Objectives: To compare burden and sociodemographic profile and to analyze the care needs of caregivers of elderly persons enrolled in Social Care Referral Centers in a municipal region in the interior of the state of São Paulo, Brazil. Method: A cross-sectional, quantitative-qualitative study was carried out. A sociodemographic questionnaire, the Zarit Burden Scale and three open questions regarding care needs were applied. The quantitative data were analyzed by descriptive statistics and the correlation test. The hermeneutic-dialectic referential was applied and the qualitative data were analyzed by the content analysis technique. Results: A total of 86 caregivers participated in the study. The majority were female (71.7%), had a mean age of 56.5 (sd=14.9) years, suffered burden and lived in vulnerable neighborhoods. With regard to care, the provision of support for activities of daily living, difficulties in caring and the help of other relatives were identified. Burden negatively correlated with age range and schooling (r=-0.11; r=-0.87). Conclusion: Guidance and the acquisition of caring skills remain unprovided by the resources and services that exist in vulnerable contexts, and resolutive support strategies are lacking in public facilities.

Perfil de idosos que cuidam de outros idosos em contexto de alta vulnerabilidade social AbstrActObjective: To characterize older adult caregivers who care for other older adults in the context of high social vulnerability. Methods:Descriptive cross-sectional study, conducted with 40 older adult caregivers using: Mini Mental State Examination, Katz Index, Lawton's Instrumental Activities of Daily Living Scale, Geriatric Depression Scale and the Frailty phenotype proposed by Fried. The previously scheduled interviews were conducted in the home of the caregiver. For the data analysis, the statistical software Stata 11.0 was used, descriptively. Results: There was a predominance of females, age range 60-69 years, married, with primary education, who were retired. They had no health insurance. Most were pre-frail, hypertensive and independent in both instrumental activities and basic activities of daily living. They showed no evidence of depressive symptoms or cognitive impairments. Conclusion: To know the profile of the older adult caregiver is essential to support health services in planning quality care.Keywords: Caregivers; Geriatric Nursing; Older Adult; Social Vulnerability. La mayoría era pre-frágil, hipertensa e independiente, tanto para las actividades instrumentales como para las actividades básicas de la vida diaria. No presentaban indicios de síntomas depresivos ni de alteraciones cognitivas. Conclusión: Conocer el perfil de los ancianos cuidadores es imprescindible para subsidiar los servicios de salud en la planificación de una atención de calidad.

Objective: To identify the relationship between frailty, sociodemographic characteristics, and social vulnerability of the elderly enrolled in a primary care service. Methods: This was an exploratory, comparative, and cross-sectional study with a quantitative research approach performed with 247 elderly people enrolled in a primary care service, in a city in the interior of São Paulo. A questionnaire was used for socio-demographic characterization of the participants, and the Edmonton Frail Scale was used to evaluate frailty. Vulnerability was classified according to the Paulista Index of Social Vulnerability. Data were analyzed in a descriptive and inferential manner. All ethical recommendations were met. Results: There was a prevalence of frail elderly women, with a mean age of 68.5 (SD=7.3) years, low education, who were retirees. There was a statistically significant difference between frailty and the number of diseases reported (p<0.001). Frailty correlated negatively with social vulnerability (r=-0.043). Conclusion: These results should receive attention from public administrators to understand frailty of the elderly in a context of social vulnerability. ResumoObjetivo: Identificar a relação entre fragilidade, características sociodemográficos e vulnerabilidade social de idosos cadastrados em um serviço de atendimento primário. Métodos: Trata-se de um estudo exploratório, comparativo e transversal, com abordagem quantitativa de investigação realizado com 247 idosos cadastrados em um serviço de atendimento primário, em um município do interior paulista. Utilizou-se questionário para caracterização sócio demográfica dos participantes e Escala de Fragilidade de Edmonton, para avaliar a fragilidade. A vulnerabilidade foi classificada segundo Índice Paulista de Vulnerabilidade Social. Os dados foram analisados de forma descritiva e inferencial. Todas as recomendações éticas foram respeitadas. Resultados: Houve prevalência de idosos frágeis pertencentes ao gênero feminino, com média de idade de 68,5 (dp=7,3) anos, baixa escolaridade e aposentados. Houve diferença estatisticamente significativa entre fragilidade e número de doenças relatadas (p<0,001). A fragilidade se correlacionou negativamente com a vulnerabilidade social (r=-0,043). Conclusão: Os resultados encontrados devem suscitar atenção aos gestores públicos para a necessidade de conhecer a fragilidade de idosos em contexto de vulnerabilidade social.

Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a signifi cant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services. Descriptors: Caregivers; Fragile Elderly; Geriatric Nursing; Social Vulnerability; Family Health. RESUMO Objetivo: Identifi car a prevalência de fragilidade em cuidadores idosos inseridos em contexto de alta vulnerabilidade social e sua correlação com aspectos sociodemográfi cos e de saúde. Método: Estudo descritivo, correlacional, transversal. Foram avaliados 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. As entrevistas foram realizadas no domicílio, sendo previamente agendadas. Todos os cuidados éticos foram observados. Os dados foram analisados com apoio do pacote estatístico Stata versão 11.0. Resultados: 10,0% dos cuidadores idosos eram frágeis. Houve correlação signifi cativa entre fragilidade e: sexo, atividades instrumentais de vida diária e cognição. Conclusão: Cuidadoras do sexo feminino, indivíduos parcialmente dependentes em relação às atividades instrumentais de vida diária e com pior estado cognitivo merecem especial atenção dos serviços de saúde. Descritores: Cuidadores; Idoso Fragilizado; Enfermagem Geriátrica; Vulnerabilidade Social; Saúde da Família. RESUMENObjetivo: Identifi car la existencia de la fragilidad en ancianos cuidadores en un contexto de elevada vulnerabilidad social y su correlación con aspectos sociodemográfi cos y sanitarios. Método: Estudio descriptivo, correlacional, transversal. Se evaluaron a cuarenta ancianos cuidadores empleando: un cuestionario para conocer el cuidador, el Miniexamen del Estado Mental, el Índice de Katz, la Escala de actividades instrumentales de la vida diaria de Lawton, la Escala de depresión geriátrica y el fenotipo de fragilidad, de Fried. Se realizaron las entrevistas en las residencias con fecha y horario agendado. Se observaron todos los cuidados éticos. Se evaluaron los datos mediante el software Stata, ve...

Objective: to investigate the association between frailty, loneliness and depressive symptoms of elderly caregivers. Method: a cross - sectional study carried out with 341 elderly caregivers enrolled in Family Health Units of a city in the countryside of São Paulo State. The interviews were domiciliary and included questionnaire for characterization of the caregiver, Fried’s frailty phenotype, family APGAR (family functionality), Geriatric Depression Scale (depressive symptoms) and item 3 of the Herth Hope Scale (loneliness). Logistic regression was used to analyze the association between depressive symptoms and solitude (independent variables), and frailty and pre-frailty (dependent variables). Results: there was an association between frailty, loneliness and depressive symptoms. Elderly caregivers had increased odds of 158% presenting pre-frailty, and 360% of frailty. Elderly caregivers with depressive symptoms had an increased chance of 242% of presenting fragility. Conclusion: elderly and lonely caregivers with depressive symptoms are more likely to be frail and pre-frail.

Objective: To evaluate the functional capacity, cognition and mood in three different care models for older adults. Method: A cross-sectional study conducted in 2014 with 140 older adults (37 institutionalized, 53 hospitalized and 50 outpatients). The MMSE, Clock Drawing Test (CDT), Activities of Daily Living Scale -ADLs (Katz, Lawton) and the Geriatric Depression Scale (GDS) were applied. Results: Of those institutionalized, the majority were totally dependent for ADLs and 100% presented cognitive decline. Of those hospitalized and the outpatients, the majority were independent for ADLs, with 62.3% and 48.0% presenting cognitive decline, respectively. The minority presented depressive symptoms. The results indicated that age was a predictor of cognitive decline and the likelihood of prevalence in hospitalized and outpatient older adults increased by 8.7% for each year of life. Conclusion: It is important to pay attention to the cognitive and functional performance of older adults with the aim of preventing their decline, which is so frequent in the public health services in Brazil.Keywords: Older adult; Daily Activities; Cognition. resumen Objetivo: Evaluar la capacidad funcional, cognitiva y el estado de ánimo en tres modelos diferentes de la atención a las personas mayores. Método: Estudio transversal comparativo realizado en el año 2014 con 140 ancianos (37 institucionalizados, 53 hospitalizados y 50 ambulatorios). Aplicado el MMSE, test del reloj, Actividades de la Vida Diaria Escala (Katz, Lawton) y Escala de Depresión Geriátrica. Resultados: El institucionalizada, la mayoría totalmente dependiente para ADL y el 100% tenían deterioro cognitivo. En hospitales y clínicas, muchos independiente para ADL, con el 62,3% y el 48% con el deterioro cognitivo, respectivamente, la minoría tenía síntomas depresivos. Los resultados indicaron que la edad es un predictor de deterioro cognitivo y las posibilidades de prevalencia en hospitalizados y ambulatorios ancianos aumento del 8,7% por cada año de vida. Conclusión: Cabe destacar la importancia de dar atención al rendimiento cognitivo y funcional de las personas mayores a la prevención disminución de éstos, tan frecuentes en los servicios de salud pública en Brasil.

This study investigated the relationship between metabolic parameters and low serum 25-hydroxyvitamin D (25(OH)D) levels in older adults (n = 265). They were assessed for anthropometrics and metabolic measurements, including 25(OH)D, insulin, glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and other inflammatory markers. Vitamin D deficiency was defined as a 25(OH)D level below 50 nmol/L. Comparisons between groups were performed using Wilcoxon–Mann–Whitney or Pearson’s Chi-squared test. A multivariate adjusted Poisson regression was used to model the number of metabolic parameters as a function of a set of explanatory variables. Subjects with 25(OH)D deficiency were predominantly females and presented higher body weight, body mass index, waist circumference, triglycerides and Tumor Necrosis Factor-α (TNF-α), and higher insulin resistance. Metabolic syndrome was also more prevalent among 25(OH)D-deficient subjects. In those without metabolic syndrome, 25(OH)D deficiency was related only to obesity and higher insulin resistance. Female sex, hypertension, higher waist circumference and higher levels of hemoglobin A1C (%), HDL-C, and TG were significantly associated with an increased number of metabolic syndrome parameters after adjusting for covariates, but 25(OH)D was not. The fact that serum 25(OH)D concentration was inversely associated with metabolic syndrome and insulin resistance not only reaffirms the relevance to consider serum 25(OH)D concentration as an influencing factor for insulin resistance, but also the need to actively screen for hypovitaminosis D in all patients with this condition.

Resumo O objetivo do estudo foi associar a fragilidade com perfil sociodemográfico e cognição de idosos residentes em contexto de alta vulnerabilidade social cadastrados em um Centro de Referência de Assistência Social em um município do interior paulista. Estudo transversal e quantitativo realizado com 48 idosos. Para a coleta de dados utilizou-se entrevista sociodemográfica, Escala de Fragilidade de Edmonton e Montreal Cognitive Assessment. Para a análise dos dados foi empregado teste de Jonckheere-Terpstra, correlação de Spearman e regressão logística (α = 5,0%). Dos 48 entrevistados, 33,4% não eram frágeis, 20,8% se mostraram aparentemente vulneráveis e 45,8% estavam frágeis em algum nível. As mulheres (OR = 4,64) e os de raça não branca (OR = 3,99) tiveram maior chance de apresentar fragilidade. Os domínios com maior influência na determinação da fragilidade foram: cognição, independência e desempenho funcional, estado geral da saúde e humor, embora sexo (p = 0,0373) e raça (p = 0,0284) tenham apresentado associação significativa. Destaca-se que considerar o perfil de fragilidade dos idosos subsidia o desenvolvimento de estratégias específicas de cuidado para este segmento populacional em área vulnerável prevenindo futuras complicações.