Factors associated with older adults' cognitive decline 6 months after gamma-variant SARS-CoV-2 infection.

Background: Cognitive deficits are commonly reported after COVID-19 recovery, but little is known in the older population. This study aims to investigate possible cognitive damage in older adults 6 months after contracting COVID-19, as well as individual risk factors. Methods: This cross-sectional study involved 70 participants aged 60-78 with COVID-19 6 months prior and 153 healthy controls. Montreal Cognitive Assessment-Basic (MoCA-B) screened for cognitive impairment; Geriatric Depression Scale and Geriatric Anxiety Inventory screened for depression and anxiety. Data were collected on demographics and self-reports of comorbid conditions. Results: The mean age of participants was 66.97 ± 4.64 years. A higher proportion of individuals in the COVID group complained about cognitive deficits (χ2 = 3.574; p = 0.029) and presented with deficient MoCA-B scores (χ2 = 6.098, p = 0.014) compared to controls. After controlling for multiple variables, all the following factors resulted in greater odds of a deficient MoCA-B: COVID-19 6-months prior (OR, 2.44; p = 0.018), age (OR, 1.15; p < 0.001), lower income (OR, 0.36; p = 0.070), and overweight (OR, 2.83; p = 0.013). Further analysis pointed to individual characteristics in COVID-19-affected patients that could explain the severity of the cognitive decline: age (p = 0.015), lower income (p < 0.001), anxiety (p = 0.049), ageusia (p = 0.054), overweight (p < 0.001), and absence of cognitively stimulating activities (p = 0.062). Conclusion: Our study highlights a profile of cognitive risk aggravation over aging after COVID-19 infection, which is likely mitigated by wealth but worsened in the presence of overweight. Ageusia at the time of acute COVID-19, anxiety, being overweight, and absence of routine intellectual activities are risk factors for more prominent cognitive decline among those infected by COVID-19.

The context of COVID-19 affected the long-term sleep quality of older adults more than SARS-CoV-2 infection.

Introduction: Sleep problems are one of the most persistent symptoms of post-COVID syndrome in adults. However, most recent research on sleep quality has relied on the impact of the pandemic, with scarcely any data for older adults on the long-term consequences of COVID infection. This study aims to understand whether older individuals present persistently impaired sleep quality after COVID-19 infection and possible moderators for this outcome. Methods: This is a cross-sectional analysis of a longitudinal cohort study with 70 elders with 6-month-previous SARS-CoV-2 infection and 153 controls. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality; Geriatric Depression Scale and Geriatric Anxiety Inventory for screening depression and anxiety. Demographics and comorbid conditions were collected. Results: The mean age of participants was 66,97 ± 4,64 years. There were no statistical differences in depression and anxiety between groups. Poor sleep quality was found in 52,9% and 43,8% of the COVID and control groups (p=.208). After controlling for multiple variables, all the following factors resulted in greater chances of poor sleep quality: female gender (OR, 2.12; p=.027), memory complaints (OR, 2.49; p=.074), insomnia (OR, 3.66; p=.032), anxiety (OR, 5.46; p<.001), depression (OR, 7.26; p=.001), joint disease (OR, 1.80; p=.050), glucose intolerance (OR, 2.20; p=.045), psychoactive drugs (OR, 8.36; p<.001), diuretics (OR, 2.46; p=.034), and polypharmacy (OR, 2.84; p=.016). Conclusion: Psychosocial burden in the context of the COVID-19 pandemic and pre-existing conditions seems to influence the sleep quality of older adults more than SARS-CoV-2 infection.

Estimation of the availability of iron in the school meals of Municipal Centers for Early Childhood Education of a capital city in northeastern Brazil.

The final stage of Fe deficiency is Fe deficiency anaemia, with repercussions for human health, especially in children under 5 years of age. Studies conducted in Brazilian public daycare centres show high prevalence of anaemia. The present study aims to evaluate the availability of Fe in the meals of the Municipal Centers of Early Childhood Education in Maceió. The experimental design comprises selection of algorithms, menu evaluation, calculation of the estimates, comparison between the estimates obtained and the recommendations, and analysis of correlation between meal constituents, and of the concordance between the absorbable Fe estimates. Four algorithms were selected and a monthly menu consisting of 22 d. The correlation analysis showed a moderate positive correlation to animal tissue (AT) v. non-heme iron (r = 0·42; P = 0·04), and negative to AT v. Ca (r = -0·54; P = 0·09) and Ca v. phytates (r = -0·46, P = 0·03). Estimates of absorbable Fe ranged from 0·23 to 0·44 mg/d. The amount of Fe available, unlike the total amount of Fe offered, does not meet the nutritional recommendations on most school days. The Bland-Altman analysis indicated that the Monsen and Balinfty and Rickard et al. showed greater agreement. The results confirm the need to adopt strategies to increase the availability of Fe in school meals.

Cognitive Dysfunction of Chikungunya Virus Infection in Older Adults.

Background: Chikungunya fever is a disabling articular disease caused by chikungunya virus (CHIKV). In the past decade it has affected millions of people across America, Africa, Asia, and Europe, turning this infection into a public health concern. The acute phase of chikungunya infection is usually self-limiting, characterized by severe arthralgia, fever, chills, myalgia, headache, and rash. CHIKV neurovirulence is evident and seems to be higher among elders. Considering their susceptibility to cognitive decline and dementia, the aim of our study was to investigate whether CHIKV infection might cause long-term cognitive impairment in aged people. Methods: A cross-sectional study was conducted with volunteers aged from 60 to 90 who had been affected by chikungunya and also with healthy controls. A structured questionnaire was used to record demographic and clinical data, functional status, and depression. Global cognitive function was assessed through MoCA. A comprehensive neuropsychological battery was performed to assess specific cognitive functions. Results: Subjective memory complaints were present in 70% of subjects with previous chikungunya. This group had a poorer performance in MoCA (p = 0.000) and specific cognitive tests: Semantic (p = 0.05) and Phonemic Verbal Fluency (p = 0.003), 5-Digit (choice, reading, counting and alternance, p = 0.003, p = 0.014, p = 0.021, and p = 0.021, respectively), Stroop test (time, errors and interference, p = 0.000, p = 0.027 and p = 0.015, respectively), and RAVLT (word total session p = 0.05). These tests reflect performance on general executive functions, cognitive flexibility, inhibitory control, processing speed, semantic memory and episodic memory. Conclusion: Our data suggest that CHIKV infection may cause long-term cognitive decline in aged people and might be a risk factor for future dementia in this population.

Baru (Dipteryx alata Vogel) Oil Extraction by Supercritical-CO2: Improved Composition by Using Water as Cosolvent.

Baru (Dipteryx alata) almond is an emerging nut from the Brazilian savannah, that presents unique flavor and an interesting specialty oil. In this study, we aimed at investigating the effects of pressure, temperature, type (alcohol and/or water), and concentration of polar cosolvent on the extraction yield and tocopherol contents of baru oil obtained by supercritical-CO2 extraction (SC-CO2); and to investigate the effect of temperature and pressure on phytosterol, phenolic, and volatile compounds' profile in the oil when H2O was the cosolvent. Baru oil extracted with SC-CO2 using alcohol as a cosolvent showed a higher extraction yield (20.5-31.1%) than when using H2O (4.16-22.7%). However, when 0.3% H2O was used as cosolvent, baru oils presented the highest γ-tocopherol (107 and 43.7 mg/100 g) and total tocopherol (212 and 48.7 mg/100 g) contents, depending on the temperature and pressure used (50°C and 10 MPa or 70°C and 30 MPa, respectively). Consequently, the lowest pressure (10 MPa) and temperature (50°C) values resulted in baru oils with better γ/α-ratio, and the highest contents of ß-sitosterol (107 mg/100 g) and phenolic compounds (166 mg/100 g). However, the highest pressure (30 MPa) and temperature (70°C) values improved the volatile profile of oils. Therefore, although alcohol as a cosolvent improved oil yield, small amounts of H2O provided a value-added baru oil with either high content of bioactive compounds or with a distinctive volatile profile by tuning temperature and pressure used during SC-CO2 extraction.

SPIKES-D: a proposal to adapt the SPIKES protocol to deliver the diagnosis of dementia.

Dementia is a life-threatening and stigmatizing condition, with devastating impacts on the patient's personal identity and caregivers. There are many barriers to an effective diagnosis disclosure of dementia, including fear of causing distress, uncertainty of diagnosis, caregivers' objection and lack of training in communication skills in undergraduate medical schools. Although some studies have been published on how to help physicians deliver an Alzheimer's disease diagnosis, no specific protocol has been published yet. The SPIKES protocol is a didactic approach designed to deliver bad news related to cancer, but it has been used globally and in a variety of clinical settings, including the teaching of communication skills to medical students and residents. It is known, however, that the cognitive impairment of Alzheimer's disease and other dementias may limit the understanding of the diagnosis' complexity; hence, a few adaptations of this model were made after reviewing the current literature on dementia diagnosis disclosure. The suggested SPIKES-D protocol seems to encompass current guidelines about the communication of the diagnosis of dementia, keeping its didactic approach on breaking bad news and helping fulfill the gaps in this topic.

A demência é uma condição incurável e estigmatizada, com impacto devastador na identidade pessoal do paciente e seus cuidadores. Existem muitas barreiras para uma adequada comunicação do diagnóstico às pessoas com demência, incluindo medo de causar estresse psicológico, incerteza do diagnóstico, objeção dos cuidadores e falta de treinamento em habilidades de comunicação nas escolas de medicina. Embora alguns artigos sobre como auxiliar a equipe médica a comunicar um diagnóstico de demência tenham sido publicados, nenhum protocolo específico foi publicado até o presente momento. O protocolo SPIKES é uma abordagem didática desenvolvida para auxiliar a comunicação de más notícias relacionadas ao câncer, mas tem sido utilizado em todo o mundo e nos mais diversos contextos clínicos, inclusive no ensino de habilidades de comunicação para estudantes e residentes de medicina. Entretanto, é sabido que o declínio cognitivo inerente à doença de Alzheimer e outras demências pode limitar a compreensão da complexidade do diagnóstico, tendo sido realizadas, portanto, algumas adaptações nesse protocolo após revisão da literatura acerca da comunicação do diagnóstico das demências. O protocolo SPIKES-D aqui sugerido parece englobar as diretrizes atuais sobre a comunicação do diagnóstico de demências, preservando seu caráter didático na comunicação de más notícias e auxiliando no preenchimento das lacunas neste tópico.

Loss of functional capacity in elderly individuals with Alzheimer disease.

BACKGROUND: The functional capacity of elderly individuals with Alzheimer disease (AD) progressively declines. OBJECTIVE: To verify the influence of sociodemographic, clinical, staging, mobility, and postural and cognitive balance data on the impairment of the functional capacity of elderly individuals with AD. METHODS: This observational, analytical, cross-sectional study was performed at the Physiotherapy Department of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. The study consisted of forty elderly individuals aged ≥60 years old with mild or moderate AD, who could ambulate independently. The instruments used included a questionnaire to assess sociodemographic and anthropometric data; the Mini-Mental Health State Examination (MMSE); the Clinical Dementia Rating (CDR); a clock drawing test (CDT); a verbal fluency test (VFT); the Timed Up and Go Test (TUG); and the Clinical Test of Sensory Organization and Balance (CTSIB). Simple descriptive analyses, Mann-Whitney test, Spearman's correlation test, linear regression modeling, and prediction equation (p<0.05, 95% confidence interval [95%CI]) were performed. RESULTS: Fifteen linear regression models were generated, with the final model chosen for analysis. The variables assumed in that model were CDR, MMSE score, and condition 3 of the CTSIB, which explained 60.1% of the outcome. CONCLUSIONS: Impairment of functional capacity in elderly individuals with AD was influenced by disease progression, which was due to cognitive deficits and deficits in postural balance, which are related to the inaccuracy of the somatosensory system in performing sensory integration.

INTRODUÇÃO: A capacidade funcional de idosos com doença de Alzheimer (DA) sofrerá prejuízo progressivo. OBJETIVO: O presente estudo visou verificar a influências de dados sociodemográficos, clínicos, de estadiamento, mobilidade, equilíbrio postural e cognitivos no prejuízo da capacidade funcional de idosos com DA. MÉTODOS: Trata-se de um estudo observacional, analítico e transversal, realizado no Departamento de Fisioterapia da Universidade Federal do Rio Grande do Norte, em Natal, Rio Grande do Norte, Brasil. O estudo contou com a participação de 40 idosos com idade igual ou superior a 60 anos com DA leve ou moderada, com deambulação independente. Os instrumentos utilizados incluíram um questionário para avaliação de dados sociodemográficos e antropométricos; o Mini-Exame de Estado de Saúde Mental (MEEM); a Avaliação Clínica da Demência (CDR); o Teste do desenho do Relógio (TDR); o Teste de Fluência Verbal (TFV); o Timed Up and Go Test (TUG); e o Clinical Test of Sensory Organization and Balance (CTSIB). Foram realizadas análises descritivas simples, teste de Mann-Whitney, teste de correlação de Spearman, modelo de regressão linear e equação de predição (p<0,05 e intervalo de 95% [IC95%]). RESULTADOS: Foram gerados quinze modelos de regressão linear e foi escolhido o último para a análise. As variáveis assumidas nesse modelo citado foram: CDR, MEEM e condição três do CTSIB, que explicam 60,1% do desfecho. CONCLUSÕES: Pode-se concluir que o prejuízo da capacidade funcional de idosos com DA é influenciado pelo avançar da doença, pelos déficits cognitivo e de equilíbrio postural, sendo esse mais relacionado à imprecisão do sistema somatossensorial em realizar a integração sensorial.

Loss of functional capacity in elderly individuals with Alzheimer disease / Prejuízo da capacidade funcional de idosos com doença de alzheimer

ABSTRACT. Background: The functional capacity of elderly individuals with Alzheimer disease (AD) progressively declines. Objective: To verify the influence of sociodemographic, clinical, staging, mobility, and postural and cognitive balance data on the impairment of the functional capacity of elderly individuals with AD. Methods: This observational, analytical, cross-sectional study was performed at the Physiotherapy Department of the Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. The study consisted of forty elderly individuals aged ≥60 years old with mild or moderate AD, who could ambulate independently. The instruments used included a questionnaire to assess sociodemographic and anthropometric data; the Mini-Mental Health State Examination (MMSE); the Clinical Dementia Rating (CDR); a clock drawing test (CDT); a verbal fluency test (VFT); the Timed Up and Go Test (TUG); and the Clinical Test of Sensory Organization and Balance (CTSIB). Simple descriptive analyses, Mann-Whitney test, Spearman's correlation test, linear regression modeling, and prediction equation (p<0.05, 95% confidence interval [95%CI]) were performed. Results: Fifteen linear regression models were generated, with the final model chosen for analysis. The variables assumed in that model were CDR, MMSE score, and condition 3 of the CTSIB, which explained 60.1% of the outcome. Conclusions: Impairment of functional capacity in elderly individuals with AD was influenced by disease progression, which was due to cognitive deficits and deficits in postural balance, which are related to the inaccuracy of the somatosensory system in performing sensory integration.

RESUMO. Introdução: A capacidade funcional de idosos com doença de Alzheimer (DA) sofrerá prejuízo progressivo. Objetivo: O presente estudo visou verificar a influências de dados sociodemográficos, clínicos, de estadiamento, mobilidade, equilíbrio postural e cognitivos no prejuízo da capacidade funcional de idosos com DA. Métodos: Trata-se de um estudo observacional, analítico e transversal, realizado no Departamento de Fisioterapia da Universidade Federal do Rio Grande do Norte, em Natal, Rio Grande do Norte, Brasil. O estudo contou com a participação de 40 idosos com idade igual ou superior a 60 anos com DA leve ou moderada, com deambulação independente. Os instrumentos utilizados incluíram um questionário para avaliação de dados sociodemográficos e antropométricos; o Mini-Exame de Estado de Saúde Mental (MEEM); a Avaliação Clínica da Demência (CDR); o Teste do desenho do Relógio (TDR); o Teste de Fluência Verbal (TFV); o Timed Up and Go Test (TUG); e o Clinical Test of Sensory Organization and Balance (CTSIB). Foram realizadas análises descritivas simples, teste de Mann-Whitney, teste de correlação de Spearman, modelo de regressão linear e equação de predição (p<0,05 e intervalo de 95% [IC95%]). Resultados: Foram gerados quinze modelos de regressão linear e foi escolhido o último para a análise. As variáveis assumidas nesse modelo citado foram: CDR, MEEM e condição três do CTSIB, que explicam 60,1% do desfecho. Conclusões: Pode-se concluir que o prejuízo da capacidade funcional de idosos com DA é influenciado pelo avançar da doença, pelos déficits cognitivo e de equilíbrio postural, sendo esse mais relacionado à imprecisão do sistema somatossensorial em realizar a integração sensorial.

SPIKES-D: a proposal to adapt the SPIKES protocol to deliver the diagnosis of dementia / Protocolo spikes-d: proposta de adaptação do protocolo spikes para comunicar o diagnóstico de demência

ABSTRACT. Dementia is a life-threatening and stigmatizing condition, with devastating impacts on the patient's personal identity and caregivers. There are many barriers to an effective diagnosis disclosure of dementia, including fear of causing distress, uncertainty of diagnosis, caregivers' objection and lack of training in communication skills in undergraduate medical schools. Although some studies have been published on how to help physicians deliver an Alzheimer's disease diagnosis, no specific protocol has been published yet. The SPIKES protocol is a didactic approach designed to deliver bad news related to cancer, but it has been used globally and in a variety of clinical settings, including the teaching of communication skills to medical students and residents. It is known, however, that the cognitive impairment of Alzheimer's disease and other dementias may limit the understanding of the diagnosis' complexity; hence, a few adaptations of this model were made after reviewing the current literature on dementia diagnosis disclosure. The suggested SPIKES-D protocol seems to encompass current guidelines about the communication of the diagnosis of dementia, keeping its didactic approach on breaking bad news and helping fulfill the gaps in this topic.

RESUMO. A demência é uma condição incurável e estigmatizada, com impacto devastador na identidade pessoal do paciente e seus cuidadores. Existem muitas barreiras para uma adequada comunicação do diagnóstico às pessoas com demência, incluindo medo de causar estresse psicológico, incerteza do diagnóstico, objeção dos cuidadores e falta de treinamento em habilidades de comunicação nas escolas de medicina. Embora alguns artigos sobre como auxiliar a equipe médica a comunicar um diagnóstico de demência tenham sido publicados, nenhum protocolo específico foi publicado até o presente momento. O protocolo SPIKES é uma abordagem didática desenvolvida para auxiliar a comunicação de más notícias relacionadas ao câncer, mas tem sido utilizado em todo o mundo e nos mais diversos contextos clínicos, inclusive no ensino de habilidades de comunicação para estudantes e residentes de medicina. Entretanto, é sabido que o declínio cognitivo inerente à doença de Alzheimer e outras demências pode limitar a compreensão da complexidade do diagnóstico, tendo sido realizadas, portanto, algumas adaptações nesse protocolo após revisão da literatura acerca da comunicação do diagnóstico das demências. O protocolo SPIKES-D aqui sugerido parece englobar as diretrizes atuais sobre a comunicação do diagnóstico de demências, preservando seu caráter didático na comunicação de más notícias e auxiliando no preenchimento das lacunas neste tópico.

Ação de prevenção e controle da hipertensão e diabetes na comunidade: subsídios para enfermagem / Action for the prevention and control of hypertension and diabetes in the community: nursing benefits

Objetivo: descrever a prática de discentes, do 9º período de enfermagem de um centro universitário privado de Maceió, a respeito de uma ação em saúde voltada para pessoas hipertensas e diabéticas. Metodologia: estudo descritivo do tipo relato de experiência, realizado pelas discentes, juntamente com a equipe de saúde da família e com o núcleo de apoio a saúde da família de um município do referente estado. Na ação foi realizada educação em saúde abordando temáticas do programa hiperdia do Ministério da Saúde e outras atividades adotando medidas preventivas. Resultados: a experiência foi significativa e enriquecedora para as discentes quanto aos aspectos pessoais, acadêmicos e profissionais, pois possibilitou o aprimoramento dos conhecimentos técnico-científicos e a formação de vínculos com a comunidade e com a equipe de saúde, além de promover a melhoria da saúde e do bem-estar dos pacientes. Conclusão: a experiência vivenciada foi de suma importância para a formação profissional, pois proporcionou a ampliação do conhecimento sobre as temáticas abordadas, aumento da motivação da aprendizagem, da autoconfiança na realização da educação em saúde e do vínculo com a comunidade.

Objective: to describe the practice of students, from the 9th period of nursing at a private university center in Maceió, regarding a health action for hypertensive and diabetic people. Methodology: it is a descriptive study of the experience report type, conducted by the students, together with the family health team and the family health support nucleus of a municipality of the referent state. In the action was carried out health education addressing themes of the Ministry of Health's "hyperdia" program and other activities adopting preventive measures. Results: the experience was significant and enriching for the students regarding the personal, academic and professional aspects, since it enabled the improvement of the technical-scientific knowledge and the formation of links with the community and with the health team, besides promoting the improvement of the health and well-being of patients. Conclusion: the experience was of paramount importance for professional training, since it provided the widening of the knowledge about the topics addressed, increased motivation for learning, self-confidence in the accomplishment of health education and the bond with the community.

Hass avocado (Persea americana Mill.) oil enriched in phenolic compounds and tocopherols by expeller-pressing the unpeeled microwave dried fruit.

This study investigated how the quality of avocado oil is affected by the fruit ripening stage and peeling, and the drying process used. Expeller pressed avocado oils were obtained from unripe or ripe pitted avocados after drying peeled or unpeeled pulps by convection oven, microwave or freeze-drying. Oils from the unpeeled microwave dried pulp (from unripe or ripe avocados) showed the highest induction period (54.2-83.6 h) and antioxidant capacity (4.07-5.26 mmol TE/kg), and high amounts (mg/100 g) of α-tocopherol (11.6-21.0), ß-carotene (0.49-0.65) and chlorophyll (44.3-54.0), and unsaponifiable matter (2.48-2.99 g/100 g). Pulp drying process and avocado (un)peeling were the major contributors to the induction period (R2 = 0.61; p = 0.0139) and antioxidant capacity (R2 = 0.62; p = 0.011), and the oils from microwave dried unpeeled pulp were those that presented the best performance. The phenolic composition of these oils improved with ripening and keeping the peel during the pressing process.

Achillea millefolium L. hydroethanolic extract inhibits growth of human tumor cell lines by interfering with cell cycle and inducing apoptosis.

The cell growth inhibitory activity of the hydroethanolic extract of Achillea millefolium was studied in human tumor cell lines (NCI-H460 and HCT-15) and its mechanism of action was investigated. The GI50 concentration was determined with the sulforhodamine B assay and cell cycle and apoptosis were analyzed by flow cytometry following incubation with PI or Annexin V FITC/PI, respectively. The expression levels of proteins involved in cell cycle and apoptosis were analyzed by Western blot. The extracts were characterized regarding their phenolic composition by LC-DAD-ESI/MS. 3,5-O-Dicaffeoylquinic acid, followed by 5-O-caffeoylquinic acid, were the main phenolic acids, while, luteolin-O-acetylhexoside and apigenin-O-acetylhexoside were the main flavonoids. This extract decreased the growth of the tested cell lines, being more potent in HCT-15 and then in NCI-H460 cells. Two different concentrations of the extract (75 and 100 µg/mL) caused alterations in cell cycle profile and increased apoptosis levels in HCT-15 and NCI-H460 cells. Moreover, the extract caused an increase in p53 and p21 expression in NCI-H460 cells (which have wt p53), and reduced XIAP levels in HCT-15 cells (with mutant p53). This work enhances the importance of A. millefolium as source of bioactive phenolic compounds, particularly of XIAP inhibitors.

Anticoagulação oral em idosos portadores de fibrilação atrial / Oral anticoagulation in elderly patients with atrial fibrillation

Objetivos: avaliar fatores associados à dose de varfarina em idosos portadores de fibrilação atrial e possíveis complicações da anticoagulação nesta população. Métodos: seguimento de 32 idosos portdores de fibrilação atrial em um ambulatório de geriatria, recebendo varfarina para prevenção de AVC INR 2-3 por um tempo médio de 7 meses. Resultados: a faixa etária dos pacientes variou de 68 a 95 anos e estes foram divididos em 2 grupos: <80 anos e >80 anos. Trinta e um por cento dos pacientes eram de alto risco para desenvolvimento de AVC e 65% de risco intermediário. A taxa estimada de sangramentos menores foi de 25/100 pacientes-ano e de 1,7 sangramentos maiores/100 pacientes-ano. Nenhum sangramento com risco de vida ou fatal ocorreram. Peso, altura, superfície corpórea e índice de massa corpórea foram estatisticamente associados à dose de manutenção da varfarina pela Correlação de Pearson. A idade não foi correlacionada à dose da varfarina. Conclusão: nenhum sangramento grave ocorreu no estudo. A taxa de sangramentos menores foi semelhante à descrita na literatura. Todas as medidas antropométricas foram correlacionadas à dose de manutenção da varfarina. Apesar de estudos prévios mostraram uma tendência a menores doses de anticoagulantes em pacientes idosos, esta associação não foi encontrada neste estudo. Novos trabalhos devem ser realizados para estabelecer metas para as doses de anticoagulante nesta população

Anticoagulação oral em idosos portadores de fibrilação atrial

Objetivos: avaliar fatores associados à dose de varfarina em idosos portadores de fibrilação atrial e possíveis complicações da anticoagulação nesta população. Métodos: seguimento de 32 idosos portdores de fibrilação atrial em um ambulatório de geriatria, recebendo varfarina para prevenção de AVC INR 2-3 por um tempo médio de 7 meses. Resultados: a faixa etária dos pacientes variou de 68 a 95 anos e estes foram divididos em 2 grupos: 80 anos. Trinta e um por cento dos pacientes eram de alto risco para desenvolvimento de AVC e 65% de risco intermediário. A taxa estimada de sangramentos menores foi de 25/100 pacientes-ano e de 1,7 sangramentos maiores/100 pacientes-ano. Nenhum sangramento com risco de vida ou fatal ocorreram. Peso, altura, superfície corpórea e índice de massa corpórea foram estatisticamente associados à dose de manutenção da varfarina pela Correlação de Pearson. A idade não foi correlacionada à dose da varfarina. Conclusão: nenhum sangramento grave ocorreu no estudo. A taxa de sangramentos menores foi semelhante à descrita na literatura. Todas as medidas antropométricas foram correlacionadas à dose de manutenção da varfarina. Apesar de estudos prévios mostraram uma tendência a menores doses de anticoagulantes em pacientes idosos, esta associação não foi encontrada neste estudo. Novos trabalhos devem ser realizados para estabelecer metas para as doses de anticoagulante nesta população