Navegando por Palavras-chave "elderly"

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    Alcohol and tobacco consumption concordance and its correlates in older couples in Latin America
    (Wiley, 2017) Alves Machado, Mayra Pires [UNIFESP]; Opaleye, Davi Camara [UNIFESP]; Pereira, Tiago Veiga; Padilla, Ivan [UNIFESP]; Noto, Ana Regina [UNIFESP]; Prince, Martin; Ferri, Cleusa Pinheiro [UNIFESP]
    AimAs little is known about alcohol and tobacco consumption concordance between older spouses in low- and middle-income countries, the present study aimed to estimate this in older couples from five Latin American countries. MethodsThis study is a secondary analysis of data collected between 2003 and 2007 by the 10/66 Dementia Research Group, from 1451 couples aged over 65 years from Cuba, the Dominican Republic, Peru, Mexico and Puerto Rico. Kappa statistic was used to assess the agreement of the behavior beyond chance, and logistic regression models with meta-analyses were used to estimate the factors associated with concordance. ResultsThe mean age of the total sample was 74.8 years (SD 6.6). The results showed high levels of agreement rates in relation to drinking and smoking (75.9% and 85% of couples, respectively, did not drink or smoke), which were beyond the agreement expected by chance. Increased age was associated with concordance on both being non-drinkers (OR 1.03, 95% CI 1.01-1.05) and non-smokers (OR 1.05, 95% CI 1.02-1.07); and having a larger social network was associated with less likelihood of the couple being non-drinkers (OR 0.93, 95% CI 0.88-0.98). Attending religious meetings was associated with increased likelihood of the couple being non-smokers (OR 1.19, 95% CI 1.01-1.41). Socioeconomic circumstances were not associated with couples' concordance. ConclusionsOlder Latin American couples have high levels of concordance in drinking and smoking habits, which increases with age, and were not associated with socioeconomic circumstances, but were with social network. This knowledge can assist the development of policies and interventions to promote health among this growing population. Geriatr Gerontol Int 2017; 17: 1849-1857.
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    Angiotensin II antagonists - therapeutic benefits spanning the cardiovascular disease continuum from hypertension to heart failure and diabetic nephropathy
    (Librapharm, 2006-01-01) Ribeiro, A. B.; Universidade Federal de São Paulo (UNIFESP)
    Background: the cardiovascular benefits of angiotensin II antagonists (AIIAs) have been evaluated not only in terms of their ability to lower blood pressure but also on their ability to prevent strokes, cardiac events, and target organ damage. This review summarizes the body of evidence-based data demonstrating the efficacy of AIIAs across the spectrum of cardiovascular disease.Methods:A PubMed/MEDLINE search of English-language articles (1990 to September 2005) was used to identify articles describing clinical studies, particularly outcome trials, or mechanisms of therapeutic action pertinent to the therapy of cardiovascular disease or nephropathy.Findings: the antihypertensive efficacy of AIIAs is apparent across a wide spectrum of hypertensive patients, including black and Asian patients and patients with isolated systolic hypertension. More importantly, large outcome-based studies have demonstrated the efficacy of AIIAs across the continuum of cardiovascular disease, including hypertension, heart failure, post-myocardial infarction, and diabetic nephropathy. the Losartan Intervention for Endpoint reduction in hypertension study (LIFE), Reduction of Endpoints in Non-insulin-dependent Diabetes Mellitus with the All Antagonist Losartan (RENAAL), and the Irbesartan Type 2 Diabetic Nephropathy Trial (IDNT) indicate that AIIAs confer cardiovascular and renal protective effects beyond their ability to lower blood pressure. These blood-pressure independent protective benefits of AIIAs may arise not only by blocking the deleterious effects of All mediated via the AT(1)-receptor but may also be due to beneficial molecule-specific effects. As a class, AIIAs are well tolerated with an overall adverse event profile generally comparable to placebo and superior to that typically seen with calcium channel blockers, ACE inhibitors, diuretics, and beta-blockers.Conclusions: By utilizing the body of clinical trial evidence as a guide to rational prescribing of AIIAs, practitioners can expect to deliver clinical benefits to their patients in terms of survival, prognosis, and quality of life.
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    Anxiety disorders in old age
    (Lippincott Williams & Wilkins, 2012-11-01) Blay, Sergio L. [UNIFESP]; Marinho, Valeska; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro (UFRJ)
    Purpose of reviewThis review highlights the key recent issues and novel findings on anxiety disorders in older adults. Studies of the epidemiology, medical and psychiatric comorbidity, neurobiology, and treatment of anxiety in the elderly are discussed.Recent findingsOverall prevalence studies of anxiety symptoms or disorders in older adults indicate that, although less common than in younger adults, they are relatively common in late life. We examine the prevalence of specific anxiety disorders in the elderly, as mechanisms, outcomes, and treatment response may vary by type of anxiety disorder. Physical and psychiatric comorbidity are common. Certain anxiety disorders, such as generalized anxiety disorder, have demonstrated a positive impact following acute coronary syndrome. Regarding treatment, small effect sizes and incomplete response are typical, posing a challenge when treating this age group.SummaryThe epidemiology, neurobiology, and treatment of anxiety conditions in late life have recently received more attention in the medical literature. Areas in need of further investigation include neurobiology, clinical presentation, management, and treatment, as we do not know whether procedures indicated for younger cohorts hold for older adults.
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    Aplicabilidade do programa personalizado de atividades (tap-br) em idosos com demência e seus respectivos cuidadores familiares
    (Universidade Federal de São Paulo (UNIFESP), 2016-03-16) Machado, Styfany Correa Batista [UNIFESP]; Novelli, Marcia Maria Pires Camargo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Applicability of the Tailored Activity Program (TAP-Br) in elderly patients with dementia and their caregivers family members Introduction: The Tailored Activity Program (TAP-Br) is the Portuguese version of the Tailored Activity Program (TAP), which is an intervention program in Occupational Therapy, proposed for individuals with dementia and their caregivers, based on 8 sessions, delivery by home (90 minutes each) over a period of 3 to 4 months. The TAP is a program that develops from two approaches: the activities proposition adequate the ability of individuals with dementia that enable them the participation and engagement in these activities and orientation of caregivers/family members in the use and implementation of these activities. Objectives: To assess the applicability of the program adapted to our culture, session by session, taking into account the view of occupational therapists and family caregivers and the development of the program. Materials and Methods: The TAP-Br was applied in a sample of elderly patients with dementia (n = 13) and their caregivers/family members (n = 13). The feasibility was documented by the occupational therapists: the time spent on the sessions, the facility of administration of each evaluation proposed by the program, the application and use of activities, use of educational materials, the simplification of the activity and the environment. Another aspect evaluated was the interpretation of the ease of use of these interventions in the therapeutic context, considering its full implementation and the need for adjustments and adaptations in the use of the program. It is also was evaluated the perceptions of occupational therapists on the acceptance of the sessions by caregivers and the elderly, and on the identified benefits. This evaluation step was performed by numerical scales, ranging from 1 (very difficult) to 5 (very easy) and was discussed among the occupational therapists who were part of the team, to identify the need for adjustments in the original proposal considering our reality and culture. To assess the social impact of the adapted program, the perception of caregivers, numerical rating scales was applied with a range from 1 (very difficult) to 5 (very easy) for the testing of items: time spent on the sessions, ease of implementation and use of activities, use of simplification of activities and communication strategies. Results: The elderly are mostly male (61.54%), the average age is 78.23 ± 8.00 years and the schooling of 12.92 ± 3.49. Regarding the caregivers, these are, in their entirety, women with an average age of 62.53 ± 6.10 years and 14.38 ± 2.06 schooling. For the 13 pairs VII (elderly/caregivers) were prescribed 43 activities. The occupational therapists point out as the potential of the program was the centered care caregiver - caregiver empowerment (69.23%), and as difficulty/fragility was the use of cognitive assessment (LACLS-5) (92.30%). The caregivers point to potential of the program was the custom guidelines (76.92%) and the majority of them (76.92%) indicated no weaknesses. Conclusions: The TAP-Br was shown to be applicable in the view of occupational therapists and caregivers - considering the full program and its potential for full action.
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    APO A-V-1131T -> C polymorphism frequency and its association with morbidity in a Brazilian elderly population
    (Walter de Gruyter & Co, 2006-01-01) Chen, E. S.; Cendoroglo, M. S.; Ramos, L. R.; Araujo, LMQ; Carvalheira, GMG; Labio, R. W. de; Burbano, R. R.; Payao, SLM; Smith, MDC; Universidade Federal de São Paulo (UNIFESP); Fac Med Marilia
    Identification of genetic polymorphisms as risk factors for complex diseases affecting older people can be relevant for their prevention, diagnosis and management. the -1131T -> C polymorphism of the apolipoprotein A-V gene (APO A-V) is tightly linked to lipid metabolism and has been associated with increased triglyceride levels and familial dyslipidemia. the aims of this study were to analyze the allele and genotype frequencies of this polymorphism in a Brazilian elderly population and to investigate any association between the polymorphism and major morbidities affecting elderly people. This polymorphism was investigated in 371 individuals, aged 66-97 years, in a Brazilian Elderly Longitudinal Population Study. Major morbidities investigated were: cerebrovascular diseases (CVD); myocardial infarction (MI); type 2 diabetes; hypertension; obesity; dementia; depression; and neoplasia. DNA was isolated and amplified by PCR and its products were digested with restriction enzyme Tru1I. T and C allele frequencies were 0.842 and 0.158, respectively. Our population showed allele frequencies that were similar to European and Afro-American and different from Asiatic populations. Genotype distributions were not within Hardy-Weinberg equilibrium only for the obesity subject sample. On the other hand, a significant association between the C allele and obesity in the presence of CVDX depression interaction was observed. Logistic analysis showed no association of the polymorphism with each morbidity group. Therefore, the C allele in elderly Brazilian subjects may represent a risk factor for these morbidity interactions, which may lead to better comprehension of their pathophysiology.
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    Associação entre a ocorrência de quedas e o desempenho no Incremental Shuttle Walk Test em mulheres idosas
    (Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia, 2012-08-01) Bardin, Marcela Grigol [UNIFESP]; Dourado, Victor Zuniga [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    BACKGROUND: Because the incremental shuttle walk test (ISWT) requires agility in its performance, we hypothesized that the test may be associated with balance and risk of falls in the elderly. Objective: To evaluate and compare the association between the performance on the ISWT, the timed up and go (TUG) and the occurrence of falls in the elderly. METHOD: Thirty-three elderly individuals (68±7 years) performed the TUG and the ISWT. Balance was assessed using the Berg Scale (BBS). Participants who fell at least twice in the last 12 months were placed in the falls group (FG) and all other participants comprised the control group (CG). RESULTS: There were seventeen elderly women in the FG and 16 in the CG. Participants from the FG had a significant worse performance (p<0.05) on the TUG (8.01±0.22 vs. 6.22±0.21 s), BBS (51±3 vs. 55±1 points) and ISWT [313±79 (92±15%pred.) vs. 395±75 m (113±19%pred.)] than participants from the CG. The ISWT significantly correlated with the TUG (r=-0.75, p<0.001), BBS (r=0.50, p=0.002) and number of falls (r=0.36, p=0.031). After logistic regression, the TUG was determinant (p=0.03) and the ISWT showed a tendency to determine the occurrence of falls (p=0.05). CONCLUSION: The ISWT was a valid measure to assess the risk of falls and balance and therefore, may be useful for the simultaneous assessment of cardiorespiratory fitness and balance in older women.
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    Association of lipase lipoprotein polymorphisms with myocardial infarction and lipid levels
    (Walter de Gruyter & Co, 2007-01-01) Gigek, Carolina de Oliveira; Chen, Elizabeth Suchi; Cendoroglo, Maysa Seabra; Ramos, Luiz Roberto; Quirino Araujo, Lara M.; Payão, Spencer Luiz Marques [UNIFESP]; Cardoso Smith, Marilia de Arruda; Universidade Federal de São Paulo (UNIFESP); FAMEMA
    Background: Lipoprotein lipase has an important role in lipid metabolism. Elevated levels of very-low-density lipoprotein (VLDL) and low-density lipoprotein (LDL) are associated with increased risk of coronary artery disease and low levels of high-density lipoprotein (HDL) are potentially atherogenic. the Hindill and S447X polymorphisms of the lipoprotein lipase (LPL) gene are associated with cardiovascular disease in some populations.Methods: LPL Hindill and S447X polymorphisms were analyzed in 343 individuals of 66-97 years of age from a cohort of a Brazilian elderly longitudinal study. Allele frequencies, genotype distribution and allele association with major morbidities and with serum lipid, urea, creatinine and albumin levels were also investigated. the whole sample was genotyped by PCR-restriction fragment length polymorphism (RFLP). Descriptive statistics, logistic regression analysis and t-test were used.Results: Allele frequencies were H+=0.652 and H-0.348 for LPL Hindill and S=0.824 and X=0.176 for LPL S447X polymorphism. Both polymorphisms have frequencies similar to those in some European populations. LPL Hindill polymorphism showed significant association of the HI allele with myocardial infarction. the H- allele showed a tendency to associate with higher HDL levels. the LPL S447X S allele was associated with higher triglyceride levels.Conclusions: These findings may help to identify risk factors for subjects and families and clarify the physiopathological role of these polymorphisms in age-related diseases.
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    Avaliação da abordagem da sexualidade em idosos com dor crônica
    (Universidade Federal de São Paulo (UNIFESP), 2015-06-30) Cherpak, Guilherme Liausu [UNIFESP]; Santos, Fania Cristina dos Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Sexual health has great importance in quality of life and general health of the elderly. Chronic pain has great impact in sexual health. Some 73% of older persons living with chronic pain have sexual dysfunctions as well. Very few of those get to discuss this matter with a physician. To find the reasons lying beneath this silence can help develop history-taking strategies that include this important topic to elders. To know how sexuality is approached in medical consultations in various specialties can provide good examples and changes in history taking. Physicians with chronic pain suffering elderly patients answered to a self-reported questionnaire about their clinical practice and their experience in approaching the subject of sexuality. Of the 155 physicians in the sample, 63.9% referred not discussing sexuality in their consultations. Of the 36.1% that referred discussing sexuality, only 23.2% did it in more than 60% of the consultations. The main reasons for not discussing were lack of time, fear to embarrass the patient and lack of knowledge to do so. It is important to develop strategies to enhance these numbers, in order to improve health care for elders, viewing them as whole beings, including their sexuality. This would have a positive impact in quality of life.
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    Avaliação do processamento auditivo em idosos que relatam ouvir bem
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2008-12-01) Sanchez, Maura Ligia [UNIFESP]; Nunes, Flavio Barbosa; Barros, Flavia [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Minas Gerais Hospital das Clínicas programa de pós-graduação em Cirurgia
    In the elderly, the results of central auditory pathways behavioral assessments are considered to be difficult to read because of the possible interference of peripheral auditory pathway involvement. AIM: Assess the efficacy of the central auditory function in elderly patients who do not complain of hearing. MATERIALS AND METHODS: Case study involving 40 individuals within the age range of 60 to 75 years. The patients underwent auditory processing evaluation based on anamnesis, otorhinolaryngological exam, threshold tonal audiometry, speech recognition threshold, speech recognition index, immittance measures, stapes reflex study, synthetic phrases identification test with ipsilateral competitive message, frequency pattern test and alternate twin-syllable test through dichotic task; age range and hearing loss influenced results from the phrases identification with ipsilateral competitive message. Percentages of right answers below normal standards were seen in the three tests that assessed the central auditory functions. CONCLUSION: Elderly individuals who did not complain of hearing presented relevant prevalence of signs of central auditory function inefficiencies.
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    Bone mineral density and osteoporosis among a predominantly Caucasian elderly population in the city of São Paulo, Brazil
    (Springer, 2005-11-01) Camargo, MBR; Cendoroglo, M. S.; Ramos, L.; Latorre, MDDD; Saraiva, G. L.; Lage, A.; Neto, N. C.; Araujo, LMQ; Vieira, JGH; Lazaretti-Castro, M.; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    This cross-sectional study covered 301 individuals over 70 years of age-207 women (W) and 94 men (M)-living in the city of São Paulo, Brazil. Our aims were to evaluate the prevalence of low bone mineral density (BMD) in this population and the possible factors that influence BMD. the subjects were submitted to a bone densitometry scan (DXA) to evaluate the BMD at lumbar spine (LS), femoral neck (FN), trochanter (T), total femur (TF) and total body composition. At the time, the participants filled in a questionnaire about lifestyle habits, diet and medical history, as well as having blood samples taken to check hormone and biochemical levels. Anthropometric parameters were measured. Osteopenia and osteoporosis were defined in accordance with the criteria suggested by the World Health Organization. in the different sites studied, the prevalence of osteopenia and osteoporosis varied, in men ranging 33.3-57.4% and 6.4-16.1%, respectively, and in women ranging 36.6-56.5% and 22.2-33.2%, respectively. Weight was the variable that most strongly correlated with BMD at the proximal femur in both sexes (men, r =0.44-0.52; women, r =0.48-0.52) and with BMD at LS in women ( r =0.44). Height was the parameter that best correlated with BMD at LS in men ( r =0.34). in men follicle-stimulating hormone, growth hormone and glycemia correlated with BMD at T and TF, while plasma albumin only correlated with BMD at T. in women glycemia correlated with BMD at LS, and follicle-stimulating hormone correlated with BMD at FN, T and TF. in conclusion, we found a high prevalence of osteopenia and osteoporosis in this population, with weight being the best predictor of BMD. the prevalence of osteoporosis and osteopenia at FN was as high in men as that observed in women.
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    Caracterização clínica de idosos com disfunção vestibular crônica
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-08-01) Gazzola, Juliana Maria [UNIFESP]; Ganança, Fernando Freitas [UNIFESP]; Aratani, Mayra Cristina [UNIFESP]; Perracini, Monica Rodrigues [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN; Universidade Cidade de São Paulo; Centro de Medicina Diagnóstica Fleury Setor de Otorrinolaringologia
    Dizziness is common among the elderly. AIM: To characterize social, demographic, clinical, functional and otoneurological data in elderly patients with chronic vestibular disorder. METHOD: A sequential study of 120 patients with chronic vestibular disorder. Simple descriptive analyses were undertaken. RESULTS: Most of the patients were female (68.3%) with a mean age of 73.40±5.77 years. The average number of illnesses associated with the vestibular disorder was 3.83±1.84; the patients were taking on average 3.86±2.27 different medications. The most prevalent diagnosis on the vestibular exam was unilateral vestibular loss (29.8%) and the most prevalent etiology was metabolic vestibulopathy (40.0%) followed by benign paroxysmal positional vertigo (36.7%). Fifty-two patients (43.3%) had experienced dizziness for 5 years or more. Sixty-four patients (53.3%) had at least one fall in the last year and thirty-five (29.2%) had recurrent falls. CONCLUSIONS: Most of the sample included females with associated diseases, and using many different drugs. The most prevalent vestibular diseases were metabolic and vascular labyrinth conditions. Dizziness is a chronic symptom in elderly patients. The association of two vestibular diseases is common. Falls are prevalent in chronic dizzy elderly patients.
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    Circunstâncias e conseqüências de quedas em idosos com vestibulopatia crônica
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2006-06-01) Ganança, Fernando Freitas [UNIFESP]; Gazzola, Juliana Maria [UNIFESP]; Aratani, Mayra Cristina [UNIFESP]; Perracini, Monica Rodrigues [UNIFESP]; Ganança, Mauricio Malavasi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); UNIBAN; UNICID; Centro de Medicina Diagnóstica Fleury - São Paulo (SP)
    AIM: To investigate the circumstances and consequences of falls in the chronically dizzy elderly and to correlate them with the number of falls (one/two and more). METHOD: Transversal descriptive analytic study with 64 patients aged 65 or over, with history of falls and diagnostic of chronic vestibular dysfunction. We performed a descriptive analysis and Qui-Square test (x<0.05). RESULTS: The sample was constituted by a female majority (76.6%) with a mean age of 73.62±5.69 years. The vestibular examination showed peripheral vestibulopathy in 81.5% of the cases and the most prevalent diagnostic hypothesis were benign paroxysmal positional vertigo (43.8%) and metabolic inner ear disease (42.2%). Recurrent falls were seen in 35 elderly (53.1%). In relation to the last fall, 39.1% of the patients had fallen in their homes, 51.6% of them occurred during the morning, 51.6% with some propulsion mechanism, 53.1% when walking, 25.0% caused by dizziness and 23.4% by stumbling. Activity restriction was significantly greater in patients that have already had two and more falls, when compared with those who had fallen only once (p=0.031). We found a significant association between the number of falls and their causes (p<0.001). Falls that have happened by slipping were more frequent in the elderly that reported one fall (p=0.0265) and falls that had happened because of dizziness were more frequent in the elderly that complained of two or more falls (p=0.0012). CONCLUSION: Fear and tendency to fall are referred by the majority of chronically dizzy elderly. Fall are more frequent in the morning, in the home and during walking. The propulsion direction is mentioned by half of the elderly and the most common cause for falls are dizziness and stumbling. The number of falls is significantly associated with activity restrictions after the last fall and with the causes for falling (slipping and dizziness).
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    Co-occurrence of chronic physical pain and psychiatric morbidity in a community sample of older people
    (Wiley-Blackwell, 2007-09-01) Blay, Sergio Luis; Andreoli, Sergio Baxter; Dewey, Michael E.; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Kings Coll London
    Background Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. Objective To study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Method Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. Results the overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain,joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 5 1.1%. in logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. the odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. Conclusion the association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population. Copyright (c) 2007 John Wiley & Sons, Ltd.
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    Composição corporal por bioimpedância e antropometria de idosos longevos
    (Universidade Federal de São Paulo (UNIFESP), 2016-05-31) Bertolini, Audrey Andrade [UNIFESP]; Cendoroglo, Maysa Seabra Cendoroglo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Aging is associated with changes in body composition in both men and women. Gender differences can impact the functional fitness in elderly with 80 or more years of age, and assessment methods are important to scale these differences. Objective: to compare the assessment of body composition by bioimpedance and anthropometry of physically independent men and women aged 80 years or more. Materials and methods: Individuals above 80 years old independently living in the city of São Paulo were invited to participate in this study through written and verbal communication. The elderly individuals underwent anthropometric evaluation and body composition assessments by bioimpedance. The 2003 criteria of the Pan-American Health Organization (OPAS) was used to assess the nutritional status of the participants. Lean body mass (LBM) variables were identified from the predictive equations of Kyle, Dey, and Valencia. ROC curves were used to demonstrate the sensitivity and specificity of the LBM results by BIA versus equations, and body fat percentage (BFP) results versus tricipital cutaneous fold (TCF) and waist circumference (WC). Results: This study included 221 elderly (72 men and 149 women) aged between 80 and 97 years old. The average values of WC were not different among males 95.3 ± 11 cm and females 90.9 ± 10.8 cm (p = 0.007). Likewise, the averaged values of body mass index (BMI), calf circumference, mid-upper arm muscle circumference (MUAMC) and body fat were similar between the two gender groups. However, TCF and lean body mass (LBM) values showed differences between genders: TCF 18.6 ± 5.7 mm in females and 15.4 ± 5.7 mm in males (p <0.001); LBM 37.0 ± 6.6 kg in females and 45.0 ± 10.4 kg in males (p <0.001). We found a strong correlation between body fat and BMI among women (r = 0.88; p <0.001) and men (r = 0.78; p <0.001), as well as body fat and WC in women (r = 0.76; p <0.001) and also in men (r = 0.79; p <0.001). Calf circumference values showed a stronger correlation to muscle mass in women (r = 0.72; p < 0.001). We also observed that WC and BFP values were high for both genders, except in underweight and eutrophic women. The average LBM index was lower in women with nutritional diagnosis of low weight. The comparison between the LBM by BIA versus predictive equations showed that Dey?s equation is the best estimate of BIA results when applied to eutrophic women. The analysis of skeletal muscle mass index (SMI) revealed that low-weight men showed lower SMI values than women. Conclusion: in order to identify obesity and sarcopenic obesity, even in individuals with normal BMI, it is crucial to consider gender differences and to combine different methods of evaluation, such asskeletal muscle mass (SMM) and SMI.
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    Computer classes and games in virtual reality environment to reduce loneliness among students of an elderly reference center Study protocol for a randomised cross-over design
    (Lippincott Williams & Wilkins, 2017) Campos Antunes, Thaiany Pedrozo; Bulle de Oliveira, Acary Souza [UNIFESP]; Crocetta, Tania Brusque; Ferreira de Lima Antao, Jennifer Yohanna; de Almeida Barbosa, Renata Thais; Guarnieri, Regiani; Massetti, Thais; de Mello Monteiro, Carlos Bandeira; de Abreu, Luiz Carlos
    Introduction: Physical and mental changes associated with aging commonly lead to a decrease in communication capacity, reducing social interactions and increasing loneliness. Computer classes for older adults make significant contributions to social and cognitive aspects of aging. Games in a virtual reality (VR) environment stimulate the practice of communicative and cognitive skills and might also bring benefits to older adults. Furthermore, it might help to initiate their contact to the modern technology. The purpose of this study protocol is to evaluate the effects of practicing VR games during computer classes on the level of loneliness of students of an elderly reference center. Methods and Analysis: This study will be a prospective longitudinal study with a randomised cross-over design, with subjects aged 50 years and older, of both genders, spontaneously enrolled in computer classes for beginners. Data collection will be done in 3 moments: moment 0 (T0) - at baseline
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    Correlação entre dados obtidos em um questionário de exposição solar e os níveis séricos de 25-hidroxivitamina d em população de jovens e de idosos, caucasoides, da cidade de São Paulo, durante o verão e no inverno São Paulo 2015
    (Universidade Federal de São Paulo (UNIFESP), 2015-08-24) Bittar, Fernanda Barros [UNIFESP]; Szejnfeld, Vera Lucia Szejnfeld [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: The aim of the present study is to verify if there is a correlation between the sun exposure questionnaire developed by Hanwell et al. (2010) and the serum vitamin D level in healthy caucasian subjects, young and old during the summer and winter. Subjects and Methods: A cross-sectional study was carried out in healthy subjects living in São Paulo city. All participants answered a sun exposure questionnaire and had blood samples collected for the serum vitamin D concentrations at the same day. Anthropometric data were also collected. The relationship between the questionnaire variables (such as time of sun exposure, amount of exposed skin, Total Sun Exposure Score and other data) and serum vitamin D status of individuals was evaluated. These associations were studied in summer and winter, in young and elderly, as well as, in the total sample. It was adopted statistical significance level 5 %. Results:The study sample consisted of 200 subjects, divided into four groups: 50 young and 50 elderly in the summer, 50 young and 50 elderly in the summer. The average serum vitamin D concentration was 17.60 ng/ml (± 7.3) with no difference accordingmaturity (P = 0293). The Total Sun Exposure Score correlated with serum vitamin D levels in the analysis of all subjects(r = 0.264; p < 0.001). By dividing in young and old, summer and winter, it was observed that the correlation remained only among the elderly in the summer (r = 0.322; p < 0.023). BMI had inverse correlation with vitamin D status (OR = 0.926; p = 0.027). In linear regression, The Total Sun Exposure Score and BMI were significant to estimate serum vitamin D levels. The Total Sun Exposure ROC curve was analyzed, and the AUC had no significance in determining individuals with vitamin D insufficiency (p = 0.172). Conclusion: The questionnaire, when associated with BMI, can estimate serum vitamin D level, but does not define insufficient vitamin D subjects. The questionnaire had correlation with serum vitamin D only in the summer elderly group. More than half of the participants had serum vitamin D levels consistent with insufficiency.
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    Correlates of lifetime alcohol misuse among older community residents in Brazil
    (Cambridge Univ Press, 2009-04-01) Blay, Sergio Luis [UNIFESP]; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter [UNIFESP]; Gastal, Fabio Leite; Universidade Federal de São Paulo (UNIFESP); Duke Univ; Vet Adm Med Ctr; Universidade Federal de Minas Gerais (UFMG)
    Background: Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community dwelling elderly people in Brazil.Method: Data were obtained from a representative sample of 6961 residents aged 60+ in the state of Rio Grande do Sul, Brazil. the structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and questions regarding sociodemographic characteristics, lifestyle and social support, and health conditions.Results: in the interview, 10.6% respondents (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one or more than one item endorsed), found that men, people aged 60-69 (compared to older persons) and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income and who were of non-white race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorders, but was protective against vascular conditions.Conclusions: Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly) lower income, non-whites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder.
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    Cortisol, DHEAS and aging: Resistance to cortisol suppression in frail institutionalized elderly
    (Editrice Kurtis S R L, 2003-01-01) Carvalhaes-Neto, N. [UNIFESP]; Huayllas, M. K. [UNIFESP]; Ramos, L. R. [UNIFESP]; Cendoroglo, Maysa Spínola [UNIFESP]; Kater, C. E. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Convincing evidences has linked the hypothalamus-pituitary-adrenal (HIPA) axis to aging patterns. F excess is implicated in the development of frailty characteristics whereas DHEAS is positively correlated to successful aging. We compared serum F and DHEAS levels of independent community-living (successful group, 19 M and 28 F, 69 to 87 yr) with those of institutionalized elderly (frail group, 20 M and 30 F, 65 to 95 yr). Serum F was determined at 1) baseline (08:00 h, 16:00 h and 23:00 h), 2) after 2 overnight dexamethasone (DEX) suppression tests (DST, using 0.25 and 1.0 mg doses), and 3) 60 min after ACTH stimulation (250 mug i.v. bolus); serum DHEAS was determined at 08:00 h. Basal serum F at 08:00 h, 16:00 h and 23:00 h and serum DHEAS levels were similar in both groups; however F: DHEAS ratio at 08:00 h was higher in the frail, compared to the successful group (mean+/-SD: 0.55+/-0.53 and 0.35+/-0.41, respectively; p=0.04). In response to DST, F suppression was less effective in frail elderly after either 0.25 or 1.0 mg doses (9.0+/-6.0 and 2.0+/-0.9 mug/dl), as compared to the successful group (5.8+/-4.4 and 1.5+/-0.5 mug/dl) (p=0.01). In addition, a significant correlation was observed between post-DEX F levels (both doses) and parameters of cognitive and physical frailty. Normal and similar F levels were observed after ACTH stimulation in both groups. Our data suggest a deficient feedback regulation of the HPA axis in frail institutionalized elderly, as demonstrated by a higher set point for F suppression. This augmented HPA tonus enforces the hypothesis that even milder F excess may be related to characteristics of frailty in the elderly. ((C))2003, Editrice Kurtis.
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    Delirium no idoso hospitalizado: aplicabilidade de um instrumento prático com enfoque preventivo
    (Universidade Federal de São Paulo (UNIFESP), 2014-12-17) Correia, Deborah Carvalho [UNIFESP]; Toniolo Neto, Joao Toniolo Neto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The central nervous system is most often involved in the process of aging, subject to damage by extrinsic factors and intrinsic biological system. Within this context, the delirium stands as one associated with increasing age syndrome, brain aging and cognitive decline is a result of transient disruption of brain homeostasis secondary to systemic disorders or central nervous system. Delirium is one of the most common complications among hospitalized elderly patients, independently associated with adverse outcomes, however, likely to be preventable in a third of cases. Nevertheless, the implementation in the hospitals of interventions to prevent delirium is still not as common as one would expect. The HELP (Hospital Elder Life Program) is an intervention strategy developed by Inouye and colleagues at Yale targeting the prevention of delirium and functional decline in the hospitalized elderly. This program achieved important results using protocols for the management of six risk factors for delirium: cognitive impairment, sleep deprivation, immobility, visual impairment, hearing impairment and dehydration. This dissertation will deepen the knowledge about brain aging and delirium in the elderly and discuss peculiarities of the HELP instrument management and its applicability in Geriatrics, Hospital, UNIFESP, the feasibility of a preventive intervention on delirium in the elderly in hospital.
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    Densidade energética da dieta e sua relação com a presença de doenças crônicas não transmissíveis em idosos
    (Universidade Federal de São Paulo (UNIFESP), 2015-06-23) Pimenta, Sabrina Pessoni [UNIFESP]; Ramos, Luiz Roberto Ramos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The energy density (ED) is defined as the amount of energy (kcal) per weight of food (grams). A decrease in the consumption of foods with high ED may help to reduce the total caloric value of the diet, preventing weight gain and the onset of chronic noncommunicable diseases (NCDs). Objectives: To assess the energy density of the diet and its relation to nutritional status, diabetes mellitus, dyslipidemia and hypertension and socio-demographic variables in the elderly, as well as to analyze the prevalence of NCD and identify the nutritional status and point out which meal higher and lower energy density. Methods: Cross-sectional study with the elderly, part of a cohort of Epidoso.Foi assessed the diets of 345 elderly through the Food Recall 24 hours. The ED of diet was calculated with all solid and liquid food, excluding drinks energy value less than 5 kcal/100g. To examine the relationship between ED diet and the presence of NCD used the chi-square test or Fisher's exact test extension. Results: There was no significant variation between the DE into tertiles and NCD, nutritional status, sex, age and education. The total energy of the diet is lower in older age groups and higher for men. DE was very similar in all age groups and both sexes. The highest and lowest average DE were found in the breakfast and evening snack, respectively. Most seniors who consumed a diet with amount of lipids above the recommended carbohydrate and lower than recommended, was the last tertile of energy density. Conclusions: We found a high prevalence for NCDs and females was significantly related to low birth weight and obesity. The average found DE was 1.14 kcal/g, showing no association with the NCD, nutritional status and sociodemographic variables. Most DE meal was breakfast.