OBJECTIVE:To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS:The Short Assessment of Health Literacy for Portuguesespeaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defi ned as failure to fully understand standard medical prescriptions. RESULTS:Moderate to high correlations were found in the assessment of construct validity (Spearman's coeffi cients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coeffi cient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS:The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy. Health literacy is defi ned as the ability to perform basic reading and numerical tasks required to function in the health care environment.1 There is increasing evidence that health literacy skills are related to important health outcomes, even after adjustments for confounding factors such as education, age, and gender. Inadequate health literacy has been independently associated with lower utilization of preventive services, poor self-management of chronic conditions, low medication adherence, increased hospitalization, and higher death rates. 4 Some population groups are at greater risk for inadequate health literacy including the socioeconomically disadvantaged, immigrants, and older adults. Inadequate health literacy may disproportionately affect the health of older people, not only as a result of generation gap in education, but also because the elderly have more medical conditions, use more health care services, and are more likely to require complex therapeutic regimens. 12Because years of formal schooling alone are not a reliable indicator of health literacy and individuals with lower health literacy skills may try to hide it, it is diffi cult to recognize those patients with inadequate health literacy during routine clinical care.15 Developing RESUMO OBJETIVO: Desenvolver e validar um instrumento breve para avaliação de alfabetismo em saúde na língua portuguesa. MÉTODOS:O instrumento desenvolvido consiste de 50 itens que avaliam a capacidade do indivíduo de pronunciar e compreender termos médicos comuns. As propriedades psicométricas foram avaliadas e...

OBJECTIVE:To develop and validate a short health literacy assessment tool for Portuguese-speaking adults. METHODS:The Short Assessment of Health Literacy for Portuguesespeaking Adults is an assessment tool which consists of 50 items that assess an individual's ability to correctly pronounce and understand common medical terms. We evaluated the instrument's psychometric properties in a convenience sample of 226 Brazilian older adults. Construct validity was assessed by correlating the tool scores with years of schooling, self-reported literacy, and global cognitive functioning. Discrimination validity was assessed by testing the tool's accuracy in detecting inadequate health literacy, defi ned as failure to fully understand standard medical prescriptions. RESULTS:Moderate to high correlations were found in the assessment of construct validity (Spearman's coeffi cients ranging from 0.63 to 0.76). The instrument showed adequate internal consistency (Cronbach's alpha=0.93) and adequate test-retest reliability (intraclass correlation coeffi cient=0.95). The area under the receiver operating characteristic curve for detection of inadequate health literacy was 0.82. A version consisting of 18 items was tested and showed similar psychometric properties. CONCLUSIONS:The instrument developed showed good validity and reliability in a sample of Brazilian older adults. It can be used in research and clinical settings for screening inadequate health literacy. Health literacy is defi ned as the ability to perform basic reading and numerical tasks required to function in the health care environment.1 There is increasing evidence that health literacy skills are related to important health outcomes, even after adjustments for confounding factors such as education, age, and gender. Inadequate health literacy has been independently associated with lower utilization of preventive services, poor self-management of chronic conditions, low medication adherence, increased hospitalization, and higher death rates. 4 Some population groups are at greater risk for inadequate health literacy including the socioeconomically disadvantaged, immigrants, and older adults. Inadequate health literacy may disproportionately affect the health of older people, not only as a result of generation gap in education, but also because the elderly have more medical conditions, use more health care services, and are more likely to require complex therapeutic regimens. 12Because years of formal schooling alone are not a reliable indicator of health literacy and individuals with lower health literacy skills may try to hide it, it is diffi cult to recognize those patients with inadequate health literacy during routine clinical care.15 Developing RESUMO OBJETIVO: Desenvolver e validar um instrumento breve para avaliação de alfabetismo em saúde na língua portuguesa. MÉTODOS:O instrumento desenvolvido consiste de 50 itens que avaliam a capacidade do indivíduo de pronunciar e compreender termos médicos comuns. As propriedades psicométricas foram avaliadas e...

The estimated worldwide prevalence of dementia among adults older than 60 years of age was 3.9% in 2005. About 90% of demented patients will develop neuropsychiatric symptoms (NS) such as delirium, delusion, aggressiveness and agitation. The treatment of NS involves non-pharmacologic strategies (with varying degrees of success according to the scientific literature) and pharmacologic treatment (PT). The present review of literature examined the current role of AP in the management of NS in dementia.MethodsA thematic review of medical literature was carried out.Results313 articles were found, 39 of which were selected for critical analysis. Until 2005, the best evidence for PT had supported the use of selective serotonin re-uptake inhibitors (SSRIs), anticholinesterases, memantine and antipsychotics (AP). In 2005, the U.S. Food and Drug Administration (FDA) disapproved the use of atypical APs to treat neuropsychiatric symptoms in individuals with dementia (the same occurred with the typical APs in 2008). After this, at least two important randomized placebo-controlled multicenter trials were published examining the effectiveness of atypical APs in Alzheimer’s disease (CATIE-AD) and the effects of interrupting AP treatment (DART-AD).ConclusionsBased on the current evidence available, APs still have a place in treatment of the more serious psychotic symptoms, after the failure of non-pharmacological treatment and of an initial approach with selective inhibitors of serotonin uptake, anticholinesterases and memantine.