Could mid-upper arm circumference be a valid proxy to the body mass index for elderly persons?

Introduction: In elderly persons, due to physiological, anatomical, and functional changes, body mass index (BMI) may not be suitable for the assessment of nutritional status. Mid-upper arm circumference (MUAC) can be a proxy indicator to identify underweight and overweight/obesity among elderly persons. This study aimed to estimate the correlation between MUAC and BMI, and the cutoffs for MUAC using receiver operating characteristic (ROC) analysis. Material and Methods: This survey was carried out in a resettlement colony of Delhi. The participants were residents of the area who were aged 60 years or older, and selected by a simple random sampling technique. The arm span, weight, and MUAC of the participants were measured. The correlation between MUAC and BMI for gender and age group was calculated. The ROC curve was also constructed. Results: A total of 946 eligible participants were enrolled. The correlation between MUAC and BMI was 0.67 (P < 0.001) and 0.76 (P < 0.001) among men and women, respectively. The MUAC cutoff for underweight was <25 cm with a sensitivity of 68.8% and specificity of 84.9%. The area under the curve (AUC) was 0.84 (0.80–0.88). The MUAC cutoff for overweight/obesity was ?27 cm with a sensitivity of 83.9% and specificity of 64.9%, and AUC was 0.78 (0.75–0.82). Conclusion: The MUAC of the participants increased as the BMI of the participants increased. MUAC cutoff was determined using the ROC curve for underweight and overweight/obesity among elderly persons.

Prevalência de queda grave e fatores associados em idosos brasileiros: resultados da Pesquisa Nacional de Saúde, 2013 / The prevalence of severe falls and associated factors among elderly Brazilians: Results of the 2013 National Health Survey

Resumo O objetivo foi estimar a prevalência e os fatores associados à queda grave em idosos brasileiros. Estudo transversal, incluindo 10.537 idosos participantes da Pesquisa Nacional de Saúde (2013). A variável dependente foi relato de queda grave último. As variáveis independentes incluíram, hierarquicamente, fatores sociodemográficos, comportamentais, condição de saúde e capacidade funcional. Foi utilizada regressão logística para obter os odds ratio (OR) e os respectivos intervalos de confiança (95%), utilizando-se o programa Stata 13.1. A prevalência de queda grave foi de 7,5% (IC95%: 6,7-8,3) e as maiores chances foram entre mulheres (OR: 1,35; IC95%: 1,03-1,77), 70 a 79 anos (OR: 1,47; IC95%: 1,12-1,95) e 80 anos e mais (OR: 2,00; IC95%: 1,46-2,74), vivendo sem cônjuge (OR: 1,37; IC95%: 1,08-1,74), sedentários no lazer (OR: 1,55; IC95%: 1,06-2,26), com multimorbidades (OR: 1,54; IC95%: 1,19-2,00), dificuldades no sono (OR: 2,18; IC95%: 1,65-2,88), limitações em atividades básicas de vida diária (OR: 2,25; IC95%: 1,63-3,10) e uso de dispositivo para marcha (OR: 1,89; IC95%: 1,30-2,73). A prevalência de queda grave foi elevada e multifatorial, permitindo a identificação de perfis de maior vulnerabilidade, o que deve ser considerado no direcionamento de políticas públicas para intervenções específicas.

Abstract The scope of this study was to estimate the prevalence and factors associated with severe falls among elderly Brazilians. It included a transversal study of 10,537 elderly individuals who participated in the National Health Survey (2013). The dependent variable was a report of severe falls in the past year. The independent variables comprised, hierarchically, socio-demographic factors, behavior, health status and functional capacity. Logistic regression was used to obtain the odds ratio (OR) and the confidence interval (95%CI), using the 13.1 Stata program. The prevalence of severe falls was 7.5% (95%CI: 6.7-8.3) and the highest odds were among women (OR: 1.35; 95%CI: 1.03-1.77), 70 to 79 years of age (OR: 1.47; 95%CI: 1.12-1.95) and 80 years and above (OR: 2.00; 95%CI: 1.46-2.74), living without a spouse/partner (OR: 1.37; 95%CI: 1.08-1.74), sedentary in leisure time (OR: 1.55; 95%CI: 1.06-2.26), having multimorbities (OR: 1.54; 95%CI: 1.19-2.00), sleeping difficulties (OR: 2.18; 95%CI: 1.65-2.88), limitations in daily activities (OR: 2.25; 95%CI 1.63 -3.10) and use of a walking aid (OR: 1.89; 95%CI: 1.30-2.73). The prevalence of severe falls was high and multifactorial, enabling the identification of profiles of greater vulnerability, which should be considered in public policies for specific interventions.

Transcatheter arterial chemoembolization combined with low-dose apatinib in the treatment of unresectable hepatocellular carcinoma in elderly patients: Efficacy and safety

Context: Owing to the increasing age of the population, the incidence of hepatocellular carcinoma (HCC) in the elderly is increasing annually. Aims: This study aims to investigate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with low-dose apatinib for unresectable HCC treatment in elderly patients (≥65 years). Settings and Design: The clinical data from 61 elderly patients with unresectable HCC who were retrospectively analyzed. Subjects and Methods: Of these 61 patients, 27 received TACE combined with low-dose (250 mg/qd) apatinib (experimental group), and 34 patients received the standard TACE treatment (control group). The short-term efficacy was evaluated according to the mRECIST1.1 standards, and the mid- and long-term efficacy and safety in the two groups of patients were evaluated. Statistical Analysis Used: Statistical analyses were performed using the Statistical Package for the Social Sciences software (version 20.0; SPSS). Results: Both the objective response rate and disease control rate of the experimental group were significantly higher than those of control group (P < 0.05). The 6-month and 12-month survival rates of the experimental group were significantly higher than those of control group too (P < 0.05). The median survival in the experimental group was longer than in the control group (26.0 months vs. 20.0 months). The adverse reactions related to the intake of apatinib were higher in the experimental than the control group, but were generally alleviated after symptomatic treatment. Conclusions: TACE combined with low-dose apatinib provides an alternative treatment option for elderly patients with unresectable HCC. Our clinical study has proven its safety and efficacy.

Perfil de multimorbidade associado à incapacidade entre idosos residentes na Região Metropolitana de Belo Horizonte, Brasil / Multimorbidity profile associated with disability among the elderly living in the Metropolitan Region of Belo Horizonte, Brazil

Resumo O objetivo foi investigar as associações da incapacidade em três níveis (ABVD, AIVD e mobilidade) com doenças cardiovasculares, diabetes e multimorbidade, entre idosos residentes na Região Metropolitana de Belo Horizonte (RMBH). Estudo transversal em amostra representativa de adultos da RMBH, tendo sido selecionados 2.172 idosos (60 anos ou mais). A incapacidade, para cada domínio (ABVD, AIVD e mobilidade), foi avaliada como o relato de muita dificuldade ou necessidade de ajuda para realizar pelo menos uma atividade entre as investigadas, e as doenças autorreferidas incluíram hipertensão arterial, infarto do miocárdio e angina, acidente vascular encefálico (AVE), diabetes, e as combinações dessas doenças. Utilizou-se regressão de Poisson ajustada, estimando-se também a fração atribuível populacional. Houve importante contribuição do AVE para a incapacidade em todos os domínios, com destaque para as ABVD, bem como do infarto/angina na incapacidade em AIVD e mobilidade, sobretudo quando combinadas com diabetes e hipertensão. O perfil de multimorbidade pode ser usado para identificação de grupos vulneráveis, que deveriam ser alvo de ações de prevenção e reabilitação, reduzindo o custo financeiro e social desse evento entre idosos.

Abstract The scope of this paper was to investigate the associations of disability in three domains (BADL, IADL and mobility) with cardiovascular diseases, diabetes and multimorbidity profile, among the elderly living in the Metropolitan Region of Belo Horizonte (MRBH). A cross-sectional study was conducted with a representative sample of 2,172 elderly persons (60 years and over). Disability, for each domain (BADL, IADL and mobility), was assessed as reporting great difficulty or need for help to perform at least one activity among those investigated, and self-reported diseases included arterial hypertension, myocardial infarction or angina, stroke, diabetes, and combinations of these diseases. Adjusted Poisson regression was used, and the attributable population fraction was also estimated. A major contribution of Cerebral Vascular Accidents (strokes) to disability in all domains was observed, especially BADLs, as well as the presence of infarction or angina in disability in IADLs and mobility, especially when combined with diabetes and hypertension. The multimorbidity profile can be used to identify vulnerable groups, which should be the target of prevention and rehabilitation, reducing the financial and social cost of this event among the elderly.

Effects of three-level comprehensive interventionin of family, community and societyon improving the physical and mental health in empty nest disabled elderly / 中国实用护理杂志

Objective To investigate the effects of three-level comprehensive interventionof family, community and society on physical and mental health of empty nest disabled elderly. Methods From February 2017 to July 2017, the empty nest elderly aged more than 75 years old and daily life ability scale score ≥14 from two communities under 10 community health service centers directly subordinate toTangshanWorker's Hospital and Hongci Hospital were randomly selected, thenthey were divided into theintervention group andthe control group with 50 persons each. The control group was given blank control, and the intervention group was given a 6-month intervention based on the theory of healthy ecology. The intervention consisted of threes-level of family, community and society, each aspect included four aspects such as daily life, environmental safety, medical care and spiritual comfort. Six months later, the Health Promotion Lifestyle Scale, the Comprehensive Frailty Assessment Instrument, Loneliness Scale, Perceived Social Support from Family Scale, Social Support Rating Scale, Activityof Daily Living Scalewere used to evaluate. Results Sixmonths later, the scores of health promotion behavior (114.44± 6.14), family support (9.16 ± 0.93) and social support (30.06 ± 1.48) in the intervention group were higher than those in the control group(t=45.363, 21.672, 64.046, P<0.01); the scores of frailty(35.96 ± 3.71), loneliness (34.94 ± 4.13) and ADL (20.88 ± 1.49) in the intervention group were lower than those before intervention (t=28.946,-31.295,-18.886, P<0.01). Conclusions Thecomprehensive intervention in three-level of family, community and society based on the theory of ecology health can improve the support of empty nest disabled elderly, reduce loneliness and weakness, improve the health promotion behavior and daily life ability of empty nest elderly, and promote physical and mental health.

Life quality protection rights for elderly people. communities of posorja and puna / Protección de los derechos de calidad de vida para adultos mayores. comunidades de posorja y puna / Proteção dos direitos à qualidade de vida para idosos. as comunidades de posorja e puna

Abstract Background: The present article aims to measure the extent to which the physical and recreational needs of elderly persons in the communities of Posorja and Puna are being met. Nowadays, it is known that physical activity is beneficial for the elderly, as it helps to diminish illness and all kinds of diseases. Method: The population in this study is comprised on 378 elderly persons between 65 and 90 years of age: 200 belong to the community of Posorja and 178, to the community of Puna in Guayas Province. The tools used for this research include, among others, the ADL Test (Activities of Daily Living), which evaluates the degree of self-care and mobility; the Lawton and Brody Scale, which is an appropriate instrument to evaluate the level of independence and skills; and the MMT (Mini Mental Test), which evaluates cognitive functions such as memory, language, praxis and attention. They all are essential to detecting and diagnosing Alzheimer´s disease. Results: Various statistical techniques were used to obtain the results, such as descriptive analysis, contingency tables and main components. Conclusions: The population between 65 and 90 years of age was analyzed and it accounted for 35.9% of the total population back in 2010, which means there was a variation. Nowadays, it represents 56.6% of the obtained sample. This generational group refers to the elderly, who should be favored by public policies that are intended to improve health programs, generate recreational areas, and create senior care centers. Generally, the demographic dynamics of Posorja show a structured pyramid, with an expanding population, a large amount of young people and adults who contribute to the economic dynamics and productivity of the area. The questionnaire could be adapted and contain the specifications required to suit the true dimensions of this population.

Resumen Antecedentes: este artículo tiene como propósito medir el grado en que se satisfacen las necesidades físicas y recreativas de los adultos mayores en las comunidades de Posorja y Puna. Hoy en día, se sabe que la actividad física es beneficiosa para los ancianos, ya que ayuda para disminuir dolencias y todo tipo de enfermedades. Método: La población en este estudio está compuesta por 378 personas mayores entre 65 y 90 años de edad: 200 pertenecen a la comunidad de Posorja y 178 a la comunidad de Puna en la provincia de Guayas. Las herramientas utilizadas para esta investigación se incluyen, entre otros, la Prueba ADL (Actividades de la vida diaria), que evalúa el grado de autocuidado y movilidad; la Escala de Lawton y Brody, que es un instrumento apropiado para evaluar el nivel de independencia y habilidades; y la MMT (Mini prueba mental), que evalúa las funciones cognitivas, como la memoria, el lenguaje, la praxis y la atención. Todos son esenciales para detectar y diagnosticar la enfermedad de Alzheimer. Resultados: Se utilizaron diversas técnicas estadísticas para obtener los resultados, como el análisis descriptivo, tablas de contingencia y componentes principales. Conclusiones: Se analizó la población entre 65 y 90 años de edad que representó el 35.9% de la población total en 2010, lo que significa que hubo una variación. Hoy en día, representa el 56.6% de la muestra obtenida. Este grupo generacional se refiere a las personas mayores, que deberían ser favorecidos por las políticas públicas que se pretenden para mejorar los programas de salud, generar áreas recreativas y crear centros de cuidado para adultos mayores. En general, la dinámica demográfica de Posorja muestra una pirámide estructurada, con una población en expansión, una gran cantidad de jóvenes y adultos que contribuyen a la dinámica económica y productividad del área. El cuestionario podría modificarse y contener las especificaciones requeridas para adaptarse a las verdaderas dimensiones de esta población.

Resumo Contexto: O presente artigo visa analisar em que medida as necessidades físicas e recreacionais dos idosos das comunidades de Posorja e Puna, no Equador, estão sendo atendidas. Atualmente, sabe-se que a atividade física é benéfica para os idosos, já que ajuda a diminuir enfermidades e todos os tipos de doenças. Metodologia: Neste estudo, a população é composta por 378 pessoas idosas com idades entre 65 e 90 anos - 200 pertencem à comunidade de Posorja e 178 à comunidade de Puna, na província de Gayas. As ferramentas utilizadas nesta pesquisa incluem, entre outras, o Teste ADL (Activities of Daily Living), que avalia o grau de autocuidado e mobilidade; a Escala de Lawton e Brody, que é um instrumento apropriado para avaliar o nível de independência e as habilidades; e o MEEM (Miniexame do Estado Mental), que avalia funções cognitivas, como a memória, a linguagem, a práxis e a atenção. Todas elas são essenciais para detectar e diagnosticar a Doença de Alzheimer. Resultados: Várias técnicas estatísticas foram usadas para obter os resultados, tais como análise descritiva, tabelas de contingência e principais componentes. Conclusões: A população entre 65 e 90 anos foi analisada e somava 35,9% da população total em 2010, o que significa que houve uma variação. Atualmente, essa população representa 56,6% da amostra obtida. Esse grupo geracional se refere aos idosos, que deveriam ser favorecidos por políticas públicas que visam melhorar programas de saúde, gerar espaços recreacionais e abrir centros especializados no cuidado de idosos. Em geral, as dinâmicas demográficas de Posorja mostram uma pirâmide estruturada com uma população em expansão, uma grande quantidade de jovens e adultos que contribuem para as dinâmicas econômicas e para a produtividade da região. O questionário poderia ser adaptado para conter as especificações requeridas para adequar-se às verdadeiras dimensões dessa população.

Analysis of the functional capacity of elderly residents of communities with a rapid population aging rate / Como está a capacidade funcional de idosos residentes em comunidades com taxa de envelhecimento populacional acelerado?

Abstract Introduction: The elderly population has risen sharply in Brazil, increasing the need for a health policy focused on health promotion and disease prevention. Attention should also be focused on functional capacity because of the personal and family suffering caused by dependency, as well as the increased demand placed on public services. Objective: To check the health and functional capacity of elderly residents in a small town with a high population aging rate. Methods: A cross-sectional, analytical and non-probabilistic study was performed of 528 elderly persons aged ≥60 years, of both genders, who were evaluated in their home environment. The variables of interest were general health and functional capacity, assessed by the adapted Katz and Lawton and Brody scales. Data analysis was carried out using descriptive and analytical statistical tools. To assess the association between variables the chi-squared test was used, accepting the hypothesis of dependency of variables with p=0.05. Results: The mean age was 72.24±9.33 years. Functional capacity assessment identified that most of the elderly persons carried out activities of daily living (ADLs) and instrumental activities of daily living (IADL) independently; with percentages of 90% and 83.7%, respectively. A statistically significant association was observed (p=0.001) between reports of falls and functional capacity levels. Conclusion: The results show that the elderly of this municipality are mostly independent in performing their daily tasks, representing successful aging.

Resumo Introdução: O crescimento da população idosa ocorre de forma acentuada no Brasil, diante disso, faz-se necessária uma política de saúde voltada à promoção da saúde e à prevenção de doenças. Também, a capacidade funcional merece atenção devido ao sofrimento pessoal e familiar, causados pela dependência e pelo aumento da demanda por serviços. Objetivo: Verificar as condições de saúde e a capacidade funcional de idosos residentes em município de pequeno porte e que apresenta elevada taxa de envelhecimento populacional. Métodos: Estudo transversal, analítico e não probabilístico, composto por 528 idosos com idade ≥60 anos, de ambos os sexos, avaliados no espaço domiciliar. As variáveis de interesse foram: condições gerais de saúde e capacidade funcional avaliada a partir das Escalas de Katz e de Lawton e Brody adaptada. A análise dos dados foi realizada a partir de ferramentas da estatística descritiva e analítica. Para verificar associação entre as variáveis foi utilizado o teste Qui-Quadrado, o qual se aceitou a hipótese de dependência das variáveis com p≤0,05. Resultados: Idosos com idade média de 72,24±9,33 anos, na avaliação da capacidade funcional identificou-se que a maioria realizava as atividades de vida diária (AVDs) e as atividades instrumentais de vida diária (AIVDs) de forma independente; 90% e 83,7% respectivamente. Observou-se associação estatisticamente significativa (p=0,001) entre o relato de quedas com os níveis de capacidade funcional. Conclusão: Os resultados mostram que os idosos desse munícipio são, na sua maioria, independentes para a realização de suas tarefas cotidianas representando um envelhecimento bem sucedido.

Quality of life and informal labor among elderly persons in an intermediate Colombian city, 2012-2013 / Calidad de vida y trabajo informal en personas mayores en una ciudad intermedia colombiana, 2012-2013

Abstract Objective: Describe the quality of life of elderly informal workers in an intermediate Colombian city. Method: A descriptive study of 320 randomly selected informal workers aged older than 18 from Manizales was performed. A sub-sample of 153 people aged older than 50, representing 47.8 percent of the study population, was performed. Two instruments were applied: one testing demographic variables and the WHOQOL-BREF quality of life questionnaire. Univariate and bivariate analyzes were performed using frequency distributions and the chi-squared test was used to identify association between variables. Results: 69.9% of the participants were men, the average age was 59.4 (+7.2) years, 62.0% had no or basic education, 52.0% belonged to social class 1 and 2; 6.5% had no affiliation with the health and social security system. The different dimensions of quality of life were perceived favorably, as was health. More than 50.0% were autonomous, had strong social and family networks, had not experienced negative feelings and found meaning to life. Statistical differences (p<0.05) by gender and age were found for environment, sex life, daily living skills, and satisfaction with work capacity. Conclusion: The quality of life of older informal workers is well perceived and is related to a positive assessment of health. From the perspective of human development, work gives meaning to the lives of older people and encourages active, healthy and productive aging.

Resumen Objetivo: Describir la calidad de vida en personas mayores trabajadoras informales en una ciudad intermedia colombiana. Método: Diseño descriptivo en 320 trabajadores informales mayores de 18 años de la ciudad de Manizales, seleccionados aleatoriamente; la sub-muestra comprende 153 personas mayores de 50 años, que representan el 47,8%. Se aplicaron dos instrumentos: uno de variables sociodemográficas y el formulario de calidad de vida WHOQOL-BREF. Se realizaron análisis univariado y bivariado utilizando distribuciones de frecuencias y el estadístico chi-cuadrado para evidenciar asociación entre variables. Resultados: 69,9% fueron hombres, la edad promedio fue 59,4 (+7,2) años; 62,0% no tienen estudios o son primarios, 52,0% pertenecen a estratos 1 y 2; 6,5% no poseen afiliación a la seguridad social en salud. La calidad de vida en sus diferentes dimensiones fue bien percibida, al igual que su salud, en porcentajes superiores al 50,0% son autónomos, tienen una buena red social y familiar, no han experimentado sentimientos negativos y le encuentran sentido a la vida. Se encontraron diferencias estadísticas p<0,05 por sexo y edad con ambiente, vida sexual, habilidad para la vida diaria, y la satisfacción con la capacidad de trabajo. Conclusion: La calidad de vida de las personas mayores trabajadoras informales es bien percibida y ésta se relaciona con la valoración positiva de la salud; el trabajo da sentido a la vida de las personas mayores, estimula el envejecimiento activo, saludable y productivo.

Estudo sobre a incidência, de pessoas idosas com deficiência, com enfoque na cor, raça e sexo, nos dados do censo IBGE/2010 / Study on the incidence of elderly people with disabilities, focusing on color, race and sex, the IBGE / 2010 Census data

O presente artigo consiste em realizar uma análise do perfil sociodemográfico de pessoas idosas com deficiência, a partir da sistematização dos dados disponibilizados pelo Censo 2010, com um recorte específico, quanto à distribuição de atributos como cor, raça e sexo. A abordagem é descritiva.

The present article is to conduct an analysis of the socio-demographic profile of older people with disabilities, from the systematization of data provided by the 2010 Census, with a specific focus on the distribution of attributes such as color, race and sex. The approach is descriptive.

The Relationship between Functional Physical Fitness and Mild Cognitive Impairment in Older Adults / 대한스포츠의학회지

In a cross-sectional design, this study examined the relationship between functional physical fitness and mild cognitive impairment (MCI) in older adults. A total of 306 older adults (91 men and 215 women) aged 65 years or older were recruited from our local community. A senior fitness test (SFT) was used to assess functional domains of physical fitness consisting of upper and lower body strength, endurance, upper and lower body flexibility, and agility/dynamic balance. Korean version of mini-mental state examine for dementia screening and short-form geriatric depression scale were used to assess global cognitive performance and depression, respectively. Age, sex, education, body mass index, percent body fat, blood lipids, glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed. A composite score of physical fitness was calculated as a sum of z scores for each domain of the SFT parameters. Based on the composited score of physical fitness, subjects were classified as low fit (lower 25 percentile), moderate fit (middle 50 percentile), and high fit (high 25 percentile). Linear contrast analysis using one-way analysis of variance showed significant linear trends for age (p<0.001), education (p<0.001), cognitive function (p<0.001), and depression scale (p=0.006) across incremental composite score of physical fitness. Functional physical fitness was positively associated with age, years of education and global cognitive performance and negatively with depression scale. Logistic regression analyses showed that compared to the low fit group, the moderate (p=0.004) and high fit (p=0.010) groups had significantly lower odds ratios for having MCI even after adjusted for age, sex, education, and body fatness parameters. However, the odds ratios of the moderate (p=0.101) and high fit (p=0.191) groups were not significant when additionally controlling for depression scale and HOMA-IR. The current findings suggest that physical fitness promotion along with treatments of depression and HOMA-IR should be key components of interventions to prevent and/or treat MCI with normal aging.

Sonríe con salud / The Healthy smile

Introducción: los programas educativos juegan un papel importante ya que permiten modificar hábitos y conductas perjudiciales para la salud. Las personas de la tercera edad deben adquirir los conocimientos necesarios para realizar el auto cuidado de la salud bucal mejorando así su calidad de vida. Objetivo: evaluar los resultados del programa Sonríe con salud. Métodos: se realizó una investigación descriptiva de corte transversal, con un universo de 74 personas de 60 años y más. Las variables estudiadas fueron: la edad, sexo. Se aplicó una encuesta. Las respuestas se agruparon atendiendo a si poseían o no, conocimientos acerca de la relación entre salud bucal y salud general, las principales enfermedades buco-dentales, realización del autoexamen bucal, efecto del tabaquismo y alcoholismo, ingestión de los alimentos azucarados, calientes, picantes y la importancia de la higiene bucal. La recolección de la información, la realizaron los autores empleando como fuente primaria el cuestionario aplicado en la primera etapa de la investigación. Se utilizaron los valores absolutos y el porcentaje en el análisis de los resultados. Resultados: el grupo de edad de 70 a 79 años fueron los más representados (36,5 por ciento) y el sexo femenino con un 59,5 por ciento. Se elevaron los conocimientos relacionados con el efecto perjudicial del alcoholismo al 91,9 por ciento y el tabaquismo al 95,9 por ciento; acerca de la ingestión de alimentos azucarados se elevan al 97,7 por ciento al igual que los alimentos calientes y picantes en un 90,5 por ciento, relativo al autoexamen bucal se superan los conocimientos de su realización al 78,4 por ciento y referente a la higiene bucal se elevan al 91,9 por ciento. Conclusiones: el programa educativo sonríe con salud resultó eficaz, al elevar el nivel de conocimientos de los ancianos que recibieron las actividades previstas en el programa(AU)

Introduction: educational programs play an important role in the modification of harmful habits and behavior. Elderly persons should acquire the knowledge required for oral self-care, thus improving their quality of life. Objective: evaluate the results of the Healthy smile program. Methods: adescriptive cross-sectional study was conducted with a universe of 74 persons aged 60 and over. The variables considered were age and sex. The data obtained were organized on the basis of the following criteria: knowledge about oral and general health, main oral and dental diseases, performance of the oral self-examination, effects of smoking and alcoholism, intake of sugared, hot and spicy foods, and the importance of oral hygiene. Data collection was performed by the authors based on a questionnaire applied during the first stage of the research and using absolute values and percentages for the analysis of results. Results: the 70-79 age group and female sex are the best represented variables, with 36.5 percent and 59.5 percent, respectively. Knowledge about the harmful effects of the following actions behaved in the manner indicated: alcoholism 91.9 percent, smoking 95.9 percent, intake of sugared foods 97.7 percent and intake of hot and spicy foods 90.5 percent. Knowledge about oral self-examination and oral hygiene was 78.4 and 91.9 percent, respectively. Conclusions: the Healthy smile educational program was effective to broaden the knowledge of elderly persons about the activities included in the program(AU)

Imagem corporal e envelhecimento: vicissitudes de uma tragédia moderna / Body image and aging: vicissitudes of a modern tragedy

O presente artigo visa a articulação da perspectiva que anuncia um horror à imagem de envelhecimento do corpo com os ideais sociais de juventude eterna e os apelos das tecnologias biomédicas por cirurgias plásticas. Sabemos que o envelhecimento do ser humano pode ser diferenciado segundo vários conceitos: cronológico, biológico, social e psicológico. Assim, o envelhecimento do corpo, também é determinado por fatores físicos, psíquicos e sociais. Não negamos a objetividade do envelhecimento corporal, mas não podemos negar as influências psíquicas e sociais na percepção desse corpo que envelhece. Assim, buscamos situar algumas posições sobre “corpo” e trabalhar a tragédia moderna, que acredita na vontade e na liberdade da ação para se contrapor ao envelhecimento do corpo.

This article aims to articulate the perspective which indicates horror as a reaction to the aging body, the social ideal of eternal youth, and the appeal of biomedical techniques for plastic surgery. We know that human aging can be distinguished according to various concepts: chronological, biological, social and psychological. Thus, the aging of the body is also determined by physical, psychic and social factors. We do not deny the objectivity of the aging of the body. We cannot, however, deny the psychic and social influences over the perception of the aging body. In this sense, we aim to establish certain points regarding “the body”, and to discuss the modern tragedy, which believes in will and freedom of action to counterbalance the aging of the body.

Idoso, família e domicílio: uma revisão narrativa sobre a decisão de morar sozinho / Anciano, familia y domicilio: una revisión narrativa sobre la decisión de vivir solo / Elderly persons, family and household: a narrative review of the decision to live alone

Neste artigo procura-se estabelecer bases de argumentação para melhor entender as razões que levam um idoso a morar sozinho e como se processam as transferências (fluxo de recursos, ações e informações que se trocam e circulam) quando vive sozinho. Para tanto, são revisados e discutidos fatores determinantes dos arranjos domiciliares dos idosos, incluindo aspectos demográficos, socioeconômicos e de saúde, com ênfase nos domicílios unipessoais. Destacam-se pontos que permeiam as transferências entre idosos e seus familiares, tais como características das transferências intergeracionais, diferenças entre os diversos apoios recebidos, sexo do idoso. O estudo consistiu de uma revisão narrativa, cujos resultados apontaram que melhores condições socioeconômicas e de saúde, idade mais avançada e ausência de filhos parecem contribuir para que o idoso more sozinho. Contudo, houve divergências nos resultados dos estudos analisados quanto aos fatores associados à formação de domicílios unipessoais de idosos. Embora as transferências possam se dar independentemente do arranjo domiciliar do idoso, as que ocorrem entre os membros de um mesmo domicílio parecem ser mais frequentes e, talvez por isso, mais discutidas. Os idosos que moram sozinhos, apesar de participarem das transferências, estão mais propensos a receber cuidado formal, comparativamente àqueles que residem com outras pessoas.

En este artículo se intentan establecer una bases de argumentación para entender mejor las razones que llevan a un anciano a vivir solo y cómo se procesan las transferencias (flujo de recursos, acciones e información que se intercambia y circula) cuando vive solo. Para ello, se revisan y discuten factores determinantes del manejo de los domicilios de los ancianos, incluyendo aspectos demográficos, socioeconómicos y de salud, con énfasis en los domicilios unipersonales. Se destacan puntos que van más allá de las transferencias entre ancianos y sus familiares, tales como características de las transferencias intergeneracionales, diferencias entre los diversos apoyos recibidos, sexo del anciano. El estudio consistió en una revisión narrativa, cuyos resultados apuntaron que unas mejores condiciones socioeconómicas y de salud, edad más avanzada y ausencia de hijos parecen contribuir a que el anciano viva solo. Sin embargo, hubo divergencias en los resultados de los estudios analizados, en cuanto a los factores asociados a la formación de domicilios unipersonales de enfermos. Pese a que las transferencias puedan producirse independientemente del manejo del domicilio del anciano, las que se producen entre los miembros de un mismo domicilio parecen ser más frecuentes y, tal vez por esto, más discutidas. Los ancianos que viven solos, a pesar de que participan en las transferencias, son más propensos a recibir cuidado formal, en comparación con aquellos que residen con otras personas.

The authors seek to establish bases of argumentation in order to better understand the reasons that lead elderly citizens to live alone and how transfers take place (flow of resources, actions and information that is exchanged and circulated) when such persons do live alone. Determining factors are reviewed and discussed regarding the household arrangements of elderly citizens, including demographic, socioeconomic and health factors, with emphasis on single-person households. Factors that permeate transfers between elderly citizens and their families are underscored, such as the characteristics of intergenerational transfers, differences among the various types of support provided, and the gender of the elderly persons. The study consists of a narrative review and the results indicate that comfortable socioeconomic and health conditions, more advanced age and lack of children seem to contribute to an elderly person's decision to live alone. However, there were differences in the results of the studies analyzed in terms of the factors associated with the formation of single-person households among elderly persons. Although transfers generally take place regardless of the elderly person's household arrangements, those that take place among members of a single household seem to be more frequent and, perhaps for this reason, are discussed at greater length. Even when elderly persons who live alone participate in transfers, they are more likely to receive formal care than those who live with other persons.

Dependencia y maltrato en el anciano con demencia / Dependência e maltrato em idosos com demência / Dependence and abuse affecting elderly persons with dementia

La relevancia del problema de salud pública que representan en el mundo las demencias, su asociación con la dependencia y el riesgo de maltrato en los ancianos con demencia por parte de sus cuidadores primarios o sus familiares, hacen necesario el análisis y la reflexión “de las implicaciones éticas, económicas, jurídicas, políticas y no sólo las consideraciones médicas”, de este problema, que reviste un interés particular dentro del campo de la Bioética. Se realizó una encuesta con el objetivo de determinar la dependencia física y detectar el maltrato, así como la asociación entre maltrato y respeto de sus preferencias en el anciano con demencia. Se evaluaron 61 ancianos con demencia de leve a moderada, de los cuales 73,8% fueron mujeres y 26,2% hombres. El porcentaje de pacientes que sufren maltrato fue de 29,2% en mujeres y 18,8% en hombres. No se encontró asociación estadísticamente significativa entre maltrato y dependencia física. Sin embargo, se encontró un riesgo de maltrato de 47,30% en ancianos con demencia a quienes no se les respetan sus preferencias con respecto a quienes sí se le respetan, medida con significancia estadística (IC 95%, 6,73-495,18).

The dependence and risk of abuse facing elderly people with dementia at the hand of their caregivers or relatives poses a public health problem the world over. Accordingly, analysis and reflection on the problem in light of “ethical, legal, political implications and not only medical considerations” is essential and of particular interest in the fi eld of the bioethics. The authors conducted a survey to determine the extent of physical dependence and to detect abuse, as well as the association between abuse and respect for the preferences of elderly persons with dementia. Sixty-one elderly persons with mild to moderate dementia were evaluated: 73.8% were women and 26.2%, men. Abuse was reportedamong 29.2% of the women and 18.8% of the men. No statistically significant association was found between abuse and physical dependence. However, risk of abuse was found among 47.30% of the elderly with dementia whose preferences were not being respected,compared to those whose preferences were. This is statistically significant (IC 95%, 6.73-495.18).

A importância mundial do problema da demência na saúde pública, sua associação com a dependência e o risco de abuso de idosos com demência por seus cuidadores e familiares obrigam a analisar e reflexionar “não apenas sobre considerações médicas, mas também sobre as repercussões éticas, econômicas, jurídicas e políticas” desta questão de particular interesse no campo da bioética. Foi realizada uma pesquisa para determinar a dependência física e detectar o abuso, bem como a associação entre abuso e respeito as suas preferências em idosos com demência. Foram avaliados 61 pacientes idosos com demência leve a moderada, dos quais 73,8% eram do sexo feminino e 26,2% de sexo masculino. A porcentagem de pacientes que sofrem abuso foi 29,2% nas mulheres e 18,8% nos homens. Não houve associação estatisticamente significativa entre abuso e dependência física. No entanto, encontrou-se risco de maus tratos de 47,30% em pacientes idosos com demência aos que não se respeitam as suas preferências com relação aos que se lhes respeitam, medido com significância estatística (95% CI, 6,73-495, 18).

Effects of Foot Bath on Cerebral Circulation and Mental Function in Elderly Persons / 日本温泉気候物理医学会雑誌

  The purpose of this study was to clarify effects of foot bath at 42°C for 10 min on cerebral circulation and mental function in elderly persons. The subjects of this study were 12 elderly persons (average 83.1 years old). Tissue hemoglobin concentration and blood flow at the cerebral frontal cortex were measured using near-infrared spectroscopy and blood pressure and heart rate using an autonomic spygmomanometer during for each 10 minutes before foot bath, during foot bath, and after foot bath. We measured subject's arithmetic speed and mistaken numbers as mental function. During foot bath the blood flow and after foot bath oxyhemoglobin at frontal cortex were significantly increased. Heart rate was significant increased after foot bath. But deoxyhemoglobin and blood pressure did not changed during foot bath. In addition to arithmetic speed and mistaken numbers were same before and after foot bath. These findings suggest that cerebral circulation is changed by foot bath, but mental functions is not before and after foot bath.

Soporte social informal, salud y funcionalidad en el anciano / Suporte social informal, saúde e funcionalidade no ancião / Informal social support, health and functionality in the elderly person

Existen muchas maneras de considerar el soporte social. Se ha definido en términos de actividades, y de comportamientos, de relaciones o de interacciones y también en términos de la calidad de las relaciones sociales. A pesar de la diversidad de puntos de vista, parece existir un consenso según el cual el soporte social es un constructo complejo y multidimensional que da cuenta de la calidad de las relaciones sociales y se presenta en dos formas: el formal y el informal. El apoyo o soporte formal corresponde a entidades privadas o gubernamentales, instituidas dentro de las estructuras sociopolíticas del Estado. La familia, los amigos y vecinos, componen el sistema de soporte social informal, ellos constituyen las principales fuentes de apoyo de los ancianos. A pesar del creciente interés de los investigadores de establecer lazos entre las relaciones sociales en general, y el soporte social informal en particular, con la salud y la funcionalidad, las investigaciones en torno a la manera como estos procesos se afectan mutuamente presentan aún algunas inconsistencias y confusiones, causadas probablemente por la complejidad de los fenómenos y por la diversidad de enfoques y conceptos utilizados. En consecuencia, aunque en el campo de la gerontología existe suficiente evidencia de las relaciones entre los tres procesos (soporte social informal, funcionalidad y salud), se presentan algunas situaciones problemáticas que limitan la investigación, contribuyen a producir resultados contradictorios y dificultan la aplicación y transferencia de resultados.

There are many approaches to define social support. It has been defined in terms of activities, behaviors, relations or interactions, as well as in social relation quality. In spite of the diversity of definitions, there is a consensus on social support as a complex and multidimensional concept related to the quality of social relations, conducted in formal and informal manners. Formal social support corresponds to private or governmental organizations, instituted by the social-political structures of the state. Informal social support is provided by family, friends, relatives and neighbors, making up the main source of support of elderly people. In spite of the growing interest of investigators to establish links between social relations in general and informal social support, with health and functionality, the researches on the way these processes have affected each other, present some inconsistencies and confusions, probably caused by the complex phenomena, the diversity of approaches and concepts used. Even though within gerontology there is sufficient evidence of relation between these three processes (informal social support, health conditions and functionality), some problems that limited the research are presented, which contribute to produce contradictory results, as well as making the application and transference of results difficult.

Existem muitas maneiras de considerar o soporte social. Tem definido em términos de atividades, e de comportamentos, de relações o de interações e também em términos de a qualidade das relações sociais. Apesar da diversidade de pontos de vista, parece existir um consenso conforme o qual o suporte social é um consenso complexo e multidimensional que da conta da qualidade das relações sociais e apresenta-se em duas formas: o formal e o informal. O apoio ou suporte formal corresponde a entidades privadas ou governamentais, instituídas dentro das estruturas sociopolíticas do Estado. A família, os amigos e vizinhos, compõem o sistema de suporte social informal, eles constituem as principais fontes de apoio dos anciãos. Apesar do crescente interesse dos investigadores de estabelecer laços entre as relações sociais em geral, e o suporte social informal em particular, com a saúde e a funcionalidade, as investigações em torno à maneira como estes processos se afetam mutuamente apresentam ainda algumas inconsistências e confusões, causadas provavelmente pela complexidade dos fenômenos e pela diversidade de enfoques e conceitos utilizados. Em conseqüência, porém no campo da gerontologia existe evidencia das relações entre os três processos (suporte social informal, funcionalidade e saúde), se apresentam algumas situações problemáticas que limitam a investigação, contribuem a produzir resultados contraditórios e dificultam a aplicação e transferência de resultados.

General exercises vs. walking training in the motor skill of healthful elderly persons

The objective of this study was to assess and compare the effects of two programs of physical activities (general exercises and walking training) in manual motor skill of healthful sedentary elderly persons.Thirty elderly persons were recruited (12 men, 18 women), average age of 68.6 years old, sedentary, non-institutionalized. They had their motor skill assessed through a graphic test. The subjects were randomly assigned into 3 groups of 10 each: GA carried out a general exercising program. GB took part in a walking training program. GC acted as the control. GA and GB exercised for four months, twice a week, within a one-hour session, presenting maximum heart rate between 40-70 percent. The graphic test was applied again and the number of lines and the percentage of correct lines were extracted from it...

THE PRACTICE OF TAI CHI CHUAN IN MIDDLE AND ELDERLY PERSON AND ITS EFFECT TO STATIC AND DYNAMIC POSTURAL STABILITY / 体力科学

A balance test was given to middle-aged and elderly persons who are practicing Tai Chi Chuan for evaluating its effect on postural stability. The subjects were 34 (female : 34) healthy persons aged from 50 to 70 (mean : 63.2 ± 7.8years) .<BR>The Equitest System (Neuro Com Co. Ltd.) was used for the balance test. The Equitest System has several devices for evaluating postural balance both in a static and dynamic condition. The two tests used in this study-the Sensory Organization Test (SOT) and the Movement Coordination Test (MCT) -were performed to evaluate postural stability. The SOT consists of 3 static and 3 dynamic testing conditions, while the MCT evaluates postural response time against a shift board.<BR>The subjects were separated into 2 groups-beginner and skilled-for comparison between the two. The results of SOT showed that there were statistically significant differences of postural control in the dynamic condition between the two groups. But, there was no such difference seen in the static condition. For MCT, statistically significant differences were also observed between the two groups in the dynamic postural condition. The results of SOT and MCT suggest that skilled persons in Tai Chi Chuan acquire both highly developed dynamic balance and quick response in the disturbed condition.<BR>The results of the Cybex muscle strength test also suggests that the leg extensor develops muscle strength through long-term Tai Chi Chuan training.

Survey on the Bathing Situation and the Drowning Accidents in the Bathtub among the Club Members of the Aged Persons / 日本温泉気候物理医学会雑誌

A self administered survey on bathing and nearly drowning accidents in the bathtub was conducted among subjects consisting of 216 members of an aged person's club (153 males and 63 females, 73.7±4.9 years of age) for the purpose of utilizing the results for guidance in bathing for elderly persons. The subjects were bathing almost every day. The total bathing time was 20min and the time spent in the bathtub was 11min. With regard to the preference of bathing temperature, 50.4% of males and 33.3% of females answered that they like hot bathing (P<0.05). The ratios of the subjects who bathe at water temperatures over 42°C in the cold season were 39.0% of males and 21.0% of females (P<0.05). Only 4.2% of the subjects bathe below the waist. The ratios of the subjects who frequently bathe after drinking were 9.2% of males and 1.9% of females. The ratio of the subjects who bathe alone at home was 94.1%. The ratios of the subjects in this survey who had nearly drowned in the bathtub while bathing at home was 4.3%. A nearly drowning accident occurred primarily when the subject got fatigued (44.4%) or physical condition of the subject was bad (44.4%). The ratio of the subjects who had nearly drowned in a large bathtub of a hotel was 1.4%. No subjects had experienced a nearly drowning accident in the bathtub of a public bath. These results suggested that old persons, particularly males, bathe under rather unsafe conditions.

A Survey of the Symptoms and Diseases in the Elderly / 全日本鍼灸学会雑誌

Health conditions were surveyed in elderly Persons (over sixty-five years old) liveing in two towns in Kyoto prefecture. The questionnaires were handed out and collected later. Seven hundred and sixty five elderly persons living in Hiyosi-cho, an area of agriculture and forestry, and six hundred and eight elderly persons living in Tango-cho, an area of agriculture and fishery, turned in the questionnaires.<br>On investigation it was found that elderly people living in the two towns had many symptoms or diseases. The incidence of these symptoms and diseases was over two times as high as the mean value discovered in the general elderly population nation wide. Symptoms and diseases noted included low back pain, shoulder stiffness, foot pain, hypertension, pollakiuria, cold feet, knee joint pain, eye diseases, shoulder pain and arm pain in descending order of frequency. Low back pain was noted in about 46 per cent.