Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study.

BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study

ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial.

Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

Qualidade de vida do cuidador informal de idosos com doença de alzheimer na pandemia COVID-19 / Quality of life of informal caregivers of aged people with alzheimer's disease during the COVID-19 pandemic

Objetivo: Desvelar sobre a qualidade de vida dos cuidadores informais de idosos com Doença de Alzheimer em tempos de pandemia da COVID-19. Método: Estudo descritivo, qualitativo, por meio de entrevista semiestruturada com 12 cuidadores informais de idosos, selecionados por conveniência. O processamento dos dados foi realizado pelo software IraMuTeQ e análise das classes pelo método de Strauss e Corbin, da qual emergiram 4 classes: rede social e mudança na rotina dos cuidadores informais no período da pandemia da COVID-19; fatores que interferem na QV do cuidador informal; vivenciando o diagnóstico de Alzheimer pelo cuidador informal e sentimentos despertados pela sobrecarga dos cuidadores informais de idosos com DA. Resultados: O perfil feminino se sobressaiu, com destaque para cuidadores com idade entre 40 a 49 anos, casados, ensino médio incompleto, desempenhando esta função por mais de cinco anos e em tempo integral. Os fatores que interferem na qualidade de vida são a falta de tempo, sobrecarga do cuidado, falta de lazer, baixas atividades sociais e sentimentos de tristeza, ansiedade, nervosismo, depressão e desespero. Conclusão: Constatou-se que os aspectos encontrados foram impactados ainda mais durante o período da pandemia da COVID-19, que reconfigurou a rotina do idoso com Alzheimer e do cuidador informal. Descritores: Doença de Alzheimer; Cuidadores. Idosos; Coronavírus; Qualidade de Vida.

Objective:To reveal the quality of life of informal caregivers of aged people with Alzheimer's disease in times of the COVID-19 pandemic. Method:Adescriptive and qualitative study conducted through semi-structured interviews with 12 informal caregivers of older adults, selected by convenience. Data processing was performed using the IraMuTeQ software and class analysis using the Strauss and Corbin method, from which 4 classes emerged, namely: Social network and change in the routine of informal caregivers during theCOVID-19 pandemic period; Factors that interfere with the QoL of informal caregivers; How informal caregivers experience the Alzheimer's disease diagnosis; and Feelings awakened by the burden of informal caregivers of aged people with AD. Results:The female profile stood out, with emphasis on caregivers aged from 40 to 49 years old, married, incomplete High School, and performing this role for more than five years and full-time. The factors that interfere with quality of life are lack of time, care burden, lack of leisure, few social activities and feelings of sadness, anxiety, nervousness, depression and despair. Conclusion:It was verified that the aspects found were impacted even more during the COVID-19 pandemic period, which reconfigured the routine of older adults with Alzheimer's and of informal caregivers. Descriptors: Alzheimer Disease; Caregivers; Aged; Coronavirus; Quality of Life.

Social support perceived by elderly people in social vulnerability according to family functionality: a cross-sectional study.

OBJECTIVE: To compare the social support as perceived by elderly persons in a context of social vulnerability according to family functionality. METHOD: A cross-sectional study using a quantitative approach, carried out in São Carlos-SP, with 123 elderly people living in a context of high social vulnerability. The sample was divided into two groups: good family functionality and moderate/severe family dysfunction. Data was collected on sociodemographic characteristics, family functionality (Family APGAR) and social support (Medical Outcomes Study Social Support Scale). The Mann-Whitney, Chi-square and Fisher's exact statistical tests were used. RESULTS: There was a statistically significant difference between social support and family functionality (p < 0.05). The group with good family functionality obtained higher median social support scores: affective 100.00; material 95.00; information 90.00; emotional 90.00; positive social interaction 85.00; when compared to the group with moderate/severe family dysfunction: affective 86.67; material 87.50; information 70.00; emotional 65.00; positive social interaction 65.00. CONCLUSION: Elderly persons living in dysfunctional families have less perceived social support when compared to those living in families with good family functionality.

Cross-cultural adaptation and validation of Sarcopenia and Quality of Life (SarQoL) in Brazil

ABSTRACT BACKGROUND: Sarcopenia is defined as a slow, progressive, and apparently inevitable process of involuntary loss of muscle mass, strength, and quality, which occurs with advancing age. It is widely accepted that sarcopenia can directly affect quality of life. OBJECTIVE: Translate, adapt and validate the "Sarcopenia and Quality of Life" instrument (SarQoL) to the Brazilian context. DESIGN AND SETTINGS: Translation, cross-cultural adaptation, and validation study carried out at the Federal University of São Carlos, São Carlos, São Paulo, Brazil. METHODS: The population consisted of 221 older adult participants. The steps recommended by the guidelines from the authors of the original instrument were followed sequentially: initial translation, synthesis of translations, backward translation, evaluation by a panel of judges, pre-test, and analysis of psychometric properties. The translation and adaptation process was conducted as recommended. RESULTS: Two hundred and twenty-one participants took part in the step analysis of the psychometric properties of SarQoL, in which 55 presented sarcopenia. Cronbach's alpha coefficient of the total SarQoL questionnaire was 0.976, indicating excellent internal consistency. Excellent agreements between the test and retest with an Interclass Correlation Coefficient (ICC) of 0.983 (95% confidence interval: 0.901-0.996) were observed in the SarQoL domains. The domains of Short-Form 36 and EuroQoL 5-dimension showed significant correlation, from moderate to strong magnitude, with SarQoL total score, indicating convergent validity. CONCLUSION: The Brazilian version of SarQoL presented evidence of reliability and validity.

Translation, adaptation, and reliability of a Social Frailty Scale for the Brazilian context: a methodological study

ABSTRACT BACKGROUND: Frailty comprises three dimensions: physical, psychological, and social. It is established that social frailty is correlated with several variables, such as quality of life, depression, and loneliness. These findings reinforce the need to investigate and define predictors of social frailty. OBJECTIVE: To translate, culturally adapt, and assess the reliability of the HALFT scale for Brazil. DESIGN AND SETTING: Methodological study conducted at Universidade Federal de São Carlos. METHODS: This study aimed to translate and culturally adapt the HALFT scale from English to Brazilian Portuguese, for which the steps of translation, synthesis of translations, back translation, evaluation by an expert committee, pre-test, and test-retest were followed. RESULTS: Two independent translators translated the HALFT. The consensual version was established by merging the translations, which were back translated into English by a third translator. The expert committee comprised seven health professionals working in frailty and/or social fields of study. Only one item on the scale had a content validity index of less than one (0.85). The instrument was pre-tested with 35 older adults who considered it clear and understandable, with no suggestion of changes. The reliability analysis (reproducibility) of the adapted version of the HALFT with test-retest of the scale with 23 participants showed a Kappa index of 0.62, showing good agreement. CONCLUSION: The HALFT scale is translated and adapted for Brazil, and shows good reliability. However, it is necessary to conduct psychometric analysis of the instrument to provide normative data for this population.

Cross-cultural adaptation and validation of Sarcopenia and Quality of Life (SarQoL) in Brazil.

BACKGROUND: Sarcopenia is defined as a slow, progressive, and apparently inevitable process of involuntary loss of muscle mass, strength, and quality, which occurs with advancing age. It is widely accepted that sarcopenia can directly affect quality of life. OBJECTIVE: Translate, adapt and validate the "Sarcopenia and Quality of Life" instrument (SarQoL) to the Brazilian context. DESIGN AND SETTINGS: Translation, cross-cultural adaptation, and validation study carried out at the Federal University of São Carlos, São Carlos, São Paulo, Brazil. METHODS: The population consisted of 221 older adult participants. The steps recommended by the guidelines from the authors of the original instrument were followed sequentially: initial translation, synthesis of translations, backward translation, evaluation by a panel of judges, pre-test, and analysis of psychometric properties. The translation and adaptation process was conducted as recommended. RESULTS: Two hundred and twenty-one participants took part in the step analysis of the psychometric properties of SarQoL, in which 55 presented sarcopenia. Cronbach's alpha coefficient of the total SarQoL questionnaire was 0.976, indicating excellent internal consistency. Excellent agreements between the test and retest with an Interclass Correlation Coefficient (ICC) of 0.983 (95% confidence interval: 0.901-0.996) were observed in the SarQoL domains. The domains of Short-Form 36 and EuroQoL 5-dimension showed significant correlation, from moderate to strong magnitude, with SarQoL total score, indicating convergent validity. CONCLUSION: The Brazilian version of SarQoL presented evidence of reliability and validity.

Translation, adaptation, and reliability of a Social Frailty Scale for the Brazilian context: a methodological study.

BACKGROUND: Frailty comprises three dimensions: physical, psychological, and social. It is established that social frailty is correlated with several variables, such as quality of life, depression, and loneliness. These findings reinforce the need to investigate and define predictors of social frailty. OBJECTIVE: To translate, culturally adapt, and assess the reliability of the HALFT scale for Brazil. DESIGN AND SETTING: Methodological study conducted at Universidade Federal de São Carlos. METHODS: This study aimed to translate and culturally adapt the HALFT scale from English to Brazilian Portuguese, for which the steps of translation, synthesis of translations, back translation, evaluation by an expert committee, pre-test, and test-retest were followed. RESULTS: Two independent translators translated the HALFT. The consensual version was established by merging the translations, which were back translated into English by a third translator. The expert committee comprised seven health professionals working in frailty and/or social fields of study. Only one item on the scale had a content validity index of less than one (0.85). The instrument was pre-tested with 35 older adults who considered it clear and understandable, with no suggestion of changes. The reliability analysis (reproducibility) of the adapted version of the HALFT with test-retest of the scale with 23 participants showed a Kappa index of 0.62, showing good agreement. CONCLUSION: The HALFT scale is translated and adapted for Brazil, and shows good reliability. However, it is necessary to conduct psychometric analysis of the instrument to provide normative data for this population.

Social support perceived by elderly people in social vulnerability according to family functionality: a cross-sectional study / Apoyo social percibido por personas mayores en situación de vulnerabilidad social según la funcionalidad familiar: un estudio transversal / Apoio social percebido por pessoas idosas em vulnerabilidade social segundo a funcionalidade familiar: um estudo transversal

ABSTRACT Objective: To compare the social support as perceived by elderly persons in a context of social vulnerability according to family functionality. Method: A cross-sectional study using a quantitative approach, carried out in São Carlos-SP, with 123 elderly people living in a context of high social vulnerability. The sample was divided into two groups: good family functionality and moderate/severe family dysfunction. Data was collected on sociodemographic characteristics, family functionality (Family APGAR) and social support (Medical Outcomes Study Social Support Scale). The Mann-Whitney, Chi-square and Fisher's exact statistical tests were used. Results: There was a statistically significant difference between social support and family functionality (p < 0.05). The group with good family functionality obtained higher median social support scores: affective 100.00; material 95.00; information 90.00; emotional 90.00; positive social interaction 85.00; when compared to the group with moderate/severe family dysfunction: affective 86.67; material 87.50; information 70.00; emotional 65.00; positive social interaction 65.00. Conclusion: Elderly persons living in dysfunctional families have less perceived social support when compared to those living in families with good family functionality.

RESUMEN Objetivo: Comparar el apoyo social percibido por personas mayores en un contexto de vulnerabilidad social según la funcionalidad familiar. Método: Estudio transversal con abordaje cuantitativo, realizado en São Carlos-SP, con 123 personas mayores residentes en contexto de alta vulnerabilidad social. La muestra fue dividida en dos grupos: buena funcionalidad familiar y disfunción familiar moderada/severa. Se recogieron datos sobre características sociodemográficas, funcionalidad familiar (APGAR Familiar) y apoyo social (Escala de Apoyo Social del Medical Outcomes Study). Se utilizaron las pruebas estadísticas de Mann-Whitney, Chi-cuadrado y exacta de Fisher. Resultados: Hubo una diferencia estadísticamente significativa entre el apoyo social y la funcionalidad familiar (p<0,05). El grupo con buena funcionalidad familiar obtuvo puntuaciones medias de apoyo social más altas: afectivo 100,00; material 95,00; información 90,00; emocional 90,00; interacción social positiva 85,00; en comparación con el grupo con disfunción familiar moderada/grave: afectivo 86,67; material 87,50; información 70,00; emocional 65,00; interacción social positiva 65,00. Conclusión: Las personas mayores que viven en familias disfuncionales tienen menos apoyo social percibido, en comparación con los que viven en familias con buena funcionalidad familiar.

RESUMO Objetivo: Comparar o apoio social percebido por pessoas idosas em contexto de vulnerabilidade social segundo a funcionalidade familiar. Método: Estudo transversal de abordagem quantitativa, realizado em São Carlos-SP, com 123 idosos inseridos em contexto de alta vulnerabilidade social. A amostra foi dividida em dois grupos: boa funcionalidade familiar e disfunção familiar moderada/severa. Foram coletados dados de caracterização sociodemográfica, funcionalidade familiar (APGAR de Família) e apoio social (Escala de Apoio Social do Medical Outcomes Study). Foram utilizados os testes estatísticos Mann-Whitney, Qui-quadrado e Exato de Fisher. Resultados: Houve diferença estatisticamente significante entre apoio social e funcionalidade familiar (p < 0,05). O grupo com boa funcionalidade familiar obteve maiores escores medianos de apoio social: afetivo 100,00; material 95,00; informação 90,00; emocional 90,00; interação social positiva 85,00; quando comparado ao grupo com disfunção familiar moderada/severa: afetivo 86,67; material 87,50; informação 70,00; emocional 65,00; interação social positiva 65,00. Conclusão: Pessoas idosas que vivem em famílias disfuncionais têm menos apoio social percebido quando comparadas àquelas que vivem em famílias com boa funcionalidade familiar.

Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial / Eficácia do iSupport-Brasil para cuidadores informais de pessoas que vivem com demência: protocolo de um ensaio clínico randomizado e controlado

ABSTRACT. Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

RESUMO. Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

Tradução e adaptação cultural da COVID-19 Anxiety Scale no Brasil / Translation and cultural adaptation of the COVID-19 Anxiety Scale in Brazil

Objetivo Este estudo objetivou traduzir e adaptar culturalmente a COVID-19 Anxiety Scale para o contexto brasileiro. Método Trata-se de um estudo transversal e metodológico, que seguiu as seguintes etapas: tradução inicial, síntese das traduções, retrotradução, revisão por um comitê de especialistas e pré-teste. Resultados Inicialmente dois tradutores fizeram uma primeira tradução da COVID-19 Anxiety Scale para o português. Depois, estabeleceu-se a versão consensual, que foi retrotraduzida para o idioma inglês por outro tradutor. Posteriormente, as versões da COVID-19 Anxiety Scale foram revistas por oito especialistas. Após a análise, dois dos sete itens da escala foram modificados, obtendo--se a versão pré-final da COVID-19 Anxiety Scale. Por fim, essa última versão do instrumento foi pré-testada com 47 pessoas, que consideraram a escala clara e compreensível. Conclusão Conclui-se, portanto, que a COVID-19 Anxiety Scale foi adequadamente traduzida e adaptada para o contexto brasileiro e almeja-se dar seguimento à pesquisa para verificar evidências de validade da escala.

Objective This study aimed to translate and culturally adapt the COVID-19 Anxiety Scale for the Brazilian context. Method Cross-sectional and methodological study that encompassed the following stages: initial translation, synthesis of translations, back-translation, expert committee review, and pre-testing. Results The COVID-19 Anxiety Scale was initially translated into Portuguese by two translators. A consensus version was established and then back-translated into English by a different translator. Eight experts reviewed these versions, resulting in modifications to two of the seven scale items. This led to the creation of the pre-final version of the COVID-19 Anxiety Scale. Finally, the pre-testing of this version was conducted with 47 individuals, who found the scale to be clear and understandable. Conclusion In conclusion, the COVID-19 Anxiety Scale was adequately translated and culturally adapted for the Brazilian context, and further research is intended to verify evidence of the scale's validity.

Change in the pattern of frailty among socially vulnerable older adults over a 36-month period and associated factors: a follow-up study / Mudança do padrão de fragilidade entre idosos socialmente vulneráveis no período de 36 meses e fatores associados: um estudo de seguimento

OBJECTIVE: To investigate changes in the frailty levels of older adults in a context of high social vulnerability. METHODS: We conducted a prospective cohort study. Data were collected from 2 surveys conducted in 2015 and 2018. The frailty phenotype and sociodemographic and health characterization instruments were used. Descriptive statistical analysis was performed, including non-parametric tests, test for equality of proportions, and multivariate multinomial logistic regression. The use of the database was authorized, and the research was approved by the Ethics Committee. RESULTS: In 2015, 346 community-dwelling older adults participated in the study. After 36 months, a final sample of 223 participants was obtained. In 2015, the prevalence of non-frail, pre-frail, and frail older adults was 13.0%, 56.5%, and 30.5%, respectively. In 2018, 22.9% were non-frail, 56.0% were pre-frail, and 21.1% were frail. Higher education and better quality of life reduced the likelihood of becoming pre-frail and frail, respectively. CONCLUSION: There was a change in the pattern of frailty among socially vulnerable older adults over a 36-month period.

OBJETIVO: Verificar alterações nos níveis de fragilidade de pessoas idosas em contexto de alta vulnerabilidade social. METODOLOGIA: Trata-se de um estudo de coorte prospectivo. Foram coletados dados de dois inquéritos realizados em 2015 e 2018. Utilizou-se o Fenótipo de Fragilidade e instrumentos de caracterização sociodemográfica e de saúde. Análises estatísticas descritivas foram realizadas, incluindo testes não-paramétricos, teste de igualdade de proporções e regressão logística multinomial multivariada. O uso do banco de dados foi autorizado, e a pesquisa foi aprovada pelo Comitê de Ética. RESULTADOS: Em 2015, 346 idosos comunitários participaram do estudo. Após o período de 36 meses, obteve-se uma amostra final de 223 participantes. Em 2015, a prevalência de não frágeis, pré-frágeis e frágeis foi de 13,0, 56,5 e 30,5%, respectivamente. Em 2018, 22,9% eram não frágeis, 56,0% pré-frágeis e 21,1% frágeis. Maior escolaridade e qualidade de vida diminuíram a probabilidade de se tornar pré-frágil e frágil, respectivamente. CONCLUSÃO: Observou-se uma mudança do padrão de fragilidade entre idosos socialmente vulneráveis no período de 36 meses.

Association between bio-sociodemographic profile and advanced activities of daily living in hospitalized elderly people / Association between bio-sociodemographic profile and advanced activities of daily living in hospitalized elderly people

RESUMO Objetivo avaliar a relação entre as características biossociodemográficas e atividades avançadas de vida diária em pessoas idosas hospitalizadas. Métodos estudo transversal. Participaram 200 pessoas idosas hospitalizadas. Utilizaram-se os instrumentos: Questionário de Avaliação do Estado Mental, Instrumento de Caracterização Biossociodemográfica e de Saúde e Escala de Atividades Avançadas de Vida Diária. Resultados a idade impactou as atividades sociais (p=0,024), de lazer (p=0,004), intelectuais (p=0,017) e religiosas (p=0,047). Em relação ao gênero, os homens apresentaram maiores escores nas atividades de lazer (p=0,046) e intelectuais (p=0,002); por outro lado, as mulheres obtiveram melhores pontuações nas atividades religiosas (p=0,001). As variáveis "renda familiar", "incapacidade física" e "atividade física" se associaram significantemente com o escore global. Conclusão houve associação das variáveis "idade", "escolaridade", "renda familiar", "incapacidade física", "prática de atividade física" e "percepção do estado de saúde" com o escore global da Escala. A maior parte das variáveis biossociodemográficas mostrou associação com o domínio Atividades de Lazer. Contribuições para a prática: a elucidação de fatores que podem estar relacionados com a realização de atividades avançadas em pessoas idosas hospitalizadas pode subsidiar a melhoria da assistência.

ABSTRACT Objective to evaluate the relationship between bio sociodemographic characteristics and advanced activities of daily living in hospitalized elderly people. Methods cross-sectional study. Two hundred hospitalized elderly people participated. The instruments were used: Mental Status Assessment Questionnaire, Bio-sociodemographic and Health Characterization Instrument and Advanced Activities of Daily Living Scale. Results age impacted social (p=0.024), leisure (p=0.004), intellectual (p=0.017) and religious (p=0.047) activities. Regarding gender, men presented higher scores in leisure (p=0.046) and intellectual (p=0.002) activities; on the other hand, women obtained better scores in religious activities (p=0.001). The variables "family income", "physical disability" and "physical activity" were significantly associated with the global score. Conclusion there was an association of the variables "age", "education", "family income", "physical disability", "physical activity practice" and "health status perception" with the global score of the scale. Most of the bio sociodemographic variables showed association with the Leisure Activities domain. Contributions to practice: the elucidation of factors that may be related to the performance of advanced activities in hospitalized elderly people can support the improvement of care.

The association between language and recognition of facial emotional expressions in elderly individuals. / Associação entre linguagem e o reconhecimento de expressões faciais de emoções em idosos.

PURPOSE: To check the association between a good performance of language and the recognition of facial emotional expressions in elderly individuals. METHODS: Transversal study performed with 118 elderly individuals from the primary care services of health of a city in the state of São Paulo. Sociodemographic data were collected, regarding the performance of language through the domain of Addenbrooke Cognitive Examination - Revised and Recognition of Facial Emotional Expressions. The sample was divided in thirds according to the performance of language: T1 = the best, T2 = average, and T3 = the worst. The groups T1xT3 were compared regarding the performance of recognition of facial expressions of anger, disgust, fear, happiness, sadness, and surprise, and for the intensities of 40%, 60%, 80%, and 100%. The association of independent variables over the performance of language was analyzed through logistic regression. The multivariate model was built from the results of the univariate analyses and has included the continuous variables by emotion and by intensity. Age and schooling associated to the performance of language in the univariate model were included in the multivariate model in order to adjust association analyses. RESULTS: The sample was mainly female (84.7%), with an average age of 70.5 years old, and 3.5 schooling years. The variables associated to the best performance of language in comparative analysis of T1 and T3 were: surprise (OR = 1.485, IC 95% 1.194 - 1.846), and disgust (OR = 1.143, IC 95% 1.005 - 1.300). CONCLUSION: The recognition of facial emotional expressions of surprise and disgust were shown as important factors associated to the good performance of language.

OBJETIVO: Verificar a associação entre o bom desempenho de linguagem e o reconhecimento de expressões faciais de emoções em idosos. MÉTODO: Estudo transversal realizado com 118 idosos dos serviços de atenção primária à saúde de um município paulista. Foram coletados dados sociodemográficos, de desempenho da linguagem pelo domínio do Exame Cognitivo de Addenbrooke - Revisado e de Reconhecimento de Expressões Faciais de Emoções. A amostra foi dividida em tercis de acordo com o desempenho na linguagem: T1 = melhor, T2 = mediano e T3 = pior. Os grupos T1xT3 foram comparados em relação ao desempenho no reconhecimento de expressões faciais de raiva, nojo, medo, alegria, tristeza e surpresa e para as intensidades 40%, 60%, 80% e 100%. A associação das variáveis independentes sobre o desempenho de linguagem foi analisada por meio de regressão logística. O modelo multivariado foi construído a partir dos resultados das análises univariadas e incluiu as variáveis contínuas por emoção e por intensidade. Idade e escolaridade, associadas ao desempenho de linguagem no modelo univariado, foram incluídas no modelo multivariado para ajustar as análises de associação. RESULTADOS: A amostra era predominantemente feminina (84,7%), com idade média de 70,5 anos e 3,5 anos de escolaridade. As variáveis ​​associadas ao melhor desempenho de linguagem na análise comparativa de T1 e T3 foram: surpresa (OR= 1,485, IC 95% 1,194 ­ 1,846) e nojo (OR= 1,143, IC 95% 1,005 ­ 1,300). CONCLUSÃO: O reconhecimento de expressões faciais das emoções surpresa e nojo mostraram-se importantes fatores associados ao bom desempenho da linguagem.

Association between frailty and depression among hemodialysis patients: a cross-sectional study

ABSTRACT BACKGROUND: Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. OBJECTIVE: To assess frailty and its relationship with depression among patients with CKD undergoing hemodialysis. DESIGN AND SETTING: Observational and quantitative cross-sectional study conducted in a renal therapy unit, located in the interior of the state of São Paulo, Brazil. METHODS: This investigation took place in 2019, among 80 patients. The following instruments were applied: a sociodemographic, economic and health condition characterization and the Subjective Frailty Assessment (SFA) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: Among the patients, there was higher prevalence of females, individuals with a steady partner and retirees, and their mean age was 59.63 (± 15.14) years. There was high prevalence of physical frailty (73.8%) and depression (93.7%). Depression was associated with frailty, such that patients with depression were 9.8 times more likely to be frail than were patients without depression (odds ratio, OR = 9.80; 95% confidence interval, CI, 1.93-49.79). CONCLUSION: Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.

Association between frailty and depression among hemodialysis patients: a cross-sectional study.

BACKGROUND: Frailty is consensually understood to be a clinical syndrome in which minimal stressors can lead to negative outcomes such as hospitalization, early institutionalization, falls, functional loss and death. Frailty is more prevalent among patients with chronic kidney disease (CKD), and those on dialysis are the frailest. Depression contributes towards putting patients with CKD into the frailty cycle. OBJECTIVE: To assess frailty and its relationship with depression among patients with CKD undergoing hemodialysis. DESIGN AND SETTING: Observational and quantitative cross-sectional study conducted in a renal therapy unit, located in the interior of the state of São Paulo, Brazil. METHODS: This investigation took place in 2019, among 80 patients. The following instruments were applied: a sociodemographic, economic and health condition characterization and the Subjective Frailty Assessment (SFA) and Patient Health Questionnaire-9 (PHQ-9). RESULTS: Among the patients, there was higher prevalence of females, individuals with a steady partner and retirees, and their mean age was 59.63 (± 15.14) years. There was high prevalence of physical frailty (73.8%) and depression (93.7%). Depression was associated with frailty, such that patients with depression were 9.8 times more likely to be frail than were patients without depression (odds ratio, OR = 9.80; 95% confidence interval, CI, 1.93-49.79). CONCLUSION: Based on the proposed objective and the results achieved, it can be concluded that depression was associated with the presence of frailty among patients with CKD on hemodialysis.

Hearing handicap and frailty in community-dwelling older adults living. / Handicap auditivo e fragilidade em idosos da comunidade.

PURPOSE: To verify the relationship between hearing handicap and frailty in community-dwelling older adults. METHODS: A cross-sectional study was carried out with 238 older adults (aged ≥ 60 years) in 2018. The Hearing Handicap Inventory for the Elderly - Screening version - HHIE-S was applied to assess the hearing handicap. To assess frailty, the Frailty Phenotype proposed for Fried and co-workers was adopted, objectively evaluating 5 criteria: unintentional weight loss, reported fatigue, reduced grip strength, reduced walking speed and low physical activity. It was investigated whether the hearing handicap were related with frailty using Kruskal-Wallis and Spearman test. RESULTS: Worse perception of the hearing handicap was found in pre-frail and frail individuals, compared to non-frail individuals. In addition, hearing handicap showed a positive and statistically significant correlation with frailty. CONCLUSION: Hearing handicap is related to frailty in community-dwelling older adults.

OBJETIVO: Verificar a relação entre o handicap auditivo e fragilidade em idosos residentes da comunidade. MÉTODO: Estudo transversal realizado com 238 idosos (idade ≥ 60 anos), no ano de 2018. O questionário Hearing Handicap Inventory for the Elderly - Screening version - HHIE-S, foi aplicado para quantificar o handicap auditivo. A fragilidade foi avaliada segundo o Fenótipo de Fragilidade proposto por Fried e colaboradores, utilizando os 5 critérios: perda de peso não intencional, fadiga relatada, redução da força de preensão, redução da velocidade de caminhada e baixa atividade física. A relação entre o handicap auditivo e a fragilidade foi realizada por meio dos Testes Kruskal-Wallis e Spermann. RESULTADOS: Maior percepção do handicap auditivo foi verificado nos indivíduos pré-frágeis e frágeis, comparados aos não frágeis. O handicap auditivo apresentou correlação positiva e estatisticamente significante com maiores níveis de fragilidade. CONCLUSÃO: O handicap auditivo está relacionado a fragilidade em idosos da comunidade.

Loneliness Level and Its Associated Factors in Patients With Hemodialysis.

The purpose of this study was to examine the level of loneliness and its relationship with socioeconomic and health conditions, social support, family functionality, and depressive symptoms in patients undergoing hemodialysis. This cross-sectional study involved analysis of a secondary data, collected in 2019 among 80 patients with CKD on hemodialysis. Participants completed the following instruments: socio-demographic, economic, and health condition characterization, UCLA Loneliness Scale, Medical Outcomes Study Social Support Scale, Patient Health Questionnaire-9, and the Family APGAR. On average, the sample was mostly female (55%), white (65%), and the mean age was 59.63 years. In the perception of loneliness, the highest index was (55%), moderately high. Social support scored the worst in the Positive Social Interaction domain. The prevalance of severe depression was approximately 29%. Family functioning was positive, with a good score (69%). There was a weak negative correlation between loneliness and all domains of Social Support, besides Family Functioning.

Association between psychosocial and functional factors and language and verbal fluency performance in older adults / Associação entre fatores psicossociais e funcionais e desempenho de idosos em linguagem e fluência verbal

ABSTRACT Purpose: to identify psychosocial and functional factors associated with language and verbal fluency performance in older adults. Methods: a study conducted with 149 older adults registered in a primary health care service in a city in inland São Paulo. Instruments such as a sociodemographic questionnaire, the Addenbrooke Cognitive Examination-Revised (verbal fluency and language domains), Geriatric Depression Scale, Perceived Stress Scale, Medical Outcomes Study, WHOQOL-OLD, and Instrumental Activities of Daily Living Scale, were used. Participants were divided into tertiles, according to their language and verbal fluency performance: T1 = best performance, T2 = median performance, and T3 = worst performance. Groups T1 and T3 were compared, and a binary regression was conducted to analyze the factors associated with the best language and verbal fluency performance. Results: higher educational attainment, higher income, and better functioning were the factors associated with the best language performance comparing T1 and T3, while higher educational attainment and better functioning were associated with the best verbal fluency. Conclusion: educational attainment and functioning proved to be important factors associated with good language and verbal fluency performance, while income was associated only with good language performance.

RESUMO Objetivo: identificar fatores psicossociais e funcionais associados ao desempenho de idosos em linguagem e fluência verbal. Métodos: estudo realizado com 149 idosos cadastrados no serviço de atenção primária à saúde de uma cidade do interior de São Paulo. Foram utilizados um questionário de caracterização sociodemográfica, Exame Cognitivo de Addenbrooke - Revisado (domínios de fluência verbal e de linguagem), Escala de Depressão Geriátrica, Escala de Estresse Percebido, Medical Outcomes Study, WHOQOL-OLD e Escala de Atividades Instrumentais da Vida Diária. Os participantes foram divididos em tercis de acordo com o desempenho em linguagem e fluência verbal: T1 = melhor desempenho, T2 = desempenho mediano e T3 = pior desempenho. Foram comparados os grupos T1 e T3 e realizada uma regressão binária para analisar os fatores associados ao melhor desempenho em linguagem e fluência verbal. Resultados: as variáveis associadas ao melhor desempenho de linguagem comparando T1 e T3 foram: maior escolaridade, maior renda e melhor funcionalidade. Para a melhor fluência verbal, os fatores associados foram: maior escolaridade e melhor funcionalidade. Conclusão: a escolaridade e a funcionalidade mostraram-se importantes fatores associados ao bom desempenho da linguagem e da fluência verbal, enquanto a renda mostrou-se associada apenas ao bom desempenho de linguagem.