associated factors. METHODS: A prospective cohort was conducted with 183 women submitted to THR. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), International Consultation on Incontinence Questionnaire-Overactive Bladder (ICIQ-OAB) and SF-12 questionnaires were administered pre- and 3 and 6 months after surgery. RESULTS: Significant improvements were found in UI and QoL 3- and 6-month postoperatively in the overall sample and in the subgroup with preoperative UI. The multivariate regression revealed that the preoperative ICIQ-SF and ICIQ-OAB final scores were the best predictors of UI 6-month postoperatively. The factors the best predicted the occurrence of UI 6-month following THR were the preoperative ICIQ-OAB scores and preoperative UI. Each unit of increase in the ICIQ-OAB increases the chances of UI by 26.9% and preoperative UI increases the chances of postoperative UI by 18.7-fold. A weak but significant negative correlation was found between the ICIQ-SF score and the SF-12 score. CONCLUSION: Significant improvements in UI, OAB and QoL were found at 3- and 6-month postoperatively. Preoperative ICIQ-SF and ICIQ-OAB final scores were the best predictors of UI at 6 months after surgery. We found significant association between urinary symptoms and THR, but this association is partially explained by current literature.

Fecal incontinence: incidence and risk factors from the SABE (Health, Wellbeing and Aging) study.

INTRODUCTION AND HYPOTHESIS: This study aimed to estimate the incidence of fecal incontinence (FI) and identify risk factors in a cohort of older individuals. METHODS: In 2006, individuals aged ≥ 60 years were selected from the SABE study. The dependent variable was FI in 2010. FI was assessed using the question: "In the last 12 months, have you ever lost control of bowel movements or stools?" Incidence was measured in units of per 1000 person-years. Multivariate analysis was used to assess risk factors for FI. RESULTS: This study was the first to examine the incidence of FI in older Brazilian individuals. In total, 1413 individuals were included; mean age was 74.5 years, and 864 (61.8%) participants were women. FI prevalence rates were 4.7% for men and 7.3% for women. Incidence rate of FI was 16.3 and 22.2 per 1000 person-years for men and women, respectively. The risk of FI was greater among women aged ≥ 75 years, with severe symptoms of depression, cancer (other than skin) and chronic obstructive pulmonary disease (COPD). In men, the risk of FI was greater among those with poor literacy (up to 3 years of schooling), an Instrumental Activities of Daily Living (IADL) category of 1-4 and those who self-reported "bad/very bad" health status. CONCLUSIONS: The FI incidence rate was high. The identified risk factors were age ≥ 75 years, with severe symptoms of depression, cancer and COPD (women); having up to 8 years of schooling; IADL category of 1-4 and self-reported health status (men).

Stages of the Smoke-Free Policy Implementation in a Psychiatric Hospital: Evolution, Effects, and Complications.

Background: The Smoke-free Policy represents a challenge in mental health services. Aim: To compare the stages of a smoke-free policy in a psychiatric hospital, according to the prevalence of smokers, hospital admission acceptance by hospitalized people, psychiatric complications, and the prescription of psychotropic drugs. Methods: Cross-sectional study was conducted with a comparison before and after implementing the Smoke-free Policy in a psychiatric hospital. Secondary data were obtained in 2020 from the medical records of 573 discharged people from psychiatric hospitalizations between September 2017 and August 2018. Fisher's exact test and the Kruskal-Wallis test were applied. Results: In the transition stage, there were more hospitalizations by court order, discharge motivated by the patient's disruptiveness behavior, administration of psychotropic drugs before the schedule time, physical aggression, physical/chemical restraints, length of stay, and dosage of psychotropic drugs. After the ban, there was a reduction in discharges motivated by the patient's disruptiveness behavior and an increase in discharge due to improvement in psychiatric symptoms, less occurrence of anticipation or modification in the use of psychotropic drugs, and fewer attempts to escape, aggressiveness, and physical restraint. Conclusion: The implementation of the Smoke-free Policy has a positive impact on psychiatric hospitalizations, with an increase in discharge due to improvement in psychiatric symptoms and a reduction in discharges due to other reasons. However, the transition stage requires greater attention from the nursing team, as the moment of adaptation to new rules and routines is followed by a momentary worsened behavior of those hospitalized.

Nurses' beliefs, attitudes, and opinions regarding a smoking ban in a psychiatric hospital.

PURPOSE: This study aims to identify the beliefs, attitudes, and opinions of nursing professionals associated with tobacco smoking and its prohibition in a psychiatric hospital in Brazil. METHODS: Using a cross-sectional epidemiologic study, a total of 73 nursing professionals in a smoke-free psychiatric hospital were interviewed. The Varimax Rotation and the Fisher's exact test at a 5% significance level were used to analyze the responses. FINDINGS: Most nursing professionals reported observations of patients becoming calmer after smoking (n = 59, 80.8%) and tobacco withdrawal worsening patients' mental health symptoms, suggesting agreement among professionals that some psychiatric patients need to smoke tobacco. Most respondents stated that patients with mental health disorders have more difficulty with smoking cessation (79.4%) and are less interested in quitting smoking than those without disorders (95.9%). While one-third mentioned having used cigarettes as a reward or bribe, the majority (83.6%) was in favor of continuing the smoking ban, with more support observed from those working on a night shift and those who worked in the public psychiatric wards. Over 71% noted improvements in their health after the smoking ban. CONCLUSION: The nursing professionals were surprised by the effectiveness of the smoking ban and highlighted the improvement in the hospital environment after its implementation. CLINICAL RELEVANCE: As trusted healthcare professionals, nurses are essential in the fight against smoking and can contribute to awareness promotion, supporting patients during nicotine withdrawal, and decision-making processes for health policies.

Changes in prevalence of cognitive impairment and associated risk factors 2000-2015 in São Paulo, Brazil.

INTRODUCTION: Decreases in prevalence of cognitive impairment and dementia over the last two decades have been observed in different countries for cohorts entering older age. This study aimed to assess the cognitive impairment prevalence and explore associated factors among subjects aged >60 living in São Paulo, Brazil. METHOD: Data came from a population-based Health, Welfare and Aging survey conducted in 2000, 2006, 2010, and 2015. Cognitive impairment was detected using the abbreviated Mini-Mental State Exam corrected by formal education years. In total, there were 5922 respondents in the statistical analyses. RESULTS: Logistic regression models adjusted for age group, income, race, cardiovascular risk factors, and depression were used to estimate cognitive impairment prevalence. Between 2015 and 2000, respondents were more likely to report formal education, hypertension, diabetes, and overweight/obesity. Moreover, the weighted analyses showed that cognitive impairment prevalence was higher in 2015, even adjusting for sociodemographic and socioeconomic characteristics, cardiovascular risk factors, and depression. CONCLUSION: In contrast to decreases in cognitive impairment prevalence in other countries and despite increases in educational years, our findings suggest no secular improvements in cognitive health for the 2015 wave of older adults residing in São Paulo.

Construct validity of the Child-Initiated Pretend Play Assessment-For 3-year-old Brazilian children.

INTRODUCTION: Play is an indication of children's development and how they function. In occupational therapy it is regarded as an important occupation of childhood. Assessment of a child's play should be included in the test batteries of occupational therapists, who understand the construct validity of the assessment they have chosen. Our aim was to provide evidence of reliability, internal consistency and hypotheses testing of the construct validity of the cross-culturally adapted version of the Child-Initiated Pretend Play Assessment. METHODS: Two hundred typically developing Brazilian children aged 3 years were evaluated individually using the Child-Initiated Pretend Play Assessment. RESULTS: The internal consistency showed a Cronbach's alpha coefficient to Percentage of Pretend Play Actions (PEPA) of 0.86 and NOS of 0.81. There were significant differences between the younger children (aged 36-41 months) and the older children (aged 42-47 months) for elaborate play across both conventional-imaginative play (p = .002), symbolic play (p = .012), and the combined score (p = .005). There were significant differences between younger and older girls for elaborate play with symbolic play materials (p = .009) and elaborate play overall (p = .039). There were significant differences between young and older boys for elaborate play with conventional toys (p = .006) and elaborate play overall (p = .025). There were no significant differences for object substitution or imitated actions. CONCLUSION: The measurement properties of the cross-culturally adapted version of the Child-Initiated Pretend Play Assessment for 3-year-old Brazilian children identified evidence for response processes, internal structure, with discussion of consequences of testing for 3-year-old Brazilian children.

Inflammation and quality of life in later life: findings from the health, well-being and aging study (SABE).

BACKGROUND: Few studies have specifically investigated the inverse relationship between reduced quality of life in different domains and elevated C-reactive protein (CRP) serum levels in older adults. Therefore, this study investigates the cross-sectional association between quality of life and inflammation in older Brazilian adults. METHODS: Data were collected from 1255 participants from the third wave (2010) of the Brazilian Health, Well-being and Aging study (SABE), a community-based cohort study of aging. Inflammation was assessed using CRP serum levels and quality of life (QoL) was measured using the 12-item Short-Form Health Survey (SF-12) questionnaire. The covariates included age, sex, education level, financial sufficiency, number of non-communicable diseases, self-reported doctor diagnosed diseases, Activity of Daily Living (ADL) difficulties, Body Mass Index (BMI), and waist circumference. RESULTS: The fully adjusted models showed that older adults with low scores in the physical domain of the SF12 (OR 1.34, 95%CI 1.02;1.77) and high BMI values (> 30) (OR 2.05, 95%CI 1.50;2.81) were more likely to present high CRP serum levels. CONCLUSION: Our findings suggest a significant association of lower scores in the physical domain of quality of life and the presence of obesity with high CRP serum levels.

A populational-based survey on the prevalence, incidence, and risk factors of urinary incontinence in older adults-results from the "SABE STUDY".

AIMS: To estimate the prevalence and incidence of urinary incontinence (UI) and identify the associated risk factors in a cohort of elderly individuals in Brazil. METHODS: In 2006, individuals aged ≥60 years were selected from the SABE Study (Health, Well-being, and Aging). The dependent variable was reported UI in 2009. UI was assessed using the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-UI SF). Incidence was measured in units of 1000 person-years, and Cox regression was applied for data analysis. Multivariate analysis was used to assess risk factors for UI. Incidence risk ratio (IRR) was used for comparison. RESULTS: This is the first study to examine the incidence of UI in Brazilian elderly individuals. In total, 1413 individuals were included; the mean age was 74.5 years, and 864 (61.8%) participants were female. The risk of UI was greater among women with cancer (other than skin) and among those with diabetes. In men, the risk of UI was greater for those in Instrumental Activities of Daily Living (IADL) category "5-8" and those who self-reported a "fair" health status. The prevalence of UI was 14.2% and 28.2% for men and women, respectively. The incidence rate of UI was 25.6 and 39.3 (×1000 person-years) for men and women, respectively. CONCLUSIONS: The incidence rate of UI among older adults in the Brazilian community was high for elderly individuals. The identified risk factors were diabetes and IADL category 5-8 (women) as well as cancer (other than skin) and self-reported health status (male).

Opinions of Hospitalized Patients with Mental Disorders and Patients in Basic Health Units in Brazil Regarding Tobacco Smoking.

This study aims to investigate the opinions of psychiatric patients and the general population on the smoking ban in health service facilities. A cross-sectional study was carried out in a mental health outpatient care unit (MHOC; n = 126), a psychiatric hospital (PH; n = 126), and a basic health unit (BHU; n = 126). The participants in the hospital were less in favor of the smoking ban compared with those attending out-of-hospital units (MHOC, 84%; PH, 69%; and BHU, 100%). Subjects with four or more psychiatric admissions (odds ratio (OR), 3.24) and smokers (OR, 3.18) were most likely to agree that patients have the right to smoke in health service facilities. The psychiatric population was less tolerant of the smoking ban, reflecting the culture of smoking in mental health service facilities.

Impact of length of stay for first psychiatric admissions on the ratio of readmissions in subsequent years in a large Brazilian catchment area.

PURPOSE: This study aims to verify the impact that the length of stay has on the rates of readmission for patients who were first admitted to various inpatient psychiatric units in a large catchment area in a middle-income country. METHODS: The study included all patients who were first admitted to the 108 acute psychiatric beds available in the catchment area of Ribeirão Preto, Brazil, for a period of 8 years. Demographic features, inpatient unit of discharge, diagnosis and length of stay were assessed by bivariate analysis. An analysis of the time span between first admission and readmission was also conducted using survival curves estimated by the Kaplan-Meier formula. For the analyses of the risk of readmissions, a logistic regression analysis was conducted. RESULTS: From a total of 6261 patients admitted in the period of the survey, approximately one-third (2006) had at least one other readmission during the follow-up period. The rates per year of early readmission (within 90 days after discharge) varied from 16.1 to 20.9 %. The risk of readmission was higher immediately after discharge. The survival analysis showed that ultrashort length of stay (1-2 days) was associated with reduced odds of readmission, but multivariate logistic analysis showed no association between length of stay and the odds of readmissions. The predictors of early readmission included the diagnosis of depressive, bipolar, psychotic, and non-alcohol-related disorders, younger ages and unemployment. CONCLUSIONS: Duration of the first psychiatric admission was not associated with a higher risk of readmissions. Predictors for early readmissions of first-time-admitted psychiatric patients seem to be more related to the severity of the psychiatric diagnosis and demographic characteristics.

Reading processes of public and private middle school and high school students.

INTRODUCTION: Reading has been widely discussed, mainly due to the published results of international performance tests of schoolchildren. The gaps generated in literacy hinder the development of basic skills necessary for reading, which will have a negative impact on the teaching-learning process from elementary school to high school. This study aimed to compare the reading performance of the students in public and private schools through tests of the Brazilian reading processes-PROLEC-SE-R. METHODS: Cross-sectional study. The Brazilian adaptation of the PROLEC-SE-R was administered to 436 students: 221 from the state school (G1 6th year, n = 30; G2 7th year, n = 33; G3 8th year, n = 35; G4 9th year, n = 31; G5 1st year, n = 32; G6 2nd year, n = 30; G7 3rd year, n = 30) e 215 private schools (G8 6th year, n = 31; G9 7th year, n = 31; G10 8th year, n = 30; G11 9th year, n = 31; G12 1st year, n = 30; G13 2nd year, n = 31; G14 3rd year, n = 31). Tools of descriptive and bivariate analysis were used. RESULTS: Superior performance of the private school students on spelling tests helps their reading as evidenced by their scores for syntactic and semantic processes. When the knowledge of the use of the word in text, extraction of meaning and its understanding was needed, the difficulty of access to the mental lexicon of the studied population became evident. CONCLUSION: The PROLEC-SE-R, in addition to establishing the reading profile of elementary and high school students, shows that the gaps in teaching and learning, which exist between public and private education in the literacy period, accompany students throughout the basic education cycle. Knowing the reading profile and in which process there is a disruption is important so that the teaching of specific strategies can be promoted throughout the entire schooling process, especially in primary and secondary education.

Lack of association between month of birth and risk of developing type 1 diabetes in Brazil: a 40-year analysis.

OBJECTIVES: Seasonal environment at birth may influence diabetes incidence in later life. We sought evidence for this effect and analyzed the association between the month of birth and the risk of developing type 1 diabetes mellitus (T1DM). METHODS: This was a cohort study carried out with 814 patients diagnosed with T1DM in the region of Bauru - São Paulo State, Brazil, receiving medical care in a private Endocrinology clinic or in the public Brazilian National Health Care System, from 1981 to 2021. All live births that occurred in São Paulo State between 1974 and 2020 were classified by month of birth and were considered as the control group. RESULTS: We found no statistically significant difference (χ2=16.31, critical 19.68) between the month of birth and risk of developing T1DM, when comparing our patients with the background population of the region. There was no association between the month of birth, sex, age at diagnosis, duration of symptoms before diagnosis, self-reported color, and socioeconomic status. CONCLUSIONS: We found no association between month of birth and the risk of developing T1DM in this highly admixed South American population. Our data suggest that our population heterogeneity and geographic location may be important factors in the development of T1DM. Future prospective studies, evaluating environmental factors that may confer risk or protection to the disease, are warranted.

[Cross-cultural adaptation and validation of the World Health Organization Health and Work Performance Questionnaire to Brazilian nurses]. / Adaptação transcultural e validação do World Health Organization Health and Work Performance Questionnaire para enfermeiros brasileiros.

Study aiming to cross-culturally adapt the instrument Health and Work Performance Questionnaire (HPQ) and evaluate the psychometric properties of the Brazilian version for nurses. The adaptation process followed the Process of Translation of World Health Organization. Data for the evaluation of the psychometric properties were collected in a teaching public hospital of Ribeirão Preto in 2011. The evaluated psychometric properties were: face validity and content (group of experts), reliability by Cronbach's alpha and test-retest stability. In the evaluation of psychometric properties, the internal consistency of the HPQ adapted version, Cronbach's alpha was 0.94 for the section A and 0.86 for section B of the instrument. In analyzing the agreement of test-retest stability, the agreements were positive and statistically significant. Thus, the HPQ adapted version proved valid and reliable in the sample studied.

Cross-Cultural Adaptation and Reliability of the Toddler Sensory Profile 2 for Brazilian Children Aged 7 to 35 Months.

Aim: To organize a cross-cultural adaptation study and analyze the reproducibility and test-retest reliability of a Brazilian version of the Toddler Sensory Profile 2 (TSP2Br) for children aged 7-35 months. Methods: The English language version of the profile was translated and culturally adapted into Brazilian Portuguese, administered to 168 caregivers of toddlers aged 7-35 months, and then re-administered to a portion of the sample (39 caregivers; 23%) for 7-14 days for test-retest reliability. The internal consistency and test-retest reliability was analyzed using the Cronbach's alpha and kappa coefficient, respectively. As it is a norm-referenced standardized assessment, the cut-off scores used were 1.0 and 2.0 standard deviations above and below the mean for each group of items established as the preliminary cut-off scores for the Brazilian children. Results: The TSP2Br showed good internal consistency (>0.70) when measured on the total scale; however, when it was analyzed for sensory areas, five to seven areas presented alpha values <.70. By quadrants, alpha was <.70, for all items. The test-retest values fell into the category of near-perfect agreement (.89-.97). The preliminary cut-off points of the Brazilian scores were distinct from those of the Americans. Conclusions: The TSP2Br showed preliminary reliability and validity in the identification of sensory processing problems in Brazilian children aged 7-35 months; however, it would be necessary to increase the sample size to generalize our findings to the general Brazilian population.

Family dysfunction and cognitive decline in aging: the "Health, Wellbeing, and Aging" (SABE) longitudinal population-based study.

Stress during aging is not uncommon and dysfunctional family relationships are important sources of stress in the elderly. Considering the potential stressor that family dysfunction represents, it is questioned whether prolonged exposure to dysfunctional family arrangements can contribute to cognitive decline in aging. Objective: To verify whether family dysfunction is a predictive factor of cognitive decline in aging. Methods: Secondary study with analysis of existing data from the longitudinal, population-based study "Health, Wellbeing and Aging" (SABE). Data from 791 elderly people from two cohorts of the SABE study between 2006 and 2015 were analyzed. Family dysfunction was assessed using the Apgar family instrument, while cognitive performance was assessed using the Mini-Mental State Examination (MMSE), verbal fluency (animals) and digit length in reverse order. Cognitive decline was measured by the difference in scores in the period between 2006 and 2015. Results: Approximately 10% of the sample had family dysfunction. The familial Apgar score was not associated with decline on MMSE (p=0.732), verbal fluency (p=0.852) and digit span scores (p=0.718). Scores related to cognition and family functionality, such as age, education, living alone, depression and family Apgar, do not explain cognitive decline. Conclusion: The findings indicate that family functioning is not associated with cognitive decline in community-dwelling elderly. New studies will be needed to analyze the qualitative characteristics of family relationships in the cognitive performance of the elderly.

O estresse ao longo do envelhecimento não é incomum, e as relações familiares disfuncionais constituem fontes importantes de estresse nos idosos. Considerando-se o potencial estressor que a disfunção familiar representa, questiona-se se a exposição prolongada a arranjos familiares disfuncionais pode contribuir para o declínio cognitivo no envelhecimento. Objetivo: Verificar se a disfunção familiar é um fator preditivo de declínio cognitivo no envelhecimento. Métodos: Estudo secundário com análise de dados provenientes do estudo longitudinal de base populacional "Saúde, Bem-estar e Envelhecimento" (SABE). Foram analisados dados de 791 idosos de duas coortes do estudo SABE no período entre 2006 e 2015. A disfunção familiar foi avaliada pelo instrumento Apgar familiar, enquanto o desempenho cognitivo foi avaliado pelo Miniexame do Estado Mental (MEEM), fluência verbal (animais) e extensão de dígitos na ordem inversa. O declínio cognitivo foi medido pela diferença dos escores entre 2006 e 2015. Resultados: Aproximadamente 10% da amostra apresentou disfunção familiar. O escore Apgar familiar não foi associado ao declínio cognitivo pelo MEEM (p=0,732), fluência verbal (p=0,852) e extensão de dígitos ao longo do tempo (p=0,718). Escores relacionados à cognição e funcionalidade familiar, como idade, escolaridade, morar sozinho, depressão e Apgar de família, não explicam o declínio cognitivo. Conclusão: Os achados mostram que a funcionalidade familiar não está associada ao declínio cognitivo de idosos da comunidade. Novos estudos serão necessários para analisar as características qualitativas das relações familiares no desempenho cognitivo de idosos.

Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus in the municipality of Sinop, Mato Grosso: an epidemiological study. / Síndrome de la Fragilidad y sarcopenia en ancianos con y sin diabetes mellitus tipo 2 del municipio de Sinop, Mato Grosso: un estudio epidemiológico.

OBJECTIVE: to relate Frailty Syndrome and sarcopenia in older adults with and without type 2 diabetes mellitus and identify potential risk factors for frailty and sarcopenia. METHOD: this descriptive epidemiological study was conducted with 140 older adults in the municipality of Sinop, Mato Grosso, Brazil. The frailty phenotype was used for the assessment of Frailty Syndrome, and a physical assessment questionnaire with calf circumference measurement was used for the assessment of sarcopenia. RESULTS: regarding Frailty Syndrome, a higher percentage was observed in older adults with type 2 diabetes mellitus compared to those without the disease (p = 0.00). Concerning the presence of sarcopenia, older adults with and without type 2 diabetes mellitus showed similar values, with no statistical significance (p = .74). Frailty Syndrome was associated with physical inactivity (95%CI: 3.29-56.55), age over 75 years (95%CI: 3.30- 27.82), low family income (95%CI: 1.80-50.98), and comorbidities (95%CI: 4.90-5.40). However, sarcopenia was associated with the presence of physical inactivity (95%CI: 1.26-10.44), low weight/ eutrophic (95%CI: 3.32-26.76), and malnutrition/nutritional risk (95%CI: 1.30-7.70) for older adults with and without type 2 diabetes mellitus. CONCLUSION: older adults with diabetes have a higher vulnerability to develop Frailty Syndrome, necessitating the adoption of preventive measures in primary healthcare.

[Cross-cultural adaptation of the Vulnerable Elders Survey-13 (VES-13): helping in the identification of vulnerable older people]. / Adaptação transcultural do Vulnerable Elders Survey-13 (VES-13): contribuindo para a identificação de idosos vulneráveis.

To use the VES-13 a tool for identifying vulnerable older people cultural adaptation was performed, a process that seeks the equivalence between the original instrument and its version in another culture. The evaluation of semantic, idiomatic, cultural and conceptual equivalence obtained a general average agreement of 78%, 78%, 97.0% and 94.0% respectively. Kappa coefficient was used to verify the agreement in test-retest reliability, where variables were significant. The analysis of internal consistency was measured by using Cronbach's alpha coefficient, where 70% of the phenomenon under study are represented in the VES-13. The VES-13, translated and adapted, is a reliable instrument with respect to stability and internal consistency of their measurements. Its simple structure and easy to use may therefore contribute to the identification of vulnerable older people, thus contributing to the prioritization of monitoring health services.