Objective: The Tilburg Frailty Indicator (TFI) is a self-report user-friendly questionnaire for assessing multidimensional frailty among community-dwelling older people. The main aim of this study is to re-evaluate the validity of the TFI, both cross-sectionally and longitudinally, focusing on the predictive value of the total TFI and its physical, psychological, and social domains for adverse outcomes disability, indicators of healthcare utilization, and falls. Methods: The validity of the TFI was determined in a sample of 180 Dutch communitydwelling older people aged 70 years and older. The participants completed questionnaires including the TFI, the Groningen Activity Restriction Scale (GARS) for assessing disability, and questions with regard to health care utilization and falls in 2016 and again one year later. Results: The physical and psychological domains of the TFI were significantly correlated as expected with adverse outcomes disability, many indicators of healthcare utilization, and falls. Regression analyses showed that physical frailty was mostly responsible for the effect of frailty on the adverse outcomes. The cross-sectional and longitudinal predictive validity of total frailty with respect to disability and receiving personal care was excellent, evidenced by Areas Under the Curves (AUCs) >0.8. In most cases, using the cutoff point 5 for total frailty ensured the best values for sensitivity and specificity. Conclusion: The present study provided new, additional evidence for the validity of the TFI for assessing frailty in Dutch community-dwelling older people aiming to prevent or delay adverse outcomes, including disability.
BackgroundThe increase of the elderly population and the high prevalence of chronic diseases have contributed to the increasing importance of functional ability as a global public health problem. This study aimed to assess functional capacity in institutionalized elders, as well as undertake an exploratory analysis of its associated factors.MethodsThis is a cross-sectional study with institutionalized Brazilian elders. Functional capacity was assessed using the Katz Index for Activities of Daily Living (ADL) and the Lawton Scale for Instrumental Activities of Daily Living (IADL). The characteristics of dependent individuals were described and logistic regression models were developed for both scales. Multiple models that included all selected variables were developed using a hierarchical approach. We considered the results from the Wald test (p < 0.05) as a rule for progressing to the next level.ResultsA population of 760 elders was considered. The prevalence of dependence was 50.3% for ADL and 81.2% for IADL. We observed associations between ADL dependence and the following factors: self-report of stroke, difficulty of walking 400 meters, lower total scores in questions related to the temporal orientation section of the cognition test, and self-reports of frequently feeling upset. IADL dependence was associated with educational level, self-report of cancer, difficulty of walking 400 meters, use of glasses, and self-reported memory problems.ConclusionsSociodemographic and health conditions were associated with functional incapacity in institutionalized elders. Based on these findings, we emphasize the importance of both prevention and treatment of chronic conditions as well as social support in the maintenance of individuals’ autonomy.
Pouco se conhece sobre as práticas de rastreamento para câncer de próstata em idosos brasileiros. O objetivo deste estudo foi estimar a prevalência de realização de exames de rastreamento para câncer de próstata em idosos de Juiz de Fora (MG) e analisar os fatores associados. Trata-se de estudo seccional com 2825 homens de 60 anos ou mais que participaram da campanha de vacinação contra gripe de 2006. Foram analisadas variáveis sociodemográficas e relativas a condições de saúde e ao uso de serviços de saúde. Utilizou-se a regressão de Poisson na análise multivariada para avaliar associações entre as covariáveis e as variáveis dependentes e estimou-se a prevalência de realização dos exames. A idade média da população foi de 70,0 (± 7,2) anos. A prevalência de realização de toque retal foi 61,0% e a de PSA 75,5%. As variáveis "história familiar de câncer de próstata", "tipo de serviço de saúde", "status conjugal", "uso de medicação regular" e "escolaridade" foram fatores independentes associados à realização de toque retal. As mesmas variáveis, com exceção do "status conjugal", permaneceram no modelo múltiplo para PSA. O estudo evidencia que muitos idosos têm aderido à prática do rastreamento e a necessidade de dimensionar e qualificar esse processo, tendo em vista suas possíveis repercussões na saúde pública.
Trata-se de um estudo de caso, com abordagem qualitativa, respaldado na Fenomenologia, que teve por objetivo compreender como o casal idoso vivencia a sexualidade, vislumbrando a busca de novas perspectivas de cuidar a partir da Teoria de Cuidado Transpessoal de Jean Watson. Participaram do estudo três casais idosos, pertencentes ao Grupo da Terceira Idade Envelhecendo com Alegria, do bairro Padre Palhano, município de Sobral/Ceará/Brasil. O estudo foi realizado no período de maio a julho de 2004, através de uma entrevista semi-estruturada e aplicação do Teste das Oito Cores de Lüscher. Utilizou-se a análise de conteúdo proposta por Bardin. Diante da variedade de impressões obtidas na pesquisa, os resultados desvelam facetas importantes como a existência de sentimentos de amor, respeito, cumplicidade, mas também diminuição no padrão da atividade sexual, além do preconceito em relação à manifestação de carinho entre os gerontes e o fortalecimento do vínculo afetivo com o passar dos anos.
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