RESUMOObjetivo: Investigar a associação das doenças crônicas não transmissíveis e fatores sociodemográficos com sintomas de depressão em idosos. Métodos: Foi realizado um estudo transversal com 1.391 idosos cadastrados na Estratégia Saúde da Família. Os dados sociodemográficos e de doenças crônicas não transmissíveis foram coletados pelos agentes comunitários de saúde. A Escala de Depressão Geriátrica abreviada foi utilizada para investigar os sintomas de depressão. Resultados: Aproximadamente 81% referiram ao menos uma doença crônica não transmissível. Os sintomas depressivos foram associados com sexo feminino, doença coronariana, insuficiência cardíaca e acidente vascular cerebral; ≥ 8 anos de estudo e ter companheiro foram protetores. Dentre as doenças crônicas não transmissíveis, as cardiovasculares e as cerebrovasculares têm associação independente com sintomas de depressão. Conclusões: Esses resultados corroboram a hipótese de que a doença vascular seja um fator de risco para o comprometimento encefálico associado à depressão. Evidencia-se o importante papel dos agentes comunitários de saúde, na Estratégia Saúde da Família, com potencial utilidade nas políticas públicas para a saúde mental do idoso. ABSTRACTObjective: To investigate the association between non-communicable chronic diseases and sociodemographic factors with symptoms of depression in elderly. Methods: Transversal study conducted with 1,391 elderly patients registered in the Family Health Strategy. Social--demographic and non-communicable chronic diseases data were collected by community health agents. Geriatric Depression Scale abbreviate was used to investigate symptoms of depression. Results: About 81% of all patients reported at least one non-communicable chronic disease. Symptoms of depression was associated with women, coronary disease, cardiac insufficiency and cerebrovascular accident; education ≥ 8 years and having a companion were shown to be protecting factors. Conclusions: Cardiovascular and cerebrovascular non--communicable chronic diseases are independently associated with depression. These results support the hypothesis that vascular disease is a risk factor for brain impairment associated with depression. This research illustrates the role of community health agents within Family Health Strategy as a tool for public mental health policy.

Background A growing body of literature has demonstrated the importance of discourse assessment in patients who suffered from brain injury, both in the left and right hemispheres, as discourse represents a key component of functional communication. However, little is known about the relationship between gray matter density and macrolinguistic processing. Purpose This study aimed to investigate this relationship in a group of participants with middle–low to low socioeconomic status. Method Twenty adults with unilateral left hemisphere ( n = 10) or right hemisphere ( n = 10) chronic ischemic stroke and 10 matched (age, education, and socioeconomic status) healthy controls produced three oral narratives based on sequential scenes. Voxel-based morphometry analysis was conducted using structural magnetic resonance imaging. Results Compared to healthy controls, the left hemisphere group showed cohesion impairments, whereas the right hemisphere group showed impairments in coherence and in producing macropropositions. Cohesion positively correlated with gray matter density in the right primary sensory area (PSA)/precentral gyrus and the pars opercularis. Coherence, narrativity, and index of lexical informativeness were positively associated with the left PSA/insula and the superior temporal gyrus. Macropropositions were mostly related to the left PSA/insula and superior temporal gyrus, left cingulate, and right primary motor area/insula. Discussion Overall, the present results suggest that both hemispheres are implicated in macrolinguistic processes in narrative discourse. Further studies including larger samples and with various socioeconomic status should be conducted. Supplemental Material https://doi.org/10.23641/asha.14347550

Background: In several countries, prevalence studies demonstrate that chronic use of BZD in the elderly population is very high. This scenario has reached pandemic proportions for decades and is an important public health problem. Objectives: To examine the independent association between chronic benzodiazepine use in depression, anxiety and bipolar disorder, as well as other clinical and sociodemographic factors. Methods: This cross-sectional study was developed from a population-based survey and conducted from March, 2011 to December, 2012 using a random sample of 550 elderly people who were enrolled in the Family Health Strategy in Porto Alegre, Brazil. Data was collected from identifying epidemiological and health data (sociodemographic, self-perception health, self-reported diseases, smoking, alcohol and pharmacotherapeutic evaluation) and from the diagnoses of mood and anxiety disorders. Results: Elderly patients diagnosed with depression, anxiety, concomitant depression/anxiety and bipolar disorders, and those who were using antidepressants have a higher risk of benzodiazepine use. Individuals who self-reported drinking alcohol had a lower risk of benzodiazepine use. Discussion: Benzodiazepines are often used by the elderly for long periods, which has a direct impact on the treatment of mood and anxiety disorders and on vulnerable groups such as the elderly, who may be unnecessarily taking these drugs.

Background. Dysphagia is a predictor of mortality in Parkinson’s disease (PD). Developing alternative methods to videofluoroscopy swallowing study (VFSS) for the evaluation of dysphagia is a public health necessity. The Swallowing Clinical Assessment Score in Parkinson’s Disease (SCAS-PD) is an alternative and low-cost tool for diagnosis of dysphagia, but had not been properly validated in comparison to the gold-standard method. The objective of this study was to assess the validity and reliability of the SCAS-PD. Methods. SCAS-PD was applied to 31 patients with PD, and VFSS was conducted concurrently. This clinical assessment uses different volumes and viscosities to identify signs of swallowing impairments. For validation purposes, the interclass correlation coefficient and the weighted kappa were calculated. The AUC of the ROC curve, sensitivity, and specificity values for detection of penetration/aspiration (PA) were assessed. Internal consistency was calculated by Cronbach’s alpha. Results. Fifty-one percent of patients were classified with dysphagia. SCAS-PD was differentiated between normal/functional deglutition and dysphagia with AUC 0.97, 95% CI 0.92–1.00, and an optimal cutoff at 19 (sensitivity 100% and specificity 87.5%). The internal consistency was α = 0.91 for the total score. The internal consistency of the SCAS-PD domains was oral phase (α = 0.73), pharyngeal phase (α = 0.86), and signs of PA (α = 0.95). The weighted kappa analysis demonstrated a high rate of concordance at 0.71 (p<0.001) between SCAS-PD and VFSS. Conclusions. SCAS-PD has been shown to have a good concordance with the VFSS. Considering this, SCAS-PD is highly applicable in clinical settings, since it is a simple and low-cost diagnostic tool for detecting dysphagia in PD patients.

RESUMOOBJETIVO: A prevalência de enteroparasitoses é pouco relatada em estudos com a população idosa. Sendo assim, esse estudo teve como objetivo identificar a prevalência de enteroparasitoses associadas a fatores sociodemográficos e de saúde em idosos da Estratégia Saúde da Família (ESF). MÉTODOS: Estudo transversal, realizado com uma amostra aleatória de idosos da ESF do município de Porto Alegre. A coleta de dados foi realizada pelos agentes comunitários de saúde, que aplicaram um questionário geral de inquérito epidemiológico. A coleta de sangue e fezes foi realizada pela equipe do projeto, na unidade de saúde onde o idoso estava cadastrado. RESULTADOS: Foram avaliados 581 idosos e a prevalência de enteroparasitoses foi de 10,8%. Os parasitos encontrados foram: Endolimax nana (42,7%), Entamoeba coli (33,8%), Giardia lamblia (8,8%), Ascaris lumbricoides (5,9%), Strongyloides stercoralis (4,4%), Trichuris trichiura (2,9%) e Iodamoeba bütschlii (1,5%). CONCLUSÃO: A prevalência de enteroparasitoses foi baixa quando comparada com outros estudos e com predomínio de parasitos não patogênicos. Esses achados sugerem a possibilidade de transmissão interpessoal, contaminação ambiental ou mesmo a ocorrência de ingestão de alimentos ou água contaminados. Estes resultados ressaltam a importância da implementação de medidas relacionadas ao saneamento básico e programas contínuos de educação sanitária na comunidade estudada. PALAVRAS-CHAVE: enteropatias parasitárias; idoso; saúde pública. ABSTRACT OBJECTIVE:There are few studies on intestinal parasitic infections in elderly populations. Therefore, this study aimed to determine the prevalence of intestinal parasites and identify the association between this prevalence and the sociodemographic, environmental, and health factors of the elderly attended by the Family Health Strategy (FHS). METHOD: This cross-sectional study involved the analysis of data collected from a random sample of elderly individuals. Community health workers drafted a general questionnaire to collect epidemiological data. The project team also collected blood and stool samples at the healthcare unit where each individual was enrolled. RESULTS: Among 581 elderly people, the prevalence of intestinal parasites was 10.8%. The parasites found were as follows: Endolimax nana (42.7%), Entamoeba coli (33.8%), Giardia lamblia (8.8%), Ascaris lumbricoides (5.9%), Strongyloides stercoralis (4.4%), Trichuris trichiura (2.9%), and Iodamoeba bütschlii (1.5%). CONCLUSION: The prevalence of intestinal parasites in elderly persons was lower than that reported in other studies, and the parasites identified were predominantly non-pathogenic. The findings suggest the possibility that interpersonal transmission, environmental contamination, or the ingestion of contaminated food or water is occurring in this population. These findings also highlight the importance of the ongoing implementation of sanitation and hygiene education programs in this community.

Along with cognitive disorders, depression has been a concern for mental health services due to its highly debilitating effect on the functioning and quality of life of the elderly. However, there is still little understanding of the cognitive alterations resulting from depression or of the difficult differential diagnosis with mild cognitive impairment (MCI). It is known that performance on cognitive tests is strongly influenced by education but few studies have been conducted involving low-educated populations.Objective: To evaluate the performance of elders with low education and no dementia on Addenbrooke's Cognitive Examination-Revised (ACE-R) test and its cognitive domains, and compare patients with Current Major Depressive Episode (CMDE) against those without depressive symptoms. Methods:A retrospective, cross-sectional analytical study was conducted based on medical files of patients treated at the Cerebral Aging Clinic of the Hospital São Lucas of the PUCRS. The study included 116 individuals with low education (< 8 years of education) aged between 60 and 84 (69.6 ± 6.4) years, with MCDE (N = 41) and controls (N = 75). Results:No significant difference was observed between control and MCDE groups in median scores on the ACE-R, Mini-Mental State Examination, and the five cognitive domains. There was also no difference between the groups on separate analyses of results on the clock drawing test, the categorical verbal and phonological fluency test, and the naming test. Conclusion:The results of this study showed that depressive symptoms did not influence scores on the ACE-R tests conducted in elders with low education.

<p>La presente investigación fue diseñada para verificar cuáles son las razones que conllevan a las personas con enfermedad de Alzheimer a interponer un recurso legal. Para ello, se buscó en la página web del Tribunal de Río Grande do Sul, en el trascurso de un año, las decisiones de los recursos judiciales que contenían la palabra "Alzheimer". Fueron encontradas 65 decisiones relacionadas con la enfermedad de Alzheimer. De ellas, la mayoría correspondió a solicitudes de medicamentos (61,6%), seguido de solicitud de pañales (17,0%). Es importante que se dé el cumplimiento de la legislación, posibilitando disminuir la cantidad de interpuestas judiciales, así como la importancia de que se genere la comprensión de la gravedad de esta enfermedad, para que los procesos se den de manera rápida, haciendo que no aumente la vulnerabilidad del anciano con la enfermedad de Alzheimer.</p>

Objectives To describe the process of translating and adapting the Relationship Scales Questionnaire (RSQ) from English into Brazilian Portuguese and to present the results of its test-retest reliability using the version developed for interview application. Methodology The process was based on the guidelines of the International Society for Pharmaeconomics and Outcomes Research (ISPOR), which propose 10 steps for the translation and cross-cultural adaptation of self-administered instruments. The original authors of the RSQ have agreed to the translation. The interview version was applied to a sample of 43 healthy elders (≥60 years old) enrolled in a primary health care program in the city of Porto Alegre, state of Rio Grande do Sul, southern Brazil, and then reapplied. The scores of the two applications were compared using the paired sample t-test. Results Only 6 of the 30 items required the adaptation of words or expressions to maintain its conceptual and semantic equivalence. The self-administered form of the RSQ posed difficulties for elders due to visual deficiencies and lower education level, both common in this age group, demonstrating a need for the development of a version of the RSQ in a structured interview format. Only the measure for secure attachment presented significant differences after the application of the retest, indicating reliability of the version being proposed. Conclusion Translation of the RSQ is the first step towards the validation of an attachment evaluation instrument for use in the elderly population in Brazil, allowing for future studies on this topic.