ABSTRACT
ABSTRACT Objective: This study comprises a systematic review and meta-analysis that aimed to estimate the prevalence of dementia in long-term care institutions (LTCIs). Methods: We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Original transversal and longitudinal articles published until July 2020 were eligible in this review. Databases PubMed/MedLine, Web of Science, Scopus and ScienceDirect were searched. Overall prevalence and confidence intervals were estimated. Heterogeneity was calculated according to the index of heterogeneity (I2). Results: One hundred seventy-five studies were found in all databases and 19 studies were meta-analyses, resulting in an overall prevalence of 53% (CI 46-59%; p < 0.01) of demented older adults living in LTCIs. Conclusion: Prevalence of dementia is higher in older adults living in LTCIs than those living in general communities. This data shows a worrying reality that needs to be changed. There is a need for a better understanding of the elements that cause this increase in dementia in LTCFs to direct actions to improve the quality of life and health of institutionalized elderly.
RESUMO Objetivo: Esta revisão sistemática e metanálise objetiva estimar a prevalência de demência em instituições de longa permanência para idosos (ILPIs). Métodos: Utilizou-se o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Artigos originais transversais e longitudinais publicados até julho de 2020 foram elegíveis para esta revisão. As buscas foram conduzidas por meio das bases de dados do PubMed/MedLine, Web of Science, Scopus e Science Direct. A prevalência geral e o intervalo de confiança foram estimados. A heterogeneidade foi calculada de acordo com o índice de heterogeneidade (I2). Resultados: Cento e setenta e cinco estudos foram encontrados em todas as bases de dados e 19 estudos foram analisados, resultando em uma prevalência geral de idosos com demência de 53% (IC 46-59%; p < 0,01) que habitam em ILPIs. Conclusão: A prevalência de demência é maior em idosos moradores de ILPIs que em idosos da população geral. Tal dado mostra uma realidade preocupante e que precisa ser modificada. Há necessidade de melhor entendimento dos elementos que causam esse aumento de demência nas ILPIs para direcionar ações para melhorar a qualidade de vida e a saúde dos idosos institucionalizados.
ABSTRACT
There is enough evidence that, nowadays, the sedentary lifestyle is one of the major health problems worldwide, linked to many chronic diseases, including mental comorbidities, systemic hypertension, metabolic dysregulation, and cancer. Although health societies recommend engagement to physical activities, there is an overwhelming number of people remaining sedentary, even knowing the health benefits of regular exercises. One of the main factors that justifies this scenario is the lack of motivation, which is a barrier to people intended to start new habits for health. Considering this previous information, new alternatives for exercises may help people engage in a healthier lifestyle. Technology has contributed to this with devices that allow movements based on virtual reality approaches, including the exergames. These are games available even in commercial devices, as video-games, that allow people to work with different physical components. Furthermore, exergames add cognitive gain through its dual-task characteristic. Moreover, due to the combination of these benefits, they are feasible to acquire, and easy to use. Exergames are not only a potential strategy to reduce sedentary lifestyle but also a good method to improve health gains and rehabilitation in different populations and pathological conditions: older adults, stroke survivors, and Parkinson's disease. In this review, we aim to demonstrate some conditions that literature supports the intervention with exergames due to its physical and cognitive benefits. Furthermore, at the end of this review, we also explore the neurobiological mechanisms behind virtual-reality based exercises.
