The impact of social distancing due to COVID-19 on adults' and older adults' exercise / O impacto do distanciamento social devido à COVID-19 nos exercícios de adultos e idosos / El impacto del alejamiento social por la COVID-19 para los ejercicios en adultos y mayores

Objective: The objective of this paper is to describe and compare the frequency, duration, and intensity of physical exercise performed by the participants, as well the types of exercise, in three different periods: 2019 (1), January and February 2020 (2), and during the social distancing period (SDP) due to the COVID-19 pandemic (3). Methods: This is a mixed-methods (retrospective/cross-sectional) study of a population of adults and older adults from a public recreation center in Porto Alegre, Brazil. The participants were invited to take a survey on Google Forms addressing the characteristics of the physical exercises performed in the periods covered in this research. The questionnaire remained available throughout October 2020. Results: The sample comprised 194 participants (63.49±14.14 years; 93.2% were women). During period 1, the most performed exercises were strength/aerobic exercises twice a week for 46 minutes to 1 hour per session at intensity 6. During period 2, walking was the most reported exercise performed three times a week for 31 to 45minutes per session at intensity 7. During period 3, strength/aerobic exercises were the most frequent, being performed three times a week for 31 to 45minutes per session at intensity 5. Conclusion: When compared to the first period, a significant decrease in in total time, intensity and duration of exercises performed by the population analyzed was observed in the other periods. Similar behavior was observed across the age ranges.

Objetivo: O objetivo deste artigo é descrever e comparar a frequência, a duração e a intensidade de exercícios físicos realizados pelos participantes, bem como os tipos de exercícios, em três períodos diferentes: em 2019 (1), janeiro e fevereiro de 2020 (2) e durante o período de distanciamento social devido à pandemia COVID-19 (3). Métodos: Trata-se de um estudo misto (retrospectivo/ transversal) com população composta por adultos e idosos de um centro recreativo público de Porto Alegre, Brasil. Os participantes convidados responderam a um questionário disponibilizado por meio dos Formulários Google, acerca das características dos exercícios físicos praticados nos períodos abrangidos por esta pesquisa. O questionário permaneceu disponível durante o mês de outubro de 2020. Resultados: Compuseram a amostra 194 participantes (63,49 ± 14,14 anos; 93,2% mulheres). No período 1 os exercícios mais praticados compuseram-se por força/aeróbica, duas vezes/semana, de 46 minutos a 1 hora/sessão, na intensidade 6. No período 2, a caminhada apresentou-se como a atividade mais citada, três vezes/ semana, de 31 a 45 min/sessão, na intensidade 7. No período 3, a aula de força/aeróbica apresentou-se como a atividade mais frequente, três vezes/semana, de 31 a 45 min/sessão, na intensidade 5. Conclusão: Quando comparado ao primeiro período, houve diminuição significativa nos demais períodos quanto ao tempo total, intensidade e duração de exercícios realizados pela população investigada, além de apresentar este mesmo comportamento entre os grupos etários.

Objetivo: El objetivo del artículo es describir y comparar la frecuencia, la duración y la intensidad de los ejercicios físicos de los participantes, así como los tipos de ejercicios en tres periodos distintos: enero de 2019, febrero de 2020 y durante el periodo de alejamiento social (PAS) por la pandemia de la COVID-19. Métodos: Estudio misto (retrospectivo/transversal) con la población deadultos y mayores de un centro de recreación público de Porto Alegre, Brazil. Los participantes han sido invitados para contestar una encuesta del Google Forms sobre las características de los ejercicios físicos practicados en los periodos del estudio. La encuesta estuvo disponible durante el mes de octubre de 2020. Resultados: El estudio tuvo 194 participantes (63,49±14,14 años; 93,2% mujeres). Durante el periodo 1 los ejercicios más realizados han sido los de fuerza/clase de aeróbic, dos veces a la semana con duración entre 46 minutos y una hora la sesión e intensidad 6. Durante el periodo 2, lo más relatado ha sido la caminata, tres veces a la semana entre 31- 45 minutos la sesión e intensidad 7. Durante el periodo 3, la clase de aeróbic y fuerza fue la más frecuente, tres veces a la semana, entre 31 y 45 minutos la sesión e intensidad 5. Conclusión: Hubo una disminución significativa en los otros periodos comparados al primero respecto al tiempo total, la intensidad y la duración de los ejercicios realizados por la población investigada además de presentar la misma conducta entre los grupos de edad

Analysis of suicide mortality and disease burden among elderly adults in Wuhan in 2014 - 2019 / 公共卫生与预防医学

Objective To analyze the trend of suicide mortality among the elderly aged 60 years and above in Wuhan from 2014 to 2019, to understand the disease burden of suicide deaths among the elderly adults in Wuhan, and to provide a basis for decision making to carry out suicide interventions in the elderly population. Methods The data on suicide deaths in the elderly adults of Wuhan residents whose death age was 60 years or older were collected from 2014 to 2019 using the Wuhan City's Cause of Death Monitoring Information System. Mortality, standardized mortality, years of life lost (YLL) due to early death and average years of life lost (AYLL) were calculated separately. Statistical analysis was performed using SPSS 26.0. The χ2 test was used to compare the suicide mortality rates among the elderly population by gender and region, and the annual percentage change (APC) was used for trend analysis. Results From 2014 to 2019, a total of 1010 suicide deaths were reported among elderly adults aged 60 years and older in Wuhan, with crude suicide mortality rates ranging from 7.60 to 10.77/100 000. The suicide mortality rate of elderly men was higher than that of elderly women. The suicide mortality rate of rural elderly adults was higher than that of urban elderly adults, and the suicide mortality rate of the rural elderly was decreasing. The overall suicide mortality rate of elderly people in Wuhan increased significantly with age, and the differences between the average suicide mortality rates of elderly males and elderly females in 2014-2019 were statistically significant among all age groups (P<0.01 or P<0.05). From 2014 to 2019, the YLL rate of suicide death among the elderly in Wuhan showed a trend of decreasing first and then increasing, and AYLL kept a slight fluctuation as a whole. The trends of both YLL rate and AYLL changes were not statistically significant. Conclusion The suicide mortality rate of elderly adults aged 60 years and above in Wuhan is high, especially in rural elderly men. The burden of disease caused by suicide deaths in the elderly is high, so it is necessary to take a variety of targeted measures to prevent and reduce the incidence of suicide among the elderly.

A Comparative Study of Problems Faced by the Young- Middle Aged- / Elderly-Adults during COVID Pandemic in Delhi-NCR (National Capital Region)

As the pandemic of COVID-19 has hit the globe, the associated uncertainty is progressively testing the psychological resilience of the masses in India too. Accordingly, the global focus has been mostly on scrutinizing, finding a cure and preventing its transmission; people are facing innumerable psychological problems, adjusting to the current lifestyles and also living in fear of the infection from disease. Since there is a severe dearth of research on this issue, it was decided to conduct an online survey to compare the problems faced by young and middle-aged / elderly adults in the society in Delhi-National Capital Region (NCR) during the lockdown period due to COVID-19. We wanted to analyse and compare the problems faced by young and the middle aged / elderly adults in Delhi NCR during the lockdown period of COVID-19 pandemic. METHODSA total of 450 people had given their consent to participate in this survey through a cross sectional survey during the lockdown period in Delhi-NCR region. Two separate questionnaires were created through google forms and were distributed via WhatsApp groups and other social media platforms. It consisted of 25 questions each based on the problems faced by the young and the middle aged / elderly adults. RESULTSThe study revealed that the young aged and middle-aged / elderly adults were similarly affected due to the lockdown. It also showed that the young adults were concerned to some extent about the studies in the school, college and university through online classes, not able to mix up with their friends for happy hours, getting bored and spending time watching movies / web series, and faced some mood swings due to the restrictions of COVID-19; whereas, the middle-aged / elderly adults were under a fear of getting infected, isolation, work from home, not able to help their relatives, confusion due to change in their routine, losing jobs, and were also upset with the reduction of their salary. CONCLUSIONSBoth the groups were similarly frustrated and stressed but for different reasons during this lockdown and in order to cope with the psychological stress, they should be counselled and given stress relieving sessions or should indulge in updating knowledge, skills etc. by attending to various online webinars, workshops etc.

Kaastu training for muscle fitness in the middle-aged and elderly adults: Effects and strengths / 中国组织工程研究

BACKGROUND: KAASTU training combined with low-load exercise can achieve the same effect as traditional high intensity resistance exercise. Therefore, it has been widely used in competitive sports, sports fitness, medical rehabilitation and other fields in recent years. However, there are few comments on the effects of KAASTU training on muscle fitness of the middle-aged and elderly adults. OBJECTIVE: To further explain and verify the safety, practicability and convenience of KAASTU training in the middle-aged and elderly adults exercise through a comprehensive review of the muscle fitness of middle-aged and elderly adults, and to provide scientific suggestions for the middle-aged and elderly adults to choose a safe and effective exercise. METHODS: Up to October 2019, Elsevier, PubMed, Springer, VIP, CNKI and Taiwan Academic Literature Database were searched for Chinese and English literature about KAASTU training, blood flow restriction, and muscle. Corresponding selection criteria was established according to the needs of the study, followed by literature screening. RESULTS AND CONCLUSION: KAASTU training combined with low-load exercise can effectively increase the muscle mass of the middle-aged and elderly adults, and has a positive effect on the prevention of muscle atrophy in the middle-aged and elderly adults. KAASTU training combined with low-load exercise can effectively improve the muscle strength of the lower extremities, which is beneficial to reduce exercise injury and improve the quality of life. KAASTU training has positive effects on bone health of the middle-aged and elderly adults, improves osteoporosis and increases bone mineral density of the older adults. Compared with traditional resistance training, KAASTU training is characterized by lower load and better effect. Therefore, KAASTU training is easier to be accepted by the middle-aged and elderly adults.

¿Sirven las ayudas técnicas a las personas mayores? Percepción desde la Atención Primaria sobre esta Garantía Explícita en Salud, Santiago, Chile / Are technical aids useful for elderly people? The perception of primary health care-based informants about this Explicit Health Guarantee in Santiago, Chile

OBJETIVO: Conocer la percepción de informantes clave pertenecientes a la red de Atención Primaria de Salud en Chile, respecto al proceso de gestión asistencial y el impacto del programa nacional de Garantías Explícitas en Salud (GES) sobre la entrega de ayudas técnicas a personas mayores. MATERIALES Y MÉTODOS: Un estudio cualitativo basado en análisis de casos múltiples, en el cual se realizó entrevistas semi-estructuradas a 8 informantes clave de la red asistencial, fue desarrollado en 2015 en tres comunas de Santiago, Chile. El análisis de la información recogida se realizó mediante análisis de contenido, y se finalizó el muestreo de máxima variación al saturar la información. Se resguardaron los criterios de rigor científico y el protocolo fue aprobado por un Comité de Ética. RESULTADOS: Hay una percepción de cobertura y detección de necesidad como adecuada en pacientes bajo control, aunque desde la perspectiva de los informantes, hay desconocimiento de esta garantía en la población. La necesidad es detectada por cualquier profesional de salud, pero la indicación es exclusivamente médica, lo que genera barreras de acceso. Hay una entrega oportuna; sin embargo, no se realiza seguimiento ni se aprecia como parte de una atención integral. Se percibe que la ayuda técnica es de calidad y la articulación de la red es adecuada, aunque no hay retroalimentación a Atención Primaria de Salud. El impacto lo consideran positivo en pacientes y familiares: mejora la ejecución de actividades diarias y genera mayor autonomía y capacidad de desplazamiento. CONCLUSIONES: Existe una percepción positiva de este programa GES y su impacto en la mejoría en la calidad de vida de vida de los pacientes. Pero, la entrega de ayudas técnicas se encuentra desvinculada de una atención integral, por ende, este programa prioriza sólo la garantía de oportunidad.

OBJECTIVE: To assess the perception of key informants working in Primary Health Care in Chile, regarding the administration and impact of the national Explicit Health Guarantees (GES) program which provides technical aids to vulnerable elderly adults. MATERIAL AND METHODS: A qualitative study, based on multiple case analysis of semi--structured interviews with 8 key informants of the healthcare network, was conducted in 2015 in three municipalities of Santiago, Chile. The collected information was analyzed by means of content analysis, and máximum variation sampling was carried out until the data saturation point was reached. Rigorous scientific criteria were safeguarded, and the study protocol was approved by an Ethics Committee. RESULTS: Patients deemed the program's coverage and detection of needs to be adequate, although informants conveyed that the general population is largely unaware of the program. While any health professional can detect a patient's need for technical aids, only physicians can prescribe the devices, which generates access barriers. Technical aid delivery is timely; however, it is not monitored or considered to form part of a comprehensive care system. Assistive devices are perceived to be high quality, and the delivery network coordination is seen as adequate, although there is no feedback to Primary Health Care. The program's impact is considered positive among patients and family members, as it improves the performance of daily activities and generates greater autonomy and mobility. CONCLUSIONS: This GES program is positively perceived and viewed to improve patients' quality of life. However, the delivery of technical aids is disconnected from an integral care approach, and thus the program only prioritizes the guarantee of opportunity.

Prevalence of Undernutrition and Related Dietary Factors among People Aged 75 Years or Older in China during 2010-2012 / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>Undernutrition is highly prevalent among older people. The aim of this study was to estimate the prevalence of undernutrition in elderly Chinese residents and explore the relationship between undernutrition and dietary factors.</p><p><b>METHODS</b>Data were collected from 2,552 elderly people aged 75 years and over from the Chinese Nutrition and Health Surveillance during 2010-2012 using questionnaires, anthropometric measurement, and individual consecutive 3-day 24-hour dietary records.</p><p><b>RESULTS</b>The present study showed that 10.5% of participants had undernutrition. The prevalence was higher among the population living in rural areas, those living in the South region, those who smoked, and those with low income levels. Most participants failed to meet the Chinese Dietary Reference Intakes for energy (66.1%) and protein (72.1%). When comparing quartiles of food intake, high rice consumption [odds ratio (OR) = 2.44, 95% confidence interval (CI): 1.35-4.40)], animal oil intake (OR = 1.60, 95% CI: 1.18-2.17), and high fat intake from animal sources (OR = 1.56, 95% CI: 1.06-2.31) were positively associated with underweight whereas high wheat consumption (OR = 0.44, 95% CI: 0.26-0.74), a proper proportion (24%-32%) of energy intake from fat (OR = 0.54, 95% CI: 0.35-0.83), and high fat intake from plant sources (OR = 0.67, 95% CI: 0.46-0.99) were inversely related.</p><p><b>CONCLUSION</b>The prevalence of undernutrition was high among elderly Chinese people, especially in rural areas. Dietary factors, such as high consumption of rice, were associated with undernutrition.</p>

Prevalence of hypertension and hypertension control rates among elderly adults during the cold season in rural Northeast China: a cross-sectional study / Journal of Rural Medicine

Objective: The burden of noncommunicable diseases (NCDs) is increasing in China, together with economic development and social changes. The prevalence of risk factors for NCDs, such as overweight/obesity, hypertension, diabetes, and dyslipidemia, is reported to be high even among poor residents of rural areas. We aimed to investigate the prevalence of hypertension among elderly adults in rural Northeast China and the proportion with controlled hypertension among those on antihypertensive medication (hypertension control rate). We also aimed to examine the association of hypertension control with health facilities that provide treatment.Methods: We conducted a community-based cross-sectional study in six rural villages of Northeast China from February to early March, 2012. We interviewed 1593 adults aged 50–69 years and measured their blood pressure. We examined the differences in mean blood pressure between participants who obtained antihypertensive medication from village clinics and those who obtained medication from other sources, using analysis of covariance adjusted for several covariates.Results: The prevalence of hypertension among participants was as high as 63.3%, but the hypertension control rate was only 8.4%. Most villagers (98.1%) were not registered in the chronic disease treatment scheme of the public rural health insurance. The mean systolic blood pressure, adjusted for the covariates, of participants who obtained antihypertensive medication from village clinics was significantly lower than that of participants who obtained medication from township hospitals (by 16.5 mmHg) or from private pharmacies (by 7.3 mmHg).Conclusion: The prevalence of hypertension was high and the hypertension control rate low among elderly villagers during the cold season. As treatment at village clinics, which villagers can access during the cold season seems to be more effective than self-medication or treatment at distant hospitals, improving the quality of treatment in village clinics is urgently needed.

Research and development of high-dose inactivated quadrivalent influenza serial vaccines (split virion) proposed to be used for elderly adults / 中华实验和临床病毒学杂志

Objective@#To evaluate the immunogenicity of high-dose inactivated quadrivalent influenza serial vaccines (split virion) for elderly people.@*Methods@#Immunogenicity assays on mouse as research animal model with inactivated quadrivalent influenza serial vaccines (split virion) were carried out. Then rates of seroconversion and geometric mean hemagglutination inhibition titers (GMTs) at day 21 after the last vaccination among those who received high-dose (HD) A+ B influenza vaccine, were compared with those who received other vaccines by hemagglutination inhibition (HAI) test.@*Results@#The result of HAI test showed in HD serial vaccine groups, GMTs for all kinds of HA in the two HD serial vaccine groups were significantly different from that of the two SD serial vaccine groups, respectively (P<0.0001), but not the titers for A3 in one B dose first group. Further- more, GMTs for strain A in one B dose first groups were significantly higher than that of one B dose first groups in both HD and SD groups, and vice versa in the GMTs for strain B. The result of the assay of the impact of different immunization intervals of HD serial influenza vaccine on immunogenicity indicated that the immunity responses in 7 or 10 d groups were higher than that in 3 d group.@*Conclusions@#It is a new method to prevent the flu for elderly by HD A+ B serial influenza vaccine, whose HA dose per immunization was reduced into two injections, worked best when the immunization interval was 7-10 d. The protective immunity can be improved by selecting immune procedure of the serial vaccine according to the epidemic type surveillance of influenza virus A and B strains.

Tradução e adaptação transcultural do Hospitalized Elderly Needs Awareness Scale (Henas) para a língua portuguesa (Brasil e Portugal) / Traducción y adaptación transcultural del Hospitalized Elderly Needs Awareness Scale (Henas) para la lengua portuguesa (Brasil y Portugal) / Translation and Transcultural Adaptation of the Hospitalized Elderly Needs Awareness Scale (Henas) for the Portuguese Language (Brazil and Portugal)

RESUMO Objetivos: traduzir e adaptar o Hospitalized Elderly Needs Awareness Scale (Henas) para o português do Brasil e o de Portugal. Metodologia: seguiram-se os procedimentos metodológicos de adaptação cultural e linguística: tradução inicial, síntese das traduções, retroversão, avaliação por comitê de peritos da equivalência semântica, idiomática, cultural e conceitual. A versão adaptada foi testada (pré-teste) com aplicação da escala a 249 enfermeiros portugueses e brasileiros em 2014. Resultados: não se encontraram palavras ou expressões consideradas divergentes, com exceção da palavra awareness no título do instrumento e da expressão medical acuity do item K. De acordo com o estágio IV do processo de tradução e adaptação cultural, o comitê de peritos propôs alterar a expressão 75 anos ou mais por 65 anos ou mais, na introdução do instrumento. Na versão portuguesa do Brasil, apenas se substituiu a palavra sanita por vaso sanitário. Com relação à versão adaptada, os participantes não colocaram questões nem referiram dificuldades no preenchimento do instrumento. Conclusões: o processo de tradução e adaptação cultural do Henas para a língua portuguesa seguiu as etapas recomendadas internacionalmente, e do qual se obteve equivalência semântica, idiomática, cultural e conceitual. São necessárias novas pesquisas para avaliar outras propriedades do instrumento e seu comportamento em amostras diferentes.

RESUMEN Objetivos: traducir y adaptar el Hospitalized Elderly Needs Awareness Scale (Henas) para el portugués de Brasil y de Portugal. Metodología: se siguieron los procedimientos metodológicos de adaptación cultural y lingüística: traducción inicial, síntesis de las traducciones, retroversión, evaluación por comité de expertos de la equivalencia semántica, idiomática, cultural y conceptual. La versión adaptada fue probada (pre-test) con aplicación de la escala a 249 enfermeros brasileños y portugueses en 2014. Resultados: no se encontraron palabras o expresiones consideradas divergentes, a excepción de la palabra awareness en el título del instrumento y de la expresión medical acuity del ítem K. De acuerdo con la fase IV del proceso de traducción y adaptación cultural, el comité de expertos planteó alterar la expresión 75 años o más por 65 años o más en la introducción del instrumento. En la versión portuguesa de Brasil, solo se reemplazó la palabra sanita por vaso sanitário. En cuanto a la versión adaptada, los participantes no presentaron dudas ni refirieron dificultades en completar el instrumento. Conclusiones: el proceso de traducción y adaptación cultural del Henas para la lengua portuguesa siguió las etapas recomendadas internacionalmente y del cual se obtuvo equivalencia semántica, idiomática, cultural y conceptual. Son necesarias nuevas investigaciones para evaluar otras propiedades del instrumento y su comportamiento en muestras distintas.

ABSTRACT Objectives: Translate and adapt the Hospitalized Elderly Needs Awareness Scale (Henas) into Portuguese for Brazil and Portugal. Methodology: The methodological procedures for cultural and linguistic adaptation were followed; namely, initial translation, synthesis of translations, retroversion, and an evaluation of semantic, linguistic, cultural and conceptual equivalence carried out by a committee of experts. The adapted version was tested (pre-test) by applying the scale to 249 Brazilian and Portuguese nurses during 2014. Results: No words or expressions considered divergent were found, with the exception of the word awareness in the title of the instrument and the expression medical acuity in Item K. In keeping with phase IV of the cultural translation and adaptation process, the expert committee proposed changing the expression 75 years or more to 65 years or more in the introduction to the instrument. In the Portuguese version for Brazil, the word sanita was replaced by the expression vaso sanitário. As for the adapted version, the participants did not express doubts or refer to difficulties in completing the instrument. Conclusions: The process of translation and cultural adaptation of Henas for the Portuguese language followed the stages recommended internationally and from which semantic, idiomatic, cultural and conceptual equivalence was obtained. Further research is needed to evaluate other properties of the instrument and its behavior with different samples.

Study on the association between social isolation and cognitive function among elderly in Daqing city, Heilongjiang province / 中华流行病学杂志

Objective To examine the association between social isolation and cognitive function among the elderly living in the communities of Daqing city.Methods A total of 981 community residents aged 60 years or over,were surveyed with a questionnaire.Both Lubben Social Network Scale-6 (LSNS-6) and Montreal Congnitive Assessment (MoCA) Changsha Versions were used to respectively screen the status of social isolation and cognitive function,on these elderly.Results The average age was 71 years old for the 981 study participants.10.60％ (104/981) of the participants were assessed as having the status of social isolation,9.48％ (93/981) as having marginal family ties and 13.97％ (137/981) as having marginal friendship ties.Results from the multivariate linear regression analysis revealed that participants with higher scores of LSNS-6 presenting better cognitive function score,with a partial regression coefficient as 0.10 (P＜0.01).The MoCA scores in participants with social isolation (20.38 ± 5.54) were significantly lower than the ones without social isolation (22.10 ± 5.01) and the difference was statistically significant (P＜0.01).Social isolation was significantly related to the domain scores on visuo-spatial constructional executive functions (P=0.02),naming (P=0.03),language (P=0.01) and delayed memory functions (P＜0.01),but not with other domains as concentration (P=0.33),orientation (P=0.27) or abstraction (P=0.49).Conclusion The findings suggested that social isolation was mainly caused by the lack of friendship ties and associated with cognitive function and among the elderly in Daqing city,Heilongjiang province.

Study on the association between social isolation and cognitive function among elderly in Daqing city, Heilongjiang province / 中华流行病学杂志

Objective To examine the association between social isolation and cognitive function among the elderly living in the communities of Daqing city.Methods A total of 981 community residents aged 60 years or over,were surveyed with a questionnaire.Both Lubben Social Network Scale-6 (LSNS-6) and Montreal Congnitive Assessment (MoCA) Changsha Versions were used to respectively screen the status of social isolation and cognitive function,on these elderly.Results The average age was 71 years old for the 981 study participants.10.60％ (104/981) of the participants were assessed as having the status of social isolation,9.48％ (93/981) as having marginal family ties and 13.97％ (137/981) as having marginal friendship ties.Results from the multivariate linear regression analysis revealed that participants with higher scores of LSNS-6 presenting better cognitive function score,with a partial regression coefficient as 0.10 (P＜0.01).The MoCA scores in participants with social isolation (20.38 ± 5.54) were significantly lower than the ones without social isolation (22.10 ± 5.01) and the difference was statistically significant (P＜0.01).Social isolation was significantly related to the domain scores on visuo-spatial constructional executive functions (P=0.02),naming (P=0.03),language (P=0.01) and delayed memory functions (P＜0.01),but not with other domains as concentration (P=0.33),orientation (P=0.27) or abstraction (P=0.49).Conclusion The findings suggested that social isolation was mainly caused by the lack of friendship ties and associated with cognitive function and among the elderly in Daqing city,Heilongjiang province.

Bienestar psicológico en función de la etapa de vida, el sexo y su interacción / Psychological Well-being in Terms of Life Stage, Sex, and their Interaction / Bem-estar psicológico em função da etapa de vida, sexo e sua interação

Objetivo. Evaluar las diferencias en las dimensiones del bienestar psicológico en función de los grupos de edad, sexo y su interacción. Método. Se obtuvo una muestra de 706 participantes, dividida en tres grupos de edad (jóvenes, adultos y adultos mayores), quienes respondieron a las escalas de bienestar psicológico de Ryff. Se calculó un Manova teniendo en cuenta las variables grupo de edad, sexo y su interacción. Posteriormente, se realizaron varios Anova para conocer entre cuáles grupos existían diferencias para cada dimensión. Resultados. El análisis mostró una disminución, con la edad, en las dimensiones de bienestar psicológico de relaciones positivas con otros y crecimiento personal, dominio del entorno y pérdida de autonomía en adultos mayores. Por otro lado, la dimensión de autoaceptación difiere entre sexos con la edad; las mujeres mostraron un descenso en su crecimiento personal con la edad, mientras que el dominio del entorno aumenta con la edad adulta, con mayor estabilidad en mujeres. Conclusión. Por lo anterior, se sugiere promover el trabajo de los pensamientos negativos y desadaptativos en mujeres, ya que los hombres obtienen mejores puntuaciones en dimensiones que disminuyen la aparición de patologías relacionadas con el estado de ánimo. Además, deben fomentarse las relaciones sociales y las propias capacidades de los sujetos.

Objective. To evaluate the differences in the dimensions of psychological well-being in reference to age, gender and their interaction. Method. A sample with 706 participants was obtained and then divided in three age groups (young, middle-aged adults and elderly adults), who responded to the Ryff Psychological Well-being Scale A MANOVA was calculated taking into account the group variables of age, gender and their interaction. Later, an ANOVA was done to know among which groups there were differences for each dimension. Results. The analysis showed a decrease, with age, in the dimensions of psychological well-being of positive relationships with others, and personal growth, domain of the environment and loss of autonomy in the elderly adults. In addition, the dimension of self-acceptance differs between the genders with age; women showed a decrease in their personal growth with age, while the domain of the environment increases with the adult age being more stable among women. Conclusion. Based on the above, it is suggested that a work in negative and maladaptive thoughts in women, since men get a better score in dimensions that diminish the appearance of pathologies related to the mood. A work in the social relationships as well as the individuals' aptitudes should be encouraged.

Escopo. Avaliar as diferenças nas dimensões do bem-estar psicológico em função dos grupos de idade, sexo e sua interação. Metodologia. Foi obtida uma amostra de 706 participantes, dividida em três grupos de idade (jovens, adultos e idosos), os quais responderam às Escalas de Bem-estar Psicológico de Ryff. Foi calculado um MANOVA levando em conta as variáveis grupo de idade, sexo e sua interação. Depois, foram feitas ANOVAs para conhecer entre quais grupos existem diferenças para cada dimensão. Resultados. A análise mostrou uma diminuição, com a idade, nas dimensões de bem-estar psicológico de relações positivas com outros e crescimento pessoal, domínio do entorno e perdida de autonomia em idosos. Por sua parte, a dimensão de auto-aceitação difere entre sexos com a idade; as mulheres mostraram um descenso em seu crescimento pessoal com a idade, em quanto que o domínio do entorno aumenta com a idade adulta com maior estabilidade em mulheres. Conclusão. Pelo anterior, sugere-se promover o trabalho dos pensamentos negativos e desadaptativos em mulheres, já que os homens obtêm melhores pontuações em dimensões que diminuem a aparição de patologias relacionadas com o estado de ânimo. Também é recomendável fomentar o trabalho em relações sociais assim como nas próprias habilidades dos sujeitos.

Perfil da comunicação em adultos e idosos hospitalizados / Profile of communication in hospitalized adults and elderly / Perfil de comunicación en adultos y adultos mayores hospitalizado

Introdução:Alterações de linguagem são frequentemente ocasionadas por doenças crônicas, interferindo diretamente na comunicação do indivíduo. Objetivo: caracterizar a comunicação de pacientes adultos e idosos hospitalizados e correlacionar os resultados dos subtestes da prova de Boston utilizados. Método: Participaram do estudo 30 indivíduos, adultos e idosos, de ambos os sexos, internados na enfermaria de Clínica Médica de um Hospital Regional de nível secundário. Foram excluídos da pesquisa os pacientes com nível de consciência rebaixado, doenças psíquicas, em uso de calmantes e com doenças infectocontagiosas. A pesquisa incluiu a aplicação de uma anamnese inicial, consulta ao prontuário médico e aplicação das provas de compreensão e emissão oral do teste de Boston. Os resultados foram expressos de forma absoluta e relativa e para análise estatística foram utilizados os testes de igualdade de proporções e a correlação de Pearson. Resultados: Participaram 13 adultos (43,3%) e 17 idosos (56,7%) com mediana de anos estudados de 1,5. Os piores desempenhos foram nas provas de discriminação auditiva, material ideacional complexo, identificação de partes do corpo, denominação e denominação por confrontação visual. Não houve diferença significante entre os achados utilizando valores normativos para idade ou escolaridade. Observou-se correlação entre os resultados de discriminação auditiva e identificação de partes do corpo; discriminação auditiva e material ideacional complexo; ordens e identificação de partes do corpo; agilidade oral e verbal; repetição de palavras e frases e discriminação auditiva e denominação por confrontação visual. Conclusão: As provas nas quais os pacientes hospitalizados do estudo apresentaram mais dificuldade envolviam compreensão auditiva e acesso semântico.

Introduction: Language changes are often caused by chronic diseases interfering directly in the individual communication. Objective: to characterize communication by age and education of hospitalized adult and elderly patients and relate the results of the Boston subtests used. Methods: The study included 30 individuals, adults and elderly of both sexes, hospitalized in the Medical Clinic of a second-level Regional Hospital. The study excluded patients with lowered level of consciousness, mental illness, using tranquilizers and infectious diseases. The research included the application of an initial anamnesis, analysis of medical records and application of the oral comprehension and emission of the Boston test. The results were expressed in absolute and relative terms and for statistical analysis were used the equal proportion and correlation Pearson's test. Results: The participants included 13 adults (43.3%) and 17 elderly (56.7%) with a median of 1.5 years of study. The worst performances were in the tests of auditory discrimination, complex ideational material, body-part identification, denomination and denomination by visual confrontation. There was no significant difference between results using normative values for age or education. There was a correlation between the results of auditory discrimination and body-parts identification; auditory discrimination and complex ideational materials; commands and body-part identification; nonverbal and verbal agility; repetition of words and phrases and auditory discrimination and denomination by visual confrontation. Conclusion: The tests in which the hospitalized patients of the study presented more difficulty involved oral discrimination and semantic access.

Introducción: Trastornos del lenguaje son frecuentemente causados por enfermedades crónicas que interfieren directamente con la comunicación del individuo. Objetivo: Caracterizar la comunicación de pacientes adultos e adultos mayores hospitalizados y correlacionar los resultados de la sub-prueba de Boston utilizados. Métodos: Participaron 30 personas adultas e adultas mayores, de ambos los sexos ingresados en la enfermería médica de un Hospital Regional. Fueron excluidos de la investigación los pacientes con un nivel reducido de conciencia, enfermedades psíquicas, en uso de tranquilizantes y con enfermedades infectocontagiosas. Se hizo una anamnesis inicial, análisis de las historias clínicas y aplicación de las pruebas de comprensión y emisión oral de la prueba de Boston. Los resultados se expresaron de forma absoluta y relativa y para el análisis estadístico se utilizaron las pruebas de igualdad y de proporciones y la correlación de Pearson. Resultados: Participaron 13 adultos (43,3%) y 17 adultos mayores (56,7%) con una mediana de años estudiados de 1,5. Los peores resultados fueron en las pruebas de discriminación auditiva, material con ideas complejas, identificación de partes del cuerpo, denominación y denominación por confrontación visual. No hubo diferencias significativas en los hallazgos que utilizaron valores normativos para la edad o la educación. Se observó una correlación entre los resultados de discriminación auditiva y identificación de partes del cuerpo; discriminación auditiva y material con ideas complejas; órdenes y identificación de partes del cuerpo; agilidad oral y verbal; repetición de palabras y frases y discriminación auditiva y denominación por confrontación visual. Conclusión: La pruebas en las que los pacientes hospitalizados del estudio presentaron más dificultad involucraron comprensión auditiva y acceso semántico.

Prescription Patterns and Factors Related to the Number of Medications in Chronic Obstructive Pulmonary Disease in Non-elderly Adults

BACKGROUND: This study is to investigate the prescription patterns and factors related to the number of medications treating chronic obstructive pulmonary disease (COPD) in patients under 65 years old according to GOLD guidelines. METHODS: We retrospectively analyzed the medical records of patients aged 40-64 years with a diagnosis of COPD from January to March 2016. Patients were classified by combined assessment of COPD (grades A, B, C, D) using spirometry, exacerbation history, mMRC, and/or CAT results. We analyzed prescribed medications, treatment options and factors related to the numbers of COPD medications. RESULTS: The total number of prescriptions were 251. About 35.5% of patients were classified as GOLD A, 34.2% as GOLD B, 17.1% as GOLD C and 13.2% as GOLD D. Inhaled bronchodilator was prescribed for 86.9% of patients and the most frequent COPD medication was long-acting muscarinic antagonist (LAMA) followed by inhaled corticosteroids/long acting beta agonist (ICS/LABA). The majority of low risk patients (GOLD A/B) were prescribed a monotherapy with LAMA or LABA. For high risk patients (GOLD C/D), combination treatment with ICS+LAMA+LABA was mostly prescribed. The 21.2% of patients in GOLD D received systemic corticosteroid. The average number of medications per prescription was 3.7, and this number increased with increasing COPD grade, COPD duration and lung function reduction (FEV₁, FEV₁/FVC). CONCLUSION: Generally high adherence to GOLD guideline recommendations was reported. Given the progressive nature of the disease, results suggest that closer attention to respiratory symptoms for early detection, diagnosis, and appropriate treatment of COPD is warranted.

Effects of a physical fitness program on memory and blood viscosity in sedentary elderly men

The aim of this study was to investigate the effects of a 6-month exercise program on cognitive function and blood viscosity in sedentary elderly men. Forty-six healthy inactive men, aged 60–75 years were randomly distributed into a control group (n=23) and an experimental group (n=23). Participants underwent blood analysis and physical and memory evaluation, before and after the 6-month program of physical exercise. The control group was instructed not to alter its everyday activities; the experimental group took part in the fitness program. The program was conducted using a cycle ergometer, 3 times per week on alternate days, with intensity and volume individualized at ventilatory threshold 1. Sessions were continuous and maximum duration was 60 min each. There was significant improvement in memory (21%; P<0.05), decreased blood viscosity (−19%; P<0.05), and higher aerobic capacity (48%; P<0.05) among participants in the experimental group compared with the control group. These data suggest that taking part in an aerobic physical fitness program at an intensity corresponding to ventilatory threshold-1 may be considered a nonmedication alternative to improve physical and cognitive function.

Relação familiar da pessoa idosa com comprometimento da capacidade funcional / Relación familiar del adulto mayor con comprometimiento de la capacidad funcional / Family Relationships of Elderly Adults with Compromised Functional Capacity

Objetivo: compreender a relação familiar da pessoa idosa com comprometimento da capacidade funcional. Materiais e métodos: estudo exploratório e descritivo de abordagem qualitativa, fundamentado no método da história oral, realizado com 15 pessoas idosas assistidas por uma unidade de saúde da família, residentes com familiares e que apresentavam comprometimento da capacidade funcional. Os dados foram coletados no período de março a abril de 2012, por meio de entrevistas em profundidade. As categorias temáticas foram: bom relacionamento familiar, mudanças na relação familiar, sentindo-se um incômodo para a família, sentindo-se abandonado pela família. Resultado: o estudo revelou que as pessoas idosas com comprometimento da capacidade funcional vivenciam sentimentos variados, que vão desde a alegria, por serem respeitadas e terem suas necessidades atendidas, à tristeza e revolta, pela adaptação negativa da família e o abandono dos filhos. Conclusão: a relação familiar da pessoa idosa passa por reajustes após o comprometimento da capacidade funcional, o que repercute significativamente na dinâmica das relações. A partir dessa compreensão, os profissionais de saúde, sobretudo de enfermagem, devem reconhecer os desafios enfrentados pela família, orientá-la e capacitá-la para o atendimento às demandas de cuidado apresentadas pela pessoa idosa com comprometimento da capacidade funcional, e favorecer a realização do cuidado sem que haja desgaste das relações.

Objetivo: comprender la relación familiar de la persona adulta con comprometimiento de la capacidad funcional. Materiales y métodos: estudio exploratorio y descriptivo de abordaje cualitativo, fundamentado en el método de la historia oral, realizado con 15 adultos mayores asistidos por una unidad de salud de la familia, residentes con familiares y que presentaban comprometimiento de la capacidad funcional. Se recolectaron los datos en el período de marzo y abril del 2012, por medio de entrevistas en profundidad. Las categorías temáticas fueron: buena relación familiar, cambios en la relación familiar, sintiéndose un estorbo para la familia, sintiéndose abandonado por la familia. Resultado: el estudio ha revelado que las personas mayores con comprometimiento de la capacidad funcional vivencian sentimientos diversos que van desde la alegría porque son respetadas y tienen sus necesidades atendidas, hasta la tristeza y revuelta, por la adaptación negativa de la familia y el abandono de los hijos. Conclusión: la relación familiar de la persona mayor pasa por reajustes luego del comprometimiento de la capacidad funcional, lo que repercute significativamente en la dinámica de las relaciones. Desde esta comprensión, los profesionales de salud, sobre todo de enfermería, deben reconocer los retos a los que la familia afronta, orientarla y capacitarla para la atención a las demandas de cuidado presentadas por la persona mayor con comprometimiento de la capacidad funcional, y favorecer la realización del cuidado sin que esto desgaste las relaciones.

Objective: This research was intended to understand the family relationships of adults with compromised functional capacity. Materials and Methods: It is an exploratory, descriptive study with a qualitative approach, based on the oral history method. The sample included 15 elderly adults who were being assisted by a family health unit, were living with family members, and had compromised functional capacity. The data were collected between March and April 2012, through in-depth interviews. The subject categories were: good family relationships, changes in family relationships, feeling of being a nuisance to the family, and feeling abandoned or neglected by the family. Result: The study found that elderly adults with compromised functional capacity experience a variety of feelings that range from joy, because they are respected and their needs are met, to sadness and shock over their family's negative adjustment to the situation and by being abandoned or neglected by their children. Conclusion: The dynamics of the family relationships of elderly adults change significantly when the person's functional capacity is compromised. With this in mind, health professionals, especially nurses, must recognize the challenges the family faces and be prepared to guide and train family members to satisfy the demands of caring for an elderly relative with compromised functional capacity and to favor rendering the care that is needed without jeopardizing family relationships.

El anciano con hipertensión arterial / Hypertension in the Elderly

La enfermedad cardiovascular es la principal causa de muerte en los países industrializados, siendo la hipertensión arterial (HTA) uno de sus factores de riesgo más importante. La prevalencia de la HTA aumenta en la población a partir de los 50 años de edad...

Cardiovascular Disease is the single largest cause of death in developed countries of the world. Hypertension can be quite common among the elderly; people in the 50-60 age...

Effect of progressive resistance exercise on strength evolution of elderly patients living with HIV compared to healthy controls

OBJECTIVES: Human Immunodeficiency Virus (HIV) infection worsens the frailty of elderly people, compromising their quality of life. In this study we prospectively evaluated eleven patients living with HIV and 21 controls older than 60 years and without prior regular physical activity, who engaged in a one-year progressive resistance exercise program to compare its effects on muscular strength, physical fitness and body composition. METHODS: Exercises for major muscular groups were performed 2 times/week, under professional supervision. Strength increase was evaluated bimonthly, while body composition, lipid and glycaemic profiles (only of those living with HIV) and physical fitness were evaluated before and after the one-year training. RESULTS: The participants living with HIV were lighter, had smaller Body Mass Index and were initially much weaker than controls. However, their strength increased more (1.52-2.33 times the baseline values for those living with HIV x 1.21-1.48 times for controls, p<0.01), nullifying the differences initially seen. These effects were seen independently of gender, age or baseline physical activity. In addition, those living with HIV improved their fasting glucose levels and showed a tendency to improve their lipids after the one year training program. These effects were slightly more pronounced among those not using protease inhibitors, although not significantly. CONCLUSIONS: Resistance exercise safely increased the strength of older patients living with HIV adults, allowing them to achieve performance levels observed among otherwise healthy controls. These findings favor the recommendation of resistance exercise for elderly adults living with HIV adults.

Self-rated health: importance of use in elderly adults / Auto-percepción de salud: importancia de su uso en adultos mayores

Introduction: The concept of self-rated health (SRH) was conceived during the first half of the twentieth century. Since then, numerous studies have documented the validity of its measurement and it has been widely accepted as a reliable measurement of overall health. SRH is considered a subjective measurement integrating the biological, mental, social, and functional aspects of an individual. Objective: To review the literature to determine theoretical determinants, related outcomes, and utility of SRH in elderly adults (EAs). Methods: The databases reviewed were Medline, SciELO, EMBASE, Science Direct, Proquest, and Ovid, along with information available in websites from international health agencies. Results: SRH is considered a sensitive measurement of overall health in EAs. It is influenced by physical function, the presence of disease, the existence of disabilities, functional limitations, and by the rate of aging. Many studies suggest it may be modified by demographics, as well as by social and mental factors. Thus, the perception of health is the result of multiple and complex interactions of variables determining it at any given time. SRH is based on systems theory and the bio-psychosocial health model. It has proven to be a significant independent predictor for development of morbidity, mortality, and disability in basic physical and instrumental daily life activities among elderly adults. Conclusion: In addition to reflecting the overall health status of EAs, SRH can provide information to aid health personnel and decision makers in the development and implementation of health promotion and disease prevention programs, as well as the adequacy and planning of different levels of care for this population.

Introducción: El concepto de auto-percepción de salud (APES) fue introducido a mitad del siglo XX. Desde entonces, numerosos estudios han documentado la validez de su medición y ha sido ampliamente aceptado como una medida confiable del estado de salud general. La APES se considera una medición subjetiva que integra factores biológicos, mentales, sociales y funcionales del individuo. Objetivo: Realizar una revisión de la literatura para determinar fundamentos teóricos, factores determinantes, desenlaces relacionados y utilidad de la APES en adultos mayores (AM). Metodología: Se utilizaron las bases de datos Medline, SciELO, EMBASE, Science Direct, Proquest, Ovid, así como la información disponible en sitios web de organismos sanitarios internacionales. Resultados: La APES se considera una medida sensible del estado general de salud en los AM. Está influida por la función física, la presencia de enfermedades, la existencia de discapacidades, de limitaciones funcionales y por el tipo de envejecimiento. Muchas investigaciones sugieren que la pueden modificar variables demográficas, sociales y mentales. De esta manera, la APES es la resultante de múltiples y complejas interacciones de variables que la determinan en un momento dado. La APES se fundamenta en la teoría de sistemas y en el modelo bio-psicosocial de salud. Se ha demostrado que se comporta como un predictor independiente y significativo para desarrollar morbilidad, mortalidad y discapacidad, tanto en las actividades básicas cotidianas como en los aspectos físico e instrumental en adultos mayores. Conclusión: La APES además de reflejar el estado de salud global del AM, puede brindar información que ayude al personal de salud y a tomadores de decisiones en el desarrollo e implementación de programas de promoción de la salud y prevención de la enfermedad, así como en la adecuación y planificación de diferentes niveles asistenciales para este grupo poblacional.

Propiedades psicométricas de la escala de ansiedad ante la muerte de Templer en sujetos mexicanos: mexican psychometric properties / Templers death anxiety scale

La presente investigación adaptó la Escala de Ansiedad ante la Muerte de Templer (1970) al español mexicano y obtuvo sus propiedades psicométricas para dos muestras de adultos mexicanos radicados en la ciudad de México. Se entrevistaron 314 sujetos: 165 fueron adultos mayores (97 mujeres y 68 hombres con una edad media de 61.7 y 62.7 respectivamente) y 149 estudiantes universitarios (132 mujeres y 17 hombres con una edad media de 19.4 y 19.9 años). La escala de respuesta se cambió por una escala Likert de cuatro puntos. La estructura del instrumento fue evaluada mediante análisis factorial de componentes principales con rotación varimax en ambas muestras, logrando tres factores para cada grupo. La estructura factorial obtenida de las respuestas de los estudiantes universitarios sólo concordó ligeramente con lo reportado por Tomás-Sábado & Gómez-Benito (2002) en una muestra española equivalente. La consistencia interna del instrumento, medida con el alfa de Cronbach, en cada muestra indica para adultos mayores (.86) y para estudiantes (.83). Se obtuvieron propiedades psicométricas que la hacen recomendable para su uso en adultos mayores mexicanos. Finalmente, los resultados aportan nuevas evidencias sobre los efectos psicométricos derivados del posible impacto cultural de diferentes naciones de habla hispana y, entre generaciones.

This research adapted Templer's Death Anxiety Scale (1970) for Mexican Spanish and obtained psychometric properties for two samples of Mexican adults. A total of 314 subjects were interviewed, 165 of whom were elderly adults (97 women, average age 61.7, SD = 9.7 and 68 men, average age 62.7, SD = 8.3) and 149 undergraduate students (132 women, average age 19.4, SD = 1.3 and 17 men, average age 19.9, SD = 1.3. The scale was changed to a four point Likert scale. The principal component analysis with varimax rotation, applied to the data from both samples (elderly adults and undergraduate students), yielded 3 factors for each group. The factor structure obtained from the responses provided by the undergraduate students only slightly agreed with that reported by Tomás-Sábado and Gómez-Benito (2002) for an equivalent Spanish sample. Internal consistence for elderly adults was a=.86, and a=.83 for undergraduate students. Discriminant validity was documented. The version of Templer's Death Anxiety Scale presented would seem to have adequate psychometric properties for its use with elderly Mexican adults. Finally, the results provide evidence of the possible impact the cultural differences between Spanish-speaking nations and generations have on the psychometric properties of the scale.