ObjectiveThe aim of this paper was to present the results of the first stage of cross-cultural adaptation of the Functional Activities Questionnaire (FAQ).MethodsThe tool was subjected to translation and re-translation, and the test-retest reliability of a proposed version for use in Brazil was analyzed.ResultsOf the 548 questionnaire respondents, a convenience sample of 68 informants was selected for retesting. Internal consistency was measured by Cronbach's alpha (0.95) while test-retest reliability was assessed using intra-class correlation (0.97). The findings have shown that FAQ is brief - averaging seven minutes to apply, easily understood and has good intra-rater test-retest reliability.ConclusionOur results suggest this adapted version of the FAQ is a reliable and stable tool which may be useful for assessing function in Brazilian elderly. Notwithstanding, the version should be subjected to further analysis with the aim of reaching functional equivalence.

This article presents the results of the translation and cross-cultural adaptation of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and the test-retest reliability of a version to be used in Brazil. An instrument review committee analyzed the conceptual and item equivalence. In order to analyze semantic equivalences, three translations and three back-translations were performed; a summary version was devised and pre-tested, and a test version elaborated. The Cronbach's +/- coefficient and intraclass correlation coefficient (ICC) were used to measure the internal consistency and test-retest reliability, respectively. Of the 169 informants assessed, 97 were retested. A Cronbach's +/- of 0.94 and an ICC of 0.92 were found. The reliability levels lead to the conclusion that the IQCODE-BR version is easy to comprehend. Satisfactory equivalence to the original version was observed.

KeywordsHealth services for the aged. Aging health. Needs assessment. Ambulatory care. Triage. AbstractIn Brazil, the rapid growth of the elderly population has been causing a great impact on the healthcare system, with increased costs and service utilization. The inefficiency of traditional models for geriatric healthcare has made it essential to change the healthcare concepts for this population. This can take place through the development of new healthcare models that include the means to identify, assess and treat elderly patients with a variety of morbid and functional conditions, and which can be applied diverse healthcare scenarios. An outpatient model is proposed, with two stages that differ in the depth and coverage of their actions. These stages are organized as increasing levels of complexity and are capable of selecting subgroups of individuals that, because of their risk characteristics, should follow different paths through the healthcare structure. This paper discusses the first stage of this model, which involves risk identification among large groups of elderly people, by means of structuring a hierarchical flow of actions and using assessment tools of adequate sensitivity and specificity. Individuals aged 65 years or over who are detected through walk-in outpatient consultation, home visits or telephone interview are classified using a rapid screening risk evaluation instrument composed of eight items. Depending upon the level of risk presented, the individual will either be referred to another level of functional evaluation (medium-high and high risk levels), or to normal clinical care and old people's community centers (low and medium risk levels). The second stage will be the subject of a subsequent paper.

The findings highlight the importance of developing interventions and compensatory strategies to prevent loss of ADL in dementia, also suggesting that early intervention in older adults with depression should focus on advanced ADL to prevent social isolation and withdrawal. Finally, the findings indicate that self-information about ADL may be compromised in dementia, so clinicians exploring disability should consider fully different aspects of ADL in this group. Copyright © 2017 John Wiley & Sons, Ltd.

BackgroundIn low or middle income countries chronic diseases are rapidly becoming the main cause of disease burden. However, the main focus of health policymakers has been on preventing death from cancer and heart disease, with very little attention to the growing problem of long-term needs for care (dependence). Numbers of dependent older people are set to quadruple by 2050. The economic impact of providing long-term care is likely to be substantial.Methods/designThe study uses mixed methods and draws on and extends the population-based surveys conducted by the 10/66 Dementia Research Group. We focus on two countries in Latin America (Peru and Mexico), China and Nigeria. The surveys comprised baseline surveys of health, socioeconomic circumstances and care arrangements, repeated three to four years later. We are going back to these households to make a detailed assessment of the overall economic status and the use of health services by all family members. We will compare households where: a) an older resident became dependent between baseline and follow-up (incident care), b) one or more older people were dependent at both time points (chronic care), b) c) no older residents had needs for care (control households) for household income, consumption, healthcare expenditure and economic strain. In each of the four countries we are carrying out six detailed household ‘case studies’ to explore in more depth the economic impacts of dependence, and the social relations between household members and others in their network.DiscussionThe INDEP study will provide a detailed examination of the economic and social effects of care dependence in low and middle income settings. As the proportion of older people with needs for care rises rapidly in these countries, this neglected policy area is likely to become increasingly salient for families, communities and policymakers alike. Our detailed multilevel plans for dissemination will ensure that the study helps to put this important issue on the agenda for the international and national media, the public and researchers.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-379) contains supplementary material, which is available to authorized users.

RESUMO Objetivos identificar indicadores de fragilidade capazes de gerar situação de dependência e de internação hospitalar em amostra de idosos de um Centro de Convivência. Métodos avaliação da probabilidade de internação hospitalar através de um instrumento composto por oito variáveis e avaliação funcional, com utilização de instrumento composto de 11 testes rápidos para aferição do nível de capacidade funcional e entrevista estruturada para colher informações acerca das morbidades auto-referidas. Os dados estatísticos foram tratados de forma descritiva e analisados à luz de fundamentação teórica nos campos da Gerontologia e Saúde Coletiva. Resultados Entre outubro de 2005 a setembro de 2006, foram entrevistados 430 idosos, dos quais foi retirada uma subamostra composta de 285 pessoas submetidas à avaliação funcional. Dentre os avaliados, 25% apresentaram queixa de memória, 32,2% apresentavam história prévia de depressão, 55,7% com diagnóstico de hipertensão e 30,5% relataram episódios de quedas no último ano. Conclusão Ao final da avaliação breve, 10% dos idosos necessitavam de avaliação geriátrica com urgência, 45% apresentavam indicadores de fragilidade importantes, com necessidade de avaliação mais acurada e 28% se beneficiariam de uma avaliação para detecção precoce dos déficits funcionais e adoção de medidas de reabilitação, com o objetivo de prevenir a incapacidade funcional.

A síndrome de fragilidade está associada a eventos indesejáveis, como incapacidade e morte. No Brasil, é uma condição pouco conhecida. O objetivo do presente relato é apresentar a metodologia de trabalho utilizada no FIBRA-RJ, seção Rio de Janeiro do estudo Fragilidade em Idosos Brasileiros (FI-BRA-BR), desenvolvido para superar esta lacuna. A linha de base (primeira fase) do estudo FIBRA-RJ foi desenvolvida em 2009-2010. A amostra (847 indivíduos, ≥ 65 anos, clientes de uma operadora de saúde) foi aleatória, estratificada por sexo e idade. Teve como objetivo estimar a prevalência de fragilidade e seus fatores associados. A segunda fase (2010-2011) teve como objetivo estimar a prevalência da demência e seus fatores associados. A terceira fase (2012-2013) buscou estimar a prevalência e incidência de sarcopenia/obesidade sarcopênica e seus fatores associados. A prevalência de fragilidade foi de 9,1%; esteve associada a idade, menores escolaridade e cognição, percepção de saúde negativa, comorbidades e pior funcionalidade. A prevalência de demência foi de 16,9%; esteve associada a idade e analfabetismo. No total, foram publicados onze artigos, quatro dissertações e duas teses; outras sete dissertações e teses estão em andamento, incluindo resultados da terceira fase. O FIBRA-RJ tem relatado estudos descritivos com conhecida limitação associada à causalidade reversa. A fase 3 nos permitirá estudar incidências e validade preditiva de biomarcadores vis-à-vis mortalidade, desfechos adversos e uso de serviços de saúde. O FIBRA-RJ representa um grande avanço no conhecimento sobre os agravos de saúde que acometem a população idosa brasileira.

This study suggests that the IQCODE-BR is a valid tool for screening of dementia and that IQCODE-BR scores do not seem to be influenced by age, educational level and other factors associated with the informants. However, further studies are required to evaluate informant characteristics, such as anxiety states, depression and burden level.