This study aims to analyze the impact of frailty, multimorbidity and disability on the survival of elderly people attended in a geriatric outpatient facility, and identify the clinical risk factors associated with death. It is a longitudinal study, with 133 elderly people initially evaluated in relation to frailty, multimorbidity (simultaneous presence of three or more chronic diseases) and disability in Daily Life Activities. The Kaplan Meier method was used to analyze survival time, and the Cox regression was used for association of the clinical factors with death. In follow-up over six years, 21.2% of the participants died, survival being lowest among those who were fragile (p < 0.05). The variables frailty (HR = 2.26; CI95%: 1.03-4.93) and Chronic Renal Insufficiency (HR = 3.00; were the factors of highest risk for death in the multivariate analysis. Frailty had a negative effect on the survival of these patients, but no statistically significant association was found in relation to multimorbidity or disability. Tracking of vulnerabilities in the outpatient geriatric service is important, due to the significant number of elderly people with geriatric syndromes that use this type of service, and the taking of decisions on directions for care of these individuals.
Resumo O objetivo deste estudo foi investigar prevalências de falhas no diagnóstico, no uso de anti-hipertensivos e na eficácia do tratamento medicamentoso da hipertensão, e a associação destes parâmetros com variáveis sociodemográficas, de saúde e acesso ao serviço de saúde em idosos não institucionalizados. O estudo foi descritivo, transversal, com 3478 idosos, analisados separadamente em regiões Norte/Nordeste e Sul/Sudeste. Utilizou-se a regressão múltipla de Poisson para estimar razões de prevalência brutas e ajustadas pelo tipo de serviço de saúde utilizado. Do total, 29,6% dos idosos apresentaram falhas no diagnóstico, 4,6% no uso de anti-hipertensivos e 65,3% na eficácia medicamentosa. A falha no diagnóstico associou-se ao sexo masculino, menos morbidades, ter um companheiro, raça/cor branca, ter acesso ao convênio ou serviço privado de saúde, possuir renda pessoal inferior/média e ainda trabalhar. A falha no uso de anti-hipertensivos esteve associada à renda pessoal inferior/média e trabalhar. As falhas no manejo da hipertensão são prevalentes em idosos não institucionalizados. Há necessidade de ações que minimizem os impactos negativos destas insuficiências em saúde, em um país com diferenças sociais, econômicas e étnicas.
Objetivo: Analisar a influência do Watsu na qualidade de vida e na dor de idosas com fibromialgia. Método: Realizou um estudo de intervenção, quase experimental, onde participaram 17 idosas com fibromialgia, com média de idade de 67,5±4,7 anos. Foi utilizado, pré e pós intervenção, o SF-36 para avaliação da qualidade de vida, e a Escala visual analógica para dor. O protocolo de intervenção foi a realização de 10 sessões de Watsu, sendo duas vezes por semana, com duração de 40 minutos cada. Resultados: ficou evidenciado aumento estatisticamente significativo na Capacidade Funcional (p=0,00445), Limitação por aspectos físicos (p=0,01347), Dor (p=0,00861), Vitalidade (p=0,00044), Limitação por aspectos emocionais (p=0,02019) Saúde mental (p=0,00748). Já a EVA, foi estatisticamente menor na segunda avaliação (p=0,00059). Conclusão: Foi possível verificar que o método Watsu proporcionou benefícios na redução da dor e melhora da qualidade de vida de idosas com de fibromialgia.
Background
It is important to study multiple social, physical and psychosocial factors associated with frailty in populations characterized by social and health disparities, such as men and women.
Methods
This was a cross-sectional population-based study with older adults ≥65 years from the FIBRA (Frailty in Brazilian Older Adults) 2008-2009 study. We carried out a comparative analysis of the factors associated with the frailty phenotype in older men (N=706) and women (N=1.251) using networks based on mixed graphical models (MGM) according to sex.
Results
In the male network, frailty was most strongly associated with years of schooling, overall satisfaction with life and falls; in the female network, the syndrome was associated with satisfaction with problem solving, depression and diabetes in addition to years of schooling. Furthermore, permutation tests showed that the networks for males and females were statistically different in terms of their structure, the global strength of the relationships and the strength of the relationships between frailty and diabetes; frailty and falls; frailty and depression; frailty and overall satisfaction with life; and frailty and satisfaction with problem solving (p<0.05). The walktrap network cluster detection algorithm revealed that in men, frailty was in a physical and social dimension while in women the syndrome was in a cardiometabolic and psychosocial dimension.
Conclusions
Network analysis showed that different factors are associated with frailty for each sex. The findings suggest that different strategies for dealing with frailty should be adopted for men and women so that care and prevention efforts can be directed appropriately.
Objective: to compare the functional capacity and quality of life of older women practicing and not practicing hydrogymnastics. Methods: this is a simple natural experiment study, of a sample of 40 older women practicing hydrogymnastics and 40 not practicing hydrogymnastics. Latin American Development Group's protocol was used to evaluate the functional capacity, and the WHOQOL-Bref and Old was used to evaluate the quality of life. Results: there were no differences in functional capacity or quality of life between the groups. Conclusion: it is concluded that there was not enough strong evidence to prove that older women practicing hydrogymnastics have a different functional capacity and quality of life compared to those not practicing physical exercise.Objetivo: comparar a capacidade funcional e a qualidade de vida de mulheres idosas que praticam e que não praticam hidroginástica. Métodos: trata-se de um experimento simples natural, de uma amostra de 40 mulheres idosas praticantes de hidroginástica e 40 não praticantes. O protocolo do Grupo de Desenvolvimento Latino-Americano foi utilizado para avaliar a capacidade funcional e o WHOQOL-Bref e o WHOQOL-Old para avaliar a qualidade de vida. Resultados: não houve diferenças na capacidade funcional ou qualidade de vida entre os grupos. Conclusão: conclui-se que não houve evidência suficiente para provar que mulheres idosas praticantes de hidroginástica têm capacidade funcional e qualidade de vida diferentes em comparação com aquelas que não praticam exercício físico.
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