Objective: To determine the accuracy of the Timed Up and Go Test (TUGT) for screening the risk of falls among community-dwelling elderly individuals. Method: This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson´s disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) was determined through the Older American Resources and Services, and the sociodemographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT. Results: Elderly individuals who fell had greater difficulties in ADL and IADL (p<0.01) and a slower performance on the TUGT (p=0.02). No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers. Considering the different sensitivity and specificity, the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [(RR=3.2) 95%CI: 1.3-7.7]. Conclusions: The TUGT proved to be an accurate measure for screening the risk of falls among elderly individuals. Although different from that reported in the international literature, the 12.47 second cutoff point seems to be a better predictive value for Brazilian elderly individuals.Keywords: elderly; falls; TUGT; sensitivity; specificity; physical therapy. ResumoObjetivo: Determinar a acurácia do Timed Up and Go Test (TUGT) para rastrear risco de quedas em idosos da comunidade. Método: Tratase de um estudo de coorte prospectivo com amostra sorteada aleatoriamente, sem reposição e estratificada por partilha proporcional em relação ao sexo de 63 idosos da comunidade. Excluíram-se idosos com doença de Parkinson, ataque isquêmico transitório, acidente vascular encefálico, Miniexame do Estado Mental inferior ao considerado normal de acordo com a escolaridade, movimentação exclusiva por cadeira de rodas e relato de uma queda nos seis meses anteriores à primeira entrevista. O TUGT, um teste de mobilidade, foi a medida testada, e o desfecho, a ocorrência de queda. Mensuraram-se atividades básicas (ABVD) e instrumentais de vida diária (AIVD) pela Older American Resources and Services e dados sociodemográficos e clínicos por questionário complementar. Para analisar a sensibilidade e a especificidade do TUGT, utilizou-se a Receiver Operating Characteristic Curves (ROC). Resultados: Os idosos que caíram tinham maior dificuldade na execução de ABVD e AIVD (p<0,01) e desempenho mais lento no TUG...

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OBJECTIVE:To analyze whether quality of life in active, healthy elderly individuals is influenced by functional status and sociodemographic characteristics, as well as psychological parameters.

OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults.METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome.RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women.CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke, disables elderly men more, whereas early deficits regarding balance disable women more.

The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.

ABSTRACT. Limited formal education is still common in ageing populations. Although limited formal education seems to be independently and negatively associated with cognition, functional abilities and frailty in ageing, no studies have examined whether the gradient of limited formal education has an impact on health in later life. Objective: to examine the relationship of limited formal education with cognitive status, functional abilities, and frailty status. Methods: a cross-sectional study was conducted involving 540 older adults stratified into groups: no formal education, 12-24 months of education, and 25-48 months of education. Cognitive screening (MMSE), functional abilities (Lawton Index), and frailty (CHS criteria) were measured. Regression analyses were performed. Results: 27% had no formal education, 21% had 12-24 months of formal education, and 55% had 25-48 months of formal education. Limited formal education has a clear gradient of negative impact: No formal education was associated with scoring below MMSE cut-off scores (OR = 7.9), being totally/partially dependent for IADLs (OR = 2.5) and frail (OR = 2.0). Having 12-24 months of education was associated with scoring below MMSE cut-off scores (OR = 5.2) and with being frail (OR = 2.0). The No formal education group was 10.1 times more likely to have worse cognitive scores, worse functional abilities and frailty/pre-frailty status concomitantly (CCoFF), while older adults who had 12-24 months of education had a 4.6 times greater chance of having CCoFF. Conclusion: limited education had a gradient association with cognitive performance, functional disability and frailty. These findings clearly emphasize the importance of prevention through education from childhood to older age.

Background The Short Physical Performance Battery (SPPB) is widely used to predict negative health-related outcomes in older adults. However, the cutoff point for the detection of the frailty syndrome is not yet conclusive. Objective The aim of this study was to determine the diagnostic value of the SPPB for detecting frailty in community-dwelling older adults. Design This was a population-based cross-sectional study focusing on households in urban areas. A total of 744 people who were 65 years old or older participated in this study. Methods Frailty was determined by the presence of 3 or more of the following components: unintentional weight loss, self-reported fatigue, weakness, low level of physical activity, and slowness. Diagnostic accuracy measures of the SPPB cutoff points were calculated for the identification of frailty (individuals who were frail) and the frailty process (individuals who were considered to be prefrail and frail). Receiver operating characteristic curves were constructed. Odds ratios for frailty and the frailty process and respective CIs were calculated on the basis of the best cutoff points. A bootstrap analysis was conducted to confirm the internal validity of the findings. Results The best cutoff point for the determination of frailty was ≤8 points (sensitivity = 79.7%; specificity = 73.8%; Youden J statistic = 0.58; positive likelihood ratio = 3.05; area under the curve = 0.85). The best cutoff point for the determination of the frailty process was ≤10 points (sensitivity = 75.5%; specificity = 52.8%; Youden J statistic = 0.28; positive likelihood ratio = 1.59; area under the curve = 0.76). The adjusted odds of being frail and being in the frailty process were 7.44 (95% CI = 3.90–14.19) and 2.33 (95% CI = 1.65–3.30), respectively. Limitations The external validation using separate data was not performed and the cross-sectional design does not allow SPPB predictive capacity to be established. Conclusions The SPPB might be used as a screening tool to detect frailty syndrome in community-dwelling older adults, but the cutoff points should be tested in another sample as a further validation step.

The EWGSOP definition of sarcopenia and dynapenia can help to determine risk for mortality and can be used as a screening instrument in public health.