ABSTRACT
OBJECTIVES: We aimed to investigate the acute effects of heat stress on body temperature and blood pressure of elderly individuals living in poor housing conditions. METHODS: Repeated measurements of the indoor temperature, relative humidity, body temperature, and blood pressure were conducted for 20 elderly individuals living in low-cost dosshouses in Seoul during hot summer days in 2010. Changes in the body temperature, systolic blood pressure (SBP) and diastolic blood pressure (DBP) according to variations in the indoor and outdoor temperature and humidity were analyzed using a repeated-measures ANOVA controlling for age, sex, alcohol, and smoking. RESULTS: Average indoor and outdoor temperatures were 31.47degrees C (standard deviation [SD], 0.97degrees C) and 28.15degrees C (SD, 2.03degrees C), respectively. Body temperature increased by 0.21degrees C (95% confidence interval [CI], 0.16 to 0.26degrees C) and 0.07degrees C (95% CI, 0.04 to 0.10degrees C) with an increase in the indoor and outdoor temperature of 1degrees C. DBP decreased by 2.05 mmHg (95% CI, 0.05 to 4.05 mmHg), showing a statistical significance, as the indoor temperature increased by 1degrees C, while it increased by 0.20 mmHg (95% CI, -0.83 to 1.22 mmHg) as outdoor temperature increased by 1degrees C. SBP decreased by 1.75 mmHg (95% CI, -1.11 to 4.61 mmHg) and 0.35 mmHg (95% CI, -1.04 to 1.73 mmHg), as the indoor and outdoor temperature increased by 1degrees C, respectively. The effects of relative humidity on SBP and DBP were not statistically significant for both indoor and outdoor. CONCLUSIONS: The poor and elderly are directly exposed to heat waves, while their vital signs respond sensitively to increase in temperature. Careful adaptation strategies to climate change considering socioeconomic status are therefore necessary.
Subject(s)
Aged , Humans , Blood Pressure , Body Temperature , Climate Change , Hot Temperature , Housing , Humidity , Infrared Rays , Social Class , Vital SignsABSTRACT
OBJETIVOS: Comparar o desempenho de idosos com diferentes níveis de gravidade de demência em questionários de atividades básicas de vida diária (ABVDs) e atividades instrumentais de vida diária (AIVDs). Verificar se existe correlação entre os questionários de AIVDs aplicados. METODOLOGIA: Foram aleatorizados 90 idosos (75,46 ± 7,66 anos) atendidos no Centro de Referência do Idoso-MG, com diagnóstico clínico de demência (DSM-IV/APA) e classificados quanto ao nível de gravidade da demência (Clinical Dementia Rating). As ABVDs foram avaliadas pelo índice de Katz, e as AIVDs, pelo índice de Lawton-Brody e de Pfeffer. Os testes de Kruskal-Wallis e de Mann-Whitney foram utilizados para verificar o desempenho dos idosos nas ABVDs, e a correlação de Spearman, para investigar a relação entre os instrumentos de AIVDs (alfa< 0,05). RESULTADOS: Foram encontradas diferenças estatisticamente significativas entre o desempenho dos idosos com diferentes níveis de gravidade de demência avaliados pelos instrumentos de ABVDs e AIVDs (p< 0,001). Os questionários de AIVDs apresentaram correlação significativa na amostra total (p< 0,0001; r= -0,818), nos grupos com demência leve (p= 0,007; r= -0,530) e grave (p< 0,0001; r= -0,723). CONCLUSÃO: A gravidade do processo demencial interferiu no desempenho dos idosos nas atividades básicas e instrumentais de vida diária. As AIVDs foram mais comprometidas nos estágios iniciais das demências, e as ABVDs, nos estágios mais avançados. Os questionários de AIVDs utilizados, apesar de sua particularidade estrutural, parecem medir um construto comum. A variabilidade do quadro clínico nos indivíduos com demência moderada pode explicar a ausência de correlação dos questionários usados nesse grupo específico.
OBJECTIVE: To compare the performance of elderly people with different levels of severity of dementia using questionnaires on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Also, to verify whether there were any association between the IADL questionnaires applied. METHOD: Ninety elderly people, aged 75.46 ± 7.66 years with a clinical diagnosis of dementia (DSM-IV/APA) who were seen at the Minas Gerais Reference Center for the Elderly, were randomized selected and classified according to the level of severity of their dementia (Clinical Dementia Rating). Their BADLs were assessed using the Katz Index and their IADLs by the Lawton-Brody and Pfeffer indexes. The Kruskal-Wallis and Mann-Whitney tests were used in order to investigate the elderly people's performance regarding BADLs, while the Spearman correlation was used to investigate the relationships among the IADL (alpha< 0.05). RESULTS: Statistically significant differences in performance were found between the elderly people with different levels of severity of dementia, as assessed by the BADL and IADL questionnaires (p< 0.001). The IADL questionnaires presented significant correlation for the total sample (p< 0.0001; r = -0.818) as well as for the groups with mild dementia (p= 0.007; r = -0.530) and severe dementia (p< 0.0001; r = -0.723). CONCLUSION: The severity of the dementia process interfered with the elderly people's performance of the elderly in BADLs and IADLs. The IADLs were more affected in the early stages of dementia whereas the BADLs were more affected in the more advanced stages. Despite structural particularities, the IADL questionnaires utilized seemed to be measuring a common construct. The variability in the clinical condition of the individuals with moderate dementia may be an explanation for the lack of correlation between the questionnaires in this specific group.