Envejecimiento saludable: un primer acercamiento a la revisión de indicadores subjetivos de salud en zonas urbanas y rurales en Costa Rica / Healthy aging: An initial review of subjective health indicators in urban and rural areas in Costa Rica

Resumen En este artículo se presentan los resultados de una primera aproximación al análisis del efecto moderador del contexto social, cultural y geográfico en indicadores subjetivos del envejecimiento saludable en personas mayores de 46 años residentes en territorios con características diferenciadas en Costa Rica. Se trabajó con una muestra de 305 personas residentes en tres áreas geográficas: una urbana, una semiurbana y una tercera principalmente rural. La diferenciación de las tres zonas se basó en criterios de densidad poblacional, infraestructura y acceso a bienes y servicios. Los indicadores subjetivos del envejecimiento saludable analizados fueron: participación social, apoyo social, salud percibida, espiritualidad, autoeficacia, comportamientos de autocuidado, bienestar subjetivo (satisfacción con la vida y bienestar psicológico) y estado de ánimo; todas las variables fueron condicionadas por zona de residencia, edad y sexo. Para analizar los indicadores subjetivos se estimó un análisis de covarianza (ANCOVA) o un análisis multivariado de covarianza (MANCOVA), dependiendo del número de variables dependientes analizadas. En general, se identificaron indicadores subjetivos de envejecimiento saludable altos en las personas participantes del estudio, quienes reportaron altos niveles de participación social, satisfacción con la vida y estados de salud y ánimo positivos. Se encontraron diferencias por edad entre los grupos. Sin embargo, no se evidenciaron diferencias estadísticamente significativas en los indicadores subjetivos analizados según la zona de residencia o el sexo. En síntesis, este estudio encontró que los indicadores subjetivos de envejecimiento saludable analizados eran muy similares en residentes de tres zonas geográficas con características distintas. Estos hallazgos iniciales se discuten desde una perspectiva cultural y geográfica y en relación con los modelos de envejecimiento saludable.

Abstract This review exposes the results of a first approximation to the analysis of the moderator effect of the geographical, social, and cultural context on subjective indicators of healthy aging in the Costa Rican context. Costa Rica is a middle-income democratic country that is in an advanced demographic changing process; this phenomenon makes it one of the aged countries in the Latin American region. Therefore, studying healthy aging becomes relevant in the context of population demographic change in the present and future aging societies. The study compared several subjective indicators of healthy aging among people older than 46 who resided in three different geographical areas in the country. Participants were 305 healthy people from three locations: one urban (Heredia Central City), one semi-urban (Santa Ana Central City), and one mainly rural (Nicoya). Participants completed standardized assessment scales to evaluate social participation, social support, perceived health, spirituality, self-efficacy, self-care behaviors, and subjective well-being (life satisfaction and psychological well-being). All variables were conditioned by geographical zone (urban, semi-urban, and mainly rural), age, and gender. Either Analysis of Covariance (ANCOVA) or Multivariate Analysis of Covariance (MANCOVA) were estimated depending on the number of dependent variables analyzed to test the effect of the zone of residence, gender, and age, over the subjective indicator of healthy aging studied. In general, participants evidenced high scores on subjective indicators such as self-care, social support, spirituality, life satisfaction, and psychological well-being, which have been associated with health and well-being during the aging process. Participants reported high levels of social participation and perceived that they received adequate support for their daily life needs. Likewise, participants evidenced a general state of well-being, a positive state of health, high levels of self-efficacy, and positive moods. Differences were found among the groups by comparing age. However, no significant differences were found in the variables studied related to geographical areas of residence and sex, suggesting invariant comparison evidence by zone of residence and sex. Nevertheless, the results indicate that the subjective indicators of healthy aging studied are key to promoting healthy aging at the national level. It is considered necessary to improve opportunities for social participation aimed at older adults, to strengthen community and family social networks, to promote socio-economic support such as financial and instrumental support for activities of daily living, and finally emotional support such as listening, empathy and advice. Although the differences among geographical areas of residence of the people studied were not statistically significant in this study, the evidence suggested a trend of high well-being indicators mainly in the rural areas studied, and particularly more in males than in females. As this study only reached preliminary data, further research must obtain conclusive evidence, as previous research had suggested older people living in rural areas with high longevity indicators in Costa Rica might enjoy unusual environmental characteristics and personal protective factors that could be absent in most of the urban areas in the country. On the other hand, it will be necessary to include the historical and socio-cultural determinants focusing on context-specific review analyses in the mainstream research on healthy aging, even more in aged countries like Costa Rica. The findings are discussed within the inter-cultural emphasis and healthy aging models in order to contribute to a better understanding of how the context (physical-constructed and social/cultural) influences the differences, although subtle, in the study´s variables and participants, and how the process of aging might be different according to the multiple contextual conditions in which people live and adapt their capacities and abilities for coping with daily life demands.

Motivos psicossociais para cirurgia bariátrica em adultos jovens e mais velhos / Psychosocial factors for bariatric surgery in young and older adults / Razones psicosociales de adultos jóvenes y de mediana edad para realizar la cirugía bariátrica

A obesidade decorre da interação de fatores biológicos, sociais e comportamentais, além de ser vista como uma marca social e moral indesejável, que pode causar limitações psicossociais originadas do preconceito, do estigma e da exclusão e, consequentemente, resultar em tristeza, culpa, ansiedade, vergonha e isolamento social, bem como afetar o bem-estar dos pacientes. Objetivou-se identificar motivos psicossociais que levaram obesos - adultos jovens e adultos mais velhos - a optar pela cirurgia bariátrica. Participaram desta pesquisa 11 pacientes, homens e mulheres, de 20 a 65 anos, residentes no Rio de Janeiro, antes da cirurgia. Os dados foram coletados por meio de entrevista semiestruturada e submetidos à análise de conteúdo, da qual resultaram em três categorias: Educação Alimentar, Família e Apelo Externo, Moralização da Obesidade e Questões Emocionais, Decisão: Saúde e Estética. Os resultados revelaram que a maioria dos participantes optou pela cirurgia motivados por questões de saúde e estética e que a bariátrica é percebida como ferramenta que contribui com a reeducação alimentar para a perda de peso, reduz as comorbidades e melhora a mobilidade, a aparência e a autoestima, de forma que ajuda o indivíduo a se readequar aos padrões corporais estabelecidos pela sociedade e a voltar ao convívio social. As conclusões destacam que o indivíduo comprometido com o tratamento da obesidade também adere ao tratamento multidisciplinar, que concorre para o sucesso da cirurgia em relação ao bem-estar. São recomendadas novas pesquisas sobre a estética enquanto motivo para realização da cirurgia bariátrica em jovens adultos e mais velhos.(AU)

Obesity results from the interaction between biological, social, and behavioral factors. Often considered a social an moral undesirable imprint, such condition may lead to psychosocial problems arising from prejudice, stigma, and exclusion, affecting the well-being of patients due to feelings of sadness, guilt, anxiety, shame, and social isolation. This study sought to identify psychosocial factors that led young and older adults with obesity to opt for bariatric surgery. The sample consisted of 11 patients, men and women, aged between 20 and 65 years, who lived in Rio de Janeiro. Data were collected by means of semi-structured interviews and submitted to content analysis, resulting in three categories: Food Education; Family and External Support; and Moralization of Obesity, Emotional Issues, and Decisions - Health and Aesthetics. The results reveal that most participants opted for bariatric surgery due to health and aesthetic reasons, being perceived as a strategy that contributes to nutritional education for weight loss, reduces comorbidities, and improves mobility, appearance, and self-esteem, helping the individual to fit to the body standards socially determined, being reintegrated onto social life. Individuals committed to the treatment for obesity also adhere to the multidisciplinary treatment, which seems to contribute to the surgery success regarding well-being. Further empirical studies addressing aesthetics as a reason to undergo bariatric surgery in young and older adults are required.(AU)

La obesidad resulta de la interacción entre los factores biológicos, social y de comportamiento, y es una marca social y moral no deseada, que puede causar limitaciones psicosociales que se originan en el prejuicio, el estigma y la exclusión, y producir tristeza, culpa, ansiedad, vergüenza y aislamiento social, además de afectar el bienestar de los pacientes. Se pretende identificar las razones psicosociales que llevaron adultos obesos - adultos jóvenes y de mediana edad - a optar por la cirugía bariátrica. Participaron en este estudio 11 pacientes, hombres y mujeres, entre los 20 años y los 65 años que vivían en Río de Janeiro antes de la cirugía. Para la recopilación de datos se empleó entrevista semiestructurada, y para evaluarlos se utilizó el análisis de contenido, del cual emergieron tres categorías: Educación alimentaria, familia y apelación externa; moralización de la obesidad; y temas emocionales, decisión: salud y estética. Los resultados apuntan que la mayoría optó por la cirugía por razones de salud y de estética, y que la cirugía bariátrica se percibe como una herramienta que contribuye a la educación nutricional para bajar de peso, reduce las comorbilidades y mejora la movilidad, la apariencia y la autoestima, lo que le ayuda al individuo a reajustarse a los patrones corporales establecidos por la sociedad y volver a la vida social. Se concluye que el individuo comprometido con el tratamiento de la obesidad tiene una adherencia al tratamiento multidisciplinar que parece contribuir al éxito de la cirugía en relación con su bienestar. Se recomienda la realización de más estudios empíricos sobre la estética como razón para la realización de la cirugía bariátrica en adultos jóvenes y de mediana edad.(AU)

Percepción de autoeficacia y rendimiento en tareas de memoria operativa: Comparación entre adultos mayores y jóvenes / Perception of self-efficacy and actual performance in working memory tasks: A comparison between older and younger adults

Resumen La vejez se ha caracterizado por la existencia de una declinación natural de la memoria, como asimismo de su autoeficacia. La relación entre ambas ha sido objeto de varias investigaciones que confirman que la autoeficacia de la memoria afecta el rendimiento en tareas de memoria. Sin embargo, existe un grupo menor de investigaciones donde no se presenta dicha relación. El objetivo del estudio fue comparar la percepción de autoeficacia de la memoria con el rendimiento en tareas de memoria en adultos mayores y jóvenes. Los participantes fueron 200 adultos mayores y 111 jóvenes universitarios quienes respondieron dos instrumentos: uno de percepción de autoeficacia de memoria, y otro de rendimiento en tareas memoria operativa y/o memoria de corto plazo, ambos instrumentos fueron construidos y adaptados de forma tal que fueran comparables entre sí. Los resultados muestran que los adultos mayores presentan un menor rendimiento en casi todas las tareas de memoria y una leve superioridad en la percepción de autoeficacia de la memoria, existe una relación significativa entre ambas medicinas. En cambio, en los jóvenes su percepción de autoeficacia fue levemente inferior, pero su rendimiento fue superior.

Aging has been characterized by a natural decline of memory, as well as by a decline in the perception of memory self-efficacy. The relationship between these two variables has been the subject of several studies, confirming that the perception of mnemonic self-efficacy affects actual performance on memory tasks. However, there is a smaller group of studies where this relationship has not been found. The objective of the present study was to compare the perception of self-efficacy of memory with performance in memory tasks in older and younger adults. Two hundred older adults and 111 university students participated in the study by responding two instruments: one Perception of Memory Self-Efficacy, and another one on Performance in Operational Memory tasks. Both instruments were constructed and adapted so that they be comparable. The results showed that older adults have a lower performance in almost all memory tasks and a slight superiority in the perception of memory self-efficacy, and a significant relationship was found between the two. On the other hand, in younger people's beliefs about their memory were slightly lower, but they performed better.

Depletion of occupational performance effectiveness in electric power engineering industry: psychophysiological factors and risk evaluation

Background: The modern society cause the increase of workload and impact of environment factors on performance efficiency of occupational duties and health safety of workers. Emergencies and expert mistakes often arise not so much from rules ignorance of object management, but due to insufficient development of worker’s own psychophysiological qualities. The goal of our investigation is to develop the estimation technique for evaluation the risk of depletion in efficiency performance of occupational duties for operative service workers in electric power engineering industry.Methods: In our investigation, we examined the materials of psychophysiological survey by the multivariate statistics, dispersion analysis and regression binary choice models. The study is based on workers’ survey, encompassed exogenous psychophysiological indicators that included the observation of 466 operative service workers of in electric power engineering industry in Ukraine.Results: We determined seven psychophysiological indicators that are significant important risk cause of critical depletion in worker’s occupational efficiency. We estimated the multivariate regression logit model that evaluate the impact of each factor taking into account the age of worker.Conclusions: For workers with high values of average reaction time, regardless of the age group, we predict a high risk of occupational effective performance loss. The analysis showed that for workers with average values of other factors, the increase of adaptability and variability lead to decrease in risk of occupational professional efficiency depletion. Based on developed approach, we estimated that, in electric power engineering industry in Ukraine, the risk of effectiveness loss is less than 0.5 for 84% of workers.

Percepción de autoeficacia y rendimiento en tareas de memoria operativa: comparación entre adultos mayores y jóvenes / Perception of self-efficacy and actual performance in working memory tasks: a comparison between older and younger adults

Resumen La vejez se ha caracterizado por la existencia de una declinación natural de la memoria, como asimismo de su autoeficacia. La relación entre ambas ha sido objeto de varias investigaciones que confirman que la autoeficacia de la memoria afecta el rendimiento en tareas de memoria. Sin embargo, existe un grupo menor de investigaciones donde no se presenta dicha relación. El objetivo del estudio fue comparar la percepción de autoeficacia de la memoria con el rendimiento en tareas de memoria en adultos mayores y jóvenes. Los participantes fueron 200 adultos mayores y 111 jóvenes universitarios quienes respondieron dos instrumentos: uno de percepción de autoeficacia de memoria, y otro de rendimiento en tareas memoria operativa y/o memoria de corto plazo, ambos instrumentos fueron construidos y adaptados de forma tal que fueran comparables entre sí. Los resultados muestran que los adultos mayores presentan un menor rendimiento en casi todas las tareas de memoria y una leve superioridad en la percepción de autoeficacia de la memoria, existe una relación significativa entre ambas medicines. En cambio, en los jóvenes su percepción de autoeficacia fue levemente inferior, pero su rendimiento fue superior.

Aging has been characterized by a natural decline of memory, as well as by a decline in the perception of memory self-efficacy. The relationship between these two variables has been the subject of several studies, confirming that the perception of mnemonic self-efficacy affects actual performance on memory tasks. However, there is a smaller group of studies where this relationship has not been found. The objective of the present study was to compare the perception of self-efficacy of memory with performance in memory tasks in older and younger adults. Two hundred older adults and 111 university students participated in the study by responding two instruments: one Perception of Memory Self-Efficacy, and another one on Performance in Operational Memory tasks. Both instruments were constructed and adapted so that they be comparable. The results showed that older adults have a lower performance in almost all memory tasks and a slight superiority in the perception of memory self-efficacy, and a significant relationship was found between the two. On the other hand, in younger people's beliefs about their memory were slightly lower, but they performed better.

Rendimiento de la memoria prospectiva en personas mayores, adultos y jóvenes / Prospective memory performance in older people, adults and youth / Rendimento da memória prospectiva em idosos, adultos e jovens

La finalidad del presente trabajo fue comprobar las diferencias que pudieran existir en Memoria Prospectiva (MP) entre jóvenes, adultos y personas mayores; analizar las relaciones existentes entre variables de comprensión y fluidez verbal y la MP; y verificar la existencia de relaciones entre la percepción subjetiva del estado de salud y el rendimiento de la MP. A través de un diseño transversal, se trabajó con 270 participantes distribuidos en tres grupos de edad: jóvenes de 18 a 28 años; adultos de 45 a 55, y personas mayores de 60 a 80. Se evaluó a los participantes en relación con sus aptitudes de comprensión y fluidez verbal, así como en la percepción subjetiva de su estado de salud. Posteriormente se realizó un experimento donde se les presentaron párrafos de tres frases en la pantalla del computador y ellos tenían que reconocer palabras previamente acordadas, que indicarían su nivel de MP. Los resultados permitieron confirmar diferencias significativas en memoria prospectiva entre mayores y jóvenes. Sin embargo, no se encontraron diferencias entre jóvenes y adultos. Se detectó la importancia de las aptitudes verbales y la influencia de la percepción subjetiva del estado de salud para tener un mejor rendimiento en estas tareas de laboratorio de MP.

The aims of this study were to verify the potential differences in prospective memory (PM) among young people, adults and the elderly; analyze the relationships between variables of comprehension and verbal fluency and PM; and finally, verify the existence of a relationship between self-reported health status and performance on PM. A cross- sectional design was used. The study involved 270 participants divided into three age groups: young people aged 18 to 28 years; adults 45 to 55, and seniors 60 to 80. Their comprehension and verbal fluency skills were assessed as well as their self-perceived health status. Subsequently, an experiment was carried out where participants were presented with paragraphs of three sentences on a computer screen and they had to recognize previously agreed words that would indicate their level of MP. The results established significant differences in prospective memory between adults and older people and between young people and the elderly. But no differences between youth and adults were found..The importance of verbal comprehension and verbal fluency in solving prospective memory experimental tasks was also significant. In addition, a better self-perception of well-being was linked to a higher performance in PM.

A finalidade do presente trabalho foi comprovar as diferenças que puderam existir na Memória Prospectiva (MP) entre jovens, adultos e idosos; analisar as relações existentes entre variáveis de compreensão e fluência verbal e a MP; e verificar a existência de relações entre a percepção subjetiva do estado de saúde e o rendimento da MP. Através de um desenho transversal, se trabalhou com 270 participantes distribuídos em três grupos de idade: jovens de 18 a 28 anos; adultos de 45 a 55, e idosos de 60 a 80. Avaliaram-se os participantes em relação com suas aptidões de compreensão e fluência verbal, assim como na percepção subjetiva de seu estado de saúde. Posteriormente realizou-se um experimento onde foram apresentados parágrafos de três frases na tela do computador e eles tinham que reconhecer palavras previamente lembradas, que indicariam seu nível de MP. Los resultados permitiram confirmar diferencias significativas em memória prospectiva entre idosos e jovens. Porém, não se encontraram diferenças entre jovens e adultos. Detectou-se a importância das aptidões verbais e a influencia de a percepção subjetiva do estado de saúde para ter um melhor rendimento nestas tarefas de laboratório de MP.

Substance use across adolescence: do gender and age matter? / Consumo de substâncias na adolescência: o género e a idade são importantes?

Many of the choices which impact in lifetime health, such as substance use, are made in adolescence. It becomes, therefore, important to know the factors associated to these behaviours in adolescence in different contexts of life. To analyze these factors, an explanatory model was developed using structural equation modeling. Data from 12.881 state school students from Portugal who participated in two waves of the Health Behaviours in School-aged Children (HBSC) / World Health Organization (WHO) survey were analyzed. The model fits well the data [CFI: .985; NNFI: .980; RMSEA: .018 (.017-.020); SRMR: .018]. For each of the dependent factors, the levels of variance ranged from 12% (tobacco use) to 47% (alcohol and illicit drugs use). Alcohol and tobacco present the strongest associations to illicit drugs use. Relationships with family, friends, classmates, and teachers were also associated with substance use, being this association mediated by certain factors, including psychological symptoms, well-being, and school satisfaction. Several non-invariant paths were obtained in gender and age comparisons. The results showed that substance use is associated with several factors and that social factors are mediated by personal factors. Results have also shown that gender and age are important factors on substance use.

Muitas das escolhas com impacto na saúde a longo prazo, como o consumo de substâncias, são feitas na adolescência. Torna-se pois importante conhecer os fatores associados a estes comportamentos em diferentes contextos de vida. Para analisar estes fatores, foi desenvolvido um modelo explicativo através da modelação de equações estruturais. Para este estudo foram analisados dados de 12881 alunos de escolas públicas participantes em duas recolhas do estudo HBSC/OMS. O modelo apresenta uma boa adequação [CFI:.985; NNFI:.980; RMSEA:.018 (.017-.020); SRMR:.018]. Para cada um dos fatores dependentes, os níveis de variância explicada variaram entre 12% (tabaco) e 47% (álcool e drogas ilícitas). Os consumos de álcool e tabaco apresentaram as associações mais fortes com o consumo de drogas ilícitas. As relações com a família, amigos, colegas e professores estão associadas ao consumo de substâncias, sendo esta associação mediada por vários fatores, nomeadamente sintomas psicológicos, bem-estar, e satisfação com a escola. Ligações não-invariantes foram obtidas nas comparações de género e idade. Os resultados mostraram que o consumo de substâncias está associado a vários fatores, e que o impacto dos fatores sociais é mediado por fatores pessoais. Os resultados mostraram ainda que o género e a idade são fatores importantes no consumo de substâncias.

Os efeitos da idade na seleção de carga perceptual / Effects of aging on the selection of perceptual load

Algumas pesquisas sugerem a existência de momentos distintos de maturação do sistema atentivo. O presente estudo investigou os padrões de seleção da informação visual através de uma tarefa de carga perceptual executada por três grupos etários: crianças, adultos e idosos. De maneira geral os resultados obtidos indicaram uma diminuição da eficiência no processo de seleção da informação em condições de baixa carga perceptual na população de idosos e uma diminuição da eficiência da seleção em condições de alta e baixa carga perceptual na população composta por crianças. Estes resultados sugerem a existência de padrões específicos na seleção da informação visual em função da idade e da carga perceptual a ser processada pelo sistema visual.

Some studies suggest the existence of distinct maturation moments of the attentional system. This study investigated the selection patterns of visual information through a perceptual load task performed by three age groups: children, adults and elderly people. In general, the obtained results indicate a decrease of the efficiency in the process of information selection under low perceptual load in the group of elderly people, and a decrease of the selection efficiency under conditions of high and low perceptual load in the group composed by children. The results suggest the existence of specific patterns in the selection of visual information in relation to age and the perceptual load to be processed by the visual system.