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SUMMARY: Frailty affects the functional autonomy (FA) of older adults and could manifest itself in muscle imbalances in the limbs, resulting in a disparity in size and strength between them. In Chile, information on the relationship between muscle strength (MS) levels and FA asymmetries in older women is limited. This study related the levels of MS, anthropometric parameters, and asymmetries of the lower and upper limbs, with the FA of a group of older Chilean women. The study included 39 women who participated, and their FA was evaluated using the GDLAM index (IG). Based on the score obtained in the IG, they were classified by percentiles as Group 1 with favorable FA (P ≤ 50) and Group 2 with low FA (P > 50). Anthropometric parameters were BMI, fat percentage, bone mass, circumferences (arm, thigh, calf), diameters (humerus, femur) and upper/lower limb strength was evaluated to determine asymmetries. The differences between the covariates of both groups were evaluated using the student's t test and the Mann-Whitney test for independent samples. G1 presented less asymmetry (p > 0.05) in the lower limbs and greater calf circumference than G2 (p < 0.05). G1 presented greater bilateral strength (dominant and non-dominant limb) compared to G2 (p < 0.05). The covariates of age, anthropometry, MS, and lower/upper limb asymmetries influence FA in older women.
La fragilidad afecta la autonomía funcional (AF) de las personas mayores y podría manifestarse en desequilibrios musculares en los miembros, dando lugar a una disparidad de tamaño y fuerza entre ellos. En Chile, la información que relaciona los niveles de fuerza muscular (FM) y las asimetrías con la AF en mujeres mayores es limitada. Este estudio relacionó los niveles de FM, parámetros antropométricos y asimetrías de los miembros inferiores y superiores, con la AF de un grupo de mujeres mayores chilenas. Participaron 39 mujeres, cuya AF se evaluó mediante el índice GDLAM (IG). En función de la puntuación obtenida en el IG, se clasificaron por percentiles en Grupo 1 con AF favorable (P ≤ 50) y Grupo 2 con AF baja (P > 50). Los parámetros antropométricos fueron IMC, porcentaje de grasa, masa ósea, circunferencias (brazo, muslo, pantorrilla), diámetros (húmero, fémur) y se evaluó la fuerza de los miembros superiores/ inferiores para determinar asimetrías. Las diferencias entre las covariables de ambos grupos se evaluaron mediante la prueba t de student y la prueba de Mann-Whitney para muestras independientes. G1 presentó menor asimetría (p > 0,05) en los miembros inferiores y mayor perímetro de pantorrilla que G2 (p < 0,05). G1 presentó mayor fuerza bilateral (miembro dominante y no dominante) en comparación con G2 (p < 0,05). Las covariables de antropometría, FM y asimetrías de extremidades inferiores/superiores influyen en la AF en mujeres mayores.
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ABSTRACT BACKGROUND: Although studies have examined the relationship between variables associated with active aging and quality of life (QoL), no studies have been identified to have investigated the effect of a structural model of active aging on QoL in a representative sample of older people in the community. OBJECTIVE: To measure the domains and facets of QoL in older people and identify the effect of the structural model of active aging on the self-assessment of QoL. DESIGN AND SETTING: This cross-sectional analytical study included 957 older people living in urban areas. Data were collected from households using validated instruments between March and June 2018. Descriptive, confirmatory factor, and structural equation modeling analyses were performed. RESULTS: Most older people self-rated their QoL as good (58.7%), and the highest mean scores were for the social relationships domain (70.12 ± 15.4) and the death and dying facet (75.43 ± 26.7). In contrast, the lowest mean scores were for the physical domains (64.41 ± 17.1) and social participation (67.20 ± 16.2) facets. It was found that active aging explained 50% of the variation in self-assessed QoL and directly and positively affected this outcome (λ = 0.70; P < 0.001). CONCLUSION: Active aging had a direct and positive effect on the self-assessment of QoL, indicating that the more individuals actively aged, the better the self-assessment of QoL.
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ABSTRACT Purpose To determine the relationship between mastication and malnutrition in community-dwelling older adults. Research strategies To establish the eligibility criteria, the acronym PECOS was used: Population: non-institutionalized older adults; Exposure: older adults with malnutrition; Control: older adults without malnutrition; Outcome: masticatory problems in malnourished older adults; Study types: observational studies. Selection criteria It selected studies assessing malnutrition and mastication difficulties in non-institutionalized adults over 60 years old, of both sexes. Mastication and malnutrition were evaluated with questionnaires on self-reported symptoms and clinical and instrumental assessments. There were no restrictions on language, year of publication, or ethnicity. Data analysis The included studies were evaluated for methodological quality with the Joanna Briggs Institute tool for cross-sectional studies. For the cross-sectional studies included, the odds ratio (OR) was calculated with 95% confidence intervals. Results After searching the databases, 692 references were retrieved, with three studies selected for quantitative and qualitative analysis. The values obtained in the meta-analysis for association show that malnutrition and mastication difficulties were 2.21 times as likely to occur (OR = 2.21; 95%CI = 0.93 - 5.26; I2 = 94%) as individuals without malnutrition (p < 0.001). The assessment of the risk of bias presented a high-risk, a moderate-risk, and a low-risk study. The certainty of evidence was rated very low with the GRADE tool. Conclusion Individuals at risk of malnutrition are 2.21 times as likely to have mastication difficulties.
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Resumo É possível envelhecer com saúde e qualidade de vida no Brasil? Este artigo defere a resposta por meio da proposição de um modelo assistencial resolutivo e com excelente relação custo-benefício, em linha com o que há de mais contemporâneo no cuidado integral para o grupo etário dos idosos. O modelo aqui apresentado propõe pensar, de forma absolutamente inovadora, o cuidado que deve ser prestado a essa parcela da população. Neste texto, são apresentados a teoria e os conceitos que fundamentam o modelo proposto. Basicamente, o texto relata a necessidade de ênfase nas instâncias leves de cuidado; em outros termos, foco na coordenação, na prevenção e no monitoramento do cliente, de forma a minimizar desperdícios, oferecendo uma assistência de melhor qualidade e a custos reduzidos. Também são apresentados os instrumentos de avaliação epidemiológica utilizados e o passo a passo de todos os profissionais da equipe de saúde.
Abstract Is it possible to age with health and quality of life in Brazil? This article defers the answer through the proposition of a cost-effective care model, in line with what is most contemporary in comprehensive care for the elderly age group. The model presented here proposes to think, in an absolutely innovative way, the care that must be provided to this portion of the population. In this text, the theory and concepts that underlie the proposed model are presented. Basically, the text reports the need for emphasis on light instances of care; in other words, focus on coordination, prevention and customer monitoring, in order to minimize waste, offering better quality care and reduced costs. The epidemiological assessment instruments used and the step by step of all health professionals are also presented.
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Introducción: La detección temprana del deterioro cognitivo en personas mayores permite disminuir la incertidumbre y mejorar las tareas de intervención. El objetivo de esta investigación fue determinar las características psicométricas de un protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores. Método: el método usado fue de tipo mixta con preguntas de tipo cuantitativas y cualitativas. La muestra fue de 75 personas mayores del gran Concepción, región del Bio-Bio. El protocolo estaba compuesto por: Cuestionario sociodemográfico, Test del Reloj Versión Cacho, Moca, Escala Depresión Yesavage y Test Acentuación de Palabras. El procedimiento consistió en la aplicación del protocolo a través de un Tablet o Laptop, videollamadas. Resultados: Se encontró que el protocolo presenta validez discriminante y convergente. Conclusiones: se concluye que el protocolo de cribado online para detectar tempranamente deterioro leve en personas mayores es válido y fiable. Se discute el uso y la aplicación de un protocolo cribado usando la Teleneuropsicología (TeleNP), en personas mayores
ABTRACT Introduction: Early detection of cognitive impairment in the elderly allows us to reduce uncertainty and improve intervention tasks. The objective of this research was to determine the psychometric characteristics of an online screening protocol for early detection of mild impairment in the elderly. Method: the method used was of a mixed type with quantitative and qualitative questions. The sample consisted of 75 older people from the greater Concepción, Bio-Bio region. The protocol consisted of: Sociodemographic Questionnaire, Cacho Version Clock Test, Mocha, Yesavage Depression Scale and Word Stress Test. The procedure consisted of the application of the protocol through a Tablet or Laptop, video calls. Results: It was found that the protocol presents discriminant and convergent validity. Conclusions: it is concluded that the online screening protocol for early detection of mild deterioration in the elderly is valid and reliable. The use and application of a screening protocol using Teleneuropsychology (TeleNP) in older people is discussed.
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Background@#The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings. @*Objectives@#This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, “In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?”@*Methods@#A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA on older people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot. @*Results@#This meta-analysis which compared studies that employed similar methodologies, found that CSA has a significant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMD of 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitive function was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran’s Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment. @*Conclusion@#Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study’s significant, large effect, and non-significant heterogeneity warrants caution.
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Cognición , Disfunción Cognitiva , MetaanálisisRESUMEN
Introducción: Aunque a nivel mundial se ha demostrado que la población adulta mayor mantiene una vida sexual activa, es limitada por estereotipos, cambios fisiológicos resultados del proceso de envejecimiento y la ausencia de estrategias de salud integral para la sexualidad. Objetivo: Documentar la experiencia sexual de los adultos mayores en el país y entender los motivos que promueven o limitan la búsqueda de atención en salud sexual. Metodología: Estudio cualitativo en el que se realizaron 39 entrevistas y 4 talleres virtuales con hombres y mujeres de 50 años y más en Barranquilla, Bogotá, Cali, Medellín, sin excluir personas de otras ciudades. Resultados: Entre los principales hallazgos se evidencia que la población adulta mayor tiene valoraciones positivas frente a la sexualidad y el sexo, pero su desarrollo se ve limitado, especialmente para las mujeres, por los roles de género. La sexualidad en las personas mayores está atravesada por la educación inicial, la transformación de ideas sobre la sexualidad a lo largo de sus trayectorias de vida, las transformaciones del cuerpo, el estado de salud, las prácticas y experiencias sexuales recientes y la manera en la que se aproximan a la dimensión salud sexual con profesionales de la salud. Conclusiones: La heterogeneidad de experiencias, prácticas y valores dados a la sexualidad y al sexo en la vejez requieren de la generación de políticas y programas de atención integral basadas en investigaciones empíricas que superen las concepciones edadistas de la sexualidad. Este estudio es una contribución a la literatura local sobre sexualidad y vejez, así como al diseño de servicios de atención de salud y bienestar de acuerdo con las necesidades, identidades y circunstancias específicas de la población adulta mayor en materia de sexualidad.
Introduction: Although worldwide has been demonstrated that the older adult population maintains an active sexual life, this is limited by stereotypes, physiological changes resulting from the aging process and the absence of comprehensive health strategies for sexuality. Objective: To document the sexual experience of older adults in the country and to understand the reasons that promote or limit the search for sexual healthcare. Methodology: Qualitative study. Thirty-nine interviews and four virtual workshops were conducted with men and women 50 years of age and older in Barranquilla, Bogotá, Cali, and Medellín, although people from other cities were not excluded. Results: Among the main findings, it is evident that this population has positive evaluations of sexuality and sex, but its development is limited, especially for women, by gender roles. Sexuality in the elderly is formed by their initial education, the transformation of ideas about sexuality throughout their life trajectories, the transformations of their bodies, their state of health, recent sexual practices and experiences, and the way in which they approach this topic with health professionals. Conclusions: The heterogeneity of experiences, practices and values given to sexuality and sex in old age require policies and programs based on empirical research that overcome the ageist conception of sexuality. This study is a contribution to the national literature on sexuality and aging, and to the design of health care and well-being services according to the specific needs, identities and circumstances of the older adult population in terms of sexuality.
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Antecedentes: La población sobre 60 años va en aumento y es relevante tener más conocimiento sobre los factores que inciden en su bienestar y salud mental. Objetivo: Este estudio busca comprender la relación entre bienestar, apoyo social y sintomatología depresiva en personas mayores de la provincia de Concepción. Método: 538 adultos mayores fueron seleccionados aleatoriamente de 15 Centros de Salud Primaria de la provincia de Concepción, Chile. Se midieron sus niveles de bienestar (con el Pemberton Happiness Index), de apoyo Social (con la Escala Multidimensional de Percepción de Apoyo Social de Zimet) y de sintomatología depresiva (mediante el Patient Health Questionnaire-9). Resultados: Los adultos mayores mostraron un puntaje elevado (M=8,54; DE = 1,34) en bienestar, sin diferencias por sexo (t(536) = −1,065, p = 0,288 > 0,05). En los análisis de regresión lineal, el apoyo social (β =0,463, p<0,001) y la sintomatología depresiva (β =-1,585, p<0,001) aparecen como influyentes en el bienestar de las personas mayores; y el apoyo social actúa como un factor moderador (β=0,049, p=0,007, IC =0,021; 0,077) en la relación entre sintomatología depresiva y bienestar. Conclusiones: Las personas mayores muestran elevado bienestar. Los resultados refuerzan la relevancia del apoyo social como un factor protector en las personas mayores. Ello corrobora la importancia del fomento de este aspecto en los programas promocionales y preventivos destinados al bienestar y salud mental de adultos mayores.
Background: The population over 60 years of age is increasing. Aim: This research aims to understand the relationship between well-being, social support, and depressive symptoms in older Chilean people. Method: 538 older adults were randomly selected from 15 Primary Health Centers in the province of Concepción, Chile, 341 women and 197 men. Well-being was measured with the Pemberton Happiness Index, Social Support with the Zimet Multidimensional Scale of Perceived Social Support, and Depressive Symptomatology using the Patient Health Questionnaire-9. Results: Older adults showed a high mean score (M=8.54; SD=1.34) in well-being, with no differences by sex (t(536) = −1.065, p = .288 > .05.) In linear regression analyses, social support (β =0,463, p<0,001) and depressive symptomatology (β =-1,585, p<0,001) influence the well-being of the elderly, and social support acts as a moderating factor (β=0.049, p=0.007, CI =0.021; 0.077) in the relationship between social support and well-being. Conclusions: Older people show high well-being. The results reinforce the relevance of social support as a protective factor for the positive mental health of older adults. This corroborates the importance of including this aspect in promotional and preventive mental health programs for older adults.
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Resumo O objetivo deste artigo é avaliar as Instituições de Longa Permanência para Idosos (ILPI) brasileiras, segundo o Modelo Teórico Multidimensional Integrado de Qualidade e Atendimento (MIQA), e comparar o desempenho alcançado entre as regiões do país. Estudo ecológico descritivo realizado com dados secundários públicos das ILPI participantes do Censo do Sistema Único da Assistência Social de 2018. Uma Matriz de Avaliação foi construída a partir das variáveis do Censo e do Modelo Teórico MIQA. Parâmetros de qualidade foram empregados para classificar o desempenho das instituições para cada indicador em "incipiente", "em desenvolvimento" ou "desejável. O índice de disparidade foi obtido para cada indicador. Foram analisadas 1.665 instituições. Observaram-se diferenças nos percentuais de ILPI com desempenho "desejável" entre as regiões brasileiras, e a necessidade de aprimoramento na maioria das ILPI em relação à proporção de cuidadores de pessoas idosas, a composição da equipe multiprofissional, a acessibilidade e a oferta de ações de promoção de saúde. Verificou-se a necessidade de apoio governamental para a supressão dos critérios de diferenciações excludentes e para a expansão dos serviços para superar as superlotações.
Abstract This article aims to evaluate the Brazilian Long-Term Institutions for Older People (LTIE), according to the Integrated Multidimensional Theoretical Model of Quality and Service (MIQA), and compare the performance achieved between the regions of the country. Descriptive ecological study carried out with public secondary data from the LTIE participating in the 2018 Census of the Unified Social Assistance System. An Evaluation Matrix was constructed from the Census variables and the MIQA Theoretical Model. Quality parameters were used to classify the institutions' performance for each indicator as "incipient", "developing" or "desirable". The disparity index was obtained for each indicator. 1,665 institutions were analyzed. Differences were observed in the percentages of LTIE with "desirable" performance between Brazilian regions, and the need for improvement in most LTIE in relation to the proportion of caregivers of older people, the composition of the multidisciplinary team, accessibility and supply of health promotion actions. There was a need for government support for the suppression of exclusionary differentiation criteria and for the expansion of services to overcome overcrowding.
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O envelhecimento populacional, realidade no Brasil, é um processo fisiológico acompanhado por diversos fatores que podem aumentar a vulnerabilidade dessa população. O objetivo do presente estudo foi caracterizar uma amostra de idosos usuários da Atenção Primária à Saúde quanto aos fatores sociodemográficos, aspectos de saúde e hábitos de vida, associados à prevalência de vulnerabilidade social, de acordo com variáveis preditoras. Os dados foram coletados por meio de aplicação de questionário e posteriormente digitados, validados e analisados por meio de estatística descritiva. Foram entrevistados 403 idosos, com maioria composta pelo sexo feminino, idade entre 60-69 anos, da cor branca, que possuem companheiro, cursaram o ensino fundamental, que praticam atividade física, não fumam ou bebem, não exercem atividade remunerada, com renda per capita mensal menor ou igual a 1 salário mínimo, que residem com 2 pessoas e que possuem 3 ou mais doenças crônicas não transmissíveis. A prevalência de vulnerabilidade social, dada pela ausência de cônjuge, baixa escolaridade e baixa renda, foi de 51% e variou em função do sexo (56,7% em mulheres; p=0,01), mas não variou em função da idade (p=0,30) e da cor da pele (p=0,07). A maior vulnerabilidade social em idosas é decorrente da maior longevidade, associada muitas vezes à ausência de companheiro, bem como pelas históricas desvantagens educacionais, que culminam em baixa escolaridade, e dificuldades financeiras, como menor renda, em comparação aos homens.
Ageing population, a reality in Brazil, is a physiological process accompanied by several factors that can increase the vulnerability of this population. The objective of the present study was to characterize a sample of older population users of the urban network of Primary Health Care regarding sociodemographic factors, health aspects and lifestyle habits, associated with the prevalence of social vulnerability, in accordance with predictor's variables. Data were collected through questionnaire application and later typed, validated and analyzed using descriptive statistics. We interviewed 403 elderly, with a majority composed of females, aged 60-69 years, white, who have a partner, attended elementary school, who practice physical activity, do not smoke or drink, do not perform paid activity, with per capita monthly income less than or equal to 1 minimum wage, who live with 2 people and who have 3 or more chronic non-communicable diseases. The prevalence of social vulnerability, given by the absence of spouse, low schooling and low income, was 51% and varied according to gender (56.7% in women; p=0.01), but did not vary according to age (p=0.30) and skin color (p=0.07). The greater social vulnerability in the old women is due to greater longevity, often associated with the absence of a partner, as well as historical educational, with low educational level, and income disadvantages, as lower income, compared to men.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , AncianoRESUMEN
RESUMO Objetivo Verificar se existe relação entre duração do sono, sintomas depressivos e estresse em pessoas idosas da comunidade. Métodos Estudo transversal, realizado com 116 idosas residentes em áreas de Unidades de Saúde da Família no município de São Carlos/SP. Foram utilizados os seguintes instrumentos: questionário de caracterização sociodemográfica; Índice de Qualidade do Sono de Pittsburgh; Escala de Depressão Geriátrica e Escala de Estresse Percebido. Os testes estatísticos utilizados foram teste de qui-quadrado de Pearson, Kruskall-Wallis, teste de Mann-Whitney e regressão linear múltipla. Resultados Entre as idosas, 50% referiram ter boa qualidade do sono e 49,1% dormiam entre sete e nove horas de sono noturno. Quando comparadas, as idosas com maior duração do sono apresentaram mais sintomas depressivos e escores mais elevados para o estresse percebido. Conclusão O modelo com aplicação do método hierárquico aponta que existe relação entre duração do sono, sintomas depressivos e estresse.
ABSTRACT Objective To verify whether there is a relationship between sleep duration, depressive symptoms and stress in elderly people in the community. Methods A cross-sectional study carried out with 116 older people living in areas of Family Health Units in the city of São Carlos/SP. The following instruments were used: sociodemographic characterization questionnaire; Pittsburgh Sleep Quality Index; Geriatric Depression Scale and Perceived Stress Scale. The statistical tests used were Pearson's chi-square test, Kruskall-Wallis, Mann-Whitney test and Multiple Linear Regression. Results 50% of the older people reported a good quality of sleep and 49.1% slept between seven and nine hours of sleep at night. When compared, older women with longer sleep duration had more depressive symptoms and higher scores for perceived stress. Conclusion The model with application of the hierarchical method points out that there is a relationship between sleep duration, depressive symptoms and stress.
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En los últimos años distintos estudios muestran la eficacia de las intervenciones en Psicología Positiva para mejorar la sintomatología depresiva y el bienestar en población adulta; sin embargo, hay pocos estudios que revisen la eficacia de estas intervenciones en personas de 60 años o más. Objetivo: recoger y sintetizar la evidencia existente en la última década con respecto a las intervenciones en Psicología Positiva en estas personas. Método: se ha realizado una revisión sistemática (RS) que recoge las publicaciones, realizadas entre enero de 2012 y julio de 2022, procedentes de las bases de datos SCOPUS, WOS/Medline y PROQUEST/PsycInfo. Se seleccionaron 944 estudios empíricos, de los cuales 18 cumplieron los criterios de inclusión. Resultados: se presenta evidencia sobre la eficacia de las intervenciones en Psicología Positiva para reducir la sintomatología depresiva e incrementar el bienestar subjetivo y psicológico en personas de estas edades, con efectos superiores a los de otros grupos de control. Esto sucede con programas de intervención en bienestar, al entrenar varias fortalezas- gratitud o perdón junto con otras- o entrenando en mindfulness. Conclusión: estos resultados subrayan la importancia de considerar las intervenciones en Psicología Positiva como terapias complementarias para mejorar la salud mental y la calidad de vida en personas mayores de 60 años.
Recently, different studies have shown the efficacy of interventions in Positive Psychology to improve both depressive symptoms and well-being in adults. However, there are only a few studies that review the efficacy of these interventions in people aged 60 years and older. Objective: synthesize the evidence from the last decade about these interventions in these people. Method: A systematic review was conducted. Publications between 2012 and 2022 -from SCOPUS, WOS/Medline and PROQUEST/PsycInfo- were included. After analyzing 944 empirical works, 18 studies have met the inclusion criteria. Results: the results show the efficacy of interventions in Positive Psychology, both to reduce depressive symptoms, and to increase subjective and psychological well-being in people of these ages, compared to other control groups. These effects are found with interventions on well-being, with interventions on personal strengths -gratitude or forgiveness in combination with sense of humor, empathy, meaning of life or emotional regulation- or through training on mindfulness. Conclusions: The preliminary results point out the importance of interventions in Positive Psychology as complementary therapies to improve the metal health and quality of life in people over 60 years.
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Humanos , Persona de Mediana Edad , Anciano , Depresión/terapia , Bienestar PsicológicoRESUMEN
Antecedentes: el envejecimiento de la población chilena y la transición epidemiológica que atraviesa el país, ha incrementado la necesidad de formar, entre otros especialistas, a médicos geriatras. Objetivo: estimar la brecha de geriatras en Chile de acuerdo con necesidades epidemiológicas de la población de 65 años y más. Método: se realizó una estimación de brecha de horas de geriatra para la red de salud, a partir de una consulta a 57 geriatras de laboralmente activos de un total de 156 geriatras registrados a enero del 2021. En dicha consulta se indagó sobre tiempo de duración de consulta y frecuencia de consultas ideales de acuerdo con la capacidad funcional de las personas mayores a nivel nacional y por región obtenida de la encuesta Casen 2017. Resultados: a febrero del 2022 existe un total de 162 geriatras en Chile, cifra que equivale a un geriatra por cada 15.806 personas de 65 años y más. De acuerdo con la estimación realizada, se requeriría en Chile, un total de 1.244.689 horas de geriatra anual, equivalentes a la existencia de 589 geriatras a nivel nacional. Conclusión: según los resultados del estudio, a nivel nacional se necesitarían de un total de 589 geriatras para cubrir las necesidades de atención de las personas mayores con algún nivel de dependencia. De acuerdo con estas cifras, al primer trimestre del 2022 el país presentaría una brecha de 427 geriatras. Ante lo elevada de esta brecha, se cree necesario avanzar en estrategias de formación general en geriatría y gerontología en los equipos de salud y socio-sanitarios.
Background:The ageing between the Chilean population and the epidemiological transition that the country is going through has increased the need to train, among other specialists, geriatric doctors.Objective: To estimate the gap between geriatricians in Chile according to the epidemiological needs of the population aged 65 years and over. Method:An estimate of the gap in geriatrician hours was made for the health network based on a consultation of 57 active geriatricians out of 156 registered as of January 2021. In this consultation, the duration and frequency of ideal consultations were inquired according to the functional capacity of the elderly at the national level and by region obtained from the Casen 2017 survey.Results: as of February 2022, there are 162 geriatricians in Chile, equivalent to one geriatrician for every 15,806 people aged 65 years and over. According to the estimate, a total of 1,244,689 hours of annual geriatrician would be required in Chile, equivalent to 589 geriatricians nationwide. Conclusion:According to the study's results, at the national level, a total of 589 geriatricians would be needed to cover the care needs of older people with some level of dependen-ce. According to these figures, in the first quarter of 2022, the country would present a gap of 427 geriatricians. Given the highness of this gap, it is believed necessary to advance general training strategies in geriatrics and gerontology in health and socio-health teams
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Este artigo tem o objetivo de analisar dois episódios da primeira temporada da Unidade Básica (2016), a fim de identificar sentidos sobre a saúde mental de idosos. Esta série televisiva foi divulgada pela Universal Channel e escrita por Helena Petta, Newton Cannito e Ana Petta. Apenas dois episódios compõem o corpus desta pesquisa; os outros foram desconsiderados por não abordarem o tema. O primeiro trata de Vilma, uma idosa que abandonou o autocuidado por causa da depressão, e o quarto fala sobre Eraldo, um idoso que ficou depressivo em razão de problemas financeiros, amorosos e alcoólicos. A análise de narrativas será utilizada como metodologia, possibilitando a identificação e a interpretação crítica dos sentidos sobre idosos e saúde mental. De forma geral, os resultados revelaram que os episódios não seguem uma visão holística, desconsiderando, portanto, a necessidade de cuidar da saúde física e mental das pessoas idosas para lhes proporcionar bem-estar.
This article aims to analyze two episodes of the first season of Unidade Básica (2016) in order to identify meanings about the mental health of older adults. This series was broadcast by Universal Channel and written by Helena Petta, Newton Cannito and Ana Petta. Only two episodes compose the corpus of this research; the others were disregarded because they do not deal with the theme. The first episode narrated the story of Vilma, an older woman who was depressed and then abandoned self-care. The fourth episode was about Eraldo, an older man who became depressed due to his financial, love and alcoholic problems. The narrative analysis was used as a methodology, enabling the identification and critical interpretation of meanings about older people and mental health. In general, the results reveal that the episodes do not follow a holistic view, disregarding the need to take care of physical and mental health to provide the well-being of them.
Este artículo tiene como objetivo analizar dos episodios de la primera temporada de Unidade Básica(2016) con el fin de identificar significados sobre la salud mental de los adultos mayores. Esta serie fue transmitida por Universal Channel y escrita por Helena Petta, Newton Cannito y Ana Petta. Sólo dos episodios constituyen el corpus de esta investigación; los demás fueron descartados por no retratar el tema. El primer episodio narra la historia de Vilma, una mujer la tercera edad que abandonó el autocuidado a causa de su estado de depresión. El cuarto episodio fue sobre Eraldo, un hombre también de la tercera edad, que se deprimió por problemas económicos, amorosos y alcohólicos. Se utilizó como metodología el análisis narrativo, que permitió la identificación e interpretación crítica de significados sobre las personas mayores y la salud mental. En general, los resultados revelan que los dos episodios no siguen una visión holística, desconociendo la necesidad de cuidar de la salud física y mental para proporcionar bienestar a las personas mayores.
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Humanos , Salud Mental , Atención Integral de Salud , Depresión , Salud Holística , Bienestar PsicológicoRESUMEN
Introduction: The Coronavirus disease 2019 (COVID-19) pandemic rapidly spread across continents causing widespread mortality. Older adults, especially those with underlying diseases, are more susceptible for COVID-19 infection. Due to this concern, reverse quarantine was adopted as a protective strategy. This can lead to several psychological and physical detrimental effects. Aims: 1). To assess the mental health status (depression and anxiety) among elderly people in the community during the COVID-19 pandemic.2) To assess the impact of COVID-19 pandemic restrictions and mental health issues on quality of life. Materials and Methods: This is a descriptive cross-sectional study among older adults (>60 yrs) residing in urban community in Central Kerala, India. Results: Of the 200 patients, more than half had moderate to high levels of anxiety and a poor social support. Depression was seen in only 1/4th of patients and that was significant in older women. Mean knowledge about COVID was below 80%. Social support was inversely associated with anxiety and depression. Anxiety and depression significantly affected QOL scores. Conclusion: This study emphasizes on the need for better mental health programmes tailored for our geriatric population. Joint multidisciplinary action plans with focus on enhancing social support can improve the quality of life of this vulnerable group
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ABSTRACT BACKGROUND: Increased longevity is accompanied by new social and health demands, such as the race/color social construct, indicating the need to identify the specific needs of older adults to maintain and improve their quality of life. OBJECTIVE: We aimed to verify the direct and indirect associations of demographic, economic, and biopsychosocial characteristics with self-assessed quality of life in older adults according to race/color. DESIGN AND SETTING: This cross-sectional study included 941 older adults living in the urban area of a health microregion in Minas Gerais, Brazil. METHODS: Older adults were divided into three groups: white (n = 585), brown (n = 238), and black (n = 102) race/color. Descriptive and trajectory analyses were performed (P < 0.05). RESULTS: Among the three groups, worse self-assessed quality of life was directly associated with lower social support scores and greater numbers of depressive symptoms. Worse self-assessed quality of life was also directly associated with a higher number of functional disabilities in basic activities of daily living and the absence of a partner among older adults of brown and black race/color. Lower monthly income and higher numbers of morbidities and compromised components of the frailty phenotype were observed among participants of white race/color, as well as lower levels of education in the brown race/color group. CONCLUSION: Factors associated with poorer self-assessed quality of life among older adults in the study community differed according to race/color.
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INTRODUCTION: Depressive symptoms can affect the quality of life of older people. Therefore, changes in this condition must be monitored. OBJECTIVE: To analyze the prevalence of changes in the indicative of depressive symptoms among older people and their associated factors. METHODS: Longitudinal study was carried out for two years with 387 older people from a municipality in Triângulo Mineiro, Brazil. Data were collected at home using Mini-Mental State Examination; a structured questionnaire prepared by the Collective Health Research Group; Lawton and Brody scale; and a short Geriatric Depression Scale. Descriptive analysis and multinomial logistic regression were performed (p<0.05). RESULTS: After the two-year follow-up, there was a decrease in the prevalence of older people with indicative depressive symptoms (24.3%). In addition, 20.2% of the older people have no indication of depressive symptoms; 63.0% maintained their initial condition and 16.8% were new cases. Positive self-rated health (p=0.003), functional independence for instrumental activities of daily living (p=0.025), and the lower number of morbidities (p=0.002) were predictors of improvement in indicative of depressive symptoms; while the increase in the number of morbidities (p=0.002) was a predictor for the presence of this condition. CONCLUSION: The occurrence of indicative depressive symptoms among older people decreased during the follow-up and the improvement of this condition was associated with positive self-rated health, functional independence for instrumental activities of daily living, and with a lower number of morbidities. Such factors should be considered when planning health actions aimed at preventing depressive symptoms in older people.
INTRODUÇÃO: A sintomatologia depressiva pode afetar a qualidade de vida dos idosos. Logo, as mudanças nesta condição devem ser acompanhadas. OBJETIVO: Analisar a prevalência de mudanças do indicativo de sintomas depressivos entre idosos da comunidade e seus fatores associados, em um período de dois anos. MÉTODOS: Estudo longitudinal realizado com 387 idosos de um município no Triângulo Mineiro. Os dados foram coletados no domicílio mediante a aplicação do Miniexame do Estado Mental; questionário estruturado elaborado pelo Grupo de Pesquisa em Saúde Coletiva; e Escalas de Lawton e Brody e de Depressão Geriátrica Abreviada. Procederam-se as análises descritiva e regressão logística multinomial (p<0,05). RESULTADOS: Após follow-up de dois anos, houve diminuição da prevalência de idosos com indicativo de sintomas depressivos (24,3%). Ademais, 20,2% dos idosos deixaram de ter indicativo de sintomas depressivos; 63,0% mantiveram a condição inicial e 16,8% foram novos casos. A autoavaliação da saúde positiva (p=0,003), independência funcional para as atividades instrumentais da vida diária (p=0,025) e o menor número de morbidades (p=0,002) foram preditores de melhora do indicativo de sintomas depressivos; enquanto, o aumento do número de morbidades (p=0,002) foi preditor para a presença desta condição. CONCLUSÃO: A ocorrência do indicativo de sintomas depressivos entre os idosos diminuiu ao longo do seguimento e a melhora desta condição esteve associada à autoavaliação da saúde positiva, independência funcional para as atividades instrumentais da vida diária e ao menor número de morbidades. Tais fatores devem ser considerados no planejamento de ações de saúde direcionadas à prevenção da sintomatologia depressiva em idosos.
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Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Salud del Anciano , Factores de Riesgo , Depresión/epidemiología , Calidad de Vida , Salud Pública , Estudios Longitudinales , Factores SociodemográficosRESUMEN
Resumo Objetivo investigar a autopercepção das condições bucais e fatores associados em idosos quilombolas rurais do norte de Minas Gerais, Brasil. Método Trata-se de um estudo analítico e transversal de base populacional, no qual utilizou-se uma amostragem por conglomerados com probabilidade proporcional ao tamanho (n=406). A coleta de dados envolveu a realização de entrevistas e exames clínicos odontológicos. A autopercepção das condições bucais foi avaliada por meio do GOHAI (Índice de Determinação da Saúde Bucal Geriátrica). Resultados A maioria dos idosos autopercebeu a saúde bucal como ótima (46,3%) ou regular (30,2%). Os pesquisados revelaram ainda precária saúde bucal e acesso restrito aos serviços odontológicos. Verificaram-se, na análise múltipla, associações significantes (p˂0,05) entre GOHAI regular e variáveis relativas ao local da última consulta e uso de prótese, bem como entre GOHAI ruim e variáveis atinentes ao estado conjugal, religião, motivo da última consulta, índice CPO-D e uso de prótese. Conclusão Parcela expressiva dos idosos quilombolas manifestou uma autoavaliação mais positiva da saúde bucal, divergente do quadro odontológico constatado profissionalmente. Constatou-se ainda que o relato de percepção ruim das condições bucais esteve fortemente associado a uma saúde bucal mais precária entre os investigados.
Abstract Objective to investigate self-perception of oral conditions and associated factors in rural quilombola older people in northern Minas Gerais, Brazil. Method This is an analytical and cross-sectional population-based study, in which cluster sampling with probability proportional to size (n=406) was used. Data collection involved conducting interviews and clinical dental examinations. Self-perception of oral conditions was assessed using the GOHAI (Geriatric Oral Health Determination Index). Results Most older people self-perceived oral health as excellent (46.3%) or regular (30.2%). Those surveyed also revealed precarious oral health and restricted access to dental services. In the multiple analysis, significant associations (p˂0.05) were found between regular GOHAI and variables related to the location of the last consultation and use of prosthesis, as well as between poor GOHAI and variables related to marital status, religion, reason for last consultation, CPO-D index and use of prosthesis. Conclusion A significant portion of the quilombola older people showed a more positive self-assessment of oral health, which differs from the professionally verified dental condition. It was also found that the report of poor perception of oral conditions was strongly associated with poorer oral health among those investigated.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Autoimagen , Servicios de Salud Dental , Odontología Geriátrica , Brasil , Salud Bucal/etnología , Cuidado Dental para Ancianos , Diagnóstico Bucal , Autoevaluación Diagnóstica , Accesibilidad a los Servicios de Salud/organización & administraciónRESUMEN
Resumo Objetivo Analisar as repercussões do ageísmo direcionado a pessoas idosas durante a covid-19, por meio dos conteúdos disponíveis na plataforma Youtube™. Método Estudo netnográfico, exploratório e qualitativo, cujos dados foram coletados em vídeos na plataforma Youtube™; foi realizada análise temática de conteúdo de Bardin e os elementos foram discutidos à luz da Teoria do Estigma. Resultados Três categorias explicam as repercussões do fenômeno investigado: expressões do ageísmo pré-existentes à pandemia, com expressões de exclusão, desconsideração e desrespeito; expressões de ageísmo durante a pandemia a partir do rótulo de grupo de risco que fortalece os estereótipos de doentes e incapazes; e sentimentos e atitudes da pessoa idosa frente às repercussões do ageísmo, que levaram a repercussões nas interações sociais, no estilo de vida e na saúde das pessoas idosas. Conclusões As repercussões podem ocasionar sequelas de ordem física, cognitiva, social e psíquica, e o combate aos seus impactos parte da esfera educativa para um pacto social que permita uma convivência respeitosa e empática entre as gerações.
Abstract Objective To analyze the repercussions of ageism directed at older people during covid-19, through the content available on the Youtube™ platform. Method Netnographic, exploratory and qualitative study, whose data were collected in videos on the Youtube™ platform; a thematic analysis of Bardin's content was performed and the elements were discussed in the light of the Theory of Stigma. Results Three categories explain the repercussions of the investigated phenomenon: expressions of ageism pre-existing to the pandemic, with expressions of exclusion, disregard and disrespect; expressions of ageism during the pandemic from the risk group label that strengthens stereotypes of sick and incapable people; and feelings and attitudes of the older people towards the repercussions of ageism, which led to repercussions on social interactions, lifestyle and health of older people. Conclusions The repercussions can cause physical, cognitive, social and psychic sequelae, and the fight against its impacts starts from the educational sphere towards a social pact that allows a respectful and empathetic coexistence between generations.
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Resumo Objetivo compreender as percepções dos conselheiros acerca do funcionamento dos conselhos dos direitos da pessoa idosa no estado do Rio Grande do Norte. Método Trata-se de um estudo de natureza transversal analítica com abordagem quantitativa realizado com os conselheiros municipais dos direitos da pessoa idosa do estado do Rio Grande do Norte. Participaram 109 conselheiros, havendo predominância de membros titulares, do sexo feminino, de representação governamental e com nível de escolaridade superior. Resultados Foram apontados diversos desafios para atuação e funcionamento dos conselhos, dentre os quais destacam-se: ações isoladas, baixa participação de membros governamentais e representação da sociedade civil, pouco tempo de discussão nas reuniões e necessidade de instrumentos válidos para monitorar as ações dos conselhos. Evidenciaram-se também baixo conhecimento técnico dos conselheiros e aversão às divergências e posicionamentos políticos. Conclusão é imprescindível assegurar políticas intersetoriais, maior independência perante o executivo e, prioritariamente, maior capacitação dos conselheiros e fortalecimento político democrático para que possam não só promover, mas exercer um protagonismo sociopolítico a partir de uma construção coletiva e representatividade social.
Abstract Objective to understand the perceptions of councilors about the functioning of councils for the rights of older people in the state of Rio Grande do Norte. Method This is an analytical cross-sectional study with a quantitative approach carried out with municipal councilors for the rights of older people in the state of Rio Grande do Norte. 109 councilors participated, with a predominance of full members, female, from government representation and with a higher education level. Results Several challenges were identified for the performance and operation of the councils, among which stand out: isolated actions, low participation of government members and representation of civil society, little time for discussion in meetings and the need for valid instruments to monitor the actions of the councils. Low technical knowledge of the councilors and aversion to divergences and political positions were also evidenced. Conclusion it is essential to ensure intersectoral policies, greater independence from the executive and, above all, greater training of councilors and democratic political strengthening so that they can not only promote, but exercise a socio-political protagonism based on a collective construction and social representation.