Aims and objectives To identify the frequency of falls among older people with and without cataracts and to verify the association of sociodemographic, clinical and behavioural variables with the number of falls among community‐dwelling older adults according to self‐reported cataracts. Background Although the literature on the topic is vast, no studies were found that described the explanatory factors for the relationship between sociodemographic, clinical and behavioural variables with the occurrence of falls in older people, with and without cataracts, through models previously tested in mediation analysis. Design and Method This is a cross‐sectional and quantitative study guided by the STROBE, conducted with two groups: older people with (268) and without cataracts (689). For analysing the data, the path analysis was performed. Results The occurrence of falls among the older people with cataracts was higher than in the group without cataracts. In both groups, frailty and depressive symptoms were directly associated with a higher occurrence of falls. Among older people with cataracts, the lowest physical performance score and the highest sedentary behaviour were directly associated with the highest number of falls. Among the older people without cataract, the youngest age, the highest number of morbidities and functional disability for instrumental activities of daily living were directly associated with the occurrence of falls. Conclusion The older people with cataracts have a higher frequency of falls. The factors associated with the occurrence of falls differ between the older people with and without cataracts. Relevance to clinical practice The expanded understanding of the factors associated with falls among community‐dwelling older adults, differentiating those with and without cataracts, guides the health professional in the development and implementation of measures to reduce the occurrence of these events.
Objective: to describe the occurrence of COVID-19 and the health services used by elderly individuals living by themselves; identify the knowledge held by elderly individuals regarding the transmission, signs and symptoms of COVID-19, as well as factors associated with poor knowledge of preventive measures according to sociodemographic and clinical variables. Method: cross-sectional survey conducted by telephone or mobile with 123 elderly individuals living by themselves in the Health Macro-Region of Triângulo Sul in the state of Minas Gerais, Brazil. Descriptive analysis was performed along with bivariate and multiple linear regression (p<0.05). Results: most elderly individuals did not present COVID-19 signs and symptoms (97.5%), were aware of how it is transmitted (86.6%), and of its signs and symptoms (90.8%). The elderly individuals were familiar with four preventive measures on average. After social distancing began, 85.7% of them left home and implemented three preventive measures on average, the most frequent of which was the use of face masks (99.0%). Being a man (p=0.001), 80 years old or older (p=0.045), and having fewer years of schooling (p=0.010) were associated with having less knowledge regarding the COVID-19 preventive measures. Conclusion: the elderly individuals were knowledgeable on COVID-19, but did not implement all the preventive measures. Male elderly individuals living by themselves with a low educational level are more vulnerable to COVID-19.
Objetivo: Verificar a dependência funcional para a realização das atividades básicas, instrumentais e avançadas da vida diária entre idosos e seus fatores associados. Método: Estudo transversal e analítico, com 1.611 idosos da comunidade de uma Macrorregião de Minas Gerais. Na coleta dos dados utilizaram-se: Miniexame do Estado Mental; Questionário estruturado elaborado pelo Grupo de Pesquisa em Saúde Coletiva; versão brasileira Short Physical Performance Battery; Índice de Katz; Escalas de Lawton & Brody e Atividades Avançadas da Vida Diária e fenótipo de fragilidade. Procederam-se as análises descritiva e regressão logística múltipla (p<0,05). Resultados: 6,5% dos idosos eram dependentes para as atividades básicas; 70,7% dependentes parcial/total para as atividades instrumentais e 25,1% tinham menor participação nas atividades avançadas. A dependência para as atividades básicas e instrumentais da vida diária associou-se à faixa etária de 80 anos ou mais (p= 0,001; p<0,001); presença de 5 ou mais morbidades (p= 0,023; p= 0,017); incapacidade/baixo desempenho físico (p<0,001; p<0,001) e pré-fragilidade/fragilidade (p= 0,015; p<0,001), respectivamente. A dependência para as atividades instrumentais também foi associada à ausência de escolaridade (p<0,001). Já a menor participação nas atividades avançadas associou-se à ausência de escolaridade (p<0,001); renda individual mensal ≤ 1 salário-mínimo (p<0,001); incapacidade/baixo desempenho físico (p<0,001) e pré- fragilidade/fragilidade (p<0,001). Conclusão: Os idosos apresentaram maior percentual de dependência para realização das atividades instrumentais. A saúde física está relacionada à dependência funcional do idoso, independente da complexidade das atividades cotidianas; e deve ser considerada no planejamento de intervenções direcionadas à prevenção e/ou reabilitação do declínio funcional nesse grupo etário.
Objective: to analyze functional disability and its associated factors among community-dwelling older adults. Method: a cross-sectional study, conducted with 1,635 older adults distributed in the following age groups: 60 to 69, 70 to 79, and 80 years old or more, living in a health macro-region of the state of Minas Gerais. Descriptive and trajectory analysis was carried out (p<0.05). The parameters were estimated by the Maximum Likelihood method. Results: the highest percentage was female, with a monthly income of 1 minimum wage and living with a companion. In the age groups from 60 to 69 and from 70 to 79 years old, older adults with a partner predominated; and, among those aged 80 years old or more, widowed individuals prevailed. In the three groups, functional disability occurred hierarchically. Lower schooling, frailty and depressive symptomatology were factors directly associated with functional disability in the advanced activities; frailty and sedentary behavior were directly associated with functional disability in the instrumental activities. In the older adults aged between 60 and 69 years old and from 70 to 79 years old, sedentary behavior was associated with greater dependence on the basic activities. Conclusion: the expanded understanding of the factors in the functional disability of the older adults, according to age group, helps the health professional in the development of preventive measures for this disease.
BACKGROUND: The scientific literature has shown that an association between polypharmacy and frailty exists. However, few studies have also considered drug interactions and the use of potentially inappropriate medications. OBJECTIVE: To evaluate the association between the use of drugs and frailty among community-dwelling older people. DESIGN AND SETTING: Cross-sectional study carried out among 580 older people in Uberaba (MG). METHODS: Data were collected at these older people's homes using instruments validated in Brazil. Descriptive, bivariate and binary logistic regression analyses were performed (P < 0.05). RESULTS: Most of these individuals were classified as pre-frail (55.7%), while 13.1% were frail. It was found that 31.7% of them presented polypharmacy, 41.7% had drug interactions and 43.8% were using potentially inappropriate medications. In the initial model, polypharmacy (odds ratio, OR = 1.91; confidence interval, CI = 1.27-2.86) and use of potentially inappropriate medications (OR = 2.45; CI = 1.68-3.57) increased the chance that these older people would be pre-frail or frail. In the final adjusted model, use of potentially inappropriate drugs remained associated with the outcome (OR = 2.26; CI = 1.43-3.57). CONCLUSION: Use of potentially inappropriate medications was the independent variable that explained the occurrence of frailty in a representative sample of community-dwelling older adults.
Objetivos: descrever as características sociodemográficas e de saúde de mulheres e homens com 75 anos ou mais de idade, no baseline e follow-up de quatro anos e verificar para mulheres e homens as mudanças nas condições de saúde. Métodos: estudo longitudinal com 109 idosos de 75 anos ou mais de idade de um município no Triângulo Mineiro. A coleta dos dados, realizada em dois momentos (2014-2018), ocorreu no domicílio com a aplicação de instrumentos validados no Brasil. Procederam-se às análises descritiva e teste t pareado (p<0,05). Os projetos foram aprovados pelo Comitê de Ética e Pesquisa com Seres Humanos. Resultados: verificaram-se, em ambos os sexos, aumento do número de morbidades e diminuição do escore total das atividades instrumentais da vida diária. Entre as mulheres observou-se, ainda, aumento do número de quedas e do escore de fragilidade. Conclusão: ao longo do seguimento houve piora nas condições de saúde dos idosos, sendo mais expressiva entre as mulheres.
Objetivos: Descrever as características sociodemográficas e de saúde dos longevos, identificar a ocorrência da redução da força de preensão manual dos longevos e verificar os fatores associados à redução da força de preensão manual dos longevos. Métodos: Estudo transversal e analítico, com abordagem quantitativa, desenvolvido com 313 idosos longevos da comunidade de uma Macrorregião de Saúde do Estado de Minas Gerais. Na coleta dos dados aplicaram-se: Miniexame do Estado Mental; Questionário estruturado elaborado pelo Grupo de Pesquisa em Saúde Coletiva; Questionário Internacional de Atividade Física; versão brasileira do Short Physical Performance Battery; Teste de força de preensão manual; Índice de massa corporal e questão referente à ocorrência de queda. Procederam-se às análises: descritiva, teste Qui-quadrado e regressão logística múltipla (p<0,05). Resultados: Houve predomínio de longevos do sexo feminino (64,2%); com 80-90 anos de idade (86,6%); 1-5 anos de estudo (53,0%); renda ≤1 salário mínimo (55,3%); viúvos (63,3%); que moravam acompanhados (75,7%); inativos fisicamente (51,4%); com desempenho físico moderado/bom (55,9%); sem ocorrência de quedas nos últimos 12 meses (68,4%); eutróficos (39,9%) e com cinco ou mais morbidades (62,9%). A maioria dos longevos (60,4%) apresentou redução da força de preensão manual que se associou à ocorrência de quedas nos últimos 12 meses (p=0,042) e à inatividade física (p<0,001). Conclusão: A redução na força de preensão manual dos idosos longevos foi relacionada à ocorrência de quedas e inatividade física, tais fatores contribuem para planejamento do cuidado gerontológico na prática clínica.
Objective: to propose a structural model of active ageing among elderly community members based on the World Health Organization’s theoretical framework and to identify the most relevant determinants of active ageing to the proposed model. Methods: a cross-sectional and analytical study conducted with 957 elderly community members. Confirmatory factor analysis and structural equation modeling were performed. Results: the final measurement model was composed of the six determinants of active ageing: behavioral (R²=0.66); personal (R²=0.74); physical environment (R²=0.70); social (R²=0.77); economic (R²=0.44); and social and health services (R²=0.95). The last one showed good quality of adjustment: χ2/gl=3.50; GFI=0.94; CFI=0.92; TLI=0.90; RMSEA=0.05. By analyzing the trajectories between determinants and active ageing, the most representative was social and health services active ageing (λ=0.97; p<0.001). Conclusion: satisfaction with access to health services and positive self-assessment of health status were the factors that most contributed to active ageing in this population.
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