A satisfação com a vida e a funcionalidade em idosos atendidos em um ambulatório de geriatriaSatisfaction with life and functionality among elderly patients in a geriatric outpatient clinic

Objective: The aim of this study was to investigate the relationship between participation in advanced activities of daily living (AADLs) and cognitive performance in communitydwelling elderly persons. Method: The data presented is drawn from the population-based study entitled Frailty Profile of Elderly Brazilians (FIBRA-Unicamp). The sample comprised 2,549 older adults without cognitive impairments suggestive of dementia. Data was collected relating to socio-demographic characteristics (sex, age, years of education and family income), health status (number of diseases and depressive symptoms), cognitive performance (Mini-Mental State Examination -MMSE) and self-reported social, physical and intellectual AADLs. Results: Mean MMSE scores were significantly higher among men, younger individuals and those with more years of education, higher income, fewer diseases and fewer depressive symptoms. Multivariate linear regression analysis and hierarchical regression analysis showed that years of education, family income and participation in intellectual AADLs were positively associated with cognitive performance. Conclusion: The findings suggest that these factors may have a protective role in cognitive aging and that participation in intellectual AADLs can represent a feasible strategy for the promotion of mental health among older adults.

Cognitive decline in aging can negatively impact quality of life in the elderly. However, studies have shown that elderly engaged in advanced activities of daily living (AADLs) can maintain or enhance global cognitive function or specific domains.ObjectiveTo investigate the relationship between engagement in AADLs and domains of cognition in elderly from seven different locations in Brazil.MethodsA cross-sectional study involving 2,549 elderly without cognitive deficits suggestive of dementia was conducted. Data were collected on sociodemographic characteristics, health status, the Mini-Mental State Exam (MMSE) by subdomain (orientation, memory, attention/calculus, language and constructional praxis), and engagement in AADL grouped under physical, social and intellectual activities.ResultsMultivariate linear regression analysis revealed an association, albeit modest, between intellectual AADLs and the domains orientation, attention/calculus, language and constructional praxis (R2=0.005, 0.008, 0.021, and 0.021 respectively). Social AADLs were correlated with memory (R2=0.002) and language (R2=0.004) domains. No association was found between physical AADLs and MMSE domains. Schooling and family income were the sociodemographic variables exhibiting the strongest relationship with cognitive domains.ConclusionThe study found associations between intellectual and social AADLs with higher cognitive performance, suggesting that active aging can provide opportunities to attenuate cognitive decline in aging.

Objective: The aim of this study was to investigate the relationship between subjective well-being, functional independence and lowerlimb performance (muscle strength, gait velocity and balance) among elderly people undergoing outpatient follow-up, stratified by sex and age groups. Methods: We evaluated 125 elderly people, aged 60 years and over, who received care at a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; and 3) Subjective Well-Being (SWB) with questions about health and satisfaction with life. Results: A convenience sample was used, with predominance of females (who had greater functional impairment).The Spearman correlation coefficients for subjective well-being and the performance tests varied from -0.16 to 0.31 for men and -0.09 to 0.29 for women, therefore there were no differences between the sexes. However, the older participants had a higher level of satisfaction than the younger participants. Perceived health was also more satisfactory among the older participants, however comparative perceived health was better among the elderly participants with moderate to good physical performance. Conclusion:The results suggest that older individuals have greater satisfaction with life and better perceived health. Moreover, good physical performance was an important variable for better perceived health when compared to other people.Key words: functional capacity; subjective well-being; perceived health; elderly person. ResumoObjetivo: Este estudo teve como objetivo verificar a relação entre o bem-estar subjetivo, independência funcional e desempenho de membros inferiores (força muscular, velocidade de marcha e equilíbrio) de idosos em seguimento ambulatorial, em relação ao sexo e a grupos etários. Métodos: Foram avaliados 125 idosos de ambos os sexos com idade mínima de 60 anos, atendidos em um ambulatório de geriatria. Os instrumentos utilizados foram: 1) Medida da Independência Funcional (MIF) para avaliar a dependência funcional; 2) Short Physical Performance Battery (SPPB) para medir o desempenho físico; 3) Bem-Estar Subjetivo (BES): questões sobre a saúde e satisfação com a vida. Resultados: A amostra utilizada foi de conveniência, com predomínio do sexo feminino, que apresentou maior comprometimento funcional. As correlações do bem-estar subjetivo com o teste de desempenho não demonstraram diferenças entre os sexos, contudo os idosos mais velhos apresentaram maior nível de satisfação que os idosos mais jovens. A saúde percebida também foi mais satisfatória entre os idosos mais velhos. Entretanto, a saúde percebida comparada mostrou melhores resultados nos idosos com moderado a bom desempenho físico. Conclusão: Os resultados sugerem que indivíduos mais velhos apresentam maior satisfação com a vida e melhor saúde percebida. Além disso, o bom desempenho físico foi uma variável de relevância para melhor saúde percebida quando comparada...

A quasi-experimental study using a pre-posttest design was conducted in four aged care facilities to assess the effects of a person-centred care (PCC) multisensory stimulation (MSS) and motor stimulation (MS) program, implemented by direct care workers, on the behaviors of residents with dementia. Data were collected at baseline and after the intervention through video recordings of morning care routines. Forty-five residents with moderate and severe dementia participated in the study. A total of 266 morning care routines were recorded. The frequency and duration of a list of behaviors were analyzed. The frequency of engagement in task decreased significantly ( p = .002) however, its duration increased ( p = .039). The duration of gaze directed at direct care workers improved significantly ( p = .014) and the frequency of closed eyes decreased ( p = .046). There was a significant decrease in the frequency of the expression of sadness. These results support the implementation of PCC-MSS and MS programs as they may stimulate residents' behaviors.

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Objetivo: analisar a associação entre a autoavaliação de saúde e a síndrome da fragilidade em idosos atendidos no serviço de geriatria.Método: trata-se de um estudo longitudinal que teve na linha de base a participação de 150 idosos. Após oito anos de estudo, 54 idosos da amostra inicial receberam uma segunda avaliação. Os participantes foram avaliados e reavaliados quanto a autoavaliação de saúde que foi classificada em ruim, mais ou menos e boa, assim como, pelo fenótipo da fragilidade identificada por cinco componentes: fraqueza, lentidão, baixo nível de atividade física, exaustão e perda de peso não intencional. Aqueles com nenhum componente foi classificado como não-frágil, aqueles com um ou dois componentes foram classificados como pré-frágeis e aqueles com três ou mais componentes foram considerados frágeis. Para comparar as variáveis de autoavaliação de saúde (ruim, mais ou menos ou boa); classificação da fragilidade (não-frágil, pré-frágil e frágil) e componentes da fragilidade (fraqueza, lentidão, baixo nível de atividade física, exaustão e perda de peso não intencional ), foram realizados os testes de qui-quadrado e exato de Fisher.Resultados: a autoavaliação de saúde “ruim” associou-se com os componentes “lentidão” e “exaustão” com maior frequência (87,5%) e (100,0%), respectivamente (p<0,05).Conclusão: a relação entre medidas subjetivas em saúde e a síndrome da fragilidade prevalente nos idosos, avigora a boa concordância da subjetividade em saúde e condições clínicas capaz de mostrar a relevância de instrumentos que consideram a percepção individual do estado de saúde junto ao rastreio de vulnerabilidade nesta população.

Bibliotecário: Sandra Lúcia Pereira -CRB-8ª / 6044 Sposito, Giovana Sp67rRelações entre bem-estar subjetivo e funcionalidade de idosos em acompanhamento ambulatorial de um hospital universitário / Giovana Sposito.