Efectividad del programa de musicoterapia, en el envejecimiento activo y saludable en la tercera edad - Anexo de Cochayoc, Tarma ­ 2022 / Effectiveness of the Music Therapy Program in Active and Healthy Aging in the Elderly -Cochayoc Annex, Tarma ­2022

Objetivo: Determinar el efecto del programa de musicoterapia en el envejecimiento activo y saludable en la tercera edad ­anexo de Cochayoc, Tarma. Material y métodos: Cuasi experimental, prospectivo, longitudinal, analítico, aplicativo; con pre -post test de un mismo grupo experimental; la población es de 60 personas de la tercera edad y la muestra fue seleccionada a través del muestreo no probabilístico intencional constituido por 30 personas de la tercera edad, la recolección de datos fue mediante una lista de cotejo y uso de 3 cuestionarios. La prueba de confiabilidad fue Alfa de Cronbach, con un 0.87 considerado como bueno. Resultados: Los resultados evidencian que, tras la aplicación del pre test, las personas de la tercera edad en un 90% (27) no logran el envejecimiento activo y saludable; posterior al desarrollo del programa de musicoterapia se evidencia en el post test que un 93.3% (28) logran el envejecimiento activo y saludable. Con la prueba de Wilcoxon obtuvo que el valor P = 0,000 es menor al nivel de significancia 0,05; con un 95% de confianza, la aplicación del programa de musicoterapia "Melodías para la vida" es efectiva en el envejecimiento activo y saludable en la población de la tercera edad del Anexo de Cochayoc. Conclusiones: Tras comparar los valores entre el antes y después de aplicar el programa "Melodías para la vida" se observó que mejora el envejecimiento activo y saludable en todas sus dimensiones: emocional y afrontamiento positivo, hábitos saludables, cognitivo y participación social en las personas de la tercera edad

Objective:Determine the effect of the music therapy program on active and healthy aging in the elderly -Cochayoc Annex, Tarma. Material and methods:Quasi-experimental, prospective, longitudinal, analytical, applicative; with two observations (pre -post test) of the sameexperimental group; The population is 60 elderly people, and the sample was selected through intentional non-probabilistic sampling consisting of 30 elderly people, data collection was through a checklist and use of 3 questionnaires. The reliability test was Cronbach's Alpha, with 0.87 considered good. Results:The results show that, after the application of the pre-test, 90% (27) of the elderly don't achieve active and healthy aging; after the development of the music therapy program, it is evident in thepost test that 93.3% (28) achieved active and healthy aging. With the Wilcoxon test, it was obtained that the P value = 0.000 is less than the 0.05 level of significance; with 95% confidence, the application of the music therapy program "Melodies for life" is effective in active and healthy aging in the elderly population of the Cochayoc Annex. Conclusions:After comparing the values between before and after applying the "Melodies for Life" program, it was observed that it improves active and healthy agingin all its dimensions: emotional and face positively, healthy habits, cognitive and social participation in elderly people

Assessment of intrinsic capacity in the Brazilian older population and the psychometric properties of the WHO/ ICOPE screening tool: a multicenter cohort study protocol / Avaliação da capacidade intrínseca da população idosa brasileira e das propriedades psicométricas do instrumento de triagem do ICOPE/OMS: protocolo de estudo de coorte multicêntrico

Introduction: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce. Objectives: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool. Methods: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months. Expected results: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq). Relevance: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil. (AU)

Introdução: A Organização Mundial da Saúde (OMS) propõe o monitoramento da capacidade intrínseca (CI) da população idosa como estratégia de saúde pública por meio do Programa ICOPE (Integrated Care for Older People). Embora construído com base em conceitos sólidos, a evidência científica sobre a aplicabilidade prática da proposta ainda é escassa. Objetivo: Avaliar a capacidade intrínseca da população idosa brasileira, sua trajetória e sua associação com variáveis sociodemográficas, de saúde e desfechos. Avaliar as propriedades psicométricas da ferramenta de triagem da estratégia ICOPE da OMS. Metodologia: Coorte multicêntrica prospectiva com seguimento de 36 meses. Serão recrutadas 3.838 pessoas com 60 anos ou mais, cadastradas nas unidades de saúde incluídas no estudo pelos centros participantes. Serão coletados dados sociodemográficos e de saúde e aplicados instrumentos para avaliação dos domínios da CI, tanto aqueles previstos no instrumento de triagem do ICOPE quanto a sequência de avaliações confirmatórias previstas no programa. Os participantes serão acompanhados semestralmente ao longo de 36 meses. Resultados esperados: Estabelecer o perfil da CI na população estudada, entender a sua trajetória e as variáveis associadas aos desfechos clínicos avaliados. Revelar as propriedades diagnósticas e o perfil psicométrico da ferramenta de triagem do ICOPE da OMS. O projeto tem financiamento do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). Relevância: Compreensão sobre o potencial de utilização da estratégia ICOPE de saúde pública proposta pela OMS no âmbito do Sistema Único de Saúde (SUS) pela integração de diversos centros de pesquisa científica na área de Geriatria e Gerontologia de todo o Brasil. (AU)

Construcción de la alimentación en trayectorias vitales de personas mayores

Introducción: La alimentación se construye a partir de experiencias y significados adquiridos en el curso de la vida. Las personas mayores tienen un acervo importante que informa de valores y prácticas culturales aplicadas a la alimentación. El objetivo del estudio fue interpretar los significados que entregan personas mayores a la construcción de su alimentación en trayectorias del curso de vida. Métodos: La investigación utilizó un enfoque cualitativo de alcance exploratorio, utilizando el método de teoría fundamentada de Strauss y Corbin. Para la recolección de datos se aplicó una entrevista semiestructurada entre julio de 2021 y junio de 2022. El tipo de muestreo fue teórico y el análisis de los datos cualitativos respondió al proceso de codificación abierta, axial y selectiva. Resultados: Participaron 54 personas mayores (72% mujeres) con edad promedio de 68,6 años (6,9 años). Las personas mayores construyeron su alimentación con un alto significado a las comidas caseras, con influencia de género femenino durante la niñez y adolescencia. En la adultez, se reconstruye la alimentación al ingresar al mundo laboral. En la actualidad, cimentan la alimentación con un enfoque de cuidados para su salud. Reconocen transiciones y puntos de inflexión en la alimentación provocados por terremotos, pandemia por COVID-19, situación política en el país, embarazos o el diagnóstico de alguna enfermedad crónica. Discusión: Las personas mayores reconocen diversas vivencias en trayectorias vitales que han marcado sus patrones alimentarios. Estas experiencias de vida pueden ser la base de estrategias o acciones en la práctica clínica que aporten a su bienestar.

Introduction: Food is intricately woven into the fabric of our experiences and the meanings accumulated throughout life. Older people possess a rich cultural heritage that shapes the values and practices surrounding food.The aim of the study was to interpret the meanings attributed to older people to the construction of their feeding in life course trajectories. Methods: The research employed a qualitative exploratory approach, utilizing the Grounded Theory method developed by Strauss and Corbin. Data collection took place through semi-structured interviews conducted between July 2021 and June 2022. The sampling method employed was theoretical, and the analysis of qualitative data followed the open, axial, and selective coding process. Results: A total of 54 older individuals (72% women), with an average age of 68.6 years (6,9 years), participated in the study. These individuals constructed their relationship with food, assigning significant value to homemade meals, influenced by gender roles during childhood and adolescence. In adulthood, the relationship with food transformed with entry into the workforce. Currently, their feeding are guided by a health-centric approach. They recognize transitions and turning pointsin food provoked by earthquakes, pandemic by COVID-19, political situation in the country, pregnancies or the diagnosis of a chronic disease. Discussion: Older people recognize a multitude of life experiences that have left imprints on their eating patterns. These life experiences can be the basis for strategies or actions in clinical practice that contribute to their well-being.

Quality of life of older adults in Family Health Strategy: a cross-sectional study

ABSTRACT BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

Organização da atenção à saúde da pessoa idosa - relato de experiência a partir da técnica do arco de maguerez / Organization of health care for elderly people - experience report using the maguerez arch technique / Organización de atención en salud a personas mayores - reporte de experiencia utilizando la técnica del arco de maguerez

Uma das características mais marcantes da atual dinâmica demográfica mundial é o processo de envelhecimento populacional. Nessa lógica, em 2050, cerca de um quarto da população brasileira terá mais de 60 anos, indicando um aumento progressivo de demandas em saúde. Ocorre que as equipes de Atenção Primária à Saúde, ainda apresentam dificuldades de organização e oferta de ações específicas para esse público. Nesse sentido, por meio de pesquisa-ação, utilizando a técnica do Arco de Maguerez, foram desenvolvidas oficinas para profissionais do município de Camboriú/SC, com o objetivo de reorganizar a atenção à Saúde da pessoa idosa no município. As etapas demonstram forte influência do modelo biomédico, e ausência de ações específicas para a população idosa, porém, também foi possível desenvolver reflexões e propostas de reorganização do processo de trabalho a partir dos atributos da Atenção Primária à Saúde, o que potencialmente pode produzir melhorias nos indicadores de saúde da pessoa idosa.

One of the most remarkable characteristics of the current global demographic dynamics is the process of population aging. In this context, by 2050, approximately a quarter of the Brazilian population will be over 60 years old, indicating a progressive increase in healthcare demands. However, Primary Health Care teams still face difficulties in organizing and providing specific actions for this population. On this subject, through Research-Action method using the Maguerez Arch technique, workshops were developed for professionals in the municipality of Camboriú/SC, with the aim of reorganizing healthcare for the elderly in the municipality. The stages demonstrate a strong influence of the biomedical model and a lack of specific actions for the elderly population. However, it was possible to develop reflections and proposals for reorganizing the work process based on the attributes of Primary Health Care, which potentially can result in improvements in health indicators for the elderly.

Una de las características más llamativas de la actual dinámica demográfica global es el proceso de envejecimiento de la población. Así, en 2050, alrededor de una cuarta parte de la población brasileña tendrá más de 60 años, lo que indica un aumento progresivo de las demandas de salud. Resulta que los equipos de Atención Primaria de Salud aún tienen dificultades para organizarse y ofrecer acciones específicas para este público. En este sentido, a través de la investigación acción, utilizando la técnica del Arco de Maguerez, se desarrollaron talleres para profesionales de la ciudad de Camboriú/SC, con el objetivo de reorganizar la atención a la salud de las personas mayores de la ciudad. Las etapas evidencian una fuerte influencia del modelo biomédico, y la ausencia de acciones específicas para la población adulta mayor, sin embargo, también fue posible desarrollar reflexiones y propuestas de reorganización del proceso de trabajo a partir de los atributos de la Atención Primaria de Salud, que puede potencialmente producir mejoras en los indicadores de salud de las personas mayores.

The effectiveness of participation in the active aging program of a university hospital / A efetividade de participação no programa envelhecimento ativo do hospital universitário

ABSTRACT Active aging is based on four pillars: health, safety, participation, and lifelong learning. These pillars help individuals improve their quality of life throughout the aging process. Objective: To analyze the effectiveness of the Active Aging Program; identify the sociodemographic profile of the participants; identify prevalent diseases in the initial evaluation; and assess the results of the program after one year of follow-up. Methods: This is a quantitative, cross-sectional, exploratory, desk research, and descriptive study. Data from 545 employees of University of São Paulo participating in the Active Aging Program of the University Teaching Hospital of the University of São Paulo (HU-USP) between 2015 and 2018 were analyzed using the Minitab Program. For data analysis, Pearson's chi-square test was used to determine the association between Groups A and B. For continuous measures, the paired t-test was used to verify differences in means, adopting a 95% confidence interval and significance level of 0.05. Results: Statistically significant correlations were found when crossing sex with smoking; sex with triglycerides; age with risk factors for cardiovascular diseases, being the age group 40-59 statistically more significant; physical activity with risk factors for cardiovascular diseases; and body mass index at program entry with the one-year result. Conclusion: The study expanded knowledge about risk factors for cardiovascular diseases and provided important information for the continuity of the program.

RESUMO O envelhecimento ativo se apoia em quatro pilares: saúde, segurança, participação e aprendizagem ao longo da vida. Esses pilares auxiliam os indivíduos na qualidade de vida ao longo do processo de envelhecimento. Objetivo: Analisar a efetividade do Programa Envelhecimento Ativo; identificar o perfil sociodemográfico dos participantes; identificar patologias predominantes na avaliação inicial; e verificar os resultados do programa após um ano de acompanhamento. Métodos: Trata-se de pesquisa quantitativa, de caráter transversal, exploratória, documentária e descritiva. Foram analisados os dados de 545 funcionários da Universidade de São Paulo que participaram do Programa do Envelhecimento Ativo do Hospital Universitário da Universidade de São Paulo (HU-USP) no período de 2015 a 2018. Os dados foram analisados pelo Programa Minitab. Na análise de dados, usou-se o Qui-quadrado para testar a associação entre os grupos. Já para medida contínua, utilizou-se o Teste T Pareado, para verificar se as médias eram diferentes. Nas análises, foi usado um período de confiabilidade de 95% e nível de relevância de 0,05. Resultados: Foram encontradas correlações estatisticamente expressivas no cruzamento de sexo com tabagismo; sexo com triglicérides; idade com fatores de risco para doenças cardiovasculares sendo que a faixa etária de 40-59 foi estatisticamente mais significativa; atividade física com prevalência de fatores de riscos para doenças cardiovasculares; e índice de massa corpórea inicial com o resultado após um ano. Conclusão: A pesquisa ampliou o conhecimento a respeito dos fatores de risco para doenças cardiovasculares e forneceu informações importantes para a continuidade do programa.

Capacidade intrínseca e mortalidade entre pessoas idosas residentes em uma microrregião de saúde de Minas Gerais / Intrinsic capacity and mortality among older adults living in a health microregion of Minas Gerais

Resumo Objetivo Analisar a capacidade intrínseca e sua capacidade preditiva sobre a mortalidade por todas as causas em pessoas idosas residentes em uma microrregião de saúde de Minas Gerais, Brasil. Método Estudo tipo inquérito domiciliar, de abordagem quantitativa. Os dados foram coletados no domicílio com instrumentos validados no país. Resultados A média do escore de capacidade intrínseca foi de 5,8 (±1,63) pontos. No período de acompanhamento, com média de tempo de seguimento de 58,0 (±13,1) meses, ocorreram 142 óbitos (16,4%). Observou-se que para cada acréscimo no escore de capacidade intrínseca, ocorreu diminuição do risco de mortalidade em 21% (p<0,001). Conclusão A capacidade intrínseca exerceu papel preditivo sobre a mortalidade das pessoas idosas.

Abstract Objective To analyze intrinsic capacity and its ability to predict all-cause mortality in older adults living in a health microregion of Minas Gerais state, Brazil. Method A household survey study with a quantitative approach was conducted. Data were collected at homes using instruments validated for use in Brazil. Results Mean intrinsic capacity score was 5.8 (±1.63) points. During the follow-up period, with a mean follow-up time of 58.0 (±13.1) months, 142 deaths (16.4%) occurred. For each 1 point increase in intrinsic capacity score, there was a 21% reduction in the risk of mortality (p<0.001). Conclusion Intrinsic capacity served as a predictor of mortality in older adults.

Correlación entre la Velocidad de Marcha y Largo del Paso en Personas Mayores de la Cuarta Edad que Viven en la Comunidad / Correlation between Walking Speed and Step Length in Seniors Living in the Community

Introducción. La población de personas mayores de la cuarta edad (≥80 años) crece a gran velocidad. Esta se diferencia de la tercera edad en cuanto a su funcionalidad. Es sabido que mientras menor sea la velocidad de la marcha en esta población, mayor es el riesgo de deterioro cognitivo, sarcopenia, discapacidad e institucionalización. La velocidad de marcha disminuida es un predictor importante de deterioro en el rendimiento físico. Objetivo. Determinar la correlación entre la velocidad de marcha, fuerza de miembros inferiores y largo del paso en personas mayores de cuarta edad que viven en la comunidad. Métodos. Estudio transversal en personas mayores saludables de la cuarta edad (n=14; 8 mujeres; 88 ± 3 años; 26,3 ± 3,4 kg·m-2) que fueron sometidas a evaluaciones de rendimiento físico, tales como largo del paso; fuerza de miembros inferiores a través de 1 Repetición Máxima (1RM) de extensión de rodilla en ambos miembros inferiores y velocidad de marcha en 4 metros. Los datos se presentan como media±desviación estándar. Se consideró un valor de P significativo < 0.05. Resultados. Se observó una correlación positiva moderada entre el largo del paso y la velocidad de marcha (R=0,794; P=0,001). No existieron correlaciones entre la fuerza de miembros inferiores y largo del paso (R=0,478; P=0,084), tampoco entre las variables de fuerza y velocidad de marcha (R=0,441; P=0.115). Conclusión. Las personas mayores de cuarta edad presentan una correlación positiva entre su velocidad de marcha y largo del paso.

Background. The population of people older than the fourth age (≥80 years) is growing rapidly. This differs from the third age in terms of its functionality. It is known that the lower the gait speed in this population, the greater the risk of cognitive impairment, sarcopenia, disability and institutionalization. Decreased gait speed is an important predictor of deterioration in physical performance. Objetive. To determine the correlation between gait speed, lower limb strength and stride length in fourth age people (≥80 years) who live in the community. Methods. Cross-sectional study in healthy older people of the fourth age (n=14; 8 women; 88 ± 3 years; 26.3 ± 3.4 kg·m-2) who underwent physical performance evaluations, such as long of the step; strength of lower limbs through 1 Maximum Repetition (1RM) of knee extension in both lower limbs and walking speed in 4 meters. Data are presented as mean ± standard deviation. A significant P value < 0.05 was considered. Results. A moderate positive correlation was observed between stride length and gait speed (R=0.794; P=0.001). There were no correlations between the strength of the lower limbs and stride length (R=0.478; P=0.084), nor between the variables of strength and gait speed (R=0.441; P=0.115). Conclusion. Fourth age older people older present a positive correlation between their walking speed and stride length.

El envejecimiento poblacional: una mirada desde la práctica de enfermería basada en el modelo de Nola J. Pender

El envejecimiento poblacional no es un fenómeno exclusivo de la sociedad moderna; ha estado presente en todas las etapas del desarrollo social y ha sido siempre de interés para la filosofía, el arte y la medicina. Se presenta una revisión bibliográfica, con el objetivo de valorar la aplicación del modelo de Nola J. Pender en la promoción de salud y su aplicabilidad desde su visión teórica en la práctica de enfermería comunitaria en el envejecimiento poblacional. Se analizan los aspectos teóricos expresados por ella, sus principales supuestos y su relación con el envejecimiento poblacional, además de exponer sus aportes teóricos, la importancia de su aplicación para la familia, la comunidad y su contribución al desarrollo de la enfermería no solo de Cuba sino en el mundo; si partimos de que Cuba está entre los países más envejecidos de Latinoamérica. La promoción de la salud motivada por el deseo de aumentar el bienestar y actualizar el potencial humano, es considerada en la actualidad una poderosa herramienta que permite promover actitudes, motivaciones y acciones a partir del concepto de autoeficacia, del compromiso de los individuos con el cambio de conductas para fomentar salud, no solo sobre el envejecimiento en sí, sino desde el envejecimiento. Los principales supuestos de Nola J. Pender en el modelo de promoción de salud la sitúan como marco de referencia en la investigación, al fortalecer la profesión y fundamentar su quehacer de manera objetiva hacia los intereses de los profesionales y las necesidades de las personas.

Population aging is not an exclusive phenomenon of modern society; it has been present in all social development stages and has always been of interest to philosophy, art and medicine. A bibliographical review is presented for evaluating the Nola J. Pender model application in health promotion, and its applicability from its theoretical vision in the community nursing practice in aging population. The theoretical aspects expressed by her, her main assumptions and her relationship with population aging are analyzed, in addition to exposing her theoretical contributions, the importance of her application for the family, the community and her contribution to the development of nursing not only in Cuba but in the world; if we start from the fact that Cuba is among the oldest countries in Latin America. Health promotion motivated by the desire to increase well-being and update human potential is currently considered a powerful tool that allows promoting attitudes, motivations and actions based on the concept of self-efficacy, the commitment of individuals to change of behaviors to promote health, not only about aging itself, but from aging. The main assumptions of Nola J. Pender in the health promotion model place it as a reference framework in research, by strengthening the profession and basing its work objectively on the interests of professionals and the people needs.

Modelo de co-construcción intergeneracional de cápsulas comunicacionales en base a comidas tradicionales

Introducción: La valoración de las comidas tradicionales resulta esencial para mantener el patrimonio gastronómico, sin embargo, su divulgación es limitada, por lo que se requiere de estrategias comunicacionales que promuevan la difusión de las culturas inmateriales. Objetivo: Elaborar un modelo de co-construcción de cápsulas comunicacionales intergeneracionales para difundir preparaciones culinarias significativas de personas mayores. Material y métodos: El estudio se enmarca en la investigación aplicada del tipo tecnológico. Se realizó una búsqueda teórica de aspectos relevantes en el uso de cápsulas comunicacionales (videos), así como el uso de TICs en personas mayores, siguiendo los lineamentos del diseño cualitativo a través de un análisis de contenido temático. Luego se construye un modelo, que es validado por profesionales del área gerontológica, para ser aplicado en un proyecto piloto que incluyó a una diada constituida por una persona mayor y un descendiente, los que guiaron y grabaron una entrevista en profundidad focalizada. Resultados: Se co-construyeron 6 videos con preparaciones culinarias tradicionales en el que participaron 5 mujeres y 1 hombre, de las Regiones del Biobío y Metropolitana. Se siguió modelo teórico que incorporó 7 pasos para su elaboración: identificación de diada intergeneracional, capacitación, realización del video, primera edición del video, presentación del video a la diada, edición final y difusión del video en redes sociales. Conclusiones: Como estrategia para un envejecimiento saludable, la realización de un video intergeneracional con una receta preferida se visualiza como una oportunidad para entrelazar cultura, patrimonio y emociones entre los participantes y la comunidad.

Introduction: The appreciation of traditional foods is essential in the maintenance of gastronomic heritage; however, its dissemination is limited, which is why communication strategies are required to promote the dissemination of intangible cultures. Objective: To develop a model for the co-construction of intergenerational communication capsules that allow the dissemination of significant culinary preparations for the elderly. Material and methods: The study is part of an applied technological research. In order to consolidate knowledge and use it for educational purposes, a theoretical search of relevant aspects in the use of communication capsules (videos) was carried out, following the guidelines of qualitative design through thematic content analysis. Then, a model is constructed and validated by professionals from the gerontological area to be applied to a pilot project that included a dyad made up of an elderly person and a descendant, who guided and recorded an in-depth focused interview. Results: A total of 6 videos about traditional culinary preparations made by 5 women and 1 man from the Biobío and Metropolitana Regions were co-constructed. A theoretical model that incorporated 7 steps for its elaboration was followed: identification of intergenerational dyad, training, making of the video, first edition of the video, presentation of the video to the dyad, final edition, and dissemination of the video on social networks. Conclusions: As a strategy for healthy aging, making an intergenerational video with a favorite recipe is seen as an opportunity to intertwine culture, heritage and emotions between participants and the community.

Efecto de la implementación de programas de gerontología comunitaria sobre el envejecimiento saludable o activo en adultos mayores en México: Revisión sistemática y meta-análisis / Effect of the implementation of community gerontology programs on healthy or active aging in older adults in Mexico: Systematic Review and meta-analysis

Introducción: El incremento de la población de adultos mayores y el aumento de la esperanza de vida han sido determinantes para la incidencia de las enfermedades crónico no trasmisibles en la vejez, lo que conlleva al riesgo de tener una limitación funcional física, psicológica y social. Por tal motivo, la intervención comunitaria para el Envejecimiento Saludable (ES) y Envejecimiento Activo (EA), es una oportunidad para que el adulto mayor mantenga, prolongue o recupere la capacidad funcional (CF), elemento clave del ES Método: se realizó una búsqueda de artículos científicos en las bases de datos PubMed, Scopus, SciELO, LILACS, TESIUNAM. Resultados: Se encontraron 378 artículos (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), de los cuales ocho cumplieron los criterios para el análisis cualitativo (revisión sistemática), solo 2 estudios fueron incluidos en el análisis cuantitativo (Meta-análisis). Respecto al MA los parámetros incluidos; concentración sanguínea de glucosa y colesterol (CL)así como en las cifras de presión arterial diastólica (PAD), índice de masa corporal (IMC) y peso. Es así como se encontró una disminución estadísticamente significativa después de la intervención en la concentración sanguínea, TG (-40.91, IC95% -53.90, -27.93 p<0.0001); CL (-19.39, IC95% -30.14, -8.63 p<0.0004) y PAS (-11.21 IC95% -20.29, -2.13 y p<0.02). Conclusiones: Nuestros hallazgos muestran un efecto positivo de los programas de intervención comunitaria de ES y EA, sobre las CF físicas, psicológicas y sociales, aunque existe una alta heterogeneidad en los métodos, tiempo de intervención y parámetros de medición, es a cabo estudios con una metodología similar.

Introduction: The increase in the population of older adults and the increase in life expectancy have been decisive for the incidence of chronic non-communicable diseases in old age, which entails the risk of having a physical, psychological and social functional limitation. For this reason, the community intervention for Healthy Aging (ES) and Active Aging (EA) is an opportunity for the elderly to maintain, prolong or recover functional capacity (FC), a key element of ES Method: a search of scientific articles was carried out in the PubMed, Scopus, SciELO, LILACS, TESIUNAM databases. Results: 378 articles were found (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), of which eight met the criteria for qualitative analysis (systematic review), only 2 studies were included in the quantitative analysis (Meta-analysis). Regarding the MA, the parameters included; blood glucose and cholesterol (CL) concentration, as well as diastolic blood pressure (DBP), body mass index (BMI) and weight. This is how a statistically significant decrease was found after the intervention in blood concentration, TG (-40.91, 95% CI -53.90, -27.93 p<0.0001); CL (-19.39, 95%CI -30.14, -8.63 p<0.0004) and PAS (-11.21 95%CI -20.29, -2.13 and p<0.02). Conclusions: Our findings show a positive effect of SE and EA community intervention programs on physical, psychological and social CF, although there is a high heterogeneity in the methods, intervention time and measurement parameters, it is carried out studies with a similar methodology.

Introdução: O aumento da população de idosos e o aumento da esperança de vida têm sido decisivos para a incidência de doenças crónicas não transmissíveis na velhice, o que acarreta o risco de ter uma limitação funcional física, psicológica e social. Por esta razão, a intervenção comunitária para o Envelhecimento Saudável (ES) e o Envelhecimento Ativo (EA) constitui uma oportunidade para os idosos manterem, prolongarem ou recuperarem a capacidade funcional (CF), elemento fundamental do ES. Método: foi realizada busca de artigos científicos nas bases de dados PubMed, Scopus, SciELO, LILACS, TESIUNAM. Resultados: foram encontrados 378 artigos (PubMed n=173, Scopus n=95, SciELO n=56, LILACS n=54, TESIUNAM n=17), dos quais oito atenderam aos critérios de análise qualitativa (revisão sistemática), apenas 2 estudos foram incluídos na análise quantitativa (Meta-análise). Em relação ao MA, os parâmetros incluídos; concentração de glicemia e colesterol (CL), bem como pressão arterial diastólica (PAD), índice de massa corporal (IMC) e peso. Foi assim que foi encontrada uma diminuição estatisticamente significativa após a intervenção na concentração sanguínea, TG (-40,91, IC 95% -53,90, -27,93 p<0,0001); CL (-19,39, IC95% -30,14, -8,63 p<0,0004) e PAS (-11,21 IC95% -20,29, -2,13 e p<0,02). Conclusões: Nossos resultados mostram um efeito positivo dos programas de intervenção comunitária de SE e EA na FC física, psicológica e social, embora haja uma alta heterogeneidade nos métodos, tempo de intervenção e parâmetros de medição, são realizados estudos com metodologia semelhante.

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

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

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

Implementación de una jornada virtual de telesalud y capacitación masiva para personas mayores chilenas y estudiantes de la salud. Impacto en la cobertura / Implementation of a virtual telehealth course for Chilean older adults and health students

Background: Aging increases the vulnerability to diseases and environmental changes such as the COVID-19 pandemic. Telehealth and tele-education are vital to prevent the deleterious effects of prolonged confinement, and to train the community, and constantly rotating medical students and health professionals. Aim: To assess the perception and impact of an online course about healthy aging aimed at the community and health care professionals. Material and Methods: An open online one-day course to promote healthy aging was carried out. A cross-sectional online survey about the course was answered by 386 attendants and a knowledge test was applied to 114 people. Results: Seventy-five percent of respondents attended the course synchronously. Of these, 79% were women, 20% were older people and 53% were caregivers of an older person. All respondents acquired new knowledge and were willing to participate again. The frequency of interest about self-care is three times greater than about caring for another person, In an older person, the interest is 101 more times about self-care than caring for another person. Ninety five percent of respondents felt more active and 84% felt more accompanied. Conclusions: The course facilitated access to information on the promotion of active and healthy aging in the community with a favorable perception and a positive impact. The coverage for older people with a digital gap should be improved.

Strengths, weaknesses, opportunities, and threats analysis of the national program for health care of the elderly

Background: The National Program for the HealthCare of the Elderly (NPHCE) was adopted by the Ministry of Health and Family Welfare in 2010 to provide promotional, preventive, curative, and rehabilitative health-care services for the fast-growing older population in India. As literature about the assessment of NPHCE is lacking, the present study was conducted to perform a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the program. Methods: The SWOT of the NPHCE program is analyzed using available literature and relevant documents. Results: Although this program embraces strategies to provide specialized training and services at primary health center, community health center, and district levels, including dedicated bedded wards, equipment, consumables, and pharmaceuticals but home-based care for the elderly, and the role of caregivers is overlooked in this program. NPHCE program can utilize the framework and take support of various ongoing healthy aging initiatives of international agencies to augment the health-care strategies for the elderly in India. Integrating schemes developed by the government for the upliftment of the elderly and the inclusion of traditional medicine systems in the program can serve as an opportunity for meeting unmet needs and improving the quality of life and well-being of the elderly. However, the growing elderly population, rise in nuclear families, and dual disease burden are significant threats to the program’s implementation. Conclusion: This program can be more effective in providing comprehensive health care to the elderly if more emphasis is given to community participation, home‑based care, and integrating digital health technologies and other existing welfare schemes.

Mechanisms Underlying Brain Aging Under Normal and Pathological Conditions / 神经科学通报·英文版

Aging is a major risk factor for many human diseases, including cognitive impairment, which affects a large population of the elderly. In the past few decades, our understanding of the molecular and cellular mechanisms underlying the changes associated with aging and age-related diseases has expanded greatly, shedding light on the potential role of these changes in cognitive impairment. In this article, we review recent advances in understanding of the mechanisms underlying brain aging under normal and pathological conditions, compare their similarities and differences, discuss the causative and adaptive mechanisms of brain aging, and finally attempt to find some rules to guide us on how to promote healthy aging and prevent age-related diseases.

Chemistry-led investigations into the mode of action of NAMPT activators, resulting in the discovery of non-pyridyl class NAMPT activators

The cofactor nicotinamide adenine dinucleotide (NAD+) plays a key role in a wide range of physiological processes and maintaining or enhancing NAD+ levels is an established approach to enhancing healthy aging. Recently, several classes of nicotinamide phosphoribosyl transferase (NAMPT) activators have been shown to increase NAD+ levels in vitro and in vivo and to demonstrate beneficial effects in animal models. The best validated of these compounds are structurally related to known urea-type NAMPT inhibitors, however the basis for the switch from inhibitory activity to activation is not well understood. Here we report an evaluation of the structure activity relationships of NAMPT activators by designing, synthesising and testing compounds from other NAMPT ligand chemotypes and mimetics of putative phosphoribosylated adducts of known activators. The results of these studies led us to hypothesise that these activators act via a through-water interaction in the NAMPT active site, resulting in the design of the first known urea-class NAMPT activator that does not utilise a pyridine-like warhead, which shows similar or greater activity as a NAMPT activator in biochemical and cellular assays relative to known analogues.

Research progress of physical resilience in the elderly / 中华全科医师杂志

With the increase of the elderly population, health problems of the elderly are more prominent and the health needs of the elderly are more complex and diverse, therefore, how to maintain their physical functional status has become the focus of research. Physical resilience and successful aging are closely related. This article reviews the concept of physical resilience, the relationship between physical resilience and frailty and intrinsic capacity, and its impact on the health status of the elderly. The aim of the article is to provide a reference for the assessment of physiological resilience and the related interventions to promote healthy aging.

Reflections on the Pain Points of Elderly Care during the Epidemic Prevention and Control Stage from Two Cases of Disease Narration / 中国医学伦理学

The COVID-19 has had a profound impact on human society, the elderly, as a vulnerable group, are the most affected. Based on two cases of disease narrative collected by the department of neurology of a hospital in Guiyang, this paper analyzed the shortcomings of elderly care in the context of epidemic prevention and control. The overall health information literacy of the elderly was low, which made it difficult to obtain correct epidemic related information. The lifestyle of the elderly has changed during the epidemic prevention and control stag. The long time isolation at home has reduced their constitution and made them prone to illness, thus affecting the quality of healthy elderly care. In this stage, the psychological burden of the middle-aged and elderly people has been increasing, which reduced the life satisfaction and subjective well-being of the elderly, and increased the risk of depression. In view of these outstanding problems, this paper proposed corresponding measures, aiming to improve the quality of life and physical and mental health of the elderly during the epidemic prevention and control stage, and provide reference for realizing healthy aging in China.

Equity throughout the life course and the evolving role of the Pan American Health Organization / Equidad a lo largo del curso de vida y la evolución del papel de la Organización Panamericana de la Salud / Equidade ao longo da vida e a evolução do papel da Organização Pan-Americana da Saúde

ABSTRACT The objective of this article is to summarize the evolution of the regional commitments of the Pan American Health Organization (PAHO) on health promotion and strategies to improve the health and well-being of women, children, adolescents, and older persons. PAHO regional strategies approved by Member States in the last 20 years are used as the main source of information. The article presents the challenges of making health promotion a public health strategy widely applied in the Region of the Americas and the efforts to renew Member States' collective actions. The article also describes current PAHO efforts to include the positive aspects of health (i.e., well-being, optimal development, and functional ability) and the life course approach as opportunities to advance equity. The article reflects on immunization as a public good and the urgency to address the current challenges as a core element of the regional efforts to transform health systems after more than two years of the COVID-19 pandemic.

RESUMEN El objetivo de este artículo es resumir la evolución de los compromisos regionales de la Organización Panamericana de la Salud (OPS) en materia de promoción de la salud y estrategias para mejorar la salud y el bienestar de mujeres, niños y niñas, adolescentes y personas mayores. Se han empleado como principal fuente de información las estrategias regionales de la OPS aprobadas por los Estados Miembros en los últimos 20 años. En el artículo se presentan los desafíos de convertir la promoción de la salud en una estrategia de salud pública de amplia ejecución en la Región de las Américas y los esfuerzos para renovar las medidas colectivas de los Estados Miembros. Asimismo, se describe la labor actual de la OPS para incluir los aspectos positivos de la salud (como el bienestar, el desarrollo óptimo y la capacidad funcional) y el enfoque del curso de vida como oportunidades para fomentar la equidad. Finalmente, se reflexiona sobre la inmunización como bien público y la urgencia de abordar los desafíos actuales como elemento central de los esfuerzos regionales para transformar los sistemas de salud tras más de dos años de pandemia de COVID-19.

RESUMO O objetivo deste artigo é resumir a evolução dos compromissos regionais da Organização Pan-Americana da Saúde (OPAS) relativos à promoção da saúde e estratégias para melhorar a saúde e o bem-estar de mulheres, crianças, adolescentes e pessoas idosas. As estratégias regionais da OPAS aprovadas pelos Estados Membros nos últimos 20 anos são a principal fonte de informação. O artigo apresenta os desafios enfrentados para fazer da promoção da saúde uma estratégia de saúde pública amplamente aplicada na Região das Américas e os esforços para renovar as ações coletivas dos Estados Membros. O artigo também descreve os atuais esforços da OPAS para incluir os aspectos positivos da saúde (isto é, bem-estar, desenvolvimento ideal e habilidade funcional) e a abordagem de curso da vida como oportunidades para promover a equidade. O artigo faz reflexões sobre a imunização como um bem público e a urgência de abordar os desafios atuais como um elemento central dos esforços regionais para transformar os sistemas de saúde após mais de dois anos da pandemia de COVID-19.

High performance older adults in a population-based sample with low education: Pietà study / Idosos de alta performance cognitiva em uma amostra de base populacional com baixa escolaridade: estudo Pietà

Abstract Background Healthy brain aging can be defined as aging without neurological or psychiatric disorders, sustaining functional independence. In addition to the absence of disease and preserved functionality, there are individuals who stand out for their superior performance to that considered normal for their age in cognitive tests. These individuals are called "high-performance older adults" (HPOA). Objectives To investigate the presence of HPOA in an oldest-old population with low education, and if present, to investigate associations with sociodemographic, clinical, and lifestyle variables. Methods We evaluated 132 cognitively healthy individuals from the Pietà Study, a population-based investigation with 639 participants. We used the delayed recall from the Rey Auditory-Verbal Learning Test to verify the existence of HPOA and to classify participants based on their performance. Sociodemographic, clinical, and lifestyle variables associated with HPOA were investigated. Results We identified 18 individuals fulfilling HPOA criteria (age: 77.4 ± 2.6 years old; 14 women; education: 4.6 ± 3.4 years). The other participants, 114 total (age: 79.8 ± 4.5 years old; 69 women; education: 3.0 ± 2.7 years) were classified as "standard performance older adults" (SPOA). In multivariate analysis, younger age (odds ratio [OR] =0.672; 95% confidence interval [CI]: 0.462-0.979; p = 0.037) and lower scores on the Geriatric Depression Scale (OR = 0.831; 95%CI: 0.688-0.989; p = 0.038) were associated with HPOA. Conclusions The present study identifies for the first time HPOA with low educational level, thereby reinforcing the existence of biological substrates related to this condition. Furthermore, the data suggest an association between younger age and less depressive symptoms with HPOA.

Resumo Antecedentes Envelhecimento cerebral saudável pode ser definido como envelhecimento sem transtornos neurológicos ou psiquiátricos e com independência funcional. Além da ausência de doença e funcionalidade preservada, existem indivíduos que se destacam pelo desempenho superior ao normal em testes cognitivos. Estes indivíduos são chamados de "high performance older adults" (HPOA, na sigla em inglês). Objetivos Investigar a presença de HPOA em uma população de idosos com baixa escolaridade e, se presente, investigar associações com variáveis sociodemográficas, clínicas e de estilo de vida. Métodos Avaliamos 132 indivíduos cognitivamente saudáveis do Estudo Pietà (n = 639). Foi utilizado o Teste de Aprendizagem Auditivo-Verbal de Rey para verificar a existência de HPOA e classificar os participantes em dois grupos com base em seu desempenho. Variáveis sociodemográficas, clínicas e de estilo de vida associadas a HPOA foram investigadas. Resultados Identificamos 18 indivíduos que preencheram critérios para HPOA (idade: 77,4 ± 2,6 anos; 14 mulheres; escolaridade: 4,6 ± 3,4 anos). Os demais, 114 no total (idade: 79,8 ± 4,5 anos; 69 mulheres; escolaridade: 3,0 ± 2,7 anos), foram classificados como "standard performance older adults" (SPOA, na sigla em inglês). Na análise multivariada, menor idade (odds ratio [OR] =0,672; intervalo de confiança [IC] 95%: 0,462-0,979; p = 0,037) e menor pontuação na Escala de Depressão Geriátrica (OR = 0,831; IC95%: 0,688-0,989; p = 0,038) foram associados ao grupo HPOA. Conclusões O presente estudo identifica pela primeira vez HPOA entre indivíduos de baixa escolaridade, reforçando a existência de substratos biológicos relacionados a esta condição. Além disso, os dados sugerem uma associação entre idade mais jovem e menos sintomas depressivos com HPOA.