OBJECTIVE:The increasing proportion of older adults in the general population and the specific characteristics of this age group show the need for the development of specific instruments to measure quality of life in older adults. The study aimed at describing the development and validation of the Portuguese version of the World Health Organization Quality of Life for Older Persons (WHOQOL-OLD) module. METHODS:The WHOQOL-OLD instrument was administered in a sample of 424 older adults in the city of Porto Alegre, Southern Brazil, in 2005. The questionnaire comprises 24 items divided into six facets: sensory abilities; autonomy; past, present and future activities; social participation; death and dying; and intimacy. Besides the WHOQOL-OLD module, the WHOQOL-BREF, BDI and BHS instruments were also applied. The instrument's internal consistency was assessed using Cronbach's alpha coefficient. RESULTS:The instrument showed adequate internal consistency (Cronbach's coefficients ranging from 0.71 to 0.88), discriminant validity (p<0.01), concurrent validity (correlation coefficients ranging from -0.61 to -0.50) and test-retest reliability (correlation coefficients ranging from 0.58 to 0.82). Findings concerning criterion validity need further studies. CONCLUSIONS:The WHOQOL-Old module is a useful alternative with good psychometric performance in the investigation of quality of life in older adults. KEYWORDS RESUMOOBJETIVO: O aumento da proporção de idosos na população geral e as particularidades que esta faixa etária apresenta apontam a necessidade do desenvolvimento de instrumentos específicos para a aferição de sua qualidade de vida. O objetivo foi descrever o desenvolvimento e a validação da versão em português do módulo específico para idosos do questionário de qualidade de vida (WHOQOL-OLD). MÉTODOS:O instrumento WHOQOL-OLD foi aplicado em amostra de 424 idosos na cidade de Porto Alegre, RS, em 2005. O questionário é composto por 24 itens divididos em seis facetas: funcionamento dos sentidos, autonomia, atividades passadas, presentes e futuras, participação social, morte e morrer, e intimidade. Além do Módulo

Background

Objective. Cognitive impairment reduces quality of life and is related to vascular and neurodegenerative disorders. However, there is also a close relationship between these diseases and oxidative stress. Thus, the purpose of this study was to assess whether inflammation and oxidative damage are associated with low cognitive performance in the elderly with different housing conditions. Methods. The study groups consisted of 32 institutionalized and 25 noninstitutionalized Brazilian elderly subjects. Oxidative damage, inflammation markers, and cognitive function were evaluated. Results. The results demonstrated pronounced oxidative stress in the institutionalized elderly group, which also had a lower antioxidant status compared to noninstitutionalized subjects. High levels of proinflammatory cytokines were also observed in the institutionalized elderly. Furthermore, the raised levels of inflammatory markers were correlated with increased oxidative stress, and both were associated with low cognitive performance. However, based on multiple linear regression analysis, oxidative stress appears to be the main factor responsible for the cognitive decline. Conclusions. The findings suggest that individuals with lower antioxidant status are more vulnerable to oxidative stress, which is associated with cognitive function, leading to reduced life quality and expectancy.

OBJECTIVE:To evaluate the Brazilian version of WHOQOL-OLD Module and to test potential changes to the instrument to increase its psychometric adequacy. METHODS:A total of 424 older adults living in a city in Southern Brazil completed the WHOQOL-OLD instrument, in 2005. Rasch analysis was used to explore the psychometric performance of the scale, as implemented by the RUMM2020 software. Item-trait interaction, threshold disorders, presence of differential item functioning and item fi t, were analyzed. RESULTS:Two ("death and dying" and "sensory abilities") out of six domains showed inadequate item-trait interactions. Rescoring the response scale and deleting the most misperforming items led to scale improvement. The evaluation of domains and items individually showed that the "intimacy" domain does perform well in contrast to the fi ndings using the classical approach. In addition, the "sensory abilities" domain does not derive an interval measure in its current format. CONCLUSIONS:Unidimensionality and local independence were seen in all domains. Changes in the response scale and deletion of problematic items improved the scale's performance. The world has been experiencing a profound and irreversible demographic shift as older people are living longer and healthier than ever before. 24 The most dramatic increases in proportions of older people are evident in the most advanced age groups (people over 80 years old) with an almost fi vefold increase from 69 million in 2000 to 377 million in 2050. 24 The World Health Organization (WHO) has described this demographic shift as a major societal achievement, and a challenge 25 . Increased longevity has been experienced in the developed and the developing world alike, but where developed countries grew rich before it grew old, developing countries are growing old before they have grown rich. 25This shift in the age pyramid due to increased elderly population demands further research specifi cally approaching the aging process. One important area to be assessed is quality of life. Although there are several studies on this issue, systematic reviews have pointed out that the instruments most frequently used in these investigations are not sufficiently comprehensive and/or are not validated for application in older adult populations. 4,11RESUMO OBJETIVO: Analisar a versão brasileira do Módulo WHOQOL-OLD, indicando alterações potenciais do instrumento para aumentar a adequação psicométrica. MÉTODOS:O total de 424 idosos residentes em Porto Alegre, RS, responderam o instrumento WHOQOL-OLD em 2005. O modelo de Rasch foi utilizado para a análise do desempenho psicométrico da escala, a partir do software RUMM2020. Foram analisadas a interação item-traço, a presença de funcionamento diferencial dos itens e a adequação dos itens ao modelo de Rasch.RESULTADOS: Dois domínios ("morte e morrer" e "funcionamento do sensório") apresentaram interação item-total insufi ciente. Remodelar a escala de resposta e excluir itens com pior performance resultou em melhora da escala. A a...

The Beck Depression Inventory (BDI), a scale that measures the latent trait intensity of depression symptoms, can be assessed by the Item Response Theory (IRT). This study used the Graded-Response model (GRM) to assess the intensity of depressive symptoms in 4,025 individuals who responded to the BDI, in order to efficiently use the information available on different aspects enabled by the use of this methodology. The fit of this model was done in PARSCALE software. We identified 13 items of the BDI in which at least one response category was not more likely than others to be chosen, so that these items had to be categorized again. The items with greater power of discrimination were sadness, pessimism, feeling of failure, dissatisfaction, self-hatred, indecision, and difficulty of work. The most serious items were weight loss, suicidal ideas, and social withdrawal. The group of 202 individuals with the highest levels of depressive symptoms was comprised by 74% of women and almost 84% had a diagnosis of a psychiatric disorder. The results show gains resulting from use of IRT in the analysis of latent traits.

A relação entre qualidade de vida e funções cognitivas em idosos tem sido pouco estudada. O objetivo deste estudo foi examinar a associação entre qualidade de vida, cognição e desempenho nas funções executivas de idosos. O estudo teve a participação de 88 idosos. Utilizou-se o método amostral de conveniência. Todos os participantes responderam sobre condições sociodemográficas, qualidade de vida (World Health Organization Quality of Life Group-Bref), funções cognitivas (Mini-Exame do Estado Mental e Instrumento de Avaliação Neuropsicológica Breve) e funções executivas (Teste Wisconsin de Classificação de Cartas). Os dados mostraram associações importantes entre os domínios de qualidade de vida Físico e Meio Ambiente e variáveis cognitivas, o que reforça a importância da cognição tanto na manutenção de cuidados físicos, quanto nas oportunidades de o idoso adquirir novas informações e habilidades no meio em que vive.

Background: Aging has determined a demographic shift in the world, which is considered a major societal achievement, and a challenge. Aging is primarily a subjective experience, shaped by factors such as gender and culture. There is a lack of instruments to assess attitudes to aging adequately. In addition, there is no instrument developed or validated in developing region contexts, so that the particularities of ageing in these areas are not included in the measures available. This paper aims to develop and validate a reliable attitude to aging instrument by combining classical psychometric approach and Rasch analysis.

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