Ruth Losada de Menezes

Estudo da presença de fatores de riscos intrínsecos para quedas, em idosos institucionalizados

The objective of this research was to identify intrinsic risk factors that predispose elderly people living in long-term institutions in the city of Goiânia (GO) to falls. The present descriptive transversal study was carried out in six long-term institutions for seniors in the city of Goiânia. The investigated sample consisted of 95 elderly that fitted the inclusion and exclusion criteria. A questionnaire was used for collecting clinical data related to health-disease conditions; cognitive data; capacity to develop basic daily life activities and equilibrium and gait. In general terms, as pointed out the literature, the examined elderly presented different fall risk factors such as: motor difficulty in lower limbs (90%), visual deficit (81,1%), use of 3 or more kinds of medicines (59,7%), suspected depression (37,9%), lack of equilibrium/unstable unipodal support (37,9%) abnormally decreased height in step (32,6%). The obtained data allow us to set indicators for the increase in falls among the studied sample, demonstrating the need for creating strategies for health promotion, prevention of injuries and rehabilitation.

Estudo longitudinal dos aspectos multidimensionais da saúde de idosos institucionalizados

OBJECTIVE: This study aimed to analyze the evolution of multidimensional aspects of the health of institutionalized elderly in the city of Goiânia, in two years. METHODS: A longitudinal, prospective and observational clinical study was conducted. Two assessments were carried out within an interval of two years, comprising 59 elderly living at long-term care institutions in the city of Goiânia, State of Goias, Brazil. It was used a set of standardized tools comprising different dimensions such as socio-demographic aspects, health-disease situations, psycho-emotional aspects and functional abilities. The Marginal Homogeneity and McNemars tests were used to compare health aspects in two moments of assessment, by means of the SPSS® software version 10.0 and a p value of less than 0.05. RESULTS: There was a health decline on the following aspects: stroke (p = 0,031); other diseases (p = 0,031); upper limb motor impairment (p = 0,007); use of antidepressant drugs (p = 0,039); decrease on the number of independencies for daily living activities (p = 0,017), specially the ones related to personal hygiene (p = 0,031). CONCLUSION: The results of this study highlight the areas of vulnerability of institutionalized elderly in Goiânia and the need of effective actions to promote and maintain their health.

Condições visuais autorrelatadas e quedas em idosos institucionalizados

OBJECTIVE: To evaluate the visual conditions self-reported by institutionalized elderly and their relation to accidental falls. METHODS: Prospective study in which we interviewed 59 elderly residents of long-stay institutions for elderly in Goiânia, between 2005 and 2007. Two surveys were conducted with an interval of two years to perform the assessments proposed. The visual conditions in the first survey and the report of falls in the wake were self-reported. The elderly were classified according to the presence of visual impairment and compared the occurrence of fall with the Fisher exact test. RESULTS: Visual deficit was reported by 48 (81.4%) of the elderly and accidents from falls reached 32 (54.2%) of them; which were more prevalent among older adults with visual impairment. After the first inquiry, in the following two years, found no statistically significant difference (p = 0.171) between the variable self-reported visual impairment and falls. CONCLUSION: The findings indicate the need for better research ophthalmology clinic for the elderly. Early diagnosis of visual impairment and / or correct it can benefit the elderly and to avoid future functional impairment arising from these and consequences such as falls.

Ocorrencia de quedas em idosos nao institucionalizados: revisao sistematica da literatura

This systematic literature review aimed to identify the occurrence of falls in elderly living in the community. On CAPES website, a search was conducted on the following databases: Academic Search (EBSCO), SciELO, and Science Direct (ELSEVIER). An additional search, on the EFDEPORTES website, was performed on the Lecturas Educacion Fisica y Deportes database. Using the chosen descriptors, 247 articles published from 2000 to 2011 were identified. A total of 230 articles were excluded as they did not meet all the inclusion criteria. Hence, 17 articles were included in the study, 12 of which were cross-sectional studies, two prospective studies, two population studies, and one retrospective study. The whole sample involved in the studies consisted of 114,911 subjects with an average age of 70 years, distributed across seven countries: Brazil, United States, Spain, Italy, Nigeria, Turkey and China. The occurrence of falls ranged between 15.9% and 56.3%, with a median of 28.50%. Although presenting variation, the occurrence of falls in elderly living in the community is still high.

Correlação entre três instrumentos de avaliação para risco de quedas em idosos

INTRODUCTION: Clinical and laboratory methods are increasingly being developed to assess different aspects of body balance and establish parameters for identification of elderly at risk of falls. Objectives: To analyze the correlation between the three tests used to assess the risk of falls in the elderly. MATERIALS AND METHODS: This was a crosssectional study, conducted with 49 community-dwelling elderly, healthy controls, with different levels of fitness. We used two clinical tests, the Timed Up and Go (TUG) and QuickScreen clinical assessment fall risk (QuickScreen), and one laboratory, the Biodex Balance System -Mode Fall Risk (BBS-FR). The correlation of the data was performed by using the Spearmams rank correlation coefficient, with a significance level of 5% (p < 0.5). RESULTS: There were moderate positive correlations between QuickScreen and BBS-FR (r = 0.35; p = 0.01) and between QuickScreen and TUG (r = 0.32; p = 0.02). There was no significant correlation between BBS-FR and TUG (r = -0.10; p = 0.47). CONCLUSION: The analyzed tests are complementary, given that not correlated strongly and showed up with specific and distinct limitations. However, we suggest the use of the instrument QuickScreen in the clinical setting, as this was what was best correlated with the laboratory device, the BBS-FR, and identified that more active seniors at risk of falling. Thus, QuickScreen assessed the risk of falls more broadly, as encompassing issues not addressed by the other two tests studied.

Functional disability in community-dwelling elderly: the role of cataracts and contextual factors

Introduction Cataract arises as a risk factor for functional disability in elderly Objective: To determine differences in functional capacity and contextual factors associated with it in elderly affected and not affected by cataract and association between disability and cataracts.Methods A transversal-type observational study was carried out with 100 community elderly, divided into two groups: elderly affected (n = 50) and not affected by cataracts (n = 50). It was evaluated: activities of daily living (ADL) – Katz Index –, instrumental activities of daily living (IADL) – Lawton scale – and mobility – Short Physical Performance Battery. Functional disability was detected when the elderly were dependent or semi-dependent for one or more IADL or ADL and/or when they presented any difficulty in mobility. Data analysis included absolute and relative frequencies, Chi-squared or Fisher’s exact tests (p < 0.05) and Poisson regression.Results No statistically significant associations were observed between IADL, ADL or mobility disability and cataracts. A statistically significant difference was observed between the disabled elderly affected and not affected by cataract according to contextual factors for ADL regarding age (p = 0.037) and comorbidity (p = 0.037), for mobility regarding the practice of physical activity (p = 0.013), and for IADL (p = 0.001), ADL (p = 0.001) and mobility (p = 0.013) regarding the self-reporting of eyesight problems.Conclusions Besides cataracts, physical inactivity, comorbidity and functional aging itself are contributing factors to the process of disability in elderly, so, the physiotherapy is essential both to prevent as to reverse this process.

Correlação entre sinais e sintomas de incontinência urinária e autoestima em idosas

OBJECTIVE: Identify the prevalence of signs and symptoms of urinary incontinence and their relationship with the self-esteem of elderly. METHODS: The sample was constitute by 27 elderly, mean age 67.59 (± 5.16), participants of Open University for the Elderly (UNATI) of the Social Gerontology Program of Pontifical Catholic University of Goias. Three instruments were used for: the Mini mental state examination, a specific instrument prepared for this study and a self-esteem and self-image questionnaire developed by Steglich. The statistical treatment was descriptive and non-parametrical test, with significance level of p<0.05. RESULTS: It was observed that 44.4% of the elderly have urine loss, 58.33% lose once a week, all reported losing a little amount of urine and 66.7% have urine loss for over a year. The self-esteem was considered low in 77.8% of elderly, but no correlation between self-esteem and symptoms of UI was found. CONCLUSION: The decreased self-esteem is a frequent condition in the elderly people and several factors can contribute for this, but this sample did not allow to identify the contribution of the UI.

Quedas e qualidade de vida de idosos com catarata

Objetivo: Investigar a associacao entre quedas e qualidade de vida em idosos com catarata. Metodos: Tratou-se de estudo observacional com delineamento transversal, realizado no Distrito Federal, Brasil, com uma amostra de 38 idosos comunitarios divididos em dois grupos: idosos caidores (n=18) e idosos nao caidores (n=20). Avaliou-se por meio do instrumento National Eye Institute - Visual Function Questionnaire 25 (NEI-VFQ 25) a saude geral dos individuos da amostra, assim como a qualidade de vida relacionada a saude visual. A caracterizacao da amostra foi realizada por meio da analise descritiva a fim de avaliar a associacao entre quedas e demais variaveis, utilizou-se o teste nao parametrico de Mann-Whitney (p<0,05). Resultados: A faixa etaria ≥ 70 anos prevaleceu entre os participantes da pesquisa (63,16%). Dentre os idosos que fizeram parte deste estudo, 36 (94,74%) relataram ter algum problema para enxergar. Idosos caidores apresentaram escore geral mais baixo, quando comparados aos nao caidores (p=0,0159), apresentaram tambem maior dificuldade em realizar atividades para perto (p=0,0299) e para longe (p=0,0104), pior saude mental (p=0,0001) e nivel mais elevado de dependencia (p=0,0008). Conclusao: As quedas interferem negativamente na qualidade de vida de idosos com catarata, tornando as acoes para prevencao de quedas e o tratamento e/ou correcao do deficit visual importantes para evitar prejuizos futuros.

Quedas e qualidade de vida: associação com aspectos emocionais em idosos comunitários

INTRODUCAO: As quedas sao consideradas um problema de saude publica, dada a sua prevalencia e as consequencias que podem repercutir na qualidade de vida (QV) dos idosos. OBJETIVO: Analisar a associacao entre quedas e QV. MATERIAIS E METODOS: Trata-se de estudo transversal de base populacional feito em Goiânia com 914 idosos comunitarios. Os dados coletados abordaram questoes socioeconomicas, demograficas, quedas, sendo que a QV foi avaliada pelo questionario SF-36. As associacoes foram analisadas pelos testes de Mann-Whitney e Kruskal-Wallis. RESULTADOS: A prevalencia de quedas encontrada foi de 34,7%, sendo superior no sexo feminino (38,0%) e na faixa etaria acima de 80 anos (45,4%). A analise mostrou que nao houve diferenca significativa em relacao a media da maioria dos dominios do SF-36 conforme a ocorrencia de quedas. Ja na associacao da queda, QV e faixa etaria, a media para aspectos emocionais (AE) foi de 72,9 para caidores e de 84,6 para nao caidores (p = 0,047). CONCLUSAO: Neste estudo observou-se elevada prevalencia de quedas, principalmente no grupo das mulheres e nos muito idosos (>80 anos). Quanto a associacao com QV, os idosos caidores apresentaram pior media apenas no dominio AE. Sugere-se que novos estudos possam investigar a associacao de fatores relacionados a essas duas tematicas, com emprego da metodologia qualitativa para retratar o impacto da queda na QV dessa populacao.

Factors associated with falls in older adults with cataracts

The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.