Abstract:OBJECTIVE:To analyze the predictive ability of a functional cognitive index of mortality in the elderly.
METHODS:Cohort study performed with 1,667 elderly individuals aged more than 65 years and living in the city of São Paulo, Southeastern Brazil, between 1991 and 2001. Functional cognitive index was constructed from time orientation and executive functions (going shopping and taking medication), controlled by sociodemographic variables, life habits, morbidity, selfperception of health, hospitalization, edent… Show more
“…These highly complex functions include from walking to advanced cognitive processes, like executive functions and divided attention. Youths and elderly individuals can be seen as complex systems, but many functions are approaching failure in the elderly; 24 thus, small stressors present greater clinical meaning.…”
Section: Discussionmentioning
confidence: 99%
“…These are called executive functions and are lost in early. 13,24 The elderly who present diffi culties in these functions cease to accomplish them progressively because their relatives are concerned about the mistakes they make and assume their responsibilities, which aggravates the dependence condition. Executive functions are a fundamental aspect of cognition because they can compensate for functional loss and both together are strong predictors of mortality.…”
OBJECTIVE:To identify risk factors for functional capacity loss in elderly people.
METHODS:Epidoso (Epidemiology of the Elderly) cohort study with elderly people living in São Paulo (Southeastern Brazil). A total of 326 participants in the fi rst interview (1991)(1992) who were independent or had mild dependence (one or two activities of daily living) were selected. Those who presented functional loss in the second (1994)(1995) or third interviews (1998)(1999) were compared to those who did not present it. The incidence of functional loss was calculated according to sociodemographic variables, life habits, cognitive status, morbidity, hospitalization, self-rated health, tooth loss, social support and leisure activities. Crude and adjusted relative risks with 95% confi dence intervals were estimated through bivariate and multiple analyses with Poisson regression. The criterion for the inclusion of the variables in the model was p < 0.20 and for exclusion, p > 0.10.
RESULTS:The incidence of functional loss was 17.8% (13.6; 21.9). The risk factors in the fi nal model were: age group 70-74 years RR=1.9 (0.9;3.9); age group 75-79 years RR=2.8 (1.4;5.5); age group 80 years or older RR=5.4 (3.0;9.6); score in the mini-mental state examination <24 RR=1.8 (1.1;2.9); asthma RR=2.3 (1.3;3.9); hypertension RR=1.7 (1.1;2.6); and diabetes RR=1.7 (0.9;3.0). The protective factors were: paid work RR=0.3 (0.1;1.0); monthly relationship with friends RR=0.5 (0.3;0.8); watching TV RR=0.5 (0.3;0.9); and handcrafting RR=0.7 (0.4;1.0).
CONCLUSIONS:The prevention of functional loss should include adequate control of chronic diseases, like hypertension, asthma and diabetes, as well as cognitive stimulation. Work, leisure and relationships with friends should be valued due to their protective effect.
“…These highly complex functions include from walking to advanced cognitive processes, like executive functions and divided attention. Youths and elderly individuals can be seen as complex systems, but many functions are approaching failure in the elderly; 24 thus, small stressors present greater clinical meaning.…”
Section: Discussionmentioning
confidence: 99%
“…These are called executive functions and are lost in early. 13,24 The elderly who present diffi culties in these functions cease to accomplish them progressively because their relatives are concerned about the mistakes they make and assume their responsibilities, which aggravates the dependence condition. Executive functions are a fundamental aspect of cognition because they can compensate for functional loss and both together are strong predictors of mortality.…”
OBJECTIVE:To identify risk factors for functional capacity loss in elderly people.
METHODS:Epidoso (Epidemiology of the Elderly) cohort study with elderly people living in São Paulo (Southeastern Brazil). A total of 326 participants in the fi rst interview (1991)(1992) who were independent or had mild dependence (one or two activities of daily living) were selected. Those who presented functional loss in the second (1994)(1995) or third interviews (1998)(1999) were compared to those who did not present it. The incidence of functional loss was calculated according to sociodemographic variables, life habits, cognitive status, morbidity, hospitalization, self-rated health, tooth loss, social support and leisure activities. Crude and adjusted relative risks with 95% confi dence intervals were estimated through bivariate and multiple analyses with Poisson regression. The criterion for the inclusion of the variables in the model was p < 0.20 and for exclusion, p > 0.10.
RESULTS:The incidence of functional loss was 17.8% (13.6; 21.9). The risk factors in the fi nal model were: age group 70-74 years RR=1.9 (0.9;3.9); age group 75-79 years RR=2.8 (1.4;5.5); age group 80 years or older RR=5.4 (3.0;9.6); score in the mini-mental state examination <24 RR=1.8 (1.1;2.9); asthma RR=2.3 (1.3;3.9); hypertension RR=1.7 (1.1;2.6); and diabetes RR=1.7 (0.9;3.0). The protective factors were: paid work RR=0.3 (0.1;1.0); monthly relationship with friends RR=0.5 (0.3;0.8); watching TV RR=0.5 (0.3;0.9); and handcrafting RR=0.7 (0.4;1.0).
CONCLUSIONS:The prevention of functional loss should include adequate control of chronic diseases, like hypertension, asthma and diabetes, as well as cognitive stimulation. Work, leisure and relationships with friends should be valued due to their protective effect.
“…9 In Brazil, a cohort study containing 1667 individuals aged 65 years or more in the municipality of São Paulo-SP (1991 to 2001) reported a significant association between self-assessment of health status and mortality: elderly individuals who assessed their health as good, poor or very poor exhibited a higher death risk than those who assessed their health as excellent. 18 Studies that analyze the determinant factors of self-assessments of health are important, given that interventions related to these factors modify the self-assessment of health and consequently, reduce mortality. 9 A recent systematic review of literature related to self-assessments of health status in the elderly Brazilian population found very few Brazilian publications on this subject.…”
Objective: To determine the association between negative self-assessment of health status and sociodemographic variables and health indicators in elderly persons registered with the Family Health Strategy of Campina Grande, Paraíba. Methodolog y: A cross-sectional study with home-based primary data collection was carried out among elderly persons of both genders. The variables studied were: self-assessment of health, socioeconomic and demographic factors, number of referred chronic diseases and degree of dependence in basic activities of daily living. Possible factors associated with self-assessment of health were verified through multivariate logistic regression. Results: We evaluated 420 elderly persons (68.1% of whom were women) with an average age of 71.57 years. There was a positive association between negative self-assessment of health status and elderly persons with two or three chronic diseases (OR=2.70; CI95%:1.47-4.96), four or more chronic diseases (OR=4.35; CI95%:1,58-12.01), a mild degree of dependence (OR=2.34; CI95%:1.13-4.87), moderate dependence (OR=2.11; CI95%:1.07-4.17) and those who were married (OR=2.46; CI95%:1.01-6.01). Conclusion: The results show that the negative selfassessment of health status was associated with the number of referred chronic diseases and degree of dependence in basic activities of daily living. There was also a tendency towards association with married elderly persons. The results suggest the need for actions aimed at the prevention and diagnosis of chronic diseases, as well as the promotion and maintenance of functional capacity and disability prevention or treatment.
“…O percentual de mortalidade verificado neste estudo foi menor que o registrado em outros trabalhos realizados no Brasil (MACIEL; GUERRA, 2008;XAVIER et al, 2010). Vale ressaltar que esses dados da literatura referem-se a idosos residentes na comunidade, já que não foram encontrados dados relativos a óbito em estudos sobre idosos assistidos em serviços de saúde.…”
Section: Variáveisunclassified
“…Há que se destacar, ainda, que a dificuldade para memória recente foi maior para os idosos distribuídos nos dois perfis, quando comparada à dificuldade para memória antiga, o que pode associar-se a uma hierarquia de perdas. De fato, com o processo de envelhecimento, verifica-se maior comprometimento da atenção (registro de informações) e do resgate das informações previamente estocadas (memória de evocação), tarefas dependentes da memória recente, como também na consolidação de informações imediatas (memória episódica recente) (XAVIER et al, 2010).…”
Resumo: Buscou-se avaliar o perfil funcional de idosos atendidos em nível ambulatorial (Ambulatório de Geriatria
Functionality profiles related to mortality in elders assisted in a Geriatric Outpatient ServiceAbstract: This study intended to evaluate the functional profile of the elderly in the Geriatric Outpatient Clinic of the Hospital of the State University of Campinas, correlating it with the occurrence of death. We evaluated 120 elderly outpatients (≥60 years), considering sociodemographic data, cognition by the Mini-Mental State Examination, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), self-assessment of memory, depressive symptoms, number of medical consultations, and probability of death within one year. Cluster analysis, chi-square or Fisher's exact test, and Mann-Whitney test were used as statistical analysis to compare the variables between the groups (p < 0.05). The mean age was 76.81 (±7.56) years; 66.7% were women; 63.33% were independent for ADL and 68.33% were dependent for IADL; 31.67% presented depressive symptoms; 30% presented cognitive impairment; 56.67% reported difficulty of remembering recent events; 83.33% had no difficulty remembering ancient events; 6.67% died within one year. It was possible to observe a profile consisting predominantly of younger elders, more educated, with more difficulty of remembering recent and ancient events, worse self-rated memory, and who died in greater proportion. The second profile consisted predominantly of older subjects, with higher percentage
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