Incidence of Muscular Strength, Anthropometry, and Asymmetry in the General Index of Autonomy in Older Chilean Women / Incidencia de la Fuerza Muscular, Antropometría y Asimetría en el Índice General de Autonomía en Mujeres Mayores Chilenas

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.

Study of the clinical profile of older patients with bipolar disorder in a tertiary care center in the Midwest of Brazil / Estudo do perfil clínico de pacientes idosos com transtorno bipolar em um centro terciário do Centro-Oeste do Brasil

Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms, length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15 (75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients (45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population. (AU)

Effects of endurance training combined with blood flow restriction on functionality in older adults: a systematic review / Efeitos do treinamento de resistência combinado com restrição de fluxo sanguíneo na funcionalidade de idosos: uma revisão sistemática

The aim of this review was to verify the effects of aerobic exercise combined with blood flow restriction on older adult functionality. Systematic searches were performed in PubMed, Web of Science, and Embase between July and December 2023. Randomized studies with participants aged ≥ 60 years who were evaluated before and after the experimental protocols were included. We registered this systematic review at the International Prospective Register (PROSPERO CRD42022347205). The search strategy identified 2698 studies, four of which were included in the review, with 80 participants. The results suggested that aerobic exercise combined with blood flow restriction increased performance on specific functional tests. However, these results should be interpreted with caution due to the low-to-moderate study quality, as well as the low number of participants and studies. In conclusion, aerobic exercise and blood flow restriction may increase functional capacity in older adults. Further studies are needed to confirm such findings. (AU)

Effects of cognitively stimulating activities on the cognitive functioning of older people with mild cognitive impairment: A meta-analysis

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.

Relationship between mastication and malnutrition in community-dwelling older adults: a meta-analysis

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.

Evaluación de validez convergente y discriminante de un protocolo de cribado online para detección de deterioro cognitivo leve en personas mayores en Chile

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.

Exploring the effect of the structural model of active aging on the self-assessment of quality of life among older people: A cross-sectional and analytical study

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.

Violência contra pessoas idosas dependentes no Brasil: um estudo multicêntrico / Violence against dependent older people in Brazil: a multi-center study / Violencia contra ancianos dependientes en Brasil: un estudio multicéntrico

Este estudo analisa narrativas sobre violência no âmbito do cuidado contra pessoas idosas dependentes no Brasil. A pesquisa possui abordagem qualitativa e caráter multicêntrico, realizada no ano de 2019 em oito municípios brasileiros: Porto Alegre, Rio de Janeiro, Brasília, Fortaleza, Recife, Teresina, Manaus e Araranguá. Foram entrevistas semiestruturadas com 193 pessoas: 64 pessoas idosas com dependência física e/ou cognitiva, 72 cuidadores familiares, 27 cuidadores formais, vinte profissionais de saúde e dez gestores. As informações foram analisadas por meio da "Análise de narrativa". Abandono, negligência e maus-tratos foram evidenciados. As violências foram cometidas pelos familiares e no ambiente domiciliar. As consequências para as pessoas idosas incluem sofrimento psicológico, adoecimento físico e redução da qualidade de vida. Constatou-se a importância dos profissionais de saúde na identificação da violência, a negligência estatal na atenção e a implementação de políticas públicas específicas.(AU)

This study analyzes narratives on violence against dependent older people in Brazil. We conducted a qualitative multi-center study in 2019 in eight municipalities: Porto Alegre, Rio de Janeiro, Brasília, Fortaleza, Recife, Teresina, Manaus and Araranguá. Semi-structured interviews were conducted with 193 people: 64 physically and/or cognitively dependent older people, 72 family caregivers, 27 formal caregivers, 20 health professionals and 10 managers. The data were analyzed using "narrative analysis". The findings revealed abandonment, neglect and maltreatment. Violence was committed by family members and in the home environment. Consequences for the older persons included psychological suffering, physical illness and a decline in quality of life. Our results also highlight the importance of health professionals in the identification of violence, state negligence when it comes to care, and the implementation of specific public policies.(AU)

Este estudio analiza narrativas sobre violencia en el ámbito del cuidado contra ancianos dependientes en Brasil. La investigación tiene un abordaje cualitativo y carácter multicéntrico, realizado en el año 2019 en ocho municipios brasileños: Porto Alegre, Río de Janeiro, Brasilia, Fortaleza, Recife, Teresina, Manaus y Araranguá. Se realizaron entrevistas semiestructuradas con 193 personas: 64 ancianos con dependencia física y/o cognitiva, 72 cuidadores familiares, 27 cuidadores profesionales, veinte profesionales de salud y diez gestores. Las informaciones se analizaron por medio del "Análisis de Narrativa". Quedaron en evidencia abandono, negligencia y malos tratos. Los actos de violencia fueron cometidos por familiares y en el ambiente del hogar. Las consecuencias para los ancianos incluyen sufrimiento psicológico, enfermedad física y reducción de la calidad de vida. Se constató la importancia de los profesionales de la salud en la identificación de la violencia, la negligencia estatal en la atención y la implementación de políticas públicas específicas.(AU)

Modelo assistencial contemporâneo para os idosos: a premência necessária / Contemporary care model for the aged: an imminent need

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.

Percepciones y experiencias de adultos mayores sobre sexualidad y servicios de salud sexual en Colombia

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.

Consulta de enfermagem a pessoa idosa com dor crônica atendida na atenção primária: e-book interativo / Nursing consultation for elderly people with chronic pain treated in primary care: interactive e-book

Resumo: A dor é uma das principais razões que levam à procura do atendimento de saúde, possui alta prevalência e impacta a pessoa idosa de maneira biopsicossocial. No entanto, é notável que poucos cenários de atenção contemplam esse problema de Saúde Pública. Diante da multidimensionalidade da dor crônica, a consulta de enfermagem apresenta-se como espaço oportuno para o desenvolvimento das ações de cuidado. Assim, se faz necessário qualificar essa atividdae, visando porporcionar assistência planejada e sistematizada, oferecendo subsídios ao cuidado clínico e qualificado considerando sua subjetividade. No contexto da Atenção Primária à Saúde, a consulta de enfermagem é essencial, pois através dessa ferramenta é possível identificar as necessidades, particularidades e singularidades da pessoa idosa. Objetivo: Desenvolver e-book interativo para qualificar a consulta de enfermagem à pessoa idosa com dor crônica atendida na atenção primária. Método: Trata-se de pesquisa metodológica aplicada, com elaboração e avaliação por juízes, de E-book interativo orientador da consulta de enfermagem ao idoso com dor crônica atendido na atenção primária. Foi realizada em três fases: 1) Exploratória; 2) Desenvolvimento; 3) Avaliação, compostas por nove etapas: 1) Revisão de literatura; 2) Definição dos tópicos do e-book; 3) Contrução do ebook; 4) Seleção de imagens; 5) Diagramação do e-book; 6) Revisão e edição preliminar; 7) Avaliação da qualidade do conteúdo educacional; 8) Adequação com base nas sugestões dos juízes; 9) Edição final. Desenvolvida de forma remota, mediante utilização de formulário eletrônico para coleta de dados, utilizou-se os critérios multidimensionais para avaliação da qualidade de conteúdos educacionais (tecnocientífica, pedagógica, comunicacional, tecnológica e organizacional). Resultados: Emergiram três produções sendo:1) Revisão de escopo: A pessoa idosa com dor crônica no contexto da atenção primária e secundária: scoping review; 2) Revisão integrativa: Instrumentos de avaliação e mensuração da dor crônica na pessoa idosa; e o produto dessa Dissertação, Recurso Educacional Aberto no formato de e-book: Como qualificar o cuidado à pessoa idosa com dor crônica, através da consulta de Enfermagem, composto de nove tópicos distribuídos em 125 páginas. A qualidade do conteúdo do e-book, foi avaliada por nove juízes especialistas. Após análise, observou-se equivalência de IVC igual a 88% para cada item e dimensão. A avaliação final do e-book se deu através da média dos valores dos itens calculados separadamente. O conteúdo foi considerado satisfatório, pois obteve percentual total de concordância de 88%. Considerações finais: elaborou-se E-book interativo direcionado aos enfermeiros da atenção primária com o objetivo de qualificar a consulta de enfermagem à pessoa idosa com dor crônica, auxiliando no diagnóstico, prescrição e implementação de ações de enfermagem que contribuam para a a promoção da saúde, prevenção de agravos, recuperação e reabilitação.

Abstract: Pain is one of the main reasons that lead to seeking health care, it has a high prevalence and impacts elderly people in a biopsychosocial way. However, it is notable that few care scenarios address this Public Health problem. Given the multidimensionality of chronic pain, the nursing consultation presents itself as an opportune space for the development of care actions. Therefore, it is necessary to qualify this activity, aiming to provide planned and systematized assistance, offering subsidies to clinical and qualified care considering its subjectivity. In the context of Primary Health Care, the nursing consultation is essential, as through this tool it is possible to identify the needs, particularities and singularities of the elderly person. Objective: Develop an interactive e-book to qualify nursing consultations for elderly people with chronic pain treated in primary care. Method: This is an applied methodological research, with elaboration and evaluation by judges, of an interactive E-book guiding nursing consultations for elderly people with chronic pain treated in primary care. It was carried out in three phases: 1) Exploratory; 2) Development; 3) Assessment, consisting of nine stages: 1) Literature review; 2) Definition of the e-book topics; 3) Construction of the ebook; 4) Image selection; 5) Layout of the e-book; 6) Review and preliminary editing; 7) Assessment of the quality of educational content; 8) Adequacy based on the judges' suggestions; 9) Final edition. Developed remotely, using an electronic form for data collection, multidimensional criteria were used to evaluate the quality of educational content (technological, pedagogical, communicational, technological and organizational). Results: Three productions emerged: 1) Scoping review: The elderly person with chronic pain in the context of primary and secondary care: scoping review; 2) Integrative review: Instruments for evaluating and measuring chronic pain in elderly people; and the product of this Dissertation, Open Educational Resource in e-book format: How to qualify care for elderly people with chronic pain, through Nursing consultation, composed of nine topics spread over 125 pages. The quality of the e-book content was evaluated by nine expert judges. After analysis, CVI equivalence of 88% was observed for each item and dimension. The final evaluation of the e-book was based on the average value of the items calculated separately. The content was considered satisfactory, as it achieved a total percentage of agreement of 88%. Final considerations: an interactive E-book was created aimed at primary care nurses with the aim of qualifying nursing consultations for elderly people with chronic pain, assisting in the diagnosis, prescription and implementation of nursing actions that contribute to health promotion, disease prevention, recovery and rehabilitation.

Sintomatología Depresiva y Bienestar en Personas Mayores de Concepción, Chile: Rol moderador del apoyo social

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.

Avaliação das Instituições de Longa Permanência para Idosos no Brasil: um panorama das desigualdades regionais / Evaluation of Long-Term Institutions for Older People in Brazil: an overview of regional inequalities

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.

Vulnerabilidade social na população idosa usuária da Atenção Primária à Saúde de um município do Rio Grande do Sul / Social vulnerability of the older population using PrimaryHealth Care in a municipality of Rio Grande do Sul

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.

Relação entre duração do sono, sintomas depressivos e estresse em pessoas idosas da comunidade / Relationship between sleep duration, depressive symptoms and stress in older people in the community

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.

Intervenciones en Psicología Positiva para la disminución de la depresión y el fomento del bienestar en personas mayores de 60 años: Una revisión sistemática de la última década (2012-2022) / Interventions in Positive Psychology to reduce depression and promote well-being in the elderly: A systematic review of the last decade (2012-2022)

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.

Impact of the COVID 19 pandemic on the mental health and quality of life among older adults in India

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

Saúde mental de idosos: uma análise da série Unidade Básica (2016) / Mental health of older adults: an analysis of the series Unidade Básica(2016) / Salud mental del las personas mayores: un análisis de la serie Unidade Básica (2016)

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.

Estimación de brechas de geriatras en Chile / Estimation of geriatrician gaps in Chile

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

Quality of life in older adults according to race/color: a cross-sectional study

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.