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    Achados histopatológicos renais em idosos
    (Sociedade Brasileira de Nefrologia, 2010-09-01) Carmo, Priscylla Aparecida Vieira do; Mastroianni Kirsztajn, Gianna [UNIFESP]; Carmo, Wander Barros do; Franco, Marcello Fabiano de [UNIFESP]; Bastos, Marcus Gomes; Fundação IMEPEN; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Juiz de Fora Faculdade de Medicina
    INTRODUCTION: The elderly population has significantly increased worldwide and recent studies have evidenced a 10-year increase in Brazilian life expectancy. Similarly to other comorbidities, glomerular diseases are also observed in the elderly, and, in that age group, kidney biopsy emerges as a fundamental diagnostic tool to help disease management, preventing unnecessary therapies. OBJECTIVE: To establish the frequency of histological diagnoses in the elderly undergoing kidney biopsy, with an emphasis on glomerulopathies (GPs), at two Brazilian universities. METHODS: Retrospective assessment of kidney biopsy reports of the Department of Pathology of UNIFESP (patients aged 60 years or above, from 01/01/1996 to 12/31/2003) and of the outpatient clinic of GPs of NIEPEN. The studies of transplanted kidneys and nephrectomies were excluded. The following data were analyzed: age; sex; clinical syndrome at presentation; and histological diagnosis (light microscopy and immunofluorescence). Nephropathies were classified as primary GPs, secondary kidney diseases, nonglomerular diseases, and others. RESULTS: One hundred and thirteen biopsies were assessed, the mean age of patients was 66.0 ± 6.0 years, and the male sex prevailed (54.8%). The most common clinical presentation was nephrotic syndrome (32.7%), followed by acute and chronic kidney failure (18.6%, each). Glomerular diseases were as follows: membranous nephropathy (MN), 15%; hypertensive nephrosclerosis, 11.5%; focal segmental glomerulosclerosis and vasculitis/crescentic GN, 9.7% each; amyloidosis, chronic glomerulonephritis, and minimal change disease, 7.1% each; diffuse proliferative GN, 4.4%; IgA nephropathy and lupus nephritis, 2.7% each. Primary GPs predominated (45.2%) as compared with other nephropathies. CONCLUSION: Nephrotic syndrome was the major indication for kidney biopsy. Regarding the kidney histological diagnoses, glomerular diseases predominated, in particular MN and hypertensive nephrosclerosis, findings compatible with previous studies in the area, but rarely assessed among us. It is clear that the diversity of diagnoses and differentiated treatments justify kidney biopsy for decision making in that group of patients.
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    Adaptação transcultural da escala pleasant events schedule - alzheimer's disease (pes-ad) para o português do Brasil
    (Universidade Federal de São Paulo (UNIFESP), 2016-04-26) Saviotti, Karen Rosangela Silva de Souza [UNIFESP]; Novelli, Marcia Maria Pires Camargo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Pleasant activities for elders with cognitive commitment may improve mood and reduce behavior variations. The Pleasant Event Schedule ? Alzheimer?s Disease (PES-AD) have been described as a useful tool for this purpose and its transcultural adaptation will allow professionals to aid care takers and elders in identifying these pleasurable activities. Methodology: The PES-AD was subject to a five stages process of transcultural adaptation: translation, summary of translations, retro translation, evaluation of semantic equivalences, idiomatic, cultural, conceptual and pre testing. Results: Thirty six items were subject to the five stages of the process, three were adjusted on the translation process. On the equivalences evaluation four items obtained an agreement of less than 0.8 therefore being modified according to the judges suggestions. The PES-AD presented an excellent internal consistency (?=0.73) and a high stability related an 99% reliability between examiners (CCI=0.99). Conclusion: The process of cross-cultural adaptation of the PES-AD provided content validity to the Portuguese version and the analysis of the reliability makes available a new instrument of evaluation of pleasurable activities for individuals with cognitive impairments.
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    Body balance in elderly patients, 12 months after treatment for BPPV
    (Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2013-01-01) Lanca, Solange Martiliano; Gazzola, Juliana Maria [UNIFESP]; Kasse, Cristiane Akemi [UNIFESP]; Alves Branco-Barreiro, Fatima Cristina; Vaz, Daniela Patricia; Scharlach, Renata Coelho [UNIFESP]; Dept Tech Projects & Campaigns Secretary Rights P; Universidade Federal de São Paulo (UNIFESP); Univ Bandeirante São Paulo; Metodo Sch
    Benign Paroxysmal Positional Vertigo is highly prevalent in the elderly population, triggering major changes in body balance.Objective: To compare the results obtained from static posturography in the elderly before and after otoliths repositioning maneuvers and 12 months after treatment onset. Design: longitudinal, descriptive and analytical study.Method: Elderly patients with clinical diagnosis of BPPV submitted to Balance Rehabilitation Unit static posturography in 10 sensory conditions at three time intervals: before and after the repositioning maneuver and 12 months after the treatment.Results: We studied 23 subjects with a mean age of 68.74 years. Posturography revealed that the stability limit was not significantly different when the three time intervals were compared (p = 0.405). the center of pressure (CoP) showed a significant change in condition 2 (stable surface and closed eyes), because after the repositioning maneuver, the CoP significantly differed vis-a-vis the results before and 12 months after the treatment (p = 0.003). the values of body velocity sway (BVS) were significantly different in six sensoly conditions in these three time intervals.Conclusion: 12 months after the treatment for BPPV, the static posturography showed balance abnormalities similar to those found before treatment.
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    Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study
    (Assoc Arquivos Neuro- Psiquiatria, 2017) Krug, Rodrigo de Rosso; Abreu da Silva, Anna Quialheiro; Ceola Schneider, Ione Jayce; Ramos, Luiz Roberto [UNIFESP]; d'Orsi, Eleonora; Xavier, Andre Junqueira
    Objective: To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. Methods: A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results: The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. Conclusion: The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.
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    Concentration of Hyaluronic Acid in Human Vocal Folds in Young and Old Subjects
    (Sage Publications Ltd, 2011-12-01) Korn, Gustavo Polacow [UNIFESP]; Maciel Martins, Joao Roberto [UNIFESP]; Park, Sung Woo [UNIFESP]; Mendes, Aline [UNIFESP]; Kobayashi, Elsa Yoko [UNIFESP]; Nader, Helena Bonciani [UNIFESP]; De Biase, Noemi Grigoletto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective. To compare and evaluate concentrations of hyaluronic acid (HA) in normal vocal folds of both young and elderly people of both sexes.Study Design. Experimental study.Setting. the research was carried out at the ENT, Head and Neck Surgery Department and the Pharmacology Institute of São Paulo Federal University.Subjects and Methods. Enzyme-linked immunosorbent assay plates coated with biotin-conjugated binding protein and streptavidin-europium conjugate were sequentially incubated with samples from the middle portion of the cover, vocal ligament, and vocal muscle of 19 young and 20 elderly subjects of both sexes. After the release of europium in an enhancement solution, final fluorescence was measured using a fluorometer.Results. Statistically significant comparisons: (1) all subject groups combined exhibited a higher HA concentration in the cover and ligament compared with the muscle samples; (2) women subjects had a significantly lower HA concentration in muscle compared with the ligament, and male subjects showed significantly lower HA in muscle compared with the cover; and (3) both genders of young subjects showed a higher HA concentration in ligament samples compared with the muscle.Conclusion. HA concentrations are higher in the cover and ligament compared with the muscle in both genders and age groups, and there is a higher HA concentration in ligament compared with the muscle of young subjects of both genders. HA levels in the cover samples of younger women showed great variability that may relate to ovarian hormone levels, reflecting different phases of the menstrual cycle.
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    Confiabilidade e validade da escala de depressão geriátrica em idosos com doença arterial coronariana
    (Sociedade Brasileira de Cardiologia - SBC, 2010-05-01) Pinho, Miriam Ximenes [UNIFESP]; Custódio, Osvladir [UNIFESP]; Makdisse, Marcia [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: The prevalence of depression in individuals with coronary artery disease (CAD) is high. The Geriatric Depression Scale (GDS) is a broadly used tool to screen for depression in elderly individuals. In Brazil, the psychometric properties of the short version have not been adequately assessed. OBJECTIVE: To evaluate the psychometric properties of the short version of the GDS in patients with CAD treated at a Cardiology Outpatient Clinic. METHODS: The present is a cross-sectional study that assessed 209 elderly individuals (≥ 65 years) with CAD using the GDS-15, the Cumulative Illness Rating Scale for Geriatrics (CIRS-G), the Brazilian OARS Multidimensional Function Assessment Questionnaire (BOMFAQ) and The Cambridge Examination for Mental Disorders of the Elderly (CAMDEX). The internal consistency of the GDS-15 was calculated through the KR-20. A factorial analysis of this scale was carried out. The GDS-15 scores were compared with the diagnoses of depression (DSM-IV) for the validity of criteria. At the analysis of concurrent validity, the same scores were correlated with those of the CAMDEX, mini-mental state examination (MMSE), Cambridge Cognitive Examination (CAMCOG) and BOMFAQ depression scales. RESULTS: Clinical depression was diagnosed in 35.71% of the sample assessed according to the DSM-IV. For the diagnosis of major depression or dystimia, the cutoff 5/6 presented moderate accuracy (AUROC = 0.84), sensitivity of 79.92% and specificity of 78.29%. The internal consistency was 0.80. At the factorial analysis, three obtained factors explained 52.72% of the total variance that was observed. The GDS-15 scores correlated with those of the CAMDEX depression scale. CONCLUSION: In general, the GDS-15 presented good reliability and validity (concurrent and of criterion). In cardiologic settings, its use, which is simple and fast, can be utilized in the screening for depression.
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    Cross-cultural adaptation of the Events Schedule-Alzheimer's Disease to Brazilian Portuguese
    (Univ Sao Paulo, Inst Psiquiatria, 2016) Silva de Souza Saviotti, Karen Rosangela [UNIFESP]; Fernadez Canon, Mariana Boaro [UNIFESP]; Pires Camargo Novelli, Marcia Maria [UNIFESP]
    Background: Engagement in pleasant activities for elders with cognitive impairment may improve mood and reduce behavior problems. The Pleasant Events Schedule-Alzheimer's Disease (PES-AD) has been described as a useful tool for this purpose, and its transcultural adaptation allows professionals to aid caretakers and elders in identifying pleasurable activities. Objective: Submit the PES-AD to process of cross-cultural adaptation to Brazilian Portuguese. Methods: The PES-AD was submitted to a five-stage process of cross-cultural adaptation as follows: 1) translation
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    Dietary Protein Intake in Elderly Women: Association With Muscle and Bone Mass
    (Sage Publications Inc, 2015-04-01) Genaro, Patricia de Souza; Pinheiro, Marcelo de Medeiros [UNIFESP]; Szejnfeld, Vera Lucia [UNIFESP]; Martini, Ligia Araujo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Background: An inadequate food intake, mainly with regard to protein intake, seems to contribute to a reduction of skeletal muscle and bone mass in the elderly. This study was undertaken to evaluate differences in protein intake in women with or without sarcopenia and verify the intake level that is related to a better bone and muscle mass. Methods: Elderly women older than 65 years with sarcopenia (n = 35) and without sarcopenia (n = 165) participated in the study. Assessment of bone mineral density of the lumbar spine and femur was taken, body composition was evaluated by dual-energy x-ray absorptiometry, and an evaluation of protein intake was performed through 3-day dietary records. Results: Muscle, bone, and fat mass was significantly higher in women who had protein intake > 1.2 g/kg/d. A lower intake of essential amino acids in women with sarcopenia was also observed. Protein and energy intake were significant predictors of muscle mass. the presence of osteoporosis was a predictor of muscle strength. in conclusion, the present study demonstrated that in elderly women, an adequate protein intake in terms of quality and quantity, without need of supplementation, could have a positive impact on bone mineral density, lean mass, and skeletal muscle mass.
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    Dizziness in community-dewelling older adults: a population-based study
    (Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2011-11-01) Moraes, Suzana Albuquerque de; Souza Soares, Wuber Jefferson de; Silva Rodrigues, Rosilene Andrade; Rezende Fett, Waleria Christiane; Ferriolli, Eduardo; Perracini, Monica Rodrigues [UNIFESP]; Univ Cidade Sao Paulo; Hlth Secretariat Mato Grosso State; Mato Grosso Fed Univ UFMT; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Dizziness is a common complaint among older adults.Aim: To identify the prevalence of dizziness and its related factors in a sample of community-dwelling older adults.Methods: A prospective population-based study with a representative sample of older adults aged 65 years and over. A multidimensional questionnaire and a battery of measures were used for assessing physical function.Results: The prevalence of dizziness was 45%. Vertigo was found in 70.4% of older adults with dizziness and 43.8% of them referred vertigo crises along life. A significant association was found between dizziness and female gender (p=0.004), memory difficulties complaints (p=0.015), bad health perception (p=0.001), depression (p<0.0001), five or more comorbidities (p=0.021), self-reported fatigue (p<0.0001), recurrent falls (p=0.001), excessive sleepiness (p=0.003), fear of falling (p<0.0001), left leg unipedal stance (p=0.002) and Short Performance Physical Battery score (p=0.009).Conclusion: Dizziness is a common complaint among older adults and it is associated with limiting clinical conditions, such as depression, fatigue, excessive sleepiness and impaired memory. It is highlighted the association between dizziness and recurrent falls, fear of falling and lower performance in physical function tests, which can restrict independence. These data suggest the importance of a multifactorial approach to dizziness in older adults.
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    Escore para rastrear idosos (> 75 anos) de alto risco para doença arterial periférica
    (Sociedade Brasileira de Cardiologia - SBC, 2007-06-01) Makdisse, Marcia [UNIFESP]; Ramos, Luiz Roberto [UNIFESP]; Moreira, Frederico [UNIFESP]; Oliveira, Anderson [UNIFESP]; Berwanger, Otávio [UNIFESP]; Moscardi, Alcione [UNIFESP]; Junqueira, Virginia [UNIFESP]; Rodrigues, Evandro [UNIFESP]; Carvalho, Antonio Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Israelita Albert Einstein
    BACKGROUND: The prevalence of peripheral arterial disease (PAD) in the elderly is high. Most are asymptomatic and the sensitivity of the physical exam is low. In Brazil, little is known in regard to PAD risk factors in the elderly. OBJECTIVES: To identify risk factors for PAD among elderly individuals (> 75 years) in the community and to develop a prediction score. METHODS: Cross-sectional, prospective, community-based study nested within a cohort study (Epidoso). A total of 176 individuals were assessed. PAD was defined as an ankle-brachial index <0.9. Risk factors associated with PAD were entered into a multivariate logistic regression model. Statistical modeling was used to formulate a score according to the likelihood of PAD. A p value <0.05 was significant. RESULTS: PAD was present in 36.4% of participants. Abnormal pedal pulses, hypertension, cigarette smoking, and complain of leg pain/discomfort in either leg on walking were predictors of PAD. Based on the coefficients of the logistic regression, these variables were given scores of 13, 9, 5 and 5, respectively. A cutoff point >18 points defined the high risk individuals and yielded sensitivity, specificity, positive predictive value and negative predictive value of 85.9%, 71.4%, 63.2% and 89.9%, respectively. Receiver-operator characteristic analysis yielded area under curve of 85%, indicating excellent discrimination and goodness-of-fit statistics indicated excellent calibration (p=0.639). CONCLUSION: Because of its good performance, the proposed score can become a simple and useful tool to identify elderly community residents at higher risk of PAD who should be considered for further investigation.
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    The functional assessment Berg Balance Scale is better capable of estimating fall risk in the elderly than the posturographic Balance Stability System
    (Academia Brasileira de Neurologia - ABNEURO, 2013-01-01) Pereira, Vanessa Vieira; Maia, Roberto Alcantara [UNIFESP]; Silva, Sonia Maria Cesar De Azevedo [UNIFESP]; Instituto de Assistência Médica ao Servidor Público Estadual; Universidade Federal de São Paulo (UNIFESP)
    The purpose of this study was to verify which instrument better identifies recurrent falls in the elderly. Ninety-eight old people, with an average age of 80±4 years, were submitted to an assessment of balance and fall risk by means of the Berg Balance Scale (BBS) and the posturographic Balance Stability System (BSS). The BBS was correlated with the BSS (r=-0.27; p=0.008), age (r=-0.38; p<0.001) and number of falls (r=-0.25; p=0.013) and the analysis of logistical regression showed that the elderly classified with fall risk on the BBS presented 2.5 (95%CI 1.08-5.78) more chance of identifying who had two falls or more over the last year. The BBS identified that the greater the age the worse the functional balance and demonstrated a greater capacity to identify falls risk suffered over the last year when compared with the BSS.
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    Knowledge and attitudes towards dementia among final-year medical students in Brazil
    (Assoc Medica Brasileira, 2017) Jacinto, Alessandro Ferrari; Citero, Vanessa de Albuquerque [UNIFESP]; de Lima Neto, Jose Luiz; Boas, Paulo Jose Fortes Villas; do Valle, Adriana Polachini; Raza Leite, Ananda Ghelfi
    Objective: Among all countries, Brazil is expected to have the sixth largest elderly population in 2025. Dementia syndromes are prominent among aging-related diseases. Despite the necessity of and curriculum for training in geriatric medicine to make recommendations on an approach to this theme, adequate training appears to be infrequent. The present study aimed to evaluate the knowledge about dementia and students' attitude towards it during the last semester of the medical course in two of the most important Brazilian medical schools. Method: In our study, a sample of 189 students was invited to complete questionnaires comprising demographic and professional topics, knowledge with respect to cognitive alterations in the elderly and attitudes in dealing with an elderly patient with dementia. Results: A total of 155 students accepted to participate in the study
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    Pain-induced depression is related to overestimation of sleep quality in a very elderly population with pain
    (Assoc Arquivos Neuro- Psiquiatria, 2017) Felix, Ricardo Humberto de Miranda [UNIFESP]; Almeida, Carla Bezerra Lopes [UNIFESP]; Cremaschi, Renato Carvalho [UNIFESP]; Coelho, Fernando Morgadinho Santos [UNIFESP]; Santos, Fania Cristina [UNIFESP]
    Objective: To study the quality of sleep in very elderly people with chronic pain. Methods: We investigated 51 very elderly people without dementia and with chronic pain according to the Geriatric Pain Measure. Katz and Lawton questionnaires were used to evaluate functionality. The Geriatric Depression Scale and Geriatric Psychosocial Assessment of Pain-induced Depression were also used. Self-perceptions of sleep and quality of sleep were checked using the Pittsburgh Sleep Quality Index. Results: Moderate pain was seen in 64.7% participants. The tracking of depression was positive for 41.2%. Poor quality of sleep was noted in 49% of them, but 82.3% perceived that they had a very good, or a good, sleep. The main factors associated with poor sleep quality were measurement of pain, self-perception of sleep, and pain-induced depression. Conclusion: Very elderly people with chronic pain, and without dementia, had a higher prevalence of poor sleep
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    Perda auditiva e hipertensão: achados em um grupo de idosos
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2004-10-01) Baraldi, Giovana dos Santos [UNIFESP]; Almeida, Laís Castro de [UNIFESP]; Borges, Alda Christina Lopes de Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    As the age advances, the number of chronic diseases also grows, the systemic arterial hypertension (SAH) and hearing loss having a significant prevalence in aged people. OBJECTIVE: To compare and analyze anamnesis and threshold tonal audiometry results in both hypertensive and non-hypertensive patients. STUDY DESIGN: Transversal contemporany cohort study. MATERIAL AND METHOD: This study has been conducted at UNIFESP in the period from March to November 2003. Seventy people in the age group from 60 to 92 - 15 male and 54 female - were evaluated through anamnesis and threshold tonal audiometry. RESULTS: As to audiology findings of groups studied, a difference can be noted regarding ramp-typed audiometric configuration and buzz claim, both occurring most frequently in non-hypertensive aged people. CONCLUSION: Hypertensive aged people did not present a higher hearing deficit, the degree of hearing loss being similar in both groups. Prevailing audiometric configuration in hypertensive group was that of full-type, while the non-hypertensive group presented a ramp-typed configuration. As to audiologic claims, the non-hypertensive group presented an increased occurrence of buzz claim.
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    Processamento auditivo em idosos: estudo da interação por meio de testes com estímulos verbais e não-verbais
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2004-04-01) Pinheiro, Maria Madalena Canina [UNIFESP]; Pereira, Liliane Desgualdo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Presbyacusis is a hearing loss combined with functional auditory decline due to the aging process. AIM: The aim of this study is to characterize verbal and nonverbal sound interaction aspects in elderly individuals with and without hearing loss by means of Binaural Fusion Test, Sound Localization Test at five directions and Pediatric Sentence Identification (PSI), taking into consideration each procedure and hearing loss magnitude. STUDY DESIGN: Clinical study with transversal cohort. MATERIAL AND METHOD: A number of 110 elderly individuals, aged between 60 to 85 years, with normal hearing and with symmetric neurossensorial hearing loss up to moderately severe hearing impairment participated in this study. The common auditory behavior for all the selected tests was nominated as interaction. The analysis was performed by means of a single procedure and also based on audiometric magnitude. RESULTS: There were more individuals that failed the Binaural Fusion Test. The procedures that showed significant statistical dependency on the audiometric magnitude groups were Sound Localization Test, Temporal Lateralization Test and PSI-MCI (-10) Test. CONCLUSION: Elderly individuals present difficulty in the binaural interaction process when the auditory information is not complete. The magnitude of the hearing loss interfered specially in the localization auditory behavior.
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    Processamento cognitivo e equilíbrio corporal em idosos com disfunção vestibular
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-04-01) Caixeta, Giovanna Cristina dos Santos; Doná, Flávia [UNIFESP]; Gazzola, Juliana Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Bandeirante de São Paulo Programa de Mestrado em Reabilitação do Equilíbrio Corporal e Inclusão Social
    Abnormal body balance and cognitive dysfunction may develop in elderly patients with chronic vestibular dysfunction. AIM: To evaluate the relationship between cognitive processing and body balance in elderly patients with chronic peripheral vestibular disease. Type of Study: Cross-sectional. METHODS: Seventy-six patients (> 60 years) with chronic peripheral vestibular dysfunction and dizziness for more than three months were enrolled. The tests for investigating body balance were: the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) Timed Up and Go Test modified (TUGTm); the Mini Mental State Examination (MMSE), Test Clock (RT,) and Verbal Fluency Test (VF) were applied for assessing cognition. RESULTS: The mean age was 69.03 years (SD=6.21 years); most were female (82.9%). There was a significant negative correlation between the MMSE and the TUGT (ρ=-0.312; p=0.01), MMSE and TUGTm (ρ=-0.306; p=0.01), FV and TUGT (ρ=-0.346; p=0.01), and FV and TUGTm (ρ=-0.536; p=0.01); there was a significant positive correlation between the TR and BBS (ρ=0.343; p=0.01), TR and DGI (ρ=0.298; p=0.01), FV and BBS (ρ=0.299; p=0.01), and FV and DGI (ρ=0.306; p=0.01). CONCLUSION: Elderly patients with chronic peripheral vestibular disease and worse performance in body balance tests have functional impairment in cognitive skills.
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    Qualidade de vida de idosos com tontura
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2010-12-01) Takano, Nancy Akemi; Cavalli, Silvia Sper; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Santos, Mônica Alcantara de Oliveira; Peluso, Érica de Toledo Piza [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN Programa de Mestrado em Reabilitação do Equilíbrio Corporal e Inclusão Social
    Dizziness is frequent in elderly people. AIMS: To evaluate the Quality of Life (QoL) in elderly subjects with dizziness, relate it with gender and age. MATERIAL AND METHOD: A prospective study comprising 120 elderly patients with dizziness evaluated with Brazilian versions of the Whoqol-bref and the dizziness handicap inventory (DHI). The factor analysis (FA), the Mann Whitney and Kruskal Wallis tests, and the Spearman correlation were applied to study the results. RESULTS: The most compromised domains were the DHI physical domain and the Whoqol-bref physical and environment domains. FA resulted in 3 factors in the DHI and 5 factors in the Whoqol-bref. There was a moderate correlation (-0.596) in the total scores of both instruments. Males had a better QoL in the environment perception and introspectivity and health perception factors of the Whoqol-bref test. Females had a better QoL in the functionality perception factor of the Whoqol-bref test. There were no significant age differences. CONCLUSIONS: Elderly patients with dizziness have a worse QoL. Elderly females with dizziness have worse QoL scores in environment perception and introspectivity and health perception and better QoL in the functionality perception factor compared to elderly males.
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    Tobacco use among the elderly: the first Brazilian National Survey (BNAS)
    (Routledge Journals, Taylor & Francis Ltd, 2010-01-01) Madruga, C. S. [UNIFESP]; Ferri, C. P.; Pinsky, I. [UNIFESP]; Blay, S. L.; Caetano, R.; Laranjeira, R. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Kings Coll London; Univ Texas Dallas
    Objective: This study describes the prevalence and pattern of tobacco use among the elderly in Brazil and establishes its association with socio-demographic characteristics, other substance use and depression. Method: the analyses were performed in 400 individuals aged 60 years and over who participated in the first Brazilian national alcohol survey (BNAS) in 2000. Results: Nearly 60% of the sample had ever smoked, of them one in three were still smoking at the time of the interview. Most (94.3%) of the tobacco users were smoking everyday and 34.3% consuming more than 20 cigarettes a day. Only 1% of the former smokers had received support to quit. Over half of the current users (65%) would use free treatment to quit if it existed in Brazil, and just under half of them (47.4%) would consider quitting if cigarettes' price were higher. Currently, tobacco users were more likely to be men and alcohol abusers. Prevalence of depression was high regardless participant smoking status (33.0% among non-smokers, 34.7% among current smokers and 39.3% among former smokers). There was no significant association between smoking and depression. Conclusion: This study found a disturbingly high proportion of tobacco users among the elderly in Brazil. According to the Global Burden of Disease project, tobacco has the highest mortality risk of all substance use categories, especially for the elderly. This study shows there is an urgent need to develop smoking cessation interventions targeted specifically to the elderly.
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    Treinamento auditivo formal em idosos usuários de próteses auditivas
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-12-01) Miranda, Elisiane Crestani de [UNIFESP]; Gil, Daniela [UNIFESP]; Iorio, Maria Cecilia Martinelli [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    It is of paramount importance to install hearing rehabilitation programs for the elderly. AIM: to check the efficacy of a forma auditory training program for elderly patients fitted with hearing aids for at least three months, by means of speech recognition tests and self-assessment questionnaires. METHODS: longitudinal contemporary cohort study. We selected 13 elderly hearing aid users, using intra-canal hearing aids in both ears, from both genders, with average age of 65.3 years. This group was randomly divided in Experiment Group and Control Group. The Experiment Group underwent seven formal auditory training sessions, aiming at stimulating their hearing skills for hearing closing, memory, attention, background figure and binaural integration. The participants were assessed by three behavioral tests and one self assessment questionnaire. RESULTS: The elderly from the Experiment Group had significantly better performance in the assessments after auditory training in comparison to the Control Group. conclusion: the formal auditory training program in a soundproof booth, associated with the use of hearing aids, improves speech recognition performance and reduces the perception of auditory handicap for the elderly who use intra-canal hearing aids.
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    Use of comprehensive geriatric assessment in general practice: Results from the 'Senta Pua' project in Brazil
    (Informa Healthcare, 2011-03-01) Lucchetti, Giancarlo [UNIFESP]; Granero, Alessandra L.; Universidade Federal de São Paulo (UNIFESP); Fac Ciencias Med Minas Gerais; São Paulo AF Hosp
    Background: General practitioners (GPs) are responsible for most of elderly consultations in Brazil. Being aware of the needs of older adults is important for these professionals. A comprehensive geriatric assessment (CGA) is an important tool for assessing the elderly. Objective: the aim of this study was to evaluate (a) whether a CGA can identify previously unknown health problems, and (b) whether a CGA is accepted by elderly patients. Methods: We conducted a cross-sectional study by inviting all outpatients of the São Paulo Air Force Hospital aged 60 years and older to participate. Consenting patients were examined using a CGA. Health problems revealed by the assessment were compared to those previously known from the patients 'charts. Patients' acceptability of the CGA was evaluated by a short questionnaire. Results: 170 patients were included in the final analysis. Mean age was 75.7 years (SD: 8.0 years), 65.8% was female. On average, patients had 3.2 (SD: 1.9) geriatric problems gleaned from their charts and 9.0 (SD: 3.2) revealed by CGA. the most common health problems disclosed by the CGA were pneumococcal vaccination more than 3 years earlier, followed by sleep disorder, sedentarism, urinary incontinence, fall risk and cognitive impairment. the mean duration of CGA was 52 min and patient acceptability was high.Conclusion: the present study using the CGA in a population of patients aged 60 and above disclosed, on average, 6 medical problems previously unknown to the GP. the acceptability by patients was good.