Assessment of appropriateness of prescribing among Indian geriatric outpatients using STOPP and START Criteria Version 2 at a tertiary care teaching hospital

Background: Inappropriate prescribing is more prevalent in geriatric patients. A popular tool for screening appropriateness of prescribing is the screening tool of older person’s prescriptions (STOPP) and screening tool to alert doctors to right treatment (START) criteria. In this study, our aim was to estimate the incidence of potentially inappropriate prescribing (PIP) utilizing these criteria among patients attending outpatient departments. In addition, we aimed to identify potential factors that are associated with PIP. Aims and Objectives: The objectives of the study are as follows: (1) To estimate incidence of potentially inappropriate medications (PIMs) using STOPP criteria; (2) To estimate incidence of potential prescribing omissions (PPOs) using START criteria; and (3) To identify potential factors that are associated with PIP. Materials and Methods: A prospective and cross-sectional study that was observational in nature was performed in patients with age 65 years and above. Prescriptions of these patients were analyzed by collecting relevant data that were subsequently entered in specially designed case record forms. The modified version 2.0 of STOPP/START criteria was utilized to assess PIP in the form of PIMs and PPOs. Data were entered in Microsoft Excel 2013 and analyzed. Categorical variables were described as frequency and percentage whereas continuous variables were described as mean with standard deviation. Results: Prescriptions of a total 306 patients were evaluated (mean age: 69.4, 60% male, average number of medications per prescription: 5.04 ± 2.44), PIMs were detected in 88 (28.75%) and PPOs in 30 (9.8%) patients. Ninety-six patients had either a PIM or a PPO. PIMs mainly involved were duplication of drug class (26.5%), use of first generation antihistaminic for >1 week (20.4%) and use of glimepiride (18.6%). Major PPOs identified were non-use of angiotensin converting enzyme inhibitors following acute myocardial infarction (26%), non-use of statin therapy (26%), and antiplatelet therapy (21.7%) in patients with diabetes mellitus along with cardiovascular risk factor. Polypharmacy (OR 6.011, P < 0.0001) and comorbidity (OR 3.097, P = 0.015) significantly increase the risk of PIM encounter. Conclusion: PIP in the form of PIMs and PPOs was prevalent in the studied patients. Polypharmacy and comorbidity were associated with an increased likelihood of PIM.

Asociación entre la condición física y calidad de vida con la fragilidad en personas mayores / Association between physical fitness and quality of life with frailty in elderly

RESUMEN Introducción: El envejecimiento patológico provoca cambios anatomofisiológicos responsables de generar deterioro en la condición física y calidad de vida de las personas mayores. Así también se ha observado un aumento en la presencia de síndromes geriátricos como la fragilidad física. Objetivo: Determinar si existe asociación entre la condición física y calidad de vida con la fragilidad en personas mayores. Métodos: Estudio correlacional. Se incluyeron 84 personas mayores de 65 años (62 mujeres y 22 hombres) entre agosto y septiembre del año 2021 en las regiones metropolitana y Maule, Chile. Se midieron la condición física, calidad de vida y fragilidad. La condición física se evaluó con la batería Senior Fittnes Test y la calidad de vida fue medida con el cuestionario World Health Organization Quality of Life Old (WHOQOL-OLD). La fragilidad se determinó con el fenotipo de Fried. Se utilizaron tablas de contingencia para asociar las variables de estudio con la fragilidad a través de la prueba de ji cuadrado. Resultados: La fragilidad se asoció con algunos componentes de la condición física como fuerza del tren superior (p= 0,038), fuerza del tren inferior (p= 0,018), flexibilidad del tren inferior (p= 0,004), resistencia aeróbica (p= 0,038), agilidad y equilibrio dinámico (p= 0,002). También, se observaron asociaciones significativas con dimensiones de calidad de vida como autonomía (p= 0,007), actividades del pasado, presente y futuro (p= 0,018), participación social (p= 0,006) e intimidad (p= 0,038). Conclusión: Existe asociación entre fragilidad con dimensiones de calidad de vida y con variables de la condición física.

ABSTRACT Introduction: Pathological aging causes anatomophysiological changes responsible for generating deterioration in the physical condition and quality of life of the elderly. Thus, an increase in the presence of geriatric syndromes such as physical frailty has also been observed. Objective: To determine if there is an association between physical condition and quality of life with the frailty in older adults. Methods: Correlational study. 84 people over 60 years of age (62 women and 22 men) were included. Physical fitness, quality of life and frailty were measured. Physical fitness was assessed with the Senior Fitness Test battery and quality of life was measured with the World Health Organization Quality of Life Old (WHOQOL-OLD) questionnaire. Frailty was determined with the Fried phenotype. Contingency tables were used to associate the study variables with frailty through the Chi-square test. Results: Frailty was associated with some components of physical fitness such as upper body strength (p= 0.038), lower body strength (p= 0.018), lower body flexibility (p= 0.004), aerobic endurance (p= 0.038), agility and dynamic balance (p= 0.002). Also, significant associations were observed with quality of life dimensions such as autonomy (p= 0.007), past, present and future activities (p= 0.018), social participation (p= 0.006) and intimacy (p= 0.038). Conclusion: There is an association between frailty with dimensions of quality of life and with variables of physical fitness.

Baixa reserva muscular em pessoas idosas e fatores associados / Low muscle reserve in older adults and associated factors

Resumo Objetivo Estimar a prevalência de baixa reserva muscular e identificar os fatores associados em pessoas idosas. Método Estudo transversal realizado com 784 idosos (60 anos ou mais) não institucionalizados, residentes em Viçosa, Minas Gerais no ano de 2009. As características de interesse foram sociodemográficas, hábitos de vida, condições de saúde e antropométricas. A baixa reserva muscular (BRM) foi definida como o perímetro da perna (PP) < 33 cm para mulheres e < 34 cm para homens. Realizou-se análise descritiva, análise bivariada e múltipla, por meio da regressão de Poisson com variância robusta, para identificar os fatores independentemente associados ao desfecho de interesse. Resultados Mais da metade da amostra era composta por mulheres (52,9%), maior frequência de idosos mais jovens (60 - 69 anos :49,5%), com no máximo quatro anos de estudo (79,9%). A prevalência de baixa reserva muscular foi de 21,7% (IC 95% 18,9%-24,7%) e os fatores independentemente associados foram a faixa etária de 70 a 79 anos (RP:1,31; IC95%: 0,96-1,795), 80 anos ou mais (RP:1,64; IC95%:1,12-2,70), histórico de internação hospitalar (RP: 1,46; IC95%: 1,02-2,09) e baixo peso (RP: 5,45; IC95%:3,77-7,88). Conclusões A prevalência da BRM na amostra é expressiva, se relaciona com a idade mais avançada, hospitalização e com o baixo peso. O monitoramento do PP mostra-se importante para o rastreamento de alterações relacionadas à baixa reserva muscular na pessoa idosa e os fatores associados devem ser considerados nas avaliações antropométricas destinadas a esta população.

Abstract Objective To estimate the prevalence of low muscle reserve and identify associated factors in older people. Method Cross-sectional study carried out with 784 non-institutionalized older people (60 years or older), living in Viçosa, Minas Gerais, in 2009. The characteristics of interest were sociodemographic, life habits, health and anthropometric conditions. Low muscle reserve (LMR) was defined as leg circumference (LC) < 33 cm for women and < 34 cm for men. Descriptive analysis, bivariate and multiple analysis were performed, using Poisson regression with robust variance, to identify the factors independently associated with the outcome of interest. Results More than half of the sample consisted of women (52.9%), more frequently younger seniors (60 - 69 years old :49.5%), with a maximum of four years of study (79.9%). The prevalence of low muscle reserve was 21.7% (95%CI 18.9%-24.7%) and the independently associated factors were the age group from 70 to 79 years (PR:1.31; 95%CI: 0.96-1.795), 80 years or older (PR:1.64; 95%CI:1.12-2.70), history of hospitalization (PR: 1.46; 95%CI: 1.02-2.09) and low weight (PR: 5.45; 95%CI: 3.77-7.88). Conclusions The prevalence of LMR in the sample is expressive, it is related to older age, hospitalization and low weight. LC monitoring is important for tracking changes related to low muscle reserve in older people and associated factors should be considered in anthropometric assessments for this population.

Calidad de vida: relación entre aspectos sociodemográficos y cognitivos en personas mayores de grupos sociales / Quality of life: relationship with sociodemographic and cognitive aspects in older people in community groups

Este trabajo busca verificar la relación entre la calidad de vida y los aspectos sociodemográficos y cognitivos de las personas mayores participantes de grupos sociales. El método utilizado para estos fines es el estudio epidemiológico, cuantitativo, de diseño transversal, realizado en grupos de personas mayores residentes en una capital del sur de Brasil. Se utilizaron cuatro cuestionarios referentes a caracterización sociodemográfica, calidad de vida, aspectos cognitivos y queja de memoria subjetiva. Los resultados arrojaron datos respecto a la diferencia significativa en la calidad de vida y sus dominios en términos de edad, educación, ingresos y región de residencia y aspectos cognitivos. Las respuestas obtenidas en las preguntas generales del instrumento mostraron que la calidad de vida fue considerada buena por 176 de los encuestados, equivalentes al 54,83% y 151 encuenstados que representan el 47,04% se consideraron satisfechos en términos de salud en general. Por lo tanto, las conclusiones dan luces sobre los aspectos sociodemográficos, así como los cognitivos, están asociados con la calidad de vida de las personas mayores activas del municipio. Se enfatiza la queja de memoria subjetiva, que mostró relación con todos los aspectos analizados de la calidad de vida. Los datos obtenidos pueden servir como insumos para ampliar las posibilidades de promover la salud y la calidad de vida de la población envejecida.

Objective: To verify the relationship between the quality of life and the socio-demographic and cognitive aspects of the participating elderly people from social groups. Methods: Epidemiological, quantitative, cross-sectional design study, carried out in groups of elderly people living in a capital city in southern Brazil. Four questionnaires were used concerning sociodemographic characterization, quality of life, cognitive aspects and subjective memory complaints. Results: There were significant differences in the quality of life and its domains in terms of age, education, income and region of residence, and cognitive aspects. The answers obtained in the general questions of the instrument showed that the quality of life was considered good by 176 (54.83%) of the respondents and 151 (47.04%) were considered satisfied in terms of overall health. Conclusion: Socio-demographic aspects, as well as cognitive aspects, are associated with the quality of life of active elderly people in the municipality. The complaint of subjective memory is emphasized, which showed a relationship with all the analyzed aspects of the quality of life. The data obtained can serve as inputs to expand the possibilities of promoting the health and quality of life of the elderly population.

Vulneración a la integridad física de personas mayores: prevalencia del maltrato y factores asociados / Violation of the Physical Integrity of the Elderly: Prevalence of Abuse and Related Factors

Resumen El envejecimiento poblacional que experimenta actualmente América Latina trae consigo retos para la sociedad, como la prevención de la vulneración a los derechos humanos y libertades de las personas mayores y la eliminación de todas las formas de maltrato. La prevalencia de maltrato físico a personas mayores fue de 4,1%. Se presentó principalmente en mujeres, personas sin pareja y con ingreso económico. Además, fue más prevalente en personas mayores con riesgo de depresión, ante cedentes de pensamientos suicidas, insatisfacción con la salud y que convivían con familias disfuncionales. Los hallazgos de esta investigación muestran como las re laciones familiares pueden ser un factor clave a la hora de abordar la problemática del maltrato; además, las graves repercusiones que generan estos hechos sobre la víctima, como afectaciones no solo a la salud física sino también mental.

Abstract The ageing population currently experienced by Latin America brings with it cha llenges for society, such as the prevention of human rights violation and freedoms of the elderly, and the elimination of all forms of abuse. The prevalence of physical abuse for the elderly was 4.1%. It was mainly presented in women, people without a partner, and with financial income. In addition, it was more prevalent in older people at risk of depression, a history of suicidal thoughts, dissatisfaction with health, and living with dysfunctional families. The findings of this research show how family re lationships can be a key factor in addressing the problem of abuse. In addition, the serious impact of these facts on the victim, such as affectations not only to physical health, but also to mental health.

Sexual satisfaction and associated individual factors among midlife and older people in Ile-Ife, Southwest Nigeria: implications for sexual and reproductive health

Background: Studies in Nigeria have rarely documented the prevalence and associated factors of sexual satisfaction among the midlife and older persons as a special group of underserved population in the country. This study investigates the prevalence and individual associated factors of sexual satisfaction among the midlife and older people in Ile-Ife, Southwest Nigeria.Methods: A sample size of 404 was analysed in the study. The outcome variable was sexual satisfaction. The explanatory variables are sets of individual and relational characteristics. Data were analysed using Stata 14. Bivariable and multivariable binary logistic regression models were estimated.Results: Findings reveal 42.0% level of sexual satisfaction. Higher educational attainment (AOR=0.864, p<0.01; 95% CI: 0.841-0.886), longer length of marriage (AOR=0.931, p<0.01; 95% CI: 0.912-0.950), remarriage (AOR=0.536, p<0.01; 95% CI: 0.387-0.742), economic inactivity (AOR=0.456, p<0.01; 95% CI: 0.322-0.646) reduces the odds of sexual satisfaction while absence of serious health challenges (AOR=2.742, p<0.01; 95% CI: 1.594-4.716) and spousal high wealth level (AOR=1.038, p<0.01; 95% CI: 1.017-1.059) increase the odds of sexual satisfaction.Conclusions: Individual characteristics of midlife and older men and women are significantly associated with their sexual satisfaction. These characteristics should be targeted in a special programme focusing on midlife and older persons in Nigeria.

Entrenamiento de capacidades físicas condicionantes en la calidad de vida relacionada con la salud en personas mayores con epoc estadio I y II. Revisión sistemática de literatura / Training of conditioning physical capabilities in quality of life related to health in older people with copd stadium I and II. Systematic review of literature / Treinamento de capacidades de condicionamento físico na qualidade de vida relacionada à saúde em idosos com epoc estágios I e II. Revisão sistemática da literatura

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es una patología sistémica y multifactorial que requiere manejo integral e intervención multidisciplinaria. Estudios evidencian la necesidad de que los adultos mayores con EPOC ingresen a un programa de rehabilitación pulmonar en busca la reducción de la disnea y la sensación de cansancio, además de incrementar la tolerancia al ejercicio y la calidad de vida. El entrenamiento de las capacidades físicas condicionantes reduce los efectos que causan la disminución de la capacidad pulmonar en el adulto mayor con EPOC, de la misma manera, favorece los aspectos fisiológicos, las relaciones interpersonales y la calidad de vida. Objetivo. Determinar el efecto del entrenamiento de las capacidades físicas condicionantes en la calidad de vida relacionada con la salud en personas mayores con EPOC, estadios I y II. Materiales y métodos. Se realizó una revisión bibliográfica de artículos científicos, publicados en español e inglés, en bases de datos y bibliotecas virtuales como PUBMED/MEDLINE, EMBASE, LILACS, SCIELO, Registro Cochrane Central de Ensayos Controlados (CENTRAL); se seleccionaron ECA que relacionaran EPOC en adultos mayores y capacidades condicionantes con calidad de vida. Resultado. Las intervenciones con capacidades físicas condicionantes mejoran la calidad de vida relacionada con la salud, en adultos mayores con EPOC y la percepción de estado de salud, además, se observaron mejoras significativas en los condicionantes físicos de fuerza, resistencia muscular y velocidad de la marcha. Conclusiones. La práctica de las capacidades físicas condicionantes tiene efectos positivos sobre la calidad de vida relacionada con la salud en adultos mayores con EPOC.

Introduction. Chronic obstructive pulmonary disease (COPD) is a systemic and multifactorial pathology that requires comprehensive management and multidisciplinary intervention. Studies show the need for older adults with COPD to go into a pulmonary rehabilitation program that may promote the reduction of dyspnea and tiredness, in addition to increase tolerance to exercise and quality of life. Improve physical capacities decline the decrement in lung capacity in the older adult with COPD, moreover it favors the physiological aspects, the interpersonal relationships and the life's quality. Objective. To determine the training effect of the physical conditioning capacities in the quality of life related to health in elderly people with COPD stages I and II. Materials and Methods. A literature review of scientific articles published in Spanish and English languages, articles was found in databases and virtual libraries as PUBMED / MEDLINE, EMBASE, LILACS, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL) were selected RCTs that relate COPD in older adults, conditioning capacities with life's quality. Result: The interventions with conditioning physical capacities improve life's quality related to health, in older adults with COPD and the perception of health status, significant improvements were observed in the physical conditioning factors of strength, muscular resistance and gait speed. Conclusions. The practice of conditioning physical capacities has positive effects on life's quality related to health in older adults with COPD.

Introdução. A doença pulmonar obstrutiva crônica (DPOC) é uma patologia sistêmica e multifatorial que requer uma gestão abrangente e intervenção multidisciplinar. Estudos mostram a necessidade que idosos com DPOC entram num programa de reabilitação pulmonar em busca da redução da dispnéia e da sensação de cansaço, além de aumentar a tolerância ao exercício e a qualidade de vida. O treinamento de capacidades de condicionamento físico reduz os efeitos que causam diminuição da capacidade pulmonar nos idosos com DPOC, da mesma forma, favorece os aspectos fisiológicos, as relações interpessoais e a qualidade de vida. Objetivo. Determinar o efeito do treinamento de capacidades de condicionamento físico na qualidade de vida relacionada à saúde em idosos com DPOC, estágios I e II. Materiais e métodos. Foi realizada uma revisão bibliográfica de artigos científicos, publicados em espanhol e inglês, em bancos de dados e bibliotecas virtuais como PUBMED / MEDLINE, EMBASE, LILACS, SCIELO, Registro Central de Ensaios Controlados da Cochrane (CENTRAL); ECRs; foram selecionados o ECA que relacionava DPOC em idosos e capacidades condicionantes com qualidade de vida. Resultado. As intervenções com capacidades de condicionamento físico melhoram a qualidade de vida relacionada à saúde em idosos com DPOC e a percepção do estado de saúde, além disso, foram observadas melhorias significativas nas condições físicas de força, resistência muscular e velocidade da marcha. Conclusões. A prática das capacidades de condicionamento físico tem efeitos positivos na qualidade de vida relacionada à saúde em idosos com DPOC.

Anciano al final de la vida desde una perspectiva de la Enfermería / The older person at the end of life course from the nursing perspective

RESUMEN Introducción: La Enfermería, ciencia humana y práctica, se enfrenta con frecuencia al cuidado de personas con características resultantes del envejecimiento. Anciano, un término abordado con frecuencia, tiene evocaciones e ilustraciones distintas, depende de la cultura, los objetivos de investigación y las experiencias de vida de quien la aborda. Sin embargo, no se identifica una definición configurada desde la Enfermería. Por lo que es necesario analizar los enfoques en el contexto internacional y cubano relacionado con la etapa final del ciclo vital, así como sus implicaciones en la salud, el entorno, el cuidado y la persona. Objetivo: Sistematizar el término anciano al final de la vida para lograr su contextualización en el ámbito de la Enfermería. Métodos: Se realizó una revisión bibliográfica sistemática para desarrollar un análisis crítico reflexivo del contenido de documentos, donde se consideraron, libros, documentos, artículos de revisión, desde 2006 hasta 2017. Las palabras clave utilizadas fueron anciano; envejecimiento; longevidad; enfermería; identificadas a través de DECs o de MeSH. Las búsquedas se hicieron en Scielo. Conclusiones: La sistematización permitió la definición operativa de anciano al final de la vida desde una perspectiva de la Enfermería, la que se concibe como: Persona de 60 años o más, con deterioro de la salud, pérdida de autonomía y dependencia total irreversible en lo biológico, psicológico, económico y social, que requiere de cuidados familiares y profesionales crecientes, por la afectación gradual e intensa de sus necesidades humanas(AU)

ABSTRACT Introduction: Nursing as a human and practical science frequently faces the care of people with some characteristics resulting from aging. The older person, a commonly said term, has different evocations and illustrations, depending on the culture, the research objectives and the life experiences of the one who address it. However, a definition created from the nursing's viewpoint has not yet been identified. Hence, it is necessary to analyze the international and the Cuban approaches on the final stage of the life course as well as its implications for the health, the environment, the care and the person as such. Objective: To systematize the term older person at the end of life in order to contextualize it in the field of nursing. Methods: A systematic literature review was made to develop a critical and reflective analysis on the contents of documents including books, documents and review articles published from 2006 to 2017. The keywords were older person, aging, longevity and nursing, which were identified through DECs or MeSH and searched for in SCielo. Conclusions: Systematization allowed finding the operational definition of older person at the end of life from the nursing perspective, which is conceived as an individual aged 60 years or over, with deteriorated health condition, loss of autonomy and irreversible total dependency from the biological, psychological, economic and social viewpoints. This person needs growing family and professional care since their human requirements may be gradually and intensely affected(AU)

La aplicación de un programa de intervención para el beneficio de la salud física y emocional en mujeres adultas mayores en Hermosillo, Sonora

Se llevó a cabo un estudio cuantitativo de diseño cuasiexperimental para identificar los beneficios físicos y emocionales que promueve un programa de activación física sistematizado en mujeres adultas mayores del Instituto Nacional de las Personas Adultas Mayores (INAPAM) y del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado de Sonora (ISSSTESON). Se aplicó para ello el Test de Senior Fitness (SFT) y la escala de ansiedad y depresión de Goldberg (EADG) a una muestra no probabilística de 70 personas de Hermosillo, Sonora del sexo femenino, mayores de 65 años (M= 68.4, DS= 5.12 años). Los resultados mostraron una disminución del 61 % en la prevalencia de ansiedad y un 30 % en el síntoma de depresión después del programa. Se observaron cambios estadísticamente significativos en la flexibilidad muscular de las extremidades inferiores (p<0.05). Respecto a la resistencia aeróbica, las participantes lograron aumentar en promedio 36 metros más de lo que habían recorrido en los 6 minutos de marcha al inicio del programa. El programa de actividad física sistematizado en mujeres adultas mayores disminuye la prevalencia de ansiedad y depresión, desarrolla la capacidad de estiramiento, capacidad aeróbica, agilidad y equilibrio dinámico.

A quantitative study of a quasi-experimental design was conducted to identify the physical and emotional benefits promoted by a systematized physical activation program in older women of the National Institute for Older Persons and the Institute of Worker Safety and Social Services of the State of Sonora. The Senior Fitness Test (SFT) and the Goldberg Anxiety and Depression Scale (GADS) were applied to a non-probabilistic sample of 70 women over 65 years old (M = 68.4, SD = 5.12 years) from Hermosillo, Sonora. The results showed a decrease of 61% in the prevalence of anxiety and a 30% decrease in the symptom of depression after the program. Statistically significant changes were observed in the muscular flexibility of the lower extremities (p <0.05). Regarding aerobic resistance, the participants managed to increase an average of 36 meters more than they had traveled in the six minutes of walking at the beginning of the program. The program of physical activity systematized in older women reduces the prevalence of anxiety and depression and develops the ability to stretch, aerobic capacity, agility, and dynamic equilibrium.

Um estudo quantitativo de desenho quase experimental para identificar os benefícios físicos e emocionais que promove um programa de activação física sistematizado em mulheres idosas do Instituto Nacional de Idosos e do Instituto de Segurança do Trabalhador e Serviços Sociais do estado de Sonora. Aplicou-se para isso o Teste de Senior Fitness (SFT) e a escala de ansiedade e depressão de Goldberg (EADG) a uma amostra não probabilística de 70 pessoas de Hermosillo, Sonora, do sexo feminino, maiores de 65 anos (M= 68.4, DS= 5.12 anos). Os resultados mostraram uma diminuição de 61% na prevalência de ansiedade e uma diminuição de 30% no sintoma de depressão após o programa. Observaram-se mudanças estatisticamente significativas na flexibilidade muscular das extremidades inferiores (p <0,05). Em relação à resistência aeróbica, as participantes conseguiram aumentar em média 36 metros a mais do que haviam percorrido nos 6 minutos de caminhada no início do programa. O programa de atividade física sistematizado em mulheres idosas diminui a prevalência de ansiedade e depressão, desenvolve a capacidade de alongamento, capacidade aeróbica, agilidade e equilíbrio dinâmico.

Exercise for Healthy, Active Ageing: A Physiological Perspective and Review of International Recommendations / Ejercicio para un Envejecimiento Saludable y Activo: Una Perspectiva Fisiológica y un Examen de las Recomendaciones Internacionales

ABSTRACT Healthy, active ageing is an important public health goal, which is supported by appropriate, specific, targeted physical activity. Many physiological changes to the cardiovascular and musculoskeletal system may lead to a decline in strength, fitness and resilience as the human body ages. Exercise is a proven means of overcoming physiological functional limitations and maintaining independence throughout the lifespan. The World Health Organisation, American College of Sports Medicine and American Academy of Family Medicine have proposed guidelines for the minimum amount of physical activity to be performed each week by older adults. Each adult needs an individualized mix of aerobic, strength-training, balance and flexibility exercises, to maintain autonomy, reduce chronic disease risk and enjoy a good quality of life. This review summarizes the important highlights of these recommendations and focusses on the significant physiological gains to be achieved from exercise.

RESUMEN El envejecimiento saludable y activo es un objetivo importante de la salud pública, apoyado por una actividad física apropiada, específica y dirigida a tal fin. Muchos cambios fisiológicos en el sistema cardiovascular y musculoesquelético pueden llevar a una disminución de la fuerza, la aptitud física, y la resistencia a medida que el cuerpo humano envejece. El ejercicio es un medio probado para superar las limitaciones funcionales fisiológicas y mantener la independencia durante la vida. La Organización Mundial de la Salud, el Colegio Americano de Medicina del Deporte, y la Academia Americana de Medicina de la Familia, han propuesto pautas para la cantidad mínima de actividad física que los adultos mayores deben realizar cada semana. Cada adulto necesita una mezcla individualizada de ejercicios aeróbicos y entrenamiento de fuerza, asi como ejercicios de equilibrio y flexibilidad, para mantener la autonomía, reducir el riesgo de enfermedades crónicas, y disfrutar de una buena calidad de vida. Este examen resume los aspectos más sobresalientes de estas recomendaciones y enfoca las importantes ganancias fisiológicas a lograr con el ejercicio.

Advance of Exercise Prescription in Aging Sarcopenia and Osteoporosis (review) / 中国康复理论与实践

@#Aging is associated with loss of muscle (sarcopneia) and bone (osteoporosis), resulting in an impaired capacity to perform daily activities, furthermore might progress to the extent that an older person loses his or her ability to live independently. Recent studies showed that exercise had remarkable beneficial effects on the musculoskeletal system, including prevention and treatment of these syndromes. Based on the recent research achievement, this paper reviewed exercise prescription in aging sarcopenia and osteoporosis, the result revealed resistance training is the most effective measure to prevent and treat sarcopenia and osteoporosis. In addition, long periods of walking or jogging for over half a year can increase leg muscle size in older adults.

Advance of Exercise Prescription in Aging Sarcopenia and Osteoporosis (review) / 中国康复理论与实践

Aging is associated with loss of muscle (sarcopneia) and bone (osteoporosis), resulting in an impaired capacity to perform daily activities, furthermore might progress to the extent that an older person loses his or her ability to live independently. Recent studies showed that exercise had remarkable beneficial effects on the musculoskeletal system, including prevention and treatment of these syn-dromes. Based on the recent research achievement, this paper reviewed exercise prescription in aging sarcopenia and osteoporosis, the result revealed resistance training is the most effective measure to prevent and treat sarcopenia and osteoporosis. In addition, long periods of walk-ing or jogging for over half a year can increase leg muscle size in older adults.

Caracterización de los ancianos con trastornos depresivos / Characterization of older persons with depressive disorders

Se hizo un estudio descriptivo y transversal de 47 ancianos deprimidos, ingresados en la Sala de Psicogeriatría del Servicio de Psiquiatría del Hospital General Docente Dr Juan Bruno Zayas Alfonso de Santiago de Cuba, desde marzo del 2006 hasta febrero del 2007, para identificar los trastornos depresivos que presentaban. En la casuística predominaron las mujeres (74,46 por ciento), el grupo etario de 60 a 74 años (80,85 por ciento) y la convivencia con buena comunicación (46,80 por ciento) en los que vivían con sus familiares (56,76 por ciento. Los antecedentes personales de comportamiento suicida primaron en los senescentes sin compañía, mientras que entre los síntomas psiquiátricos diagnosticados sobresalieron: reducción del nivel de energía, alteraciones de la concentración, anorexia y sentimientos de soledad. El trastorno depresivo mayor y la enfermedad bipolar, además de haber sido los diagnósticos psiquiátricos que demandaron una mayor atención médica, tanto institucional como ambulatoria, fueron también los que se asociaron a mayor riesgo de conducta suicida en los pacientes estudiados

A descriptive and cross-sectional study was carried out in 47 depressed older persons admitted to the psychogeriatry room from the Psychiatry Unit at Dr Juan Bruno Zayas Alfonso General Teaching Hospital of Santiago de Cuba, from March 2006 to February 2007, to identify their depressive disorders. Females (74,46 per cent), age group of 60 - 74 years (80,85 per cent) and the coexistence with good communication (46,80 per cent) in those that lived with their relatives (56,76 per cent) prevailed in the case material. Past medical history of suicidal behavior prevailed in those older persons without company, while among the diagnosed psychiatric symptoms were relevant: reduced energy level, impaired concentration, anorexia and feelings of solitude. Major depression and bipolar disorder, besides having been the psychiatric diagnoses that required more outpatient and inpatient care, were also associated with a greater risk of suicidal behavior in studied patients