Navegando por Palavras-chave "idoso"

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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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    Atitudes em relação aos idosos com demência: o que pensam os médicos recém-ingressos em programas de residência nas áreas de clínica médica, geriatria, psiquiatria e neurologia
    (Universidade Federal de São Paulo (UNIFESP), 2016-12-21) Siviero, Livia Pero [UNIFESP]; Citero, Vanessa de Albuquerque Citero [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    The elderly population, defined as the number of people over 60 and over 65 years has increased considerably, and this fact also observed in Brazil from the 1980s In 2005, Alzheimer's Disease International estimated that, worldwide 24.3 million people have dementia and about 4.6 million new cases per year. Given this panorama, medical education should be the focus of study in relation to vocational training for the diagnosis of dementia, and to understand the attitudes of medical professional front of the elderly demented patient. The objective is to describe the attitudes toward patient demented that are reported by freshmen resident doctors in residency programs in areas that handle the elderly with dementia. This is a descriptive cross-sectional study, consisting of a convenience sample, with 71 resident doctors of psychiatry areas (N = 11), Neurology (N = 6), Internal Medicine (N = 34) and Geriatra (N = 10) the first month of residency. Most doctors agreed fully that much can be done to improve the quality of life of caregivers of people with dementia (86.9%) and that much can be done to improve the quality of life of people with dementia (59.0% ). Most participants (63.9%) states that dementia is best diagnosed in specialized services. Much of the doctors (41%) disagree that patients with dementia can deplete resources with little positive result and 85.2% also disagree that it is better to talk to the patient using euphemisms. Only 21.3% of respondents believe that treating dementia often more frustrating than rewarding and 24.6% that is not worth driving families to specialized services when they do not want to use them. Most physicians (88.5%) disagree that primary care team has a very limited role in the care of people with dementia. The main recommendation of this study is the attention that should be given to dementia teaching in medical schools, especially in making the diagnosis, so that the doctor has an optimistic view of his role as elder care provider with dementia.
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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 da funcionalidade dos idosos um mês após fratura de fêmur proximal e variáveis associadas
    (Universidade Federal de São Paulo (UNIFESP), 2015-09-30) Silva, Mariana de Carvalho da [UNIFESP]; Lemos, Naira de Fatima Dutra Lemos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: As fraturas de fêmur proximal por fragilidade são resultantes de um trauma de baixo impacto e são consideradas uma das complicações mais graves da osteoporose no idoso. A associação com elevados índices de morbidade e mortalidade faz, destas fraturas, um preocupante problema de saúde pública. Poucos estudos avaliaram as repercussões da fratura de fêmur em idosos no primeiro mês após a alta hospitalar. Este estudo analisou a dimensão desta problemática na enfermaria de ortopedia do Hospital São Paulo, avaliando a mortalidade e a funcionalidade antes, durante internação e após um mês da alta hospitalar de pacientes idosos que sofreram fratura de fêmur osteoporótica. MATERIAL E Métodos: Estudo longitudinal, exploratório e descritivo dos pacientes com diagnóstico de fratura de fêmur proximal osteoporótica ,com idade igual ou superior a 60 anos, internados na enfermaria de ortopedia do Hospital São Paulo entre agosto e dezembro de 2014. A coleta de dados foi feita por meio de entrevista com paciente e/ou responsável, dados do prontuário e informações colhidas por telefone um mês após a alta hospitalar. A análise estatística foi efetuada através dos testes estatísticos: t-Student, ANOVA, correlação de Pearson e General Linear Model. O nível de significância foi estabelecido como 0,05 ou 5%. Resultados: Foram avaliados 30 indivíduos, dos quais 80% (24) eram do sexo feminino. A média de idade foi de 82,63 anos +/- 7,68 anos DP. A intervenção cirúrgica foi opção terapêutica em 93% (28) dos pacientes. A mortalidade intra-hospitalar foi de 10% (3). A duração média da internação foi de 9,9 dias +/- 4,79 DP. A institucionalização após a alta hospitalar ocorreu em 17,4% (4) dos casos. Após um mês da alta hospitalar, 17,4% (4) tinham falecido, totalizando 7 (23%) durante o período total do estudo. Anteriormente à fratura, 83% (25) dos pacientes eram independentes para atividades básicas de vida diária (ABVD) e um mês após a alta, somente 1 (4,3%) paciente conseguiu deambular de forma independente. Demência, delirium, dependência funcional e desidratação tiveram impacto negativo na reabilitação dos idosos no presente estudo. Conclusão: A fratura de fêmur proximal representa uma causa importante de internação na ortopedia no hospital estudado. O risco de fraturas aumenta com a idade sendo ainda mais prevalente em mulheres. Existe uma elevada mortalidade intra-hospitalar associada a esse tipo de fratura assim como no pós-operatório imediato. A influência negativa destas fraturas é comprovada por uma elevada mortalidade e uma perda funcional significativa no mês seguinte à fratura.
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    Avaliação do impacto da dor crônica no controle de pressão arterial de pacientes longevos
    (Universidade Federal de São Paulo (UNIFESP), 2013-10-30) Toledo, Jullyana Chrystina Ferreira [UNIFESP]; Miranda, Roberto Dischinger Miranda [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: Aging is associated to an increase of non transmissible chronic illnesses. In elderly they might coexist, and may play a role in the physiopathology and/or treatment of each another. Evidences suggest that the pain modulatory system and the blood pressure control system may be interrelated. Objectives: To evaluate the effects of chronic moderate to severe pain on blood pressure levels of very old individuals. Methods: All individuals of both gender, above 80 years or older, without cognitive impairment nor activities of daily living difficulties that were included on “Longevos” research protocol. Every individual included in this research had a full clinical evaluation performed. For this analysis, we considered the systolic blood pressure (SBP), diastolic blood pressure (DBP), presence of pain and its duration and intensity. After a 5 minute rest period, the blood pressure was measured twice with the individuals in the seated position. We considered the mean blood pressure. Hypertension was considered when SBP was 140 mm Hg or higher or when DBP was 90 mm Hg or higher or the individual took any antihypertensive drug. The pain was graded by the verbal numeric scale, and pain was considered moderated to severe when the individual graded the pain at level 3 or over and chronic when it lasted for at least 3 months. Results: We evaluated 191 individuals; the majority was women (137), white (130) and euthrophic (112) subjects. We found that 169 individuals (88,5%) had hypertension and 22 were normotensive. Thirty nine (23,0%) out of the hypertensive individuals had chronic pain. We noted no differences among hypertensive and normotensive subjects regarding gender, age, smoking habit, chronic pain, falls, and functional status. We found that most of the hypertensive individuals were using 2 (34,9%) or 3 (30,8%) antihypertensive drugs. The mean number of drugs used by hypertensive individuals with chronic pain was found to be 2,7 antihypertensive drugs, while the hypertensive subjects without chronic pain was found to be 2,2 drugs, but they had no statistical difference on blood pressure level (p=0,012). There were no differences among SBP, DBP, gender, age, smoking habit and functional status for the groups with or without chronic pain. Conclusion: Pain seems to have an effect over the blood pressure level of this very old population because in order to maintain similar blood pressure levels, those suffering from chronic pain were taking a larger number of antihypertensive drugs than those without chronic pain.
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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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    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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    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.
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    Depressão dor-induzida em idosos: validação das propriedades psicométricas da versão brasileira do “eriatric emotional assessment of pain geap-b”
    (Universidade Federal de São Paulo (UNIFESP), 2015-10-28) Almeida, Carla Bezerra Lopes [UNIFESP]; Santos, Fania Cristina dos Santos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    A dor crônica tem impacto no envelhecimento e, frequentemente, coexiste com a depressão e se exacerbam mutuamente, parecendo estarem intimamente ligadas. Ambas têm efeito negativo sobre o desempenho físico, tanto separadamente quanto em combinação. Vários estudos relatam que a depressão está associada a mais queixas de dor, à maior intensidade e a maior duração dessas, e ainda, a maior probabilidade de sua não resolução. Observando a relação entre dor e depressão obtêm-se que cada uma pode aumentar o risco de aparecimento e gravidade da outra (1). As consequências de tal associação além de aumentar o sofrimento dos indivíduos acometidos e piorar a qualidade de vida deles, também aumenta a taxa de desemprego, aposentadoria precoce e o grau de incapacidade desta população (2). Recentemente, alguns estudos testaram uma ferramenta desenvolvida especialmente para idosos com dor crônica, e que se propõe a avaliar a depressão dor-induzida: ?A Geriatric Psychosocial Assessment of Pain-induced Depression ?- GEAP. O objetivo maior desses estudos foi avaliar especificamente, com base em evidências, a depressão dor-induzida na população geriátrica, comparando com avaliações atuais baseadas em instrumentos que abordam apenas a depressão (Geriatric Depression Scale - GDS) ou a dor (Geriatric Pain Measure - GPM) dos idosos, e assim, fornecer uma análise quantitativa de confiabilidade e validade referentes as dimensões físicas e psicológicas da depressão dor - induzida (3). O GEAP que, atualmente, é o primeiro instrumento capaz de avaliar a depressão associada a dor em idosos, ainda não foi traduzido e adaptado transculturalmente para o português do Brasil. Assim, o presente estudo realizou a tradução, adaptação transcultural e validação desse instrumento para a população idosa brasileira, permitindo uma avaliação clínica abrangente da depressão induzida por dor em adultos mais velhos no nosso meio.
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    Efeito da estimulação acústica nas habilidades do processamento temporal em idosos antes e após a protetização auditiva
    (Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-08-01) Pinheiro, Maria Madalena Canina [UNIFESP]; Dias, Karin Ziliotto [UNIFESP]; Pereira, Liliane Desgualdo [UNIFESP]; Universidade Federal de Santa Catarina Curso de Fonoaudiologia; Universidade Federal de São Paulo (UNIFESP)
    Aging can alter temporal processing and affect speech perception. AIM: To compare temporal processing auditory processing in elderly subject to and new hearing aid users. MATERIALS AND METHODS: The study included 60 elderly patients with bilateral sensorineural hearing loss. The procedures selected were the Duration Pattern Tests (DPT) and gaps in noise (GIN) test were used to analyze the responses of correct identification, and the temporal acuity threshold before and after the fitting of hearing aids. Study design: clinical and experimental research with non-probability sample of convenience. RESULTS: There was no statistically significant difference between the responses from GI and GII individuals. The elderly users of hearing aids had a lower gap detection threshold, greater recognition of gaps and of discrimination of the duration pattern in relation to when they were only potential users. CONCLUSION: There was a deterioration in temporal processing skills, regardless of hearing loss degrees. Thus, the effect of acoustic stimulation by the use of a hearing aid improved resolution and temporal ordering.
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    Efeito da suplementação com vitamina d3 no tecido adiposo de idosas ativas
    (Universidade Federal de São Paulo (UNIFESP), 2015-05-31) Moreira, Patricia Ferreira do Prado [UNIFESP]; Cendoroglo, Maysa Seabra Cendoroglo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: O diagnóstico e o tratamento da hipovitaminose D em idosos têm grande importância, porque baixos níveis séricos de vitamina D podem afetar o sistema muscular-esquelético e cárdio-vascular. Além disso, a hipovitaminose D pode estar envolvida em muitas doenças e condições patológicas como diabetes tipo 2, câncer, obesidade e declínio cognitivo. A adiposidade tem sido estudada como fator de risco para hipovitaminose D na população geral. No idoso este fator de risco pode ser bastante frequente, considerando que no envelhecimento ocorrem mudanças na composição corporal, que favorecem ao acúmulo de gordura na região abdominal. No entanto, até o momento, não está claro se a distribuição da gordura corporal é mais importante do que a gordura total como um alvo para investigar e tratar a hipovitaminose D. Objetivos: 1. Investigar prospectivamente a influência da distribuição da gordura corporal nos níveis séricos de 25(OH)D durante a suplementação com colecalciferol em idosas. 2. Avaliar o impacto do tratamento com colecalciferol na composição corporal de idosas ativas com sobrepeso e obesidade.
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    Efeitos da reabilitação vestibular na capacidade funcional de idosos vestibulopatas crônicos: ensaio clínico randomizado
    (Universidade Federal de São Paulo (UNIFESP), 2014-11-28) Aratani, Mayra Cristina [UNIFESP]; Gananca, Fernando Freitas Gananca [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: To compare the effectiveness of two vestibular rehabilitation protocols (Conventional versus Multimodal) on the functional capacity of older people with chronic vestibulopathy. Methods: A randomized, single blind, controlled clinical trial, with a tree month follow-up was performed. The sample was composed of older individuals with a clinical diagnosis of chronic dizziness resulting from vestibular disorders. The individuals were subjected to questionnaires that assessed the impact of dizziness on quality of life, ability and confidence to perform activities of daily living and mood at baseline, post-treatment, and at follow-up. The primary outcome measure was the Dizziness Handicap Inventory. Secondary outcomes included the Vestibular Disorders Activities of Daily Living, Activities-specific Balance Confidence Scale and Geriatric Depression Scale. The older individuals were randomized to either the Conventional or Multimodal Cawthorne & Cooksey protocols. The protocols were performed during individual 50-minute sessions, twice a week, for two months. The outcomes of both protocols were compared according to the intention-to-treat analysis. Results: 82 older individuals were randomized into either Conventional (n=40) or Multimodal (n=42) protocols. There were significant increases in the primary and second outcomes at post-treatment that was maintained on follow-up period, with no significant difference between groups, nor any interaction concerning the treatment protocol. Conclusions: The vestibular rehabilitation, regardless of the treatment protocol, resulted in improvement on elderlies? functional capacity, which was maintained during a short-term period.
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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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    Estudo da capacidade funcional de idosos com neoplasias mieloides e leucemias agudas
    (Universidade Federal de São Paulo (UNIFESP), 2013-08-28) Carbonell, Ana Lucia Ippolito [UNIFESP]; Chauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introduction: The human aging has been accompanied by higher incidence and prevalence of myeloid neoplasms (MN). Hematologists use age, performance status (PS) and comorbidities indices to characterize the elderly patient. Improvement in the functional assessment can be achieved applying geriatric scales assessing functional status (FS). Objectives: To evaluate the functionality of elderly outpatients with MNs with scales utilized by hematologists and geriatricians. Thus, to study the impact of age, sex, comorbidities, and hemoglobin level in the functionality of such patients. Methods: Karnofsky (KPS), Eastern Cooperative Oncology Group (ECOG), the basic (ADL) and instrumental (IADL) activities of daily living scales were applied to assess the functionality of elderly outpatients with MN. The patients’ assessment was made by a hematologist and a geriatrician. The comorbidity index for hematopoietic cell transplantation (HCT–CI) was used to stratify the patients’ comorbidities. Statistical study applied the intraclass correlation, the alpha Cronbach’ coefficient, the Fisher tests, the t Student test and ANOVA. We fitted a mixed logistic regression model to evaluate the impact of age, sex, hemoglobin and comorbidities in performance and functional status of this group of elderly patients. Results: A total of 82 elderly patients (mean age of 72.8 years, varying from 60 to 90 years) were evaluated. Their hematological diagnosis included: essential thrombocythemia (ET; n=6); polycythemia vera (PV; n=15); chronic myeloid leukemia (CML; n=9); myelofibrosis (MF; n=25); myelodysplastic syndromes (MDS; n=17) and acute myeloid leukemia (AML; n=10). Eighty percent of the patients had good PS but only 50% of this group of individuals was independent in daily activities. All patients with poor PS were dependent in ADLs and/or IADLs. The mixed logistic regression models showed that age, sex, Hb and HCT–CI affected FS. However, only Hb and HCT–CI impacted on PS. Conclusions: The aggregation of the ADL and IADL to KPS and ECOG increases the sensibility and specificity of functional assessment of elderly patients with NM. The Hb level and comorbidity index affected both performance and functional status. However, the age and the sex only impacted on functional status.
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    Estudo da freqüência fundamental da voz de idosas portadoras de diferentes graus de perda auditiva
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-06-01) Baraldi, Giovana dos Santos [UNIFESP]; Almeida, Laís Castro de [UNIFESP]; Calais, Lucila Leal [UNIFESP]; Borges, Alda Christina Lopes de Carvalho [UNIFESP]; Gielow, Ingrid [UNIFESP]; De Cunto, Mauricio Raymundo; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    Increased life expectancy raises demands for special attention for the elderly population; speech, language and hearing science deals with their communication disorders. Hearing loss is a common disorder affecting this age group. It is known that the auditory feedback system is essential to human vocalizing, as it organizes voice production. AIM: To assess and correlate the hearing system and the Fundamental Frequency (F0) of women who have variable degrees of sensorineural hearing loss. MATERIAL AND METHOD: a cross-sectional descriptive study. 30 women with a mean age of 75.95 (SD = 7,41) were included. Inclusion criteria were: symmetric sensorineural hearing loss, a high-frequency sloping configuration, and a type A tympanogram. Subjects underwent Pure Tone Audiometry, a Word Recognition Test, Tympanometry, and Voice Assessment. RESULTS: Patients with higher degrees of hearing loss showed an increased fundamental frequency. CONCLUSION: In aged individuals with hearing loss, audiovocal monitoring is altered, resulting in voice parameter changes.
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    Evolução da perda auditiva no decorrer do envelhecimento
    (ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2007-02-01) Baraldi, Giovana dos Santos [UNIFESP]; Almeida, Laís Castro de [UNIFESP]; Borges, Alda Christina Lopes de Carvalho [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Aging is a natural consequence of a society developing process. The city of São Paulo has almost one million people who are above sixty years of age. Age-related hearing loss equals the total hearing loss resulted from cell degeneration caused by noise exposure, ototoxic agents and the loss caused by disorders and medical treatments. AIM: To study age-related hearing degeneration by means of higher thresholds and hearing sensitivity measures. MATERIALS AND METHODS: Cross-sectional contemporary cohort study in which we assessed 211 elderly patients with mean age of 75.24 years, of whom 61 were females and 150 were males. The subjects were submitted to an interview and a conventional audiometric assessment; and later divided into four groups according to age range. RESULTS: Significant threshold drop in the four established age groups, decrease in speech recognition ratio, and a significant difference regarding gender. CONCLUSION: As age advanced there was a gradual increase in hearing loss, men showed a lower threshold in the 4000Hz frequency when compared to women, and in the speech intelligibility test thre was also a gradual decrease with aging.
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    Evolução em longo prazo do transplante renal em idosos
    (Universidade Federal de São Paulo (UNIFESP), 2015-03-31) Orlandi, Paula Ferreira [UNIFESP]; Pestana, Jose Osmar Medina de Abreu Pestana [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: Apesar da grande participação dos maiores de 60 anos entre os portadores de doença renal crônica, estimada em cerca de 40% no Brasil, Transplante Renal ainda abrange pouco esta população. Metodologia: Entre 1998-2010, cerca de 7000 pacientes foram transplantados no Hospital do Rim e Hipertensão. Informações sobre todos os 366 pacientes com mais de 60 anos transplantados nesse período foram levantadas. Como controles foram pareados 366 pacientes mais jovens por gênero, tipo de doador (vivo ou falecido) e ano do transplante. Resultados: Diabetes como causa de insuficiência renal foi significativamente mais frequente entre os idosos (44%) que entre os mais jovens (12%) (p=0.002). Complicações cardiovasculares (12,3%), Câncer (6,8%), Reinternações(77,3%) e Função Tardia do Enxerto (45,6%) também foram mais comuns para os idosos, apesar das características dos doadores serem parecidas. Sobrevida do paciente em 10 anos (54% vs. 83.4%, p <0.001) e sobrevida global do enxerto (39,4% vs. 67,1%, p<0,001) foram inferiores no grupo idoso quando comparado ao mais jovem, mas não houve diferença significativa na sobrevida do enxerto censorada por óbito (75% vs. 81,1%, p=0,234). Óbito com enxerto funcionante foi responsável por 64% e 44% de todas as causas de perda do enxerto nos idosos e jovens respectivamente (p=0.023). Conclusões: Este é um dos poucos estudos comparando receptores de transplante renal idosos e não idosos no Brasil após 10 anos de evolução. Maior mortalidade entre a população senil, possivelmente associada comorbidades, em especial Diabetes, deve colaborar para a pior sobrevida deste grupo.