Avaliação da capacidade funcional em idosos diabéticos

Avaliação da incapacidade de indivíduos com diabetes mellitus: um estudo transversal com o WHODAS 2.0

RESUMO A diabetes mellitus (DM) causa diversas limitações funcionais, que podem impactar negativamente na vida pessoal e profissional do indivíduo, acarretando mais complicações e incapacidades. O objetivo do estudo foi identificar em quais domínios do World Health Organization Disability Assessment Schedule versão 2.0 (WHODAS 2.0) os indivíduos com DM apresentam as maiores incapacidades. Para tanto, foi realizado um estudo transversal com 111 pessoas com diagnóstico da doença, independentemente do tipo. Foram aplicados um questionário sociodemográfico e o WHODAS 2.0 com 36 questões, para avaliar as dificuldades apresentadas nos últimos 30 dias. A amostra foi composta predominantemente pelo sexo feminino (60,3%) e classificada como independente na comunidade (90,1%). A maior prevalência foi de indivíduos aposentados (35,1%). O domínio mobilidade apresentou o maior comprometimento (48±23), enquanto o domínio atividades de vida apresentou o menor comprometimento (28±13). Porém, para todos os domínios, o comprometimento ficou abaixo de 50, em uma escala que varia de 0 a 100. Todos os indivíduos com DM apresentaram alguma deficiência, havendo maior comprometimento do domínio relacionado à mobilidade.

Disability assessment of individuals with diabetes mellitus: a cross-sectional study with the WHODAS 2.0

ABSTRACT Diabetes mellitus (DM) causes several functional limitations, which can negatively affect the personal and professional life of individuals. This effect can lead to more complications and disabilities. This study aimed to analyze in which domains of the World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0) individuals with diabetes mellitus have the greatest disabilities. cross-sectional study was performed with 111 individuals with diabetes mellitus, of any type. A sociodemographic questionnaire and the WHODAS 2.0 with 36 questions were applied to assess individuals’ difficulties in the last 30 days. Most individuals were women (60.3%) and classified as independent in the community (90.1%). The highest prevalence was among retired individuals (35.1%). The mobility domain presented the highest impairment (48±23) whereas the life activities domain presented the lowest impairment (28±13). However, for all domains, the impairment was below 50 on a scale ranging from zero to 100. All individuals with diabetes mellitus showed some disability, but the greatest impairment was in the mobility domain.

Prevalence of peripheral arterial disease and associated factors in people with type 2 diabetes

Abstract Introduction: The high rate of diabetes mellitus index (DM), along with the increase in cardiovascular compromise that DM favors, and the scarcity of epidemiological data regarding the prevalence of peripheral arterial disease (PAD) in this population, make it important to study risk factors associated with the development of PAD in the population with type 2 diabetes mellitus (DM2). Objective: To estimate the prevalence of PAD together with the associated factors in a sample of patients with DM2, treated in the Family Health Strategies (FHS) program, in the municipality of Pindamonhangaba, SP. Methods: Quantitative research in a cross-sectional study of 38 individuals who were diagnosed with DM2, between 40 and 77 years old, selected by convenience sampling and treated in the family health program in two different districts of the municipality. The method consisted of the evaluation of personal and anthropometric data, anamnesis and physical examination including the ankle-brachial index (ABI). Results: PAD was present in 21.1% (95%CI: 16.9 to 25.8) of the investigated population. Risk factors observed were age range of 51 to 69 years (75%), overweight (50%), systemic arterial hypertension (SAH) (100%), smoking (62.5%) and physical inactivity (87.5%). Conclusion: The prevalence of PAD was more than a fifth of those diagnosed with DM2, and the most prevalent associated risk factors were SAH, physical inactivity, smoking and overweight with and without PAD.

Conhecimento sobre o diabetes e atitude para o autocuidado de idosos na atenção primária à saúde

Resumo Objetivou-se avaliar o conhecimento sobre o diabetes, a atitude para o autocuidado e os fatores associados, por meio de estudo transversal, na linha de base de um ensaio clínico randomizado, com idosos diabéticos na atenção primária de saúde do Recife, Nordeste do Brasil. Utilizou-se o Diabetes Knowledge Scale (DKN-A) e o Diabetes Attitudes Questionnaire (ATT-19). Dos 202 idosos, 77,7% apresentaram conhecimento insuficiente sobre a doença, com destaque para a cetonúria, substituição de alimentos e desconhecimento das causas e dos cuidados com a hipoglicemia. Quanto à atitude, 85,6% tiveram ajustamento psicológico negativo em relação ao diabetes. O modelo de regressão logística mostrou que morar sozinho foi fator de proteção (OR = 0,24; IC95% 00,9-0,65; OR = 0,22; IC95% 0,07-0,71) e baixa escolaridade fator de risco (OR = 7,78; IC95% 3,36-18,01; OR = 13,05; IC95% 4,63-36,82) para conhecimento insuficiente e atitude negativa para o autocuidado, respectivamente. Os achados reforçam a necessidade de ações educativas interdisciplinares que incluam aspectos socioeconômicos, psicoemocionais e educacionais na gestão do diabetes com vistas à manutenção da autonomia e funcionalidade do idoso.

Factors associated with diabetes among the elderly receiving care at a specialized gerontology-geriatric outpatient clinic

Abstract Objective: To identify the prevalence of diabetes and its relation to associated factors in elderly persons receiving care at a specialist gerontology-geriatric outpatient service. A descriptive cross-sectional study of 301 elderly persons of both genders was performed. Method: The bivariate analysis was performed using the Pearson’s Chi-square test for Independence and Fisher's exact test, considering 5% of significance and 95% confidence. A multivariate logistic regression model was adjusted to identify factors that may influence the occurrence of diabetes. Result: There was no statistically significant association between the prevalence of diabetes and socioeconomic and demographic variables, behavioral factors and health conditions. Only the Body Mass Index variable was close to being statistically significant (p=0.059). Conclusion: The result confirms the need to develop new studies on the subject to consider the particularities and specificities of the elderly population to enable the creation of educational intervention strategies aimed at this group.

Relationship between functional fitness, medication costs and mood in elderly people

OBJECTIVE

To verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people.

METHODS

A cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index.

RESULTS

An inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01).

CONCLUSION

Elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt.