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3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47910

RESUMO

Os sistemas de saúde nas Américas não estão respondendo adequadamente às necessidades das pessoas idosas e devem ser adaptados à luz da pandemia de COVID-19, afirmam especialistas da Organização Pan-Americana da Saúde (OPAS). Para o Dia Internacional do Idoso, celebrado no primeiro dia de outubro, o organismo internacional pede atenção integral, integrada e centrada nas pessoas e serviços de atenção primária à saúde que atendam necessidades dos idosos


Assuntos
Infecções por Coronavirus , América/epidemiologia , Idoso/estatística & dados numéricos
4.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(5): 266-271, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192479

RESUMO

ANTECEDENTES Y OBJETIVO: La pandemia de la COVID-19 afecta de manera diferencial a distintos grupos etarios, concentrándose la mayor parte de fallecimiento entre las personas más mayores y con afecciones de salud previas. Esto ha implicado una mayor presencia de los mayores en la agenda informativa de todos los medios de comunicación. Este artículo pretende analizar esos discursos y representaciones relacionados con los mayores tal y como se presentan en los titulares de publicaciones difundidas en 2diarios de alcance nacional (ABC y El País) durante la fase más crítica de la pandemia en España. MATERIALES Y MÉTODOS: Se analizaron 501 titulares relacionados con los mayores y la pandemia COVID-19 (380 del ABC y 121 de El País) desde la perspectiva de los Estudios Críticos del Discurso (van Dijk, 2003) y llevándose a cabo un análisis de contenido. RESULTADOS: El 71,4% de los titulares representaban de manera desfavorable a los mayores, presentándolos como un grupo homogéneo y asociándolos a fallecimientos, deficiencias en la atención residencial o vulnerabilidad extrema. La presencia de ciertos términos potencialmente peyorativos o impropios (ancianos, abuelos) estaba en coherencia con esa representación negativa. CONCLUSIONES: A la luz de esos resultados, se discute en qué medida la pandemia de la COVID-19 puede reforzar una narrativa edadista de los mayores, basada en la fragilidad, el declive y la dependencia, que pueda justificar prácticas discriminatorias dirigidas a este sector de la población


BACKGROUND AND OBJECTIVE: The COVID-19 pandemic affects various age groups differently, with most deaths concentrated among the older population and those with previous health conditions. This has led to a greater presence of older people in the agenda setting of all the media. This article aims to analyse these discourses and representations related to older people as presented in the headlines of publications disseminated in 2national newspapers (ABC and El País) during the most critical phase of the pandemic in Spain. MATERIALS AND METHODS: An analysis was made of 501 headlines related to older people and the COVID-19 pandemic (380 from ABC, and 121 from El País) from the perspective of the Critical Discourse Studies (Van Dijk, 2003), as well as carrying out a content analysis. RESULTS: 71.4% of the headlines represented the Older adults were represented unfavourably in 71.4% of the headlines, with them being presented as a homogeneous group and associating them with deaths, deficiencies in residential care, or extreme vulnerability. The presence of certain potentially derogatory or improper terms (elderly, grandparents) was consistent with this negative representation. CONCLUSIONS: In light of these results, it is discussed to what extent the COVID-19 pandemic may reinforce an ageist narrative of the older people, based on frailty, decline, and dependency, which may justify discriminatory practices directed at this sector of the population


Assuntos
Humanos , Idoso , Ageismo/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Idoso/estatística & dados numéricos , Jornais como Assunto/estatística & dados numéricos , Pandemias , Espanha/epidemiologia , Meios de Comunicação/estatística & dados numéricos
6.
PLoS One ; 15(7): e0233602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639958

RESUMO

Commonly used measures of population aging categorize adults into those who are "old" and those who are not. How this threshold of the stage of "old age" is determined is crucial for our understanding of population aging. We propose that the old age threshold be determined using an equivalency criterion. People at the old age threshold should be roughly equivalent to one another in relevant characteristics regardless of when and where they lived. The UN publishes two variants of the potential support ratio based on different old age thresholds. One old age threshold is based on a fixed chronological age and the other on a fixed remaining life expectancy. Using historical data on 5-year death rates at the old age threshold as an indicator of one aspect of health, we assess the extent to which the two approaches are consistent with the equivalency criterion. The death rates are derived from all the complete cohort life tables in the Human Mortality Database. We show that the old age threshold based on a fixed remaining life expectancy is consistent with the equivalency criterion, while the old age threshold based on a fixed chronological age is not. The picture of population aging that emerges when measures consistent with the equivalency criterion are used are markedly different from those that result when the equivalency criterion is violated. We recommend that measures of aging that violate the equivalency criterion should only be used in special circumstances where that violation is unimportant.


Assuntos
Idoso/estatística & dados numéricos , Dinâmica Populacional , Envelhecimento , Classificação , Humanos , Expectativa de Vida , Pessoa de Meia-Idade , Mortalidade , Estudos Prospectivos , Nações Unidas
7.
Sci Rep ; 10(1): 10442, 2020 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-32591610

RESUMO

Increasing life expectancy and a growing share of older people around the world spotlight the issue of health during additional years of life. Research on trends of proportions of older people with activity limitations for low and middle income countries is sparse. We use data from the World Health Survey and the UN World Population Prospects to predict prevalence of activity limitations for 23 low and middle income countries for the upcoming 30 years. Our projections highlight huge variation in the proportion of older adults with limitations across investigated countries and this variation is not expected to diminish. However, these countries are facing considerable demographic changes and even though prevalence rates appear almost constant, absolute numbers are changing which require policy interventions. Furthermore, variations across countries reflect not only disparities in health conditions, but also differences in cultural peculiarities of reporting and historical perception of health.


Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Limitação da Mobilidade , Fatores Etários , Idoso/estatística & dados numéricos , Feminino , Previsões , Disparidades nos Níveis de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
9.
JAMA Netw Open ; 3(5): e205202, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32437574

RESUMO

Importance: Randomized clinical trials (RCTs) of lipid-lowering therapies form the evidence base for national and international guidelines. However, concerns exist that women and older patients are underrepresented in RCTs. Objective: To determine the trends of representation of women and older patients (≥65 years) in RCTs of lipid-lowering therapies from 1990 to 2018. Data Sources: The electronic databases of MEDLINE and ClinicalTrials.gov were searched from January 1990 through December 2018. Study Selection: RCTs of lipid-lowering therapies with sample sizes of at least 1000 patients and follow-up periods of at least 1 year were included. Data Extraction and Synthesis: Two independent investigators abstracted the data on a standard data collection form. Main Outcomes and Measures: Patterns of representation of women and older adults were examined overall in lipid-lowering RCTs and according to RCT-level specific characteristics. The participation-to-prevalence ratio (PPR) metric was used to estimate the representation of women compared with their share of disease burden. Results: A total of 60 RCTs with 485 409 participants were included. The median (interquartile range) number of participants per trial was 5264 (1062-27 564). Overall, representation of women was 28.5% (95% CI, 24.4%-32.4%). There was an increase in the enrollment of women from the period 1990 to 1994 (19.5%; 95% CI, 18.4%-20.5%) to the period 2015 to 2018 (33.6%; 95% CI, 33.4%-33.8%) (P for trend = .01). Among common limiting factors were inclusion of only postmenopausal women or surgically sterile women (28.3%; 95% CI, 18.5%-40.7%) or exclusion of pregnant (23.3%; 95% CI, 14.4%-35.4%) and lactating (16.6%; 95% CI, 9.3%-28.1%) women. Women were underrepresented compared with their disease burden in lipid RCTs of diabetes (PPR, 0.74), heart failure (PPR, 0.27), stable coronary heart disease (PPR, 0.48), and acute coronary syndrome (PPR, 0.51). Only 23 RCTs with 263 628 participants reported the proportion of older participants. Overall representation of older participants was 46.7% (95% CI, 46.5%-46.9%), which numerically increased from 31.6% (95% CI, 30.8%-32.3%) in the period 1995 to 1998 to 46.2% (95% CI, 46.0%-46.5%) in the period 2015 to 2018 (P for trend = .43). A total of 53.0% (95% CI, 41.8%-65.3%) and 36.6% (95% CI, 25.6% to 49.3%) trials reported outcomes according to sex and older participants, respectively, which did not improve over time. Conclusions and Relevance: In this systematic review of RCTs of lipid-lowering therapies, the enrollment of women and older participants increased over time, but women and older participants remained consistently underrepresented. This limits the evidence base for efficacy and safety in these subgroups.


Assuntos
Idoso/estatística & dados numéricos , Hiperlipidemias/tratamento farmacológico , Participação do Paciente/estatística & dados numéricos , Seleção de Pacientes , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Mulheres , Fatores Etários , Feminino , Humanos , Hipolipemiantes/uso terapêutico , Fatores Sexuais
10.
J Gerontol B Psychol Sci Soc Sci ; 75(2): 459-470, 2020 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-29471360

RESUMO

OBJECTIVES: We explore adverse consequences of unmet needs for care among high-need/high-cost (HNHC) older adults. METHOD: Interviews with 4,024 community-dwelling older adults with ADL/IADL/mobility disabilities from the 2011 National Health and Aging Trends Study (NHATS). Reports of socio-demographics, disability compensatory strategies, and adverse consequences of unmet needs in the past month were obtained from older adults with multiple chronic conditions (MCC), probable dementia (DEM), and/or near end-of-life (EOL) and compared older adults not meeting these criteria. RESULTS: Older adults with MCC (31.6%), DEM (39.6%), and EOL (48.7%) reported significantly more adverse consequences than low-need older adults (21.4%). Persons with MCC and DEM (53.4%), MCC, and EOL (53.2%), and all three (MCC, DEM, EOL, 65.6%) reported the highest levels of adverse consequences. HNHC participants reported more environmental modifications, assistive device, and larger helper networks. HNHC status independently predicted greater adverse consequences after controlling for disability compensatory strategies in multivariate models. DISCUSSION: Adverse consequences of unmet needs for care are prevalent among HNHC older adults, especially those with multiple indicators, despite more disability-related compensatory efforts and larger helper networks. Helping caregivers provide better informal care has potential to contain healthcare costs by reducing hospitalization and unplanned readmissions.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Múltiplas Afecções Crônicas/epidemiologia , Atividades Cotidianas , Fatores Etários , Idoso/estatística & dados numéricos , Demência/economia , Demência/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/economia , Humanos , Masculino , Múltiplas Afecções Crônicas/economia , Fatores Sexuais , Assistência Terminal/economia , Assistência Terminal/estatística & dados numéricos , Estados Unidos/epidemiologia
11.
J Gerontol B Psychol Sci Soc Sci ; 75(2): 436-447, 2020 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-29579314

RESUMO

OBJECTIVES: Assess trends in pain prevalence from 1992 to 2014 among older U.S. adults and by major population subgroups, and test whether the trends can be explained by changes in population composition. METHODS: Health and Retirement Study data include information on any pain, pain intensity, and limitations in usual activities due to pain. Average annual percent change in prevalence is calculated for any and for 2 levels of pain-mild/moderate and nonlimiting and severe and/or limiting-across demographic and socioeconomic characteristics, and for those with and without specific chronic conditions. Generalized linear latent and mixed models examine trends adjusting for covariates. RESULTS: Linear and extensive increases in pain prevalence occurred across the total population and subgroups. The average annual percent increase was in the 2%-3% range depending upon age and sex. Increases were consistent across subgroups, persistent over time, and not due to changes in population composition. Without increases in educational attainment over time, pain prevalence increases would be even higher. DISCUSSION: The increases in pain prevalence among older Americans are alarming and potentially of epidemic proportions. Population-health research must monitor and understand these worrisome trends.


Assuntos
Dor/epidemiologia , Fatores Etários , Idoso/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Estados Unidos/epidemiologia
12.
J Gerontol B Psychol Sci Soc Sci ; 75(3): 684-693, 2020 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29669015

RESUMO

OBJECTIVES: We examine the sharp increase in poverty among older adults since the mid-1990s in South Korea. METHOD: We apply decomposition analyses to quantify the contributions of demographic and household characteristics, as well as income sources, to the rise in poverty among older adults. RESULTS: A rapid increase in the number of older adults living independently, combined with an increase in the number of old older adults, largely explains the rising poverty rate among Korean older adults. At the same time, market incomes and private transfers are no longer dominant sources of income for older adults. Gradually rising public transfer incomes offset most of the decline in market and private transfer incomes. Public transfer could not counteract the formidable consequences of changing living arrangements and other changes related to a rapidly aging population. DISCUSSION: The Korean experience shows what would have happened to older adults in rich welfare states if mature old-age income security programs had not been in place. It may also provide some lessons for lower-income countries where poverty among older adults is set to become a larger problem in the coming decades.


Assuntos
Idoso/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Fatores Etários , Características da Família , Feminino , Humanos , Renda/estatística & dados numéricos , Masculino , Modelos Estatísticos , República da Coreia , Características de Residência/estatística & dados numéricos , Fatores Sexuais , Inquéritos e Questionários
13.
J Gerontol B Psychol Sci Soc Sci ; 75(3): 661-673, 2020 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-29982726

RESUMO

OBJECTIVES: This study examines the relationships between National Health Insurance Scheme (NHIS) enrollment and the frequency and "timing" of health services utilization among community-dwelling older Ghanaians. It also investigates whether the NHIS policy has improved equity in access to health care in later life. METHODS: Cross-sectional data were derived from an Ageing, Health, Psychological Wellbeing and Health-seeking Behavior Study collected between August 2016 and January 2017 (N = 1,200). Descriptive and bivariate analyses described the sample. Generalized Poisson and logit regression models, respectively estimated the predictors of frequency of health services utilization and time from onset of illness to health facility use and during last illness episode. RESULTS: Older persons with active NHIS membership frequently used health facilities (ß = 0.237, standard error [SE] = 0.0957, p ˂ .005), but the association was largely a function of health-related factors. The NHIS enrollees were more likely to attend health facility earlier (ß = 1.347, SE = 0.3437, p ˂ .001) compared with nonenrollees, after adjusting for theoretically relevant covariates. Moreover, given the NHIS enrollment, the rich (eß = 2.149, SE = 0.240, p ˂ .005), social support recipients (eß = 1.366, SE = 0.162, p ˂ .05) and those living with relevant others (eß = 2.699, SE = 0.175, p ˂ .001) were more likely to consume health services. DISCUSSION: Ghana's NHIS policy generally increases health services utilization but at present lacks the capability to improve equitable access to health care, especially between poor and nonpoor older adults. This may hamper the progress toward universal health coverage (UHC), indicating the need for further refinements in the policy including ways to improve the health status of older persons.


Assuntos
Programas Nacionais de Saúde , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores Etários , Idoso/estatística & dados numéricos , Estudos Transversais , Feminino , Gana , Política de Saúde , Nível de Saúde , Humanos , Vida Independente , Cobertura do Seguro/estatística & dados numéricos , Modelos Logísticos , Masculino , Programas Nacionais de Saúde/organização & administração , Distribuição de Poisson , Fatores Sexuais , Fatores Socioeconômicos
14.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 466-470, jan.-dez. 2020. tab, graf
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1053071

RESUMO

Objetivo: Avaliar a qualidade de vida dos idosos que praticam atividade física. Metodologia: Amostra foi composta por 37 idosos em envelhecimento. Foi aplicado um pré- teste, o mini mental. Os critérios de inclusão e exclusão foram para a obtenção da amostra final, obtida a partir da aplicação do questionário WHOQOL ­ OLD. Foram analisados através do programa EXCEL 2010. Resultados: O estudo mostrou que a prática da atividade física com idosos teve o intuito de uma qualidade de melhor, observando-se que a prevalência é do sexo feminino. Conclusão: Este estudo pode ajudar na elaboração de ações em saúde, a partir da melhor compreensão das questões que influenciam a qualidade de vida dos idosos, devido à diminuição da autoestima


Objective: To evaluate the quality of life of the elderly who practice physical activity. Methodology: The sample was composed by 37 elderly in aging. It was applied a pre-test, the mental mini. The inclusion and exclusion criteria were for the obtaining of the final sample, obtained from of the application of the questionnaire WHOQOL-OLD. They were analysed from EXCEL 2010. Results: The study showed that the practice of physical activity with elderly has had the intent of better quality of life observing that the prevalence is female. Conclusion: This study can help in the development of health actions, from of the best understanding of the questions that influence the elderly life quality, due to decreased self- steem


Objetivo: Evaluar la calidad de vida de los ancianos que practican actividad física. Metodología: La muestra fue compuesta por 37 ancianos en envejecimiento. Se aplicó un pre-test, el mini mental. Los criterios de inclusión y exclusión fueron para la obtención de la muestra final, obtenida a partir de la aplicación del cuestionario WHOQOL - OLD. Se analizaron a través del programa EXCEL 2010. Resultados: El estudio mostró que la práctica de la actividad física con ancianos tuvo el propósito de una calida de vida mejor, observándose que la prevalencia es del sexo femenino. Conclusión: Este estudio puede ayudar en la elaboración de acciones en salud, a partir de la mejor comprensión de las cuestiones que influencian la calidad de vida de los ancianos, debido a la disminución de la autoestima


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Idoso/estatística & dados numéricos , Exercício Físico , Saúde do Idoso , Estudos Transversais , Estudos Prospectivos , Envelhecimento Saudável
16.
Rev. esp. salud pública ; 94: 0-0, 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194524

RESUMO

OBJETIVO: Los determinantes sociales tienen un gran impacto en la salud de las poblaciones. Es relevante estudiar su papel en la gestión de la epidemia de la Covid-19, especialmente en las ciudades, pues ciertas variables como el número de tests realizados o la disponibilidad de recursos sanitarios no se pueden asumir por igual. El objetivo de este trabajo fue estimar la relación de los determinantes sociales en la incidencia de la Covid-19 en Barcelona. MÉTODOS: Se realizó un estudio ecológico, observacional retrospectivo, con el barrio como unidad de población, basado en los datos publicados a fecha de 14 de mayo de 2020 sobre incidencia acumulada de Covid-19 confirmada por PCR. Se estimó la diferencia de incidencia de la Covid-19 en función de la renta de los barrios, la correlación lineal de Pearson de las distintas variables seleccionadas (edad, sexo, densidad neta, inmigrantes, comorbilidades, tabaquismo, Índice de Masa Corporal [IMC] e Índice de Renta Familiar Disponible [IRFD]) con la incidencia acumulada y se llevó a cabo un análisis multivariante mediante un Modelo Lineal Generalizado (GLM). RESULTADOS: Los barrios del quintil de menor renta presentaban un 42% más de incidencia que aquellos del quintil con más renta: 942 casos por cada 100.000 habitantes frente a los 545 casos por cada 100.000 habitantes. La correlación de Pearson se mostró estadísticamente significativa entre la incidencia de la Covid-19 y el porcentaje de población mayor de 75 años (r=0,487), el porcentaje de inmigrantes (r=-0,257) y el origen de dichos inmigrantes, el IRFD (r=-0,462), el porcentaje de fumadores (r=0,243) y de personas con un IMC mayor de 25 (r=0,483). En GLM las variables que más correlación tenían con la incidencia entre barrios eran el porcentaje de población mayor de 75 años (Z-score=0,258), el porcentaje de inmigrantes latinoamericanos (Z-score=0,19) y magrebíes (Z-score=-0,206), y el porcentaje de personas con IMC>25 (Z-score=0,334). Los resultados del GLM fueron estadísticamente significativos. CONCLUSIONES: Los determinantes sociales se correlacionan con una modificación de la incidencia de la Covid-19 en los barrios de Barcelona, con especial relevancia de la prevalencia de IMC>25 y del porcentaje de inmigrantes y de su origen


OBJECTIVE: Social determinants and health inequalities have a huge impact on health of populations. It is important to study their role in the management of the Covid-19 epidemic, especially in cities, as certain variables like the number of tests and the access to health system cannot be assumed as equal. The aim of this work was to determine the relation of social determinants in the incidence of Covid-19 in the city of Barcelona. METHODS: An observational retrospective ecological study was performed, with the neighbourhood as the population unit, based on data of cumulative incidence published at May 14th, 2020 by the Public Health Agency of Barcelona. Covid-19 incidence disparities depending on the income of the neighbourhoods, the Pearson linear correlation of the variables selected (age, sex, net density, immigrants, comorbidities, smokers, Body Mass Index [BMI] and Available Income per Family Index [AIFI]) with the incidence and the correlation with a multivariant Generalized Linear Model (GLM) were estimated. RESULTS: It was found that neighbourhoods belonging to the lowest quintile of income had a 42% more incidence than those belonging to the highest quintile: 942 cases per 100,000 inhabitants versus 545 per 100,000 inhabitants of the highest quintile. The Pearson correlation was statistically significative between the incidence of Covid-19 and the percentage of population over 75 (r=0.487), the percentage of immigration of the neighbourhood and the origin of the immigrants (r=-0.257), the AIFI (r=-0.462), the percentage of smokers (r=0.243) and the percentage of people with BMI over 25 (r=0.483). The GLM showed that the most correlated variables with the incidence are the percentage of people over 75 (Z-score=0.258), the percentage of people from Maghreb (Z-score=-0.206) and Latin America (Z-score=0.19) and the percentage of people with BMI over 25 (Z-score=0.334). The results of the GLM were significative. CONCLUSIONS: Social determinants are correlated with the modification of the incidence of Covid-19 in the neighbourhoods of Barcelona, with special relevance of the prevalence of BMI over 25 and the percentage of immigrants and its origin


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Reação em Cadeia da Polimerase/estatística & dados numéricos , Determinantes Sociais da Saúde/classificação , Registros de Doenças/estatística & dados numéricos , Espanha/epidemiologia , Pandemias/estatística & dados numéricos , Estudos Ecológicos , Emigrantes e Imigrantes/estatística & dados numéricos , Idoso/estatística & dados numéricos , Incidência
17.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 378-384, jan.-dez. 2020. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1052935

RESUMO

Objetivo: Comparar características sociodemográficas, comportamentais, condições de saúde e parâmetros laboratoriais entre idosos anêmicos e não anêmicos. Métodos: Estudo epidemiológico transversal realizado com 257 idosos. Para realizar as comparações utilizou-se o teste t para amostras independentes e o teste não paramétrico U de Mann-Whitney. Resultados: Encontrou-se maior proporção de anemia em idosos com idade acima de 80 anos (p=0,026), e maior proporção de dependência para atividades básicas (p=0,018) e instrumentais (p=0,010) da vida diária em idosos com anemia. Identificou-se diferença na distribuição da dosagem dos parâmetros laboratoriais, sendo as concentrações médias de ureia e creatinina maiores nos idosos anêmicos, e esses tiveram menores concentrações de glicemia, albumina, ALT/TGP, cálcio sérico e T3 total. Conclusão: A anemia não está relacionada exclusivamente ao processo de envelhecimento, mas sim resultado de múltiplos fatores como as condições sociodemográficas, de saúde, alimentares e de vida dos idosos


Objective: To compare sociodemographic, behavioral characteristics, health conditions and laboratory parameters among anemic and non - anemic elderly. Methods: Cross-sectional epidemiological study with 257 elderly subjects. To perform comparisons, the t-test for independent samples and the non-parametric Mann-Whitney U test were used. Results: There was a higher proportion of anemia in the elderly over 80 years (p = 0.026), and a higher proportion of dependence on basic activities (p = 0.018) and instrumental (p = 0.010) daily activities in elderly patients with anemia. Differences were observed in the distribution of laboratory parameters, with mean values of urea and creatinine being higher in anemic elderly, with lower concentrations of glycemia, albumin, ALT / TGP, serum calcium and total T3. Conclusion: Anemia is not exclusively related to the aging process, but is a result of multiple factors such as sociodemographic, health, food and life conditions of the elderly


Objetivo: Comparar características sociodemográficas, comportamentales, condiciones de salud y parámetros de laboratorio entre ancianos anémicos y no anémicos. Metodo: Estudio epidemiológico transversal realizado con 257 ancianos. Para realizar las comparaciones se utilizó la prueba t para muestras independientes y la prueba no paramétrica U de Mann-Whitney. Resultados: Se encontró mayor proporción de anemia en ancianos con edad superior a 80 años (p = 0,026), y mayor proporción de dependencia para actividades básicas (p = 0,018) e instrumentales (p = 0,010) de la vida diaria en ancianos con anemia. Se identificó diferencia en la distribución de la dosificación de los parámetros de laboratorio, siendo las concentraciones medias de urea y creatinina mayores en los ancianos anêmicos. Conclusión: La anemia no está relacionada exclusivamente con el proceso de envejecimiento, sino el resultado de múltiples factores como las condiciones sociodemográficas, de salud, alimentos y de vida de los ancianos


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Idoso/estatística & dados numéricos , Anemia/diagnóstico , Anemia/etiologia , Fatores Socioeconômicos , Saúde do Idoso , Estudos Transversais , Nutrição do Idoso
18.
Age Ageing ; 48(6): 803-810, 2019 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-31566675

RESUMO

OBJECTIVES: We examined the development of disease and disability in a large cohort of older women, the extent to which these conditions exempt them from being classified as successful agers and different trajectories of disease, disability and longevity across women's later life. METHODS: We used survey data from 12,432 participants of the 1921-26 birth cohort of the Australian Longitudinal Study of Women's Health from 1996 (age 70-75) to 2016 (age 90-95). Repeated measures latent class analysis (RMLCA) identified trajectories of the development of disease with or without disability and according to longevity. Bivariate analyses and multivariable multinomial logistic regression models were used to examine the association between participants' baseline characteristics and membership of the latent classes. RESULTS: Over one-third of women could be considered to be successful agers when in their early 70s, few women could still be classified in this category throughout their later life or by the end of the study when they were in their 90s (~1%). RMLCA identified six trajectory groups including managed agers long survivors (9.0%) with disease but little disability, usual agers long survivors (14.9%) with disease and disability, usual agers (26.6%) and early mortality (25.7%). A small group of women having no major disease or disability well into their 80s were identified as successful agers (5.5%). A final group, missing surveys (18.3%), had a high rate of non-death attrition. Groups were differentiated by a number of social and health factors including marital status, education, smoking, body mass index, exercise and social support. CONCLUSIONS: The study shows different trajectories of disease and disability in a cohort of ageing women, over time and through to very old ages. While some women continue into very old age with no disease or disability, many more women live long with disease but little disability, remaining independent beyond their capacity to be classified as successful agers.


Assuntos
Envelhecimento Saudável , Idoso/estatística & dados numéricos , Idoso de 80 Anos ou mais/estatística & dados numéricos , Austrália , Feminino , Humanos , Longevidade , Estudos Longitudinais
19.
Artigo em Inglês | MEDLINE | ID: mdl-31635191

RESUMO

Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this paper calculates the health distribution of the elderly using the Quality of Well-Being Scale (QWB) score, and then estimates health inequality among the elderly in rural China using the Wagstaff index (WI) and Erreygers index (EI). Following this, it compares health inequalities among the elderly in different age groups, and finally, uses the Shapley and recentered influence function-index-ordinary least squares (RIF-I-OLS) model to decompose the effect of four factors on health inequality among the elderly in rural China. The QWB score distribution shows that the health of the elderly in rural China improved with social economic development and medical reform from 2002 to 2014. However, at the same time, we were surprised to find that the health level of the 65-74 years old group has been declining steadily since 2008. This phenomenon implies that the incidence of chronic diseases is moving towards the younger elderly. The WI and EI show that there is indeed pro-rich health inequality among the rural elderly, the health inequality of the younger age groups is more serious than that of the older age groups, and the former incidence of health inequality is higher. Health inequality in the age group of 65-74 years old is higher than that in other groups, and the trend of change fluctuated downward from 2002 to 2014. Health inequality in the age group of 75-84 years old is lower than that in the group of 65-74 years old, but higher than that in the other age groups. The results of Shapley decomposition show that demographic characteristics, socioeconomic status (SES), health care access, and quality of later life contributed 0.0054, 0.0130, 0.0442, and 0.0218 to the health inequality index of the elderly, which accounted for 6.40%, 15.39%, 52.41%, and 25.80% of health inequality index. From the results of RIF-I-OLS decomposition, this paper has analyzed detailed factors' marginal effects on health inequality from four dimensions, which indicates that the health inequality among the elderly in rural China was mainly caused by the disparity of income, medical expenses, and living arrangement.


Assuntos
Idoso/estatística & dados numéricos , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Disparidades nos Níveis de Saúde , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Idoso de 80 Anos ou mais , China/epidemiologia , Doença Crônica , Feminino , Nível de Saúde , Humanos , Renda , Longevidade , Estudos Longitudinais , Masculino , Classe Social , Inquéritos e Questionários
20.
Int J Clin Pharm ; 41(5): 1166-1173, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31493209

RESUMO

Background Adverse reactions to warfarin may be serious and can lead to hospitalisation or death. Minimising the risk of adverse drug reactions through the intervention of community pharmacists is important for patients receiving warfarin, especially for elderly (≥ 65 years) patients living in rural areas. Objective To evaluate the impact of an intervention by community pharmacists on the risk of adverse drug reactions in elderly rural patients receiving warfarin. Setting: A community pharmacy in a rural area of Croatia. Method We conducted a prospective randomised trial. Eligible patients were recruited at the pharmacy and randomised into one of two groups. The participants were followed up every month for 6 months. Main outcome measure: The incidence and type of adverse drug reactions caused by warfarin and the time-to-event. Results In total, 140 patients were randomized and 131 patients completed the study; 65 patients were in the intervention group. The median age of patients was 73 years of age. The cumulative incidence of adverse drug reactions was significantly lower in the intervention group (6-months rate 29% vs. 85% for intervention and control, respectively; hazard ratio = 0.17, p < 0.001) than in the control group. Factors multivariately associated with the development of adverse drug reactions related to warfarin (p < 0.05) were the absence of pharmaceutical intervention, higher time in therapeutic range, change of warfarin dose, changes in dietary vitamin K intake, and marital status other than married. Conclusion Overall, the pharmacist's intervention significantly prolonged the time to occurrence of adverse drug reactions and reduced their incidence.


Assuntos
Idoso de 80 Anos ou mais/estatística & dados numéricos , Idoso/estatística & dados numéricos , Anticoagulantes/efeitos adversos , Farmacêuticos , Varfarina/efeitos adversos , Serviços Comunitários de Farmácia , Croácia/epidemiologia , Feminino , Humanos , Incidência , Masculino , Educação de Pacientes como Assunto , Farmácias , Estudos Prospectivos , População Rural
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