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Resumen Introducción: El crecimiento demográfico global observado en personas adultas mayores plantea múltiples retos para el diseño de políticas de bienestar y salud pública, los cuales requieren introducir mejoras para su calidad de vida, la de la familia y la comunidad. El presente estudio resultado de investigación recoge las percepciones relacionadas con la disyuntiva entre vivir la vida en familia o la institucionalización de las personas adultas mayores en la ciudad de Barranquilla. Objetivo: Determinar la percepción que se tiene sobre la institucionalización de las personas adultas mayores desde la perspectiva del sujeto y la familia vinculados a los hogares geriátricos/gerontológicos y grupos de la tercera edad en la ciudad. Método: La investigación se realizó desde un enfoque hermenéutico, aplicando entrevistas semiestructuradas a las personas adultas mayores y las familias. Resultado: En la ciudad existe una heterogeneidad en relación con las percepciones sobre la forma de vivir esta etapa del desarrollo humano y que se encuentra estrechamente relacionada con aspectos como la salud, la economía, la funcionalidad familiar y el cuidado subrogado como un fenómeno social vinculado a la migración de las familias. Conclusión: El tema plantea desafíos que hay que enfrentar en Colombia y el mundo ante el envejecimiento, especialmente en el contexto de la pobreza, disfuncionalidad familiar y desigualdad. Se definen las causas y consecuencias de la institucionalización de las personas adultas mayores, así como las alternativas de cuidado familiar y social, explorando las características culturales y demográficas que influyen en la situación de las personas adultas mayores en el país.

Abstract Introduction: The global demographic growth observed in the segment of older adults poses multiple challenges for the design of well-being and public health policies in the countries, which requires introducing improvements that positively impact the quality of life of the older adult, the family and the community. The present study, a result of descriptive research, collects the perceptions related to the dilemma between living life as a family or the institutionalization of the elderly in the city of Barranquilla. Objective: To determine the perception of the institutionalization of the elderly from the perspective of the subject and the family linked to geriatric/gerontological homes and groups of the elderly in the city. Method: The research was carried out from a hermeneutic approach, applying semi-structured interviews to older adults and families. Result: There is heterogeneity in the city in relation to perceptions about the way of living this stage of human development and that it is closely related to aspects such as health, economy, family functionality, and the surrogate care as a social phenomenon linked to family migration. Conclusion: The topic raises challenges to be faced in Colombia and the world when it comes to aging, especially in the context of poverty, family dysfunction and inequality. The causes and consequences of the institutionalization of the elderly are defined, as well as the alternatives of family and social care, exploring the cultural and demographic characteristics that influence the situation of the elderly in the country.

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Introdução: A deficiência auditiva (DA), ao impactar a capacidade de percepção auditiva, afeta a socialização, e está relacionada aos estados emocionais e qualidade de vida. Objetivo: Descrever estados emocionais e qualidade de vida de pessoas idosas com DA pré e pós uso do dispositivo eletrônico de amplificação sonora (DEAS). Método: Estudo descritivo, de corte longitudinal e abordagem quantitativa, composto por amostra de conveniência de 20 idosos com DA (50% homens), com média de idade de 75,8 anos (DP = 8,5), que estavam em processo de adaptação ao uso do dispositivo eletrônico de amplificação sonora - DEAS, que responderam aos instrumentos: Questionário de dados sociodemográficos, Escala Hospitalar de Ansiedade e Depressão (HAD) e Qualidade de Vida no Idoso (WHOQOL-OLD), pré e pós trinta dias de uso de DEAS por meio de comparação estatística. Resultados: Comparativamente, conforme os dois momentos, houve melhorias em redução de escore de ansiedade e depressão com o uso de DEAS, outrossim melhora da qualidade de vida, principalmente em participação social. Conclusão: O uso do DEAS demonstrou impacto positivo na vida da pessoa idosa, por meio da redução de indicadores de depressão e de ansiedade e demonstrou aumento nos escores de qualidade de vida. (AU)

Introduction: Hearing loss (HL), by impacting the auditory perception, affects socialization, and is related to emotional states and quality of life. Objective: To describe emotional states and quality of life of older adults with HL before and after the use of hearing aids (HA). Method: This is a descriptive, longitudinal study with a quantitative approach, consisting of a convenience sample of 20 older adults with HL (50% men), with a mean age of 75.8 years (SD = 8.5), who were in the process of adapting to the use of the HA, who answered the following instruments: Sociodemographic Data Questionnaire, Hospital Anxiety and Depression Scale (HAD) and Quality of Life in the Elderly (WHOQOL-OLD), before and after thirty days of HA use, by means of statistical comparison. Results: Comparatively, according to the two moments, there were improvements in the reduction of anxiety and depression scores with the use of HA, as well as an improvement in quality of life, especially in social participation. Conclusion: The use of HA was an improvement on the life of the older adults, through the reduction of depression and anxiety indicators, and has demonstrated superior scores in quality of life. (AU)

Introducción: La hipoacusia, al impactar en la capacidad de percepción auditiva, afecta la socialización, y se relaciona con los estados emocionales y la calidad de vida. Objetivo: Describir los estados emocionales y la calidad de vida de ancianos con hipoacusia antes y después del uso de audífonos. Método: Estudo descritivo, de corte longitudinal e abordagem quantitativa, composto por amostra de conveniência de 20 idosos com DA (50% homens), com média de idade de 75,8 anos (DP = 8,5), que estavam em processo de adaptação ao uso de audífonos, que responderam aos instrumentos: Cuestionario de datos sociodemográficos, Escala Hospitalaria de Ansiedad y Depresión (HAD) y Calidad de Vida en el Anciano (WHOQOL-OLD), antes y después de treinta días de uso, mediante comparación estadística. Resultados: Comparativamente, según los dos momentos, hubo mejoras en la reducción de las puntuaciones de ansiedad y depresión con el uso de audífonos, así como una mejora en la calidad de vida, especialmente en la participación social.Conclusión: El uso de audífonos ha demostrado un impacto positivo en la vida de los ancianos, a través de la reducción de los indicadores de depresión y ansiedad, y ha demostrado puntuaciones aumentadas en calidad de vida. (AU)

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Resumen Introducción : Los adultos mayores con enfermedades crónicas avanzadas y necesidad de cuidados paliativos están más expuestos a la polifarmacia y a consumir medicación potencialmente inapropiada, la cual genera un alto riesgo de eventos adversos y alteración de la calidad de vida. El objetivo de este estudio fue describir la frecuencia de consumo de medicación potencialmente inapropiada de adultos mayores con necesidad de cuida dos paliativos que ingresaron a cuidados domiciliarios luego de una hospitalización. Métodos : Estudio de corte transversal observacional de registros de dispensación e historias clínicas electró nicas, de adultos mayores en un sistema de cuidados domiciliarios y con necesidades de cuidados paliativos según el rastreo con la herramienta NECPAL, los índices PROFUND y/o PALIAR. Se analizó el consumo de fárma cos durante los 180 días posteriores al ingreso a cuidados domiciliarios. Se clasificaron los fármacos como poten cialmente inapropiados según criterios de LESS-CHRON. Resultados : Se incluyeron 176 pacientes, edad prome dio 87.4 años, 67% mujeres; 78% eran pluripatológicos y 22% presentaban una enfermedad única crónica progre siva. La mortalidad a los 6 meses fue 73%. La mediana de consumo de fármacos por paciente fue 9.1 (RIC = 4-9.7). El 87% consumía medicación potencialmente inapropia da, principalmente antihipertensivos, benzodiacepinas y antipsicóticos. Conclusión : Este estudio observó que los adultos ma yores, con necesidad de cuidados paliativos en cuidados domiciliarios, tienen un alto consumo de medicación potencialmente inapropiada. Esto refuerza la necesidad de implementar intervenciones efectivas centradas en el paciente, para prevenir la prescripción inadecuada y estimular la de-prescripción.

Abstract Introduction : Older adults with advanced chronic diseases and palliative care needs are more exposed to polypharmacy and use of potentially inappropriate medication, which generates a high risk of adverse events and impaired quality of life. The objective of this study was to describe the frequency of potentially inappropriate medication use among older adults with palliative care needs receiving home care services after hospital discharge. Methods : Observational cross-sectional study of pharmacy dispensing and electronic health records, of older adults in a home care system and with palliative care needs according to the screening with the NECPAL tool or the PROFUND and/or PALIAR indexes. Dispensed medications during 180 days after admission to home care were analyzed. Medications were classified as po tentially inappropriate according to the LESS-CHRON criteria. Results : We included 176 patients, mean age 87.4 years, 67% were women; 73% were pluripathologic pa tients and 22% had one chronic progressive disease. Mortality at 6 months was 73%. Median frequency of dispensed medications per patient was 9.1 (IQR = 4-9.7). The frequency of potentially inappropriate medication dispensation among patients was 87%, mainly antihy pertensives, benzodiazepines and antipsychotics. Conclusion : This study observed that dispensation of potentially inappropriate medication among older adults with palliative care needs and home care services is very high. This emphasizes the need for effective patient-centered interventions to prevent inadequate prescription and stimulate de-prescription.

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Resumen Introducción : Actualmente se define al paciente como adulto mayor (AM) si su edad es al menos de 60 años. Dada la expectativa de vida prolongada resulta intere sante evaluar si todos los AM con infarto agudo de mio cardio (IAM) son iguales. Los objetivos fueron conocer la prevalencia de AM en el IAM y dentro de ellos, la de los ≥75 años y analizar características, tratamientos de reperfusión y mortalidad intrahospitalaria de acuerdo a si son < o ≥ 75 años. Métodos : Se analizaron los pacientes AM ingresados en el Registro Nacional de Infarto con supra desnivel del segmento ST (ARGEN-IAM-ST). Se los dividió en grupo 1: 60-74 años y grupo 2: ≥ 75 años y se compararon entre sí. Resultados : AM 3626, 75.92% del Grupo 1, el resto del Grupo 2. En el grupo 2 hubo más mujeres, hipertensos y con antecedentes coronarios. Hubo similar porcentaje de diabetes y dislipidemia, pero menos de tabaquistas. En el Grupo 2 se empleó menos tratamiento de reperfusión (aunque más angioplastia primaria), con similar tiempo puerta-balón. Los pacientes del Grupo 2 recibieron me nos medicamentos de probada eficacia y en la evolución hospitalaria, más sangrado (aunque no mayor), más insuficiencia cardíaca y más mortalidad: 18.3% vs 9.4%, p<0.001. La edad ≥75 años fue predictor independiente de mortalidad. Conclusiones : Uno de cada cuatro AM con IAM tiene más de 75 años; estos pacientes reciben menos reper fusión, presentan más insuficiencia cardíaca y sangrado y tienen el doble de mortalidad que los pacientes de entre 60 y 74 años.

Abstract Introduction : Currently the patient is defined as an older adult (OA) when the age is at least 60 years. Given the long life expectancy, it is interesting to evaluate whether all OAs with acute myocardial infarction (AMI) are equal. The objectives were to know the prevalence of OA in AMI and within them, that of those ≥75 years of age and to analyze characteristics, reperfusion treat ments and in-hospital mortality according to whether they are < or ≥ 75 years of age. Methods : OA patients admitted to the National Reg istry of Infarction with ST segment elevation (ARGEN-IAM-ST) were analyzed. They were divided into group 1: 60-74 years old and group 2: ≥ 75 years old and compared with each other. Results : 3626 AM, 75.9% from Group 1, the rest from Group 2. In group 2 there were more women, hyperten sive and with a history of coronary arteries. There was a similar percentage of diabetes and dyslipidemia, but fewer of smokers. In Group 2, less reperfusion treat ment was used (although more primary angioplasty), with similar door-to-balloon time. Patients in Group 2 received fewer medications of proven efficacy and in the hospital course, they had more bleeding (although not major), more heart failure and more mortality: 18.3% vs. 9.4%, p<0.001. Age ≥75 years was an independent predictor of mortality. Conclusions : one in four patients with AMI is over 75 years old; they receive less reperfusion, have more heart failure, bleeding and twice the mortality rate than patients between 60 and 74 years.

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Resumen Introducción: Se ha demostrado que el aumento de la fuerza muscular del cuádriceps reduce el riesgo de mortalidad cardiovascular en un 34% en pacientes con enfermedad coronaria. Dado que la masa y la fuerza muscular disminuyen progresivamente con la edad, la rehabilitación cardíaca desempeña un papel fundamental en los adultos mayores. A pesar de estos beneficios, la adherencia a los programas de rehabilitación cardíaca sigue siendo baja. Por lo tanto, es esencial implementar estrategias que no solo proporcionen los beneficios del entrenamiento de fuerza, sino que también mejoren la adherencia para optimizar los resultados en esta población. Objetivo: Evaluar el efecto de doce sesiones de entrenamiento concurrente en la fuerza de los miembros inferiores en adultos mayores que asisten a un programa de rehabilitación cardíaca, dos a tres veces por semana. Materiales y método: Se incluyeron 98 adultos mayores (≥ 60 años) (29 mujeres, 67 ± 6 años; 69 hombres, 69.83 ± 6.5 años) que asistieron a un programa de rehabilitación cardíaca en Bogotá. Fueron evaluados entre enero del 2019 y 2020 antes y después de doce sesiones de entrenamiento, que incluyeron treinta minutos de ejercicio aeróbico y quince minutos de entrenamiento de fuerza. El entrenamiento aeróbico se realizó al 60-85% de la frecuencia cardíaca máxima estimada. El entrenamiento de fuerza incluyó tres series de diez a quince repeticiones de los principales grupos musculares con un 50-70% de una repetición máxima (1-RM). La evaluación inicial y final se realizó utilizando una máquina de prensa de piernas horizontal con estimación de 1-RM según la fórmula de Brzycki. Se realizaron pruebas t pareadas para evaluar los cambios preentrenamiento y posentrenamiento. Resultados: Después de doce sesiones, se encontró un aumento significativo en la fuerza máxima, tanto en hombres (189.6 ± 42.6 vs. 203.0 ± 47.4; p = 0.000) como en mujeres (116.1 ± 18.8 vs. 140.6 ± 31.0; p = 0.000). Conclusiones: Se encontró que doce sesiones de entrenamiento concurrente mejoran la fuerza de miembros inferiores de adultos mayores en menos tiempo y con menos volumen del reportado usualmente. Este hallazgo respalda la importancia de incluir el entrenamiento de fuerza para reducir el riesgo cardiovascular en esta población.

Abstract Introduction: Increased quadriceps muscle strength has been shown to reduce cardiovascular mortality risk by 34% in patients with coronary heart disease. As muscle mass and strength decline progressively with age, cardiac rehabilitation plays a crucial role for older adults. Despite these benefits, adherence to cardiac rehabilitation programs remains low. Therefore, strategies that not only provide the benefits of strength training but also enhance adherence are essential for improving outcomes in this population Objective: To evaluate the effect of twelve combined training sessions on lower limb strength in older adult attending a cardiac rehabilitation program two or three times per week. Materials and method: Patients included ninety-eight elderlies (≥ 60 years) (29 women, age: 67 ± 6 years; 69 males, age: 69.83 ± 6.5 years) attending a cardiac rehabilitation program in a university hospital in Bogotá city, Colombia. They were evaluated from January 2019-January 2020 before and after 12 training sessions two or three times per week, which included thirty minutes of cardiovascular aerobic and fifteen minutes of multifunctional strength training. Aerobic training was performed at 60-85% of the estimated maximal heart rate. Progressive resistance strength training included three sets of ten to fifteen repetitions of major muscle groups with a 50-70% estimated 1-repetition maximum (1-RM). Baseline and follow-up evaluation at the 12th. session was performed using a horizontal leg press machine with 1-RM estimation according to the Brzycki formula. Paired t-tests assessed pre/post-training changes. Results: After twelve training sessions, a significant maximum strength increase was found, both for men (189.6 ± 42.6 vs. 203.0 ± 47.4; p = 0.000), and women (116.1 ± 18.8 vs. 140.6 ± 31.0; p = 0.000). Conclusions: This study showed that twelve sessions of combined training in older adults attending a cardiac rehabilitation program improved lower limb strength in less time than usually reported. This finding supports the importance and feasibility of including strength in addition to aerobic training to reduce cardiovascular risk in this growing population.

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Introduction: Psychological distress among older adults in India is a concerning issue due to the aging population, the unique challenges they face, and limited access to mental health resources. Understanding and addressing this concern are crucial for promoting better mental health and overall quality of life. This study aims to estimate the prevalence of psychological distress among older adults in selected subcenters of Budge Budge II block, West Bengal; and to find out the factors associated with psychological distress among the study participants. Methods: A descriptive cross?sectional study was conducted among 180 persons aged ?60 years from different subcenters of the Budge Budge II block selected by multistage random sampling from May 2023 to July 2023 by face-to-face interview using a predesigned, pretested, structured schedule comprising the Kessler Psychological Distress Scale. Multivariable binary logistic regression was done to identify the sociodemographic factors associated with psychological distress. Results: In this study among 180 elderly individuals, the mean age was 67 (±6.34) years, with 65.5% in the 60–69 age group. Nearly two-thirds (70.5%) had no psychological distress, while 18.9%, 5%, and 5.6% had mild, moderate, and severe distress, respectively. Participants who were belonging to the age group 70–79 years [aOR (95% confidence interval [CI]) = 3.31 (1.27–8.63)], widowed or separated (aOR [95% CI] = 3.53 [1.33–9.31]), functionally dependent (aOR [95% CI]) = (8.89 [1.49–53.23]), and economically dependent (aOR [95% CI] = 7.81 [3.21–19.03]) were statistically significant covariates of psychological distress. Conclusion: Nearly one?third of the elderly were suffering from psychological distress. Preventive measures for psychological disorders should be integrated into public health at the local level by providing specialist outpatient services to diagnose and treat common psychological disorders at the primary health center level.

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Background: Frailty, a state of diminished physiological reserve and increased vulnerability to stressors, is common among geriatric Omani patients attending primary health-care settings. Frailty has been shown to be a dominant predictor of multiple adverse health outcomes such as falls, functional disability, delirium, health-care utilization, and all-cause mortality. Objective: We aimed to explore the relationship between frailty and adverse health outcomes in Omani older adults. Methods: We conducted a retrospective cohort study at a single center, from April 2020 to December 2022, involving 197 participants aged 65 years and older. Frailty was determined using the Multidimensional Prognostic Index (MPI). The adverse outcomes under investigation included a history of falling, utilization of primary health-care services, and all?cause mortality. We calculated unadjusted and adjusted odds ratios (ORs), along with their corresponding 95% confidence intervals (CIs), to evaluate the relationships between frailty and these adverse outcomes. Results: In the adjusted logistic regression model, frail older patients exhibited an elevated risk of falling in comparison to nonfrail patients (OR: 1.44, 95% CI: 0.68, 3.05; OR: 5.94, 95% CI: 1.49, 23.69, respectively). Notably, frailty status demonstrated a significant difference in terms of primary health?care utilization (P = 0.016), particularly for prefrailty (mean ± standard deviation 18.8 ± 10.8). Furthermore, a weak positive correlation was identified between MPI means and the level of primary health-care utilization (r = 0.229, P < 0.001). In addition, it was observed that prefrailty and frailty significantly heightened the risk of all-cause mortality (OR: 1.45, 95% CI: 0.16, 13.30; OR: 27.96, 95% CI: 3.37, 232.24, respectively). Conclusion: Prefrailty and frailty exert detrimental effects on older adults. It is imperative to focus on addressing prefrailty and frailty within primary health care to mitigate adverse outcomes and enhance the overall well-being of older adults.

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Background: Multimorbidity and road traffic accidents increase with increasing age. Supplemented with increasing life expectancy at birth, both multimorbidity and RTAs will contribute significantly to the growing disease burden of the country. The objective of the study was to determine the association between multimorbidity and RTAs among older adults (above 45 years) and the elderly (above 60 years) population in India. Methods: A secondary data analysis was conducted using the Longitudinal Ageing Study in India (LASI)-1st wave data (April 2017 to December 2018). Participants having at least two chronic health conditions were described as multimorbidity. Road traffic accidents (RTAs) was taken as the outcome variable. Univariate followed by multivariable logistic regression was conducted between the outcome variable and each explanatory variable. Results: Data extracted consisted of 34704 (51.1%) older adults and 31902 (47.9%) elderly. Multimorbidity was present in 25054 (37.6%) individuals. Among the RTA group, 325 (26.5%) individuals had multimorbidity. The elderly with multimorbidity (at least two) were associated with the RTA with an adjusted odds ratio (CI) of 0.55 (0.45-0.67) and p value of <0.001 in comparison to older adults. Clerical and skilled individuals with multimorbidity were associated with RTA in comparison to unemployed individuals with multimorbidity with an adjusted odds ratio (CI) of 1.40 (1.10-1.79) and p value of 0.007. Conclusions: The RTA was evident among males aged 45-60 years with multimorbidity. Clerical and skilled individuals with multimorbidity were more prone to RTA. These individuals should be encouraged to take necessary measures to promote healthy living and adhere to them.

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Resumen Objetivo: Analizar las propiedades psicométricas de la escala de resiliencia de Wagnild y Young, versión argentina, en un grupo de personas adultas mayores costarricenses. Materiales y métodos: Se contó con un grupo piloto (N = 40, X = 69.38) y otro para el análisis de las propiedades psicométricas (N = 100, X = 69.31). Se utilizó la escala de resiliencia de Wagnild y Young, versión argentina, de 25 ítems. Se efectuó un análisis por juicio de personas expertas y un estudio piloto, para establecer la escala por validar; posterior a esto, se realizó el estudio de validación completo. Se aplicaron análisis factoriales y alfa de Cronbach. Resultados: El análisis factorial extrajo dos factores denominados: a) "capacidad de autoeficacia" y b) "capacidad de propósito y sentido de vida". La consistencia interna en el nivel global fue 0.84 (21 ítems); para el primer factor, 0.81, y para el segundo factor, 0.74. Conclusiones: El instrumento es confiable y válido para valorar los niveles de resiliencia desde una óptica integral e interdisciplinaria, en una población de personas adultas mayores con las características similares a las de la muestra estudiada. A futuro, se recomienda realizar análisis cualitativos para delimitar mejor los constructos, con base en las características de la población.

Abstract Purpose: To analyze the psychometric characteristics of the Wagnild and Young Resilience Scale Argentine version in a Costa Rican elderly group. Materials and methods: The study had two groups, one for the pilot study (N = 40, X = 69.38), and another for the analysis of the psychometric properties (N = 100, X = 69.31). The 25-item Wagnild and Young Resilience Scale, Argentine version, was used. An analysis by expert judgment and a pilot study were carried out to establish the scale to be validated, after which, the complete validation study was carried out. Factor analyzes and Cronbach's alpha were applied. Results: They were obtained two factors named: a) "selfefficacy capacity", and b) "purpose in life capacity". The global internal consistency was 0.84, for the first factor was 0.81 and for the second factor was 0.74. Conclusions: The scale generated is reliable and valid to assess resilience in an elderly people with similar characteristics to the present study. In the future, it is recommended to carry out qualitative analyzes to better define the constructs based on the characteristics of the population.

Resumo Objetivo: Analisar as propriedades psicométricas da Escala de Resiliência Wagnild e Young, versão argentina, em um grupo de pessoas idosas costarriquenhas. Materiais e métodos: Um grupo piloto (N = 40, X = 69,38) e outro grupo para a análise das propriedades psicométricas (N = 100, X = 69,31) foram utilizados. A Escala de Resiliência Wagnild e Young, versão argentina, com 25 itens, foi utilizada. Para estabelecer a escala a ser validada, foi realizada uma análise de julgamento por especialistas e um estudo piloto, após o qual foi realizado o estudo de validação completo. A análise fatorial e o alfa de Cronbach foram aplicados. Resultados: A análise fatorial extraiu dois fatores: a) "capacidade de autoeficácia" e b) "capacidade de propósito e significado na vida". A consistência interna ao nível global foi de 0,84 (21 itens); para o primeiro fator foi de 0,81 e para o segundo fator foi de 0,74. Conclusões: O instrumento é confiável e válido para avaliar níveis de resiliência a partir de uma perspectiva holística e interdisciplinar em uma população de idosos com características semelhantes às da amostra estudada. Recomendam-se futuras análises qualitativas para melhor delimitar as construções com base nas características da população.

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Resumen El bienestar psicológico es un importante factor protector de la salud mental, particularmente en población vulnerable como los adultos mayores. Por lo tanto, es necesario contar con instrumentos de medición válidos, confiables e invariantes para su adecuado uso, con fines de evaluación e intervención psicológica. Este estudio se propuso analizar las evidencias de validez, confiabilidad e invarianza factorial de la Escala de Bienestar Psicológico (BIEPS-A) en una muestra de adultos mayores peruanos. Participaron 522 adultos mayores, de 60 a 93 años (M = 70.81, DE = 7.62), quienes respondieron la Escala BIEPS-A. Se encontraron adecuados índices de ajuste para un modelo de tres factores correlacionados: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, y RMSEA = .0350. También se halló relación entre las puntuaciones de la BIESP-A y el WHO-5 (r = .504), lo que es evidencia de validez convergente. Así mismo, se halló evidencia de confiabilidad de las puntuaciones con los coeficientes alfa (α) y omega (ω) (> .80). Finalmente, se encontró evidencia parcial de invarianza factorial en función al sexo (ΔCFI < .010, ΔRMSEA < .015). Se concluyó que la escala BIEPS-A reúne evidencias de validez, confiabilidad e invarianza parcial respecto al sexo para su correcto uso en adultos mayores peruanos.

Abstract Psychological well-being is an important protective factor for mental health, particularly in vulnerable populations such as the elderly. Therefore, it is necessary to have valid, reliable, and invariant measurement instruments for their proper use for psychological assessment and intervention purposes. This study aimed to analyze the evidence of validity, reliability, and factor invariance of the Psychological Well-Being Scale (BIEPS-A) in a sample of older Peruvian adults. Participants were 522 older adults, from 60 to 93 years old (M = 70.81, SD = 7.62), who answered the BIEPS-A Scale. Adequate fit indices were found for a model of three correlated factors: x2/gl = 1.631, CFI = .988, TLI = .984, SRMR = .0470, and RMSEA = .0350. A relationship was also found between the scores of the BIESP-A and the WHO-5 (r = .504, r2 = .254), which is evidence of convergent validity. Likewise, evidence of reliability of the scores with the alpha (α) and omega (ω) coefficients (> .80) was found. Finally, partial evidence of factor invariance based on gender was found (ΔCFI < .010, ΔRMSEA < .015). It was concluded that the BIEPS-A scale gathers evidence of validity, reliability and partial invariance with respect to sex for its correct use in older Peruvian adults.

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Resumen Durante el proceso de envejecimiento aparece el dolor como uno de los síntomas más comunes y al que menos se le presta atención, este puede generar un impacto negativo en la calidad de vida de las personas mayores. También, la fatiga se manifiesta frecuentemente, pero no se suele evaluar o exteriorizar en consulta. Por esto, la presente investigación tuvo como propósito estudiar la validez y fiabilidad de las escalas Siluetas de Fatiga, Caras de Dolor Revisada y Catastrofización del Dolor en una muestra de adultos mayores del área metropolitana de Bucaramanga. La muestra estuvo conformada por 131 adultos mayores tanto institucionalizados como no institucionalizados. Los resultados evidenciaron altos valores de fiabilidad en las tres escalas y se revisan las evidencias de validez con el análisis factorial exploratorio. En conclusión, las escalas contribuyen a la medición del dolor en adultos mayores colombianos, brindando a los profesionales de la salud instrumentos confiables. Se sugiere ampliar la muestra con estudios en otras regiones del país.

Abstract Throughout the ageing process, pain arises as one of the most prevalent symptoms which regularly receives the least attention. As a result, pain can negatively impact the quality of life of older people. Fatigue is often present in older adults, yet it is frequently overlooked during consultations. Therefore, the aim of this study was to assess the reliability and validity of the Fatigue Silhouettes, Pain Faces Revised, and Pain Catastrophizing scales in a sample of older adults from the metropolitan area of Bucaramanga. The study included 131 older adults, both institutionalized and non-institutionalized. The results yielded high levels of reliability across all three scales. Moreover, the evidence of validity was assessed through exploratory factor analysis. Overall, these measuring scales provide reliable instruments to healthcare professionals evaluating pain in older adults in Colombia. Future research should expand the sample to other regions of the country.

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Resumen Objetivo. Analizar las representaciones sociales (RS) de la COVID-19 en personas mayores mexicanas de Guadalajara, San Luis Potosí y Morelia, al inicio y dos años después de la pandemia. Método. Se realizó un estudio exploratorio cualitativo de dos fases: identificación del contenido y del núcleo central, e identificación de elementos periféricos de las RS. Participaron 49 personas adultas mayores habitantes de las ciudades mencionadas. Resultados. Las RS, al inicio y dos años después de la pandemia, muestran similitudes en el núcleo central con los términos enfermedad, muerte, miedo y confinamiento. Entre las diferencias, destacan el peligro y las emociones negativas en la primera fase y la vacuna y el afrontamiento en la segunda. Ello permite identificar en la segunda fase mayores elementos para el manejo y prevención de la COVID-19.

Abstract Objective. To analyze the COVID-19 social representations (SR) of older Mexican people from Guadalajara, San Luis Potosí and Morelia, at the beginning and two years after the pandemic. Method. A qualitative exploratory study of two phases, identification of the content and the central nucleus and peripheral elements of the SR, was conducted on 49 older adults from the mentioned cities. Results. The SR in the at the beginning and two years after the pandemic show similarities in the central nucleus with the terms disease, death, fear, and confinement. The differences highlight danger and negative emotions in the former; vaccine and coping in the latter. This makes it possible to identify more elements for COVID-19 management and prevention in the second phase.

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Resumen El otorgamiento de servicios de salud integradores para personas mayores requiere un abordaje holístico de las necesidades de salud y contexto inherentes a la población envejecida, para brindar una respuesta efectiva. El objetivo de este estudio fue describir las necesidades de salud de personas mayores y las condiciones del contexto, como base para la integración de servicios de atención primaria de salud. Se realizó una revisión narrativa no sistemática de la literatura en una base de datos electrónica entre 2019 y 2023 y una combinación de referencias de citas. La recolección de la información siguió los principios del análisis temático derivado del enfoque cualitativo. Dos grupos de necesidades de salud de las personas mayores fueron identificados: procesos naturales de envejecimiento y procesos de enfermedad. Las condiciones del contexto en estas necesidades se conceptualizaron en tres dimensiones interconectadas: condiciones socioeconómicas, servicios de salud y lugar de residencia. La comprensión de las necesidades de salud determinadas por las condiciones del contexto respalda estrategias para mejorar los servicios para personas mayores bajo el enfoque de atención primaria de salud.

Abstract The provision of inclusive health services for older adults requires a holistic approach to the health needs of the ageing population and their social environment, to deliver an effective response. To describe the health needs of older adults and their social environment, as a basis for integration of primary health care services. A non-systematic narrative review of the literature was conducted based on an electronic database covering the period 2019-2023 along with a combination of citation references. Information collection followed the principles of the thematic analysis derived from the qualitative approach. Two groups of health needs for older adults were identified: natural aging processes and disease processes. The social environment for these health needs were conceptualized in three interconnected dimensions: socioeconomic conditions, health services, and place of residence. Understanding the elements underlying the health needs which are determined by contextual conditions, supports strategies to improve services for older adults as part of the primary health care approach.

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Resumen Antecedentes: El deterioro cognitivo y la disfagia son comunes en personas mayores. Objetivo: Explorar las características de la disfagia mediante fluoroscopia en pacientes con deterioro cognitivo leve (DCL) y demencia. Material y métodos: Se analizaron 158 adultos de una clínica de memoria. Para evaluar el DCL y la demencia, se emplearon criterios específicos; y para la disfagia, la escala EAT-10. Se realizó fluoroscopia con trago de bario para evaluar las fases de la deglución; la presencia de broncoaspiración apoyó el diagnóstico de disfagia. Se realizó análisis de regresión logística para establecer la relación entre disfagia y DCL. Resultados: Según EAT-10, 86 pacientes (54.4 %) tenían riesgo de disfagia, la cual fue confirmada en 84 mediante fluoroscopia (53.8 % tenía DCL y 46.2 %, demencia). En el grupo con DCL se observó asociación inversa con alteraciones en la fase oral (RM = 0.23, p < 0.025) y asociación positiva con alteraciones en la protección contra la regurgitación (RM = 3.76, p < 0.056) y contracción del músculo laríngeo (RM = 3.22, p < 0.045) versus grupo con demencia. Conclusiones: El estudio mostró alta frecuencia de disfagia en pacientes con DCL, lo que resalta la importancia de su detección temprana para mejorar las complicaciones asociadas.

Abstract Background: Dysphagia and cognitive impairment are common in older people. It is linked to alterations in brain areas related to swallowing. Objective: To explore the characteristics of dysphagia using fluoroscopy in patients with mild cognitive impairment (MCI) and dementia. Material and methods: 158 participants from a memory clinic. Specific criteria for MCI and dementia were used. Dysphagia was assessed with EAT-10 (≥3). Those who accepted completed a fluoroscopy study with a barium swallow to evaluate the phases of swallowing; the presence of bronchoaspiration supported the diagnosis of dysphagia. A logistic regression analysis was performed to test the probability between dysphagia and MCI. Results: According to EAT-10, 86 (54.4 %) were at risk of dysphagia, confirmed in 84 by fluoroscopy, 53.8 % MCI group and 46.2 % dementia. An inverse association was observed in the MCI oral phase group (OR 0.23, p < 0.025), and a positive association; in protection phase against regurgitation (OR 3.76, p < 0.056) and laryngeal muscle contraction (OR 3.22, p < 0.045) versus dementia group. Conclusions: The study showed a high frequency of dysphagia in patients with MCI, this highlights the importance of its early detection to improve complications associated with dysphagia.

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Resumen Antecedentes: Los adultos mayores tienen tasas de envejecimiento heterogéneas. Objetivo: Explorar la asociación entre edad biológica (EB) y envejecimiento acelerado (EA) con fragilidad en adultos mayores. Material y métodos: Análisis de 735 adultos mayores de la Cohorte de Coyocán. Se estimó EB con AnthropoAge, EA con AnthropoAgeAccel y fragilidad con el fenotipo de Fried y el índice de fragilidad (IF). Se exploró la asociación de EB y EA (AnthropoAgeAccel ≥ 0) con fragilidad; se caracterizó su presencia simultánea sobre fenotipos de composición corporal y función física. Se determinó el riesgo de EA para progresión del fenotipo de fragilidad a tres años de seguimiento. Resultados: Los adultos mayores con EA presentaron mayor prevalencia de fragilidad e IF, menor fuerza de prensión y velocidad de marcha. Los resultados de AnthropoAgeAccel se asociaron a IF (β = 0.0053, IC 95 % = 0.0027-0.0079) y al fenotipo de fragilidad (RM = 1.16, IC 95 % = 1.09-1.25). Existieron diferencias por sexo en composición corporal y función física relacionadas con EA solo en participantes no frágiles. El EA en la evaluación basal se asoció con progresión de la fragilidad con el tiempo (RM = 1.74, IC 95 % = 1.11-2.75). Conclusiones: A pesar su asociación, el EA es independiente de la fragilidad en adultos mayores que viven en la comunidad.

Abstract Background: Older adults have highly heterogeneous aging rates. Objective: To explore the association of biological age (BA) and accelerated aging with frailty in community-dwelling older adults. Material and methods: We assessed 735 community-dwelling older adults from the Coyocan Cohort. BA was measured using AnthropoAge, accelerated aging with AnthropoAgeAccel, and frailty using Fried’s phenotype and the frailty index. We explored the association of BA and accelerated aging (AnthropoAgeAccel ≥ 0) with frailty at baseline and characterized the body composition and physical function phenotype of accelerated aging in non-frail/frail participants. We also explored accelerated aging as a risk factor for frailty progression after 3-years of follow-up. Results: Older adults with accelerated aging have higher frailty prevalence and indices, lower handgrip strength and gait speed. AnthropoAgeAccel was associated with higher frailty indices (β = 0.0053, 95 % CI = 0.0027-0.0079), and increased odds of frailty at baseline (OR = 1.16, 95 % CI = 1.09-1.25). We observed sex-based differences in body composition and physical function linked to accelerated aging in non-frail participants; however, these differences were absent in pre-frail/frail participants. Accelerated aging at baseline was associated with higher risk of frailty progression over time (OR = 1.74, 95 % CI = 1.11-2.75). Conclusions: Despite being intertwined, biological accelerated aging is largely independent of frailty in community-dwelling older adults.

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Background: Walking speed assessments are thought to predict eventual health outcomes and patient quality of life when assessing the physical mobility of an individual. Such performance measurements are functional and objective which gives us accurate interpretation to anticipate future goals. The L-test is a feasible, easy administration in clinical setup would be quick and effortless for physiotherapist professionals. As there is no normative value of L- the test that could interpret the score of the test, our study focuses on finding the cut-off value in older adults aged 60-70 years. Methods: We conducted a cross-sectional study from January 2021 to June 2021 in Mumbai, India. A total of 200 participants were selected based on inclusion criteria. The study used an L-shaped path that is 20 meters long which goes 3 meters straight, then a right turn, followed by 7 meters straight. The subjects walked along the marked pathway and the test completion time was noted. Results: A notable difference was found between the male and female participants with a p value of 0.015 and the test duration for males was 19.15 (16.87-22.64) seconds and for females was 20.22 (18.03-23.94) seconds. A positive weak correlation was found between the body mass index (BMI) and duration. Also, a positive weak correlation was found statistically significant between the age and duration of the test. Conclusions: The study showed that there is an increased time duration of the L test with advancing age and BMI.

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Este estudo teve como objetivo comparar a função dos músculos plantiflexores, o desempenho na marcha e a mobilidade entre idosos com diferentes níveis de atividade física(NAF), mensurado por meio da utilização de um acelerômetro (modelo GT3X; Actigraph). Participaram do estudo 111 pessoas idosas (h = 44, m = 67; 70,8 ± 4,5 anos; 71,52 ± kg; 1,62 ± 0,08 cm), que foram alocadas em 3 grupos como base no número de passosdiários(G1, até 4336; G2, de 4337 a 7221; G3, de 7222 a 13676). A análise do desempenho físico incluiu protocolos de avaliação envolvendo (1) função muscular (2) mobilidadefuncional(3) marcha. Os resultados demonstraram que o grupo com menor NAFapresentou um desempenho inferior na avaliação da força e mobilidade quando comparados ao grupo de maior NAF. Dessa forma, foi possível concluir que o uso de gerontotecnologia, como o acelerômetroe tapete com sensores para avaliação da marcha, oferecemuma abordagem eficaz para monitorar a atividade física e destacar os benefícios de níveis mais elevados de atividade sobre a função física, contribuindo para uma melhor qualidade de vida e independência na população idosa.(AU)

This study aimed to compare plantar flexor muscle function, gait performance, and mobility among older adults with different levels of physical activity (LPA), measured using an accelerometer (GT3X model; Actigraph). A total of 111 older adults participated in the study (males = 44, females = 67; 70.8 ± 4.5 years; 71.52 ± kg; 1.62 ± 0.08 cm), who were allocated into 3 groups based on the number of daily steps (G1, up to 4336; G2, from 4337 to 7221; G3, from 7222 to 13676). The physical performance analysis included evaluation protocols involving (1) muscle function, (2) functional mobility, and (3) gait. The results showed that the group with lower LPA had inferior performance in strength and mobility assessment compared to the group with higher LPA. Thus, it was possible to conclude that the use of gerontechnology, such as the accelerometer and sensor mat for gait assessment, offers an effective approach to monitor physical activity and highlight the benefits of higher activity levels on physical function, contributing to better quality of life and independence in the elderly population.(AU)

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Objetivo: Avaliar as possíveis implicações da COVID-19 nas condições nutricionais e de saúde de pessoas idosas institucionalizadas. Métodos: Estudo longitudinal realizado com residentes de uma instituição de longa permanência para pessoas idosas do interior de Minas Gerais, Brasil. Realizou-se análise bivariada para avaliar as variáveis bioquímicas e antropométricas antes e após a infecção por COVID-19. Resultados: Do total de 38 pessoas idosas institucionalizadas, 84,2% (n=32) foram contaminadas pela COVID-19, das quais 68,8% (n=22) eram do sexo feminino, com média de idade de 83,8 (DP+6,9) anos. Dentre os infectados, 12,5% (n=4) foram hospitalizados, 6,3% (n=2) necessitaram de ventilação mecânica e 18,7% (n=6) morreram. Dos indivíduos que foram à óbito 50,0% (n=3) estavam com baixo peso e 16,6% (n=1) com sobrepeso. Comparado ao período anterior à pandemia, as médias dos níveis de eritrócitos, glicose, triglicérides, vitamina D, sódio, potássio, aspartato aminotransferase e perímetro da panturrilha foram significativamente menores após a doença (p<0,05). Conclusão: Este estudo revela que as condições nutricionais e clínicas dos residentes apresentaram piora após a infecção, com destaque para a redução dos níveis de vitamina D e do perímetro da panturrilha, o que pode aumentar o risco de complicações como sarcopenia e fragilidade.(AU)

Objective:To evaluate the technical potential of COVID-19 in the nutritional and health conditions of institutionalized older adults. Methods:Retrospective study carried out with residents of a long-stay institution for the older adults in the interior of Minas Gerais, Brazil. Bivariate analysis was performed to assess biochemical and anthropometric variables before and after COVID-19 infection. Results:Of the total of 38 institutionalized older adults, 84.2% (n=32) were infected by COVID-19, of which 68.8% (n=22) were female, with a mean age of 83.8 (SD+6.9) years. Among those infected, 12.5% (n=4) were hospitalized, 6.3% (n=2) required mechanical ventilation and 18.7% (n=6) died. Of the individuals went to death, 50.0% (n=3) were underweight and 16.6% (n=1) were overweight. Compared to the pre-pandemicperiod, the mean levels of erythrocytes, glucose, triglycerides, vitamin D, sodium, potassium and calf circumferencewere significantly lower after the illness (p<0.05). Conclusion:This study reveals that the nutritional and clinical conditions of residents worsened after an infection, with emphasis on the reduction of vitamin D levels and the calf circumference, which may increase the risk of complications such as sarcopenia and frailty.(AU)

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Introdução:No Brasil, dentre as modalidades de cuidados de longa duração, as Instituições de Longa Permanência para Idosos (ILPIs) ocupam lugar de destaque por ser a segunda modalidade de cuidados mais prevalente depois da família. Observa-se que o financiamento dasinstituições se caracteriza como o grande calcanhar de Aquiles da gestão desses locais em função da escassez de políticas de financiamento dos cuidados. Objetivo:Compreender, pela ótica dos gestores e responsáveis técnicos de ILPIs brasileiras, como o financiamento das instituições se associa ao desenvolvimento das ofertas assistenciais e gestão do cuidado. Materiais e Métodos: Trata-se de estudo transversal, exploratório e quantitativo, em que foram aplicados formulários construídos e disponibilizados por meio da ferramenta do Google Formscom questões relativas às características e financiamento das ILPIs, bem como a compreensão da RDC nº 502/2021. Foram investigados 90 Responsáveis Técnicos e gestores durante o segundo semestre de 2021. Resultados e Discussão: Pouco menos da metade participantes classificaram o financiamento da instituição como insuficiente, elegendo as categorias "muito pouco a mais ou menos" para cobrir os gastos da instituição. Houve associações entre percepção de suficiência de financiamentodas instituições, suficiência de recursos humanos (p<0,001), à adequação da estrutura física (p=0,028) e a variáveis associadas à elaboração do plano de atenção à saúde da RDC nº 502/2021. Conclusão:O financiamento das ILPI se associou às condições estruturais, de recursos humanos e de atenção em saúde prevista pela RDC nº 502/2021. Dessa forma, investir no financiamento das instituições garantirá a melhor oferta dos cuidados.(AU)

Introduction:In Brazil, among the modalities of long-term care, Long-Term Institutions for the Older adults occupy a prominent place as they are the second most prevalent type of care after the family. It is observed that the financing of institutions is characterizedas the great Achilles heel of the management of this equipment due to the scarcity of care financing policies. Objective:To understand, from the perspective of managers and technical managers of Brazilian LTCFs, how the financing of institutions is associated with the development of assistance offers and care management. Materials and Methods:This is a cross-sectional, exploratory, and quantitative study, in which forms constructed and made available through the Google Forms tool were applied with questions relating to the characteristics and financing of ILPIs, as well as the understanding ofRDC nº 502/2021. 90 Technical Managers and managers were investigated during the second half of 2021. Results and Discussion:Just under half of the participants classified the institution's financing as insufficient, choosing the categories "very little more or less" to cover the institution's expenses. There were associations between the perception of sufficiency of institutions' financing, sufficiency of human resources (p<0.001), the adequacy of the physical structure (p=0.028) and variables associated with the preparation of the RDC health care plan nº 502/2021. Conclusion:The financing of LTCFs was associated with the structural, human resources and health care conditions provided for by RDC nº 502/2021. Therefore, investing in the financing of institutions will guarantee the best provision of care.(AU)

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Objetivo:verificar o número de passos de idosos institucionalizados durante uma intervenção aplicada por cuidadores. Métodos: Estudo experimental, realizado junto a cuidadores e pessoas idosas de 3 instituições de longa permanência para idosos (ILPI) de Curitiba -PR. Os cuidadores receberam um treinamentocomposto por: treinamento instrucional (4 semanas), e supervisão para aplicação de metas relacionadas à redução do comportamento sedentário(CS)e promoção da atividade física(AF) (12 semanas). Dentre as metas estabelecidas, utilizou-se o número de passos, estabelecendo-se um aumento progressivo de até 30%. Além das características sociodemográficas dos residentes, verificou-se a média de passos utilizando o smartwatch Xiaomi Mi Band5®, no período pré intervenção, e nas semanas 6, 9 e 12. Resultados: Participaram do estudo 15 cuidadores, e7 residentes do sexo feminino, idade 82,2±8,2anos.Notou-se que3 (42,8%), 4 (57,1%),e5 (71,4%) residentesatingiram as metas estabelecidas nas semanas 6, 9 e 12, respectivamente.Conclusão: O uso do smartwatch permitiu verificar onúmero de idosos que atingiram as metas pré-estabelecidas em relação ao número de passos. Deste modo, se apresentou como um recurso que pode auxiliar o planejamento e monitoramento de intervenções para reduzir o CSe aumentar aAF.(AU)

Objective: to verify the number of steps taken by institutionalized olderpeople during an intervention applied by caregivers. Methods: Experimental study, carried out with caregivers and older adultsfrom nursing homes (NH)in Curitiba -PR. Caregivers received training consisting of instructional training (4 weeks), and supervision to implement goals related to reducing sedentary behavior (SB) and promoting physical activity (PA) (12 weeks). Among the established goals, thenumber of steps was used, establishing a progressive increase of up to 30%. In addition to the residents' sociodemographic characteristics, the average number of steps was verified using the Xiaomi Mi Band 5® smartwatch, in the pre-intervention period, and weeks 6, 9,and 12. Results: 15 caregivers and 7 female residents participated in the study, 82.2±8.2 years. It was noted that 3 (42.8%), 4 (57.1%), and 5 residents (71.4%) achieved the goals established in weeks 6, 9 and 12, respectively. Conclusion: The use of the smartwatch made it possible to verify the number of residentswho reached pre-established goals aboutthe number of steps. In this way, it presented itself as a resource that can assist in the planning and monitoring of interventions to reduce SBand increase PA.(AU)