Maria José D'Elboux

Relationship between lower-limb muscle strength and frailty among elderly people

CONTEXT AND OBJECTIVE Sarcopenia is the main factor involved in the development of frailty syndrome. The aims here were to investigate relationships between lower-limb muscle strength and the variables of sex, age and frailty criteria; compare lower-limb muscle strength with each frailty criterion; and assess the power of each criterion for estimating the risk of frailty among elderly outpatients. DESIGN AND SETTING Cross-sectional study at the Geriatrics Outpatient Clinic of a university hospital in Campinas. METHOD A non-probabilistic convenience sample of 150 elderly people of both sexes who were followed up as outpatients was assessed. Sociodemographic data (sex and age) and physical health data (frailty criteria and the five-times sit-to-stand test) were gathered. Descriptive, comparative and multivariate logistic regression analyses were performed. RESULTS The majority of the elderly people (77.3%) were 70 years of age or over, with predominance of females (64.2%) and had a low score for the five-times sit-to-stand test (81.4% scored 0 or 1); 55.3% of the elderly people presented three or more frailty criteria. A significant association was found between lower-limb muscle strength and the variables of age and number of frailty criteria. CONCLUSIONS Lower levels of lower-limb muscle strength were associated with advanced age and greater presence of signs of frailty. Moreover, lower-limb muscle strength was also associated with the criteria of reduced walking speed criteria and hand-grip strength.

Maus-tratos contra idosos: atualização dos estudos brasileiros

O envelhecimento populacional trouxe consigo temas emergentes como os maus-tratos contra idosos, que em decorrencia de seu carater biopsicossocial, aspira por investigacoes mais profundas e solucoes urgentes. A pouca disseminacao das informacoes sobre maus-tratos aos idosos contribui para a perpetuacao da violencia e, frente a este cenario, o presente estudo objetivou realizar uma atualizacao ampla da literatura atraves da caracterizacao dos tipos de violencia, do perfil do agressor e vitima, principais locais de ocorrencia, indicadores, epidemiologia, instrumentos de deteccao e propostas de resolucao com base nos dados dos ultimos anos de pesquisa cientifica (2001 a 2008). No desenvolvimento desta producao, nos deparamos com a escassez de dados epidemiologicos atualizados que expressem a verdadeira dimensao estatistica do problema, alem da ausencia de exploracao cientifica minuciosa das diversas faces da violencia contra o idoso. Sendo assim, este possui, tambem, o intuito de enfatizar a necessidade de futuras producoes cientificas abordando a presente questao visto que, por meio do maior entendimento e desenvolvimento de pesquisas acerca do assunto, serao ampliadas as condicoes para prevencao, autuacao e condutas adequadas, tanto por parte de orgaos e profissionais, que sejam ou nao da area da saude, quanto pelos proprios idosos que necessitam de maior respaldo de orientacao.

A satisfação com a vida e a funcionalidade em idosos atendidos em um ambulatório de geriatria

Aging is often accompanied by functional limitations that affect self esteem, lowering the level of satisfaction with life. Studies highlight satisfaction with life as a predictor of quality of life and has a marked correlation with a decrease in functionality. Therefore, this study sought to examine the relationship between satisfaction with life and functional independence and performance of the lower limbs (muscle strength, gait speed and balance) among the elderly in outpatient care with respect to age groups and genders. A total of 125 elderly men and women aged 60 years and above, attending a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; 3) Satisfaction with life. The sample was random, with a predominance of females, in which the older participants had greater functional impairment. In univariate logistic regression analysis and multivariate analysis, overall self reported and comparative satisfaction with life was more satisfactory among the oldest elderly. The results suggest that older individuals have better satisfaction with life even though they have greater functional impairment.

Fatores associados à incontinência urinária em idosos com critérios de fragilidade

This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.

WOMAC and SF-36: instruments for evaluating the health-related quality of life of elderly people with total hip arthroplasty. A descriptive study

CONTEXT AND OBJECTIVES Quality-of-life results have increasingly been evaluated among patients undergoing joint replacements. The objective of this study was to compare two assessment instruments for health-related quality of life (one generic and the other specific), among elderly patients undergoing total hip arthroplasty. DESIGN AND SETTING Cross-sectional descriptive study in a reference hospital in the region of Campinas. METHODS The subjects were 88 elderly outpatients aged 60 years or over who underwent primary total hip arthroplasty. Two instruments for assessing health-related quality of life were applied: the generic Medical Study 36-item Short-Form Health Survey (SF-36) and the specific Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Cronbachs alpha and the ceiling and floor effects of the instruments were evaluated. RESULTS The scores from both instruments showed that issues of a physical nature affected these elderly peoples quality of life most. The pain and stiffness dimensions of WOMAC showed ceiling effects and only the functional capacity and pain dimensions of the SF-36 did not show the ceiling effect. The SF-36 presented floor effects in the dimensions of physical and emotional aspects. Cronbachs alpha was considered satisfactory in both instruments (α > 0.70). CONCLUSIONS The floor and ceiling effects that were observed suggest that these instruments may present some limitations in detecting changes to the majority of the SF-36 dimensions, except for functional capacity and pain, and to the pain and stiffness dimensions of WOMAC, when applied to elderly people with total hip arthroplasty.

A influência de variáveis sociodemográficas, clínicas e funcionais sobre a qualidade de vida de idosos com artroplastia total do quadril

OBJECTIVES: To evaluate the health-related quality of life (HRQOL) of elderly people with total hip arthroplasty (THA) and to investigate the relationships and influences of the sociodemographic, clinical and functional variables of these subjects. METHODS: The HRQOL was evaluated by means of the Brazilian versions of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), a general instrument, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a specific instrument. Eighty-eight elderly people of both genders with primary unilateral THA were recruited. The data were subjected to descriptive analysss, univariate analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) to investigate the influences of the variables studied in the dimensions of the SF-36 and WOMAC; and the Mann-Whitney and Kruskal-Wallis tests to compare instrument scores between the variables. RESULTS: There was a predominance of women in the study sample, and their mean age was 68.8 (± 7.4) years. Hip function, as assessed by the Harris Hip Score, had a significant influence on HRQOL from the perspective of both the general and the specific instruments. The use of accessories for locomotion, hip functions and satisfaction with the surgery were the main variables that demonstrated significant differences in the dimensions of the SF-36 and the WOMAC. CONCLUSIONS: Investments in functional and rehabilitation programs aimed towards the peculiarities of elderly people with THA can benefit this population.OBJECTIVES To evaluate the health-related quality of life (HRQOL) of elderly people with total hip arthroplasty (THA) and to investigate the relationships and influences of the sociodemographic, clinical and functional variables of these subjects. METHODS The HRQOL was evaluated by means of the Brazilian versions of the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), a general instrument, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a specific instrument. Eighty-eight elderly people of both genders with primary unilateral THA were recruited. The data were subjected to descriptive analysss, univariate analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) to investigate the influences of the variables studied in the dimensions of the SF-36 and WOMAC; and the Mann-Whitney and Kruskal-Wallis tests to compare instrument scores between the variables. RESULTS There was a predominance of women in the study sample, and their mean age was 68.8 (+/- 7.4) years. Hip function, as assessed by the Harris Hip Score, had a significant influence on HRQOL from the perspective of both the general and the specific instruments. The use of accessories for locomotion, hip functions and satisfaction with the surgery were the main variables that demonstrated significant differences in the dimensions of the SF-36 and the WOMAC. CONCLUSIONS Investments in functional and rehabilitation programs aimed towards the peculiarities of elderly people with THA can benefit this population.

Factors associated with urinary incontinence in elderly individuals who meet frailty criteria

This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.

Factores asociados con incontinencia urinaria en ancianos con criterios de fragilidad

This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.This study presents an analysis of factors associated with Urinary Incontinence among elderly individuals who meet frailty criteria (pre-frail and frail). It is a cross-sectional and quantitative study. One hundred elderly patients from a geriatric outpatient clinic at a university hospital in Campinas, SP, Brazil were interviewed. A total of 65.0% of the participants reported Urinary Incontinence, 40 (61.4%) of which reported loss of small quantities of urine several times a day. The multivariate regression analysis showed a statistically significant relationship among gender (OR=3.67), urinary tract infection (OR=6.16), and scores on the Functional Independence Measure (mobility), (OR=0.85). The results show that urinary tract infection, loss of mobility, and gender are factors associated with Urinary Incontinence in elderly patients who meet frailty criteria. These factors are susceptible to interventions designed to prevent and even reduce episodes of Urinary Incontinence. DESCRIPTORS: Urinary incontinence. Frailty elderly. Risk factors.

Quality of life and work overload among elderly outpatient caregivers

Se evaluo la calidad de vida relacionada con la salud y la carga de trabajo de 126 cuidadores de pacientes atendidos en dos centros geriatricos de un hospital universitario, y la asociacion entre el volumen de trabajo y las variables sociodemograficas y clinicas. Es un estudio exploratorio de caracter descriptivo, transversal y cuantitativo. Se utilizo el instrumento de resultados sociodemograficos y clinicos, Zarit Burden Interview para evaluacion de la carga percibida, y el Medical Outcomes Study Short-Form Health Survey (SF-36) para la evaluacion de la calidad de vida relacionada con la salud. Se hizo el analisis descriptivo, de correlacion, de comparacion, y multivariado de los datos. Se encontro diferencia significativa entre la carga de los cuidadores de los dos ambulatorios; todos los aspectos sociodemograficos y atencion se asociaron con un empeoramiento de al menos una de las dimensiones del SF-36; y las enfermedades frecuentes en los cuidadores estaban relacionadas con un empeoramiento de su calidad de vida relacionada con la salud. Tambien se pudo constatar el desgaste experimentado por los cuidadores de ancianos en estos centros de salud.

Calidad de vida y la carga de trabajo de los cuidadores de ancianos atendidos en centros geriátricos

Se evaluo la calidad de vida relacionada con la salud y la carga de trabajo de 126 cuidadores de pacientes atendidos en dos centros geriatricos de un hospital universitario, y la asociacion entre el volumen de trabajo y las variables sociodemograficas y clinicas. Es un estudio exploratorio de caracter descriptivo, transversal y cuantitativo. Se utilizo el instrumento de resultados sociodemograficos y clinicos, Zarit Burden Interview para evaluacion de la carga percibida, y el Medical Outcomes Study Short-Form Health Survey (SF-36) para la evaluacion de la calidad de vida relacionada con la salud. Se hizo el analisis descriptivo, de correlacion, de comparacion, y multivariado de los datos. Se encontro diferencia significativa entre la carga de los cuidadores de los dos ambulatorios; todos los aspectos sociodemograficos y atencion se asociaron con un empeoramiento de al menos una de las dimensiones del SF-36; y las enfermedades frecuentes en los cuidadores estaban relacionadas con un empeoramiento de su calidad de vida relacionada con la salud. Tambien se pudo constatar el desgaste experimentado por los cuidadores de ancianos en estos centros de salud.