Lucy Gomes

Prevalência de depressão em idosos que freqüentam centros de convivência

The objective of the study was to establish the prevalence rate of depression among the elderly population (those 60 and older) who frequent community centers. From February to July of 2001, a cross-sectional survey was conducted with elderly people from community centers in Taguatinga, Brasilia, FD (Federal District). The sample included 118 elderly people, distributed in five-year age brackets, who responded to a simplified version of the Yesavage Geriatric Depression Scale with 15 questions. Anova and the Tukey test were performed to analyze differences between the age groups with 95% confidence intervals. The sample was predominantly female (90%) with the majority reporting being in the age bracket of 60 to 64 years old (31%). Depression was reported by 36 respondents (31%) and severe depression was reported by 4% of those interviewed, all of whom were in the age bracket of 60 to 64 (representing 14% of this group). National programs should be developed in community centers focused on decreasing depression among the elderly population.

Association between the -174 G/C promoter polymorphism of the interleukin-6 gene and cardiovascular disease risk factors in Brazilian older women

In worldwide studies, interleukin-6 (IL-6) is implicated in age-related disturbances. The aim of the present report was to determine the possible association of IL-6 -174 C/G promoter polymorphism with the cytokine profile as well as with the presence of selected cardiovascular risk features. This was a cross-sectional study on Brazilian women aged 60 years or older. A sample of 193 subjects was investigated for impaired glucose regulation, diabetes, hypertension, and dyslipidemia. Genotyping was done by direct sequencing of PCR products. IL-6 and C-reactive protein were quantified by high-sensitivity assays. General linear regression models or the Student t-test were used to compare continuous variables among genotypes, followed by adjustments for confounding variables. The chi-square test was used to compare categorical variables. The genotypes were consistent with Hardy-Weinberg equilibrium proportions. In a recessive model, mean waist-to-hip ratio, serum glycated hemoglobin and serum glucose were markedly lower in C homozygotes (P = 0.001, 0.028, and 0.047, respectively). In a dominant hypothesis, G homozygotes displayed a trend towards higher levels of circulating IL-6 (P = 0.092). Non-parametric analysis revealed that impaired fasting glucose and hypertension were findings approximately 2-fold more frequent among G homozygous subjects (P = 0.042 and 0.043, respectively). Taken together, our results show that the IL-6 -174 G-allele is implicated in a greater cardiovascular risk. To our knowledge, this is the first investigation of IL-6 promoter variants and age-related disturbances in the Brazilian elderly population.

Fatores associados a quedas em mulheres idosas residentes na comunidade

OBJECTIVE To determine the factors related to falls of a group of independent and autonomous elderly women. METHODS This was a descriptive study of 83 elderly women enrolled on the Elderly Health Promotion Project at the Universidade Católica de Brasília. They replied to questionnaires on their age, sociodemographic factors, dizziness, use of continuous medication, self-perception of health and vision and underwent the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS No statistical relationship was identified between age, social demographic factors, dizziness, or negative self-perception of health and vision and fall phenomena. However there was a significant statistical relationship with the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION Elderly womens ability to balance was the major factor related to fall events. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered effective for predicting risk of falling, indicating that they could be used for assessment and identification of improved balance after trainingOBJECTIVE: Verify the factors related to falls of a group of independent and autonomous elderly women. METHODS: A descriptive study was conducted with 83 elderly women that participate in the Elderly Health Promotion Project of the Universidade Catolica de Brasilia. They replied to questions related to their age, social demographic factors, dizziness, use of continuous medication, self-perception of health and vision and were submitted to the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS: No statistical relation was identified between age, social demographic factors, dizziness, and negative self-perception of health and vision with fall phenomena. Although there is a significant statistical relation to the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION: Body balance condition of the elderly women was the major factor related to fall occurrences. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered efficient to predict the risk of falling, indicating that they may be used for the assessment and identification of an improved body balance after training.

A common polymorphism in the renin angiotensin system is associated with differential outcome of antihypertensive pharmacotherapy prescribed to Brazilian older women

BACKGROUND Since variations on the renin angiotensin (RA) system tend to exert effects on blood pressure, we investigated the association of the common ACE and AT1R polymorphisms with response to a multivariate pharmacotherapy. METHODS This prospective study involved 169 hypertensive, community-dwelling older women. Genotypes were obtained by length analysis or direct sequencing of PCR products. Blood pressure-lowering pharmacotherapy was conducted according to current Brazilian Guidelines on Hypertension. RESULTS Genotype frequencies were in agreement to the Hardy-Weinberg equilibrium. Interventions were found to represent actual hypertension-management practices in Brazil, and accounted for a significant reduction in both systolic (P<0.001) and diastolic (P<0.001) blood pressure. Concerning the effect of polymorphisms, no influence of the ACE and AT1R genotypes were found on the magnitude of the treatment-induced blood pressure reduction (P>0.05). Nonetheless, the clinical result varied according to the ACE alleles since mean systolic pressure was roughly 10 mm Hg higher in insertion (I) homozygotes than in the deletion (D) counterparts either in baseline (P=0.001) and endpoint (P=0.010). CONCLUSION The outcome of the antihypertensive pharmacotherapy advocated by national guidelines was significantly influenced by the ACE I/D polymorphism but not by the AT1R 1166 A/C polymorphism among postmenopausal women.

Controle do tabagismo em instituição de longa permanência para idosos: relato de experiência

The scope of this investigation was to establish the prevalence of diabetic foot amputations and analyze associations with factors related to the individual and to primary health care. It is a cross-sectional epidemiological study and the sample included 214 inpatients with diabetic feet in one of the four hospitals specialized in vascular surgery in the state of Pernambuco. Data were collected using semi-structured questionnaires. In the data analysis, chi-square association, Poisson regression (p < 0.05) and descriptive statistics procedures were applied. The prevalence of amputation ascertained was 50%. The following factors related to the individual were associated with its occurrence: low education (p = 0.027); two or more people living in the household (p = 0.046); and patient income below the minimum wage (p = 0.004). The following factors related to primary health care were associated with amputation: not having feet examined (PR = 1.17); not receiving guidance on foot care (PR = 2.24) in consultations in the past year; not using the drug for DM control as prescribed (PR = 1.60); and inadequate glycemic control (PR = 1.83). Understanding these factors helps to identify aspects of preventive care that require improvement.Estudos sobre tabagismo em idosos institucionalizados sao importantes, para que se desenvolvam intervencoes apropriadas. Estudo transversal, base populacional, em individuos com 60 anos ou mais, internados em ILPI do DF. Verificou-se prevalencia de tabagismo, perfil sociodemografico e clinico: genero, escolaridade, provavel depressao, grau de motivacao para cessacao tabagica, uso anterior de auxilio medicamentoso para abolicao do tabagismo e percepcao de prejuizo do fumo para a saude. Realizadas espirometria, medicao do monoxido de carbono exalado e classificacao segundo gravidade da dependencia nicotinica. O Programa seguiu diretrizes para cessacao do tabagismo, sendo avaliado apos um ano do inicio. Do total, 25,7% eram fumantes, sendo 22,8% homens e 2,9% mulheres, com idade media 68,3 ± 8,5 anos. Surgiu significativa reducao da prevalencia de tabagismo nos mais idosos e associacoes significativas entre grau de dependencia nicotinica e escolaridade, provavel depressao, grau de motivacao para cessacao de tabagismo e percepcao de prejuizo do fumo para saude. Identificaram-se maiores valores de monoxido de carbono naqueles com obstrucao grave. Inicialmente, 37,9% dos tabagistas concordaram em participar da Campanha, obtendo-se exito, apos um ano, em 9% deles.

Factors related to falls of elderly women residents in a community

OBJECTIVE To determine the factors related to falls of a group of independent and autonomous elderly women. METHODS This was a descriptive study of 83 elderly women enrolled on the Elderly Health Promotion Project at the Universidade Católica de Brasília. They replied to questionnaires on their age, sociodemographic factors, dizziness, use of continuous medication, self-perception of health and vision and underwent the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS No statistical relationship was identified between age, social demographic factors, dizziness, or negative self-perception of health and vision and fall phenomena. However there was a significant statistical relationship with the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION Elderly womens ability to balance was the major factor related to fall events. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered effective for predicting risk of falling, indicating that they could be used for assessment and identification of improved balance after trainingOBJECTIVE: Verify the factors related to falls of a group of independent and autonomous elderly women. METHODS: A descriptive study was conducted with 83 elderly women that participate in the Elderly Health Promotion Project of the Universidade Catolica de Brasilia. They replied to questions related to their age, social demographic factors, dizziness, use of continuous medication, self-perception of health and vision and were submitted to the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS: No statistical relation was identified between age, social demographic factors, dizziness, and negative self-perception of health and vision with fall phenomena. Although there is a significant statistical relation to the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION: Body balance condition of the elderly women was the major factor related to fall occurrences. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered efficient to predict the risk of falling, indicating that they may be used for the assessment and identification of an improved body balance after training.

Factors related to falls among elderly women resident in a community.

OBJECTIVE To determine the factors related to falls of a group of independent and autonomous elderly women. METHODS This was a descriptive study of 83 elderly women enrolled on the Elderly Health Promotion Project at the Universidade Católica de Brasília. They replied to questionnaires on their age, sociodemographic factors, dizziness, use of continuous medication, self-perception of health and vision and underwent the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS No statistical relationship was identified between age, social demographic factors, dizziness, or negative self-perception of health and vision and fall phenomena. However there was a significant statistical relationship with the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION Elderly womens ability to balance was the major factor related to fall events. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered effective for predicting risk of falling, indicating that they could be used for assessment and identification of improved balance after trainingOBJECTIVE: Verify the factors related to falls of a group of independent and autonomous elderly women. METHODS: A descriptive study was conducted with 83 elderly women that participate in the Elderly Health Promotion Project of the Universidade Catolica de Brasilia. They replied to questions related to their age, social demographic factors, dizziness, use of continuous medication, self-perception of health and vision and were submitted to the Yesavage Geriatric Depression Scale, Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. RESULTS: No statistical relation was identified between age, social demographic factors, dizziness, and negative self-perception of health and vision with fall phenomena. Although there is a significant statistical relation to the Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment. CONCLUSION: Body balance condition of the elderly women was the major factor related to fall occurrences. Functional Reach Test and Tinetti Performance-Oriented Mobility Assessment were considered efficient to predict the risk of falling, indicating that they may be used for the assessment and identification of an improved body balance after training.

A osteoporose e a mulher envelhecida: fatores de risco

Osteoporosis is a silent disease which involves the recognition of risk factors inherent to every woman in the determination of strategies to improve the quality of life. OBJECTIVE: to analyze the chance of women having risk factors for osteoporosis using the questionnaire proposed by the EVOS study and evaluate the performance in activities of daily living in relation to actions performed on most days by the IADLs questionnaire. The examination of bone densitometry was performed to diagnose osteoporosis. METHODOLOGY: we applied the plug with socio-demographic data and questionnaire EVOS the first time and after the IADLs questionnaire and examination of bone densitometry in postmenopausal women, aged = 60 years. RESULTS: we analyzed 58 women with a mean age of 67.3 years. The BMI, a risk factor, was considered as a predictor for the absence of osteoporosis, since women in this study were overweight. Sixteen (28%) had osteoporosis, with mean scores significantly lower than those who do not have osteoporosis of items: get shopping (p = 0.006), manages to do manual labor (p = 0.018) and taking care of finances (p = 0.014). CONCLUSION: the BMI variable in the logistic EVOs had relevance in the questionnaire. In the questionnaire analysis of IADLs, women with osteoporosis showed significance for those without osteoporosis for the items: go shopping, can make crafts and take care of finances.

Serum Immune Mediators Independently Associate with Atherosclerosis in the Left (But Not Right) Carotid Territory of Older Individuals

BACKGROUND AND AIM Disturbance in the carotid arteries strongly predicts cerebrovascular events and correlates with a systemic inflammatory milieu. We investigated the relationship of a profile of 10 circulating inflammatory mediators with measures of carotid intima-media thickness (cIMT) in elderly subjects, taking traditional risk factors into account. METHODS Clinical inspection for present and past chronic conditions and events, as well as biochemical and anthropometric measurements, was performed for patients in ambulatory setting. Scores of cIMT were obtained bilaterally in the distal common carotid artery wall. Serum concentrations of cytokines were assessed by bead-based, multiplexed flow cytometry immunoassays. RESULTS Correlation analysis between log-transformed cytokines levels implicated the mediators interleukin-1β (IL1β), IL6, IL8, IL10, and tumor necrosis factor-α (TNFα) (P ≤ .005) with scores of the left cIMT. Stepwise multivariate regression showed that TNFα, IL1β, and IL6 levels accounted for most of the variance in the cIMT scores. Comparison of cytokine levels across increasing tertiles of the left cIMT reproduced the positive association with TNFα and IL1β levels. CONCLUSION Five out of ten immune mediators independently correlated with cIMT of older subjects in a territory-sensitive manner. This possible contribution of immune mediators to an atherosclerotic process probably relates to the inflammaging process.

Campaign against smoking in a home for the elderly: the report of an experiment

Studies on institutionalized elderly smokers are important for developing appropriate preventive measures. This was a cross-sectional population-based study of individuals over 60 admitted to a Home for the Elderly in the Federal District. The following aspects were investigated: smoking prevalence, socio-demographic and clinical profile, gender, education, probable depression, degree of motivation to stop smoking, prior use of medication to stop smoking and perception of the harm of smoking to health. Spirometry, the measurement of exhaled carbon monoxide and classification according to severity of nicotine dependence were conducted. The program followed guidelines for stopping smoking, and was evaluated one year later. Results revealed that 25.7% were smokers, 22.8% men and 2.9% women, mean age 68.3 ± 8.5 years. A significant decrease in smoking among the more elderly was detected. Significant associations emerged between the degree of nicotine dependence and education, probable depression, degree of motivation for stopping smoking and perception of the harm of smoking to health. Higher indices of carbon monoxide were identified in individuals with severe obstruction. Initially, 37.9% of smokers agreed to participate in the campaign, and after a year 9% of them succeeded in stopping smoking.