Major depression and associated factors in institutionalized older adults.

This quantitative epidemiological study aimed to analyze the prevalence of major depression in 237 older adults aged 60 to 104 years living in long-term care facilities in a large city in the state of Ceará, Northeastern Brazil. A sociodemographic questionnaire (age, gender, education, duration of institutionalization) was administered and the DSM-IV-TR was used as a reference for the clinical assessment of major depression. The Katz scale was used to classify dependence in activities of daily living and the Pfeffer scale was used to classify dependence in instrumental activities of daily living. The Mini Mental State Examination and the Category Fluency Test were used to assess cognitive function. Data underwent descriptive and analytical statistics with a significance level of 5%. The participants' mean age was 75.3 ± 8.6 years. Of these, 82 older adults (34.6%) presented a diagnosis of major depression. Major depression was significantly associated family visits (p = 0.036). The prevalence of major depression in institutionalized older adults is high. The assessment of the prevalence of major depression should be carried out based on internationally accepted clinical criteria rather than on depressive symptoms screening tests since the diagnosis itself is what will determine the non-drug or drug therapy.

Updated geriatric cardiology guidelines of the brazilian society of cardiology ­ 2019 / Atualização das diretrizes em cardiogeriatria da sociedade brasileira de cardiologia ­ 2019

Development: The Department of Geriatric Cardiology of the Brazilian Society of Cardiology (Departamento de Cardiogeriatria da Sociedade Brasileira da Cardiologia) and the Brazilian Geriatrics and Gerontology Society (Sociedade Brasileira de Geriatria e Gerontologia). (AU)

Educação Médica em Geriatria: desafio brasileiro e mundial / Medical Education in Geriatrics: brazilian and global challenge

O acentuado envelhecimento da população mundial aumenta a demanda por profissionais com formação adequada para o atendimento da população idosa. Há carência e má distribuição de profissionais de saúde em todo o mundo, situação também vivenciada pelos profissionais capacitados para o atendimento ao idoso. A deficiência da Educação Médica em Geriatria é um fenômeno mundial: cerca de 40% dos países referem algum conteúdo de Geriatria nos cursos de graduação em Medicina. No Brasil, apesar de existir uma legislação avançada em termos de política do idoso, menos da metade dos cursos de Medicina oferecem disciplinas/módulos de Geriatria e/ou conteúdos relativos ao envelhecimento, além da escassez de atividades de formação para professores, especialistas e pesquisadores na área. Essa situação é agravada pelo fato desse grupo populacional apresentar grande predomínio de doenças crônico-degenerativas, especificidades na manifestação das doenças e, consequentemente, no seu manuseio, enfatizando a necessidade de um modelo biopsicossocial com atuação de equipe multidisciplinar capacitada para esse fim. Apesar do esforço, em âmbito mundial, de diversas entidades e sociedades envolvidas na área em instituir um currículo mínimo de Geriatria nos cursos de Medicina e em qualificar profissionais para a atuação na área, o problema agrava-se pela rapidez do envelhecimento populacional. Os desafios são muitos, e há um grande trabalho a ser realizado. A criação de modelos viáveis e sustentáveis de cuidados para idosos deve ser o objetivo de governantes e de todos os que atuam na área, não somente no Brasil, mas em todo o mundo.

The significant aging of the world population increases the demand for professionals with adequate training to care for the elderly. There is shortage and unsatisfactory distribution of health professionals worldwide, and so occurs in relation to professionals trained to care for the elderly. The deficiency of Medical Education in Geriatrics is a global phenomenon, since only about 40% of the countries refer some content of Geriatrics in undergraduate Medical courses. Even though Brazil has advanced legislation in terms of elderly policy, less than half of the medical courses offer Geriatrics disciplines/modules or content related to aging, besides the lack of training activities for teachers, specialists and researchers in the field. This situation is worsened by the fact that in this population group there is prevalence of chronic-degenerative diseases, specificities in the manifestation of diseases and, consequently, their handling, emphasizing the need for a biopsychosocial model with the performance of a multidisciplinary team trained for this purpose. Despite the efforts of several institutions and societies around the world involved in establishing a minimum Geriatrics curriculum in Medicine courses and qualifying professionals to work in the area, the problem is aggravated by the speed of population aging. The challenges are many and there is a lot of work to be done. The creation of feasible and sustainable models of care for the elderly should be the goal of governments and of all of those who work in the field, not only in Brazil, but all over the world.

The safety of oral use of L-glutamine in middle-aged and elderly individuals.

OBJECTIVE: To evaluate the safety of nutraceutical oral administration of L-glutamine (L-Gln) in middle-aged and elderly individuals. METHODS: In this randomized, crossover, double-blind clinical study, 30 residents of a long-term-care institution, selected according to a modified SENIEUR protocol (Working Party of the EURAGE Concerted Action Programme on Ageing of the European Community), were studied. Fourteen subjects received orally 0.5 g kg(-1) d(-1) of L-Gln and 16 received calcium caseinate for 14 d, followed by a 5-d washout. Supplements were switched for the second 14-d trial. Laboratory tests for hepatic and renal functions and ammonemia were performed and the estimated glomerular filtration rate (eGFR) was calculated. RESULTS: Of the 30 subjects, 16 were men, mean age was 69+/-8.8 y, average weight was 61.8+/-14.2 kg, and mean serum albumin was 4.0+/-0.3g/dL. Neither adverse clinical effects nor clinically significant laboratory changes were noted during L-Gln supplementation. There was no difference in ammonemia between the groups. There were statistically but not clinically significant increases in plasma urea nitrogen and creatinine concentrations. There was no significant decrease in eGFR during calcium caseinate supplementation (-2.9%). The eGFR decreased significantly after L-Gln supplementation (-13.3%) but well below the 25% limit for biologic significance. CONCLUSION: Increases in serum urea nitrogen and creatinine and decrease in eGFR are probably due to difficulties by older kidneys in metabolizing the supplemented protein sources. Although not clinically significant, those alterations impose a rigorous control on the evaluation parameters of renal function during oral L-Gln supplementation, with doses of 0.5 g kg(-1) d(-1) in middle-aged and elderly individuals.

[The health status of the elderly population: what do we need to know?]. / Que informações são necessárias para o conhecimento da situação de saúde do idoso?

The objective of this research was to evaluate the data on the health of the elderly population available in the Brazilian information system and their correspondence with the North American statistics using the Internet. The North American publication "Older Americans 2000: Key Indicators of Well-Being" was used as a standard. The databases and instruments used in the North American and Brazilian surveys are presented. The North American data are based on the Supplement on Aging and Second Supplement on Aging; Health and Retirement Study; National Health Interview Survey and National Long Term Care Survey. The Brazilian data were collected from the Mortality Information System; Information System of the National Program of Immunizations; National Household Sample Survey conducted in 1998 and 2003 and from the Household Survey on Risk Behavior and Morbidity from Not Transmissible Diseases of 2002-2003. There is a great number of Brazilian information about the aged population of the Country available in the Internet and with few exceptions the information on aged Brazilians corresponds to the information available about aged North Americans.

Que informações são necessárias para o conhecimento da situação de saúde do idoso? / The health status of the elderly population: what do we need to know?

O objetivo da pesquisa foi avaliar, por meio da Internet, os dados sobre a saúde da população idosa existentes no sistema de informações brasileiro e a sua correspondência com as estatísticas norte-americanas. Foram utilizados os indicadores norte-americanos da publicação Older Americans 2000: Key Indicators of Well-Being como parâmetro para busca de similares brasileiros. As bases de dados, assim como os instrumentos das pesquisas norte-americanos e brasileiros, são apresentadas. Os dados norte-americanos são provenientes do Supplement on Aging and Second Supplement on Aging; Health and Retirement Study; National Health Interview Survey e National Long Term Care Survey. Os dados brasileiros são do Sistema de Informações sobre Mortalidade (SIM), do Sistema de Informações do Programa Nacional de Imunizações (SI-PNI), da Pesquisa Nacional por Amostra de Domicílio realizada em 1998 e em 2003 e do Inquérito Domiciliar sobre Comportamentos de Risco e Morbidade Referida de Doenças e Agravos não transmissíveis de 2002-2003. Existe grande quantidade de informações brasileiras para acompanhar a população idosa do país pela Internet e, com poucas exceções, há correspondência de informações sobre idosos brasileiros e norte-americanos.

The objective of this research was to evaluate the data on the health of the elderly population available in the Brazilian information system and their correspondence with the North American statistics using the Internet. The North American publication "Older Americans 2000: Key Indicators of Well-Being" was used as a standard. The databases and instruments used in the North American and Brazilian surveys are presented. The North American data are based on the Supplement on Aging and Second Supplement on Aging; Health and Retirement Study; National Health Interview Survey and National Long Term Care Survey. The Brazilian data were collected from the Mortality Information System; Information System of the National Program of Immunizations; National Household Sample Survey conducted in 1998 and 2003 and from the Household Survey on Risk Behavior and Morbidity from Not Transmissible Diseases of 2002-2003. There is a great number of Brazilian information about the aged population of the Country available in the Internet and with few exceptions the information on aged Brazilians corresponds to the information available about aged North Americans.

Saúde e doença: e eu com isto? / Health and disease: and what do I have with this?

Não temos de ter medo de ficar velhos. Envelhecer não significa ficar doente. A velhice pode ser saudável desde que se cuide da saúde a partir da juventude. Mas, quando envelhecemos, ocorrem muitas transformações em nosso organismo, o qual fica mais suscetível a doenças