ABSTRACT
OBJECTIVES: The aim of this study was to determine the social-demographic, clinical, functional and psychological factors associated to activity restriction due to fear of falling in community-dwelling elderly and identify which variables best discriminate groups of elderly with different levels of activity restriction and fear of falling. METHODS: One hundred and thirteen community-dwelling elderly (74.5±7 years old) participated in the study. Activity restriction induced by fear of falling, previous falls, fall related self-efficacy, frailty phenotype, functional capacity, depressive symptoms, health self-perception, socio-demographic and clinical factors were assessed. Descriptive statistics, chi-square, ANOVA and Kruskal Wallis tests were used to analyze the associations between activity restriction due to fear of falling and all other variables. Path analysis (CHAID) method was used to verify which variables better discriminated groups in relation to activity restriction (α=0.05). RESULTS: The participants who reported fear of falling and activity restriction demonstrated higher depression (p=0.038), lower fall related self-efficacy (p<0.001), lower gait velocity (p=0.043) and independence level for instrumental daily living activities (p=0.017), higher number of diseases (p=0.048), worse health self-perception (p=0.040) and more depressive symptom (p=0.023). The best variables to discriminate groups were depression (p=0.004), exhaustion (frailty phenotype) (p=0.010) and social participation activities (p=0.016). CONCLUSION: Activity restriction due to fear of falling may have negative effects on functional capacity and psychological aspects in community-dwelling elderly. Psychosocial factors seem to better discriminate the elderly who avoid activities due to fear of falling.
OBJETIVOS: Determinar os fatores sociodemograficos, clinicos, funcionais e psicologicos associados a restricao de atividades por medo de cair em idosos comunitarios e identificar quais variaveis melhor discriminam os grupos em relacao a restricao de atividades por medo de cair. MÉTODOS: Cento e treze idosos comunitarios (74,5±7 anos) participaram do estudo. Foram avaliados: restricao de atividades por medo de cair, historia de quedas, autoeficacia relacionada as quedas, fenotipo de fragilidade, aspectos sociodemograficos e clinicos, capacidade funcional, depressao e autopercepcao de saude. Estatisticas descritivas, teste qui-quadrado, ANOVA e o teste Kruskal-Wallis foram utilizados para analisar as relacoes entre a restricao de atividades por medo de cair e as outras variaveis. O metodo Chi-Square Automatic Interaction Detection (CHAID) foi utilizado para verificar quais variaveis melhor discriminavam os grupos em relacao a restricao de atividades (α=0,05). RESULTADOS: Idosos que relataram restricao de atividades por medo de cair apresentaram maior autorrelato de depressao (p=0,038), menor autoeficacia em relacao as quedas (p<0,001), menor velocidade de marcha (p=0,043) e nivel de independencia para realizacao de atividades instrumentais de vida diaria (p=0,017), maior numero de doencas (p=0,048), pior autopercepcao de saude (p=0,040) e maior presenca de sintomatologia depressiva (p=0,023). As variaveis que melhor discriminaram os grupos foram depressao (p=0,004), exaustao (fenotipo de fragilidade) (p=0,010) e participacao em atividades sociais (p=0,016). CONCLUSÃO: A restricao de atividades por medo de cair pode ter efeitos negativos na capacidade funcional e nos aspectos psicologicos de idosos comunitarios. Fatores psicossociais parecem discriminar melhor os idosos que apresentam restricao de atividades por medo de cair.
Subject(s)
Aged , Female , Humans , Male , Accidental Falls , Activities of Daily Living/psychology , Fear , Cross-Sectional Studies , Residence Characteristics , Surveys and QuestionnairesABSTRACT
Citrobacter diversus is closely related to brain abscess in newborn infants. We describe a case of brain abscess by this bacteria in a newborn infant and his clinical and cranial computed tomographic evaluation until the fourth month of life and discuss therapeutic management of this patient