[Falls and health-related quality of life: influence of frequency and location type of falls]

This article aims to evaluate health-related quality of life (HRQOL) according to the frequency and characteristics of falls in the elderly. A cross-sectional study was carried out with data from a household health survey conducted in 2014 and 2015, in Campinas, SP. The dependent variables were the SF-36 domains and, the independent ones, the occurrence and the characteristics of the falls. The mean and mean differences of the SF-36 scores were estimated by simple and multiple linear regression. The study reveals that the impact on HRQOL depends significantly on the characteristics of falls. Larger declines and a greater number of SF-36 domains were observed in the elderly who suffered three or more falls (compared to those with one or two falls), reporting falls from fainting/dizziness (compared to falls due to tripping), those who fell at home (versus falls occurring elsewhere) and reported falling limitation in daily activities. Only in the falls with these characteristics did the domain of emotional aspects be affected. The impact on HRQoL, including emotional aspects, depends on the characteristics of the falls that need to be considered in prevention actions and in the control of the consequences of falls in the quality of life of the elderly.

Social inequalities in the impact of falls on health-related quality of life among older adults

The aim of the present study was to determine the association between falls and health-related quality of life (HRQoL) among older adults considering different demographic and socioeconomic characteristics. This study was developed with data from the Household Health Survey conducted in the city of Campinas, Brazil, in 2014 and 2015. HRQoL was investigated using the eight domains and two components of the SF-36 questionnaire. Simple and multiple linear regression analyses were performed with the aid of the Stata 15.0 program to determine the association between falls and HRQoL according to sex, age, income and schooling. Significant declines in the scores of the physical functioning, role physical and bodily pain domains as well as the physical component were found among women (not men) and individuals with a lower income. Among individuals aged 75 years or older and those with less schooling, declines occurred in these same domains as well as in the role emotional and mental health domains. The results reveal that the impact of falls on HRQoL differs depending on the socioeconomic and demographic characteristics of older adults, indicating that specific care strategies should target more vulnerable subgroups, with attention given to emotional aspects.

Prevalence of self-reported morbidities and associated factors among community-dwelling elderly in Uberaba, Minas Gerais, Brazil

This study aimed to verify the prevalence and socioeconomic and health factors associated with morbidity among community-dwelling elderly. This is an analytical and cross-sectional survey conducted in 2012 with 1,691 elderly from Uberaba-MG. A tool structured for socioeconomic data and self-reported morbidities was used along with the Abbreviated Geriatric Depression, Katz and Lawton-Brody scales. We proceeded to a descriptive analysis and linear regression (p < 0.05). A high percentage (88.3%) of elderly reported two or more morbidities, with higher prevalence for systemic arterial hypertension (61.9%) and back problems (48.6%). Female gender (β = 0.216; p< 0.001), functional disability in basic (β = 0.240; p < 0.001) and instrumental activities of daily living (β = 0.120; p < 0.001) and indicative of depression (β = 0.209; p < 0.001) were associated with the highest number of morbidities. The presence of two or more comorbidities and the association with socioeconomic and health variables show the need for monitoring and control actions of the factors that interfere in the elderly in this condition.

Association of socioeconomic and clinical variables with the state of frailty among older inpatients

Objectives:

to identify the prevalence of frailty among inpatient older adults in a clinical hospital and check the association of the socioeconomic and clinical characteristics with the state of frailty.

Method:

observational, cross-sectional and analytical study, conducted with 255 hospitalized patients. Materials used: structured instrument for the economical and clinical data and frailty phenotype of Fried. Descriptive and bivariate statistical analysis was carried out and, by means of chi-square tests and ANOVA One-way (p<0.05).

Results:

the prevalence of frailty corresponded to 26.3%, while pre-frailty represented 53.3%. The highest proportion of frail seniors was identified for 80 years or older (p = 0.004), widowed (p = 0.035) and with the highest average length of stay (p = 0.006).

Conclusion:

inpatient older adults presented high percentages of frail states associated with socioeconomic variables and hospitalization period. The identification of the health conditions related to pre-frailty and frailty can foster the planning and implementation of the assistance to older adults in this context.

Quality of life and self-esteem among the elderly in the community

This study sought to investigate the association between the scores for quality of life (QoL) and self-esteem among the elderly in an urban community. A cross-sectional, quantitative and analytical household survey was conducted with 1,691 elderly persons resident in an urban area in a county in Minas Gerais state. The World Health Organization Quality of Life BREF (WHOQOL-BREF), the World Health Organization Quality of Life OLD (WHOQOL-OLD) questionnaires and the Rosenberg Self-Esteem Scale were used in this study. A descriptive statistical analysis and a linear regression model (p < 0.05) were conducted. The results revealed that the social relationships domain (71.19) and the topic of death and dying (74.30) had the highest mean scores among the elderly; while the lowest mean scores were the environment domain (60.39) and the topic of social participation (63.06). The self-esteem scores showed an average of 9.36 ± 4.09. Associations were evident for the lower scores of quality of life in all the WHOQOL-BREF domains and WHOQOL-OLD aspects (except death and dying) with lower levels of self-esteem (p <0.001). The results provide data that contribute to a better understanding of the aspects that influence the QoL of the elderly due to reduced self-esteem, thus providing information for the development of health strategies.

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil

BACKGROUND

The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome.

DESIGN AND SETTING

Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil.

METHODS

The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation.

RESULTS

The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals.

CONCLUSIONS

The condition of frailty was associated with greater chances of violence against the elderly.

Incapacidade funcional e fatores associados em idosos de área urbana: um estudo de base populacional

DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n5p499 Population aging may cause impaired functional abilities in the elderly population, with increased rates of functional disability. Early detection of functional disability makes it possible to postpone possible complications and helps with health action planning. The objective of this study was to investigate the factors associated with functional disability in urban elderly. We conducted an analytical and cross-sectional household survey with 1,691 urban elderly individuals in Uberaba (MG), Brazil, in 2012. The questionnaire included socioeconomic and clinical information. We used the following instruments to assessed the participants: Abbreviated Geriatric Depression Scale, Katz Index, and Lawton and Brody Scale. We performed a descriptive bivariate analysis and used a logistic regression model (p<0.05). The prevalence of functional disability in basic activities of daily living was 21.2%; whereas the prevalence of functional disability in instrumental activities of daily living was 65.9%. The following factors were associated with functional disability in basic and instrumental activities of daily living, respectively: age of 80 years old and older [(OR= 2.18; p<0.001), (OR=3.30, p<0.001)]; larger number of self-reported diseases [(OR=1.24, p<0.001), (OR=1.12; p<0.001)]; and symptoms of depression [(OR=1.49; p<0.003), (OR = 1.75, p<0.001)]; whereas no schooling (OR=1.88; p<0.001) was related to functional disability in instrumental activities of daily living. We found significant impairment of functional status, especially in instrumental activities of daily living and in association with socioeconomic and health variables; those aspects support the implementation of actions aimed at monitoring and controlling the factors that interfere with the functional ability of the elderly.

Violência física e psicológica contra idosos: prevalência e fatores associados

RESUMO Objetivo: verificar a prevalência e os fatores associados à violência física e psicológica contra idosos e traçar o perfil sociodemográfico e dos indicadores clínicos dessa população. Método: inquérito domiciliar conduzido com 729 idosos de Uberaba - MG. Os dados foram analisados pelo teste Qui-quadrado e regressão logística (p < 0,05). Resultados: a prevalência de idosos sob violência foi de 20,9%, sendo 5,9% para física e 20,9% para psicológica. Entre eles, prevaleceram mulheres, com idade entre 60├80anos, sem escolaridade, com renda, tendo como principal agressor o cônjuge; com autopercepção negativa de saúde; hospitalização no último ano; e presença de multimorbidades. A violência associou-se a ter 60├80 anos, morar com o cônjuge e dependência para atividades instrumentais de vida diária. Conclusão: reforça-se a necessidade de identificar precocemente a violência doméstica e investir em ações de proteção da idosa, na manutenção da capacidade funcional e inserção social.

Socio-demographic characteristics and quality of life of elderly patients with systemic arterial hypertension who live in rural areas: the importance of nurses' role

OBJECTIVE

To describe the socio-demographic characteristics and quality of life of elderly patients with systemic arterial hypertension; to correlate the quality of life with the time of diagnosis and number of medication, as well as to compare the quality of life with the type of medication.

METHOD

In this cross sectional home survey design, 460 elderly people from rural areas were involved. The data was collected with the use of the following instruments: World Health Organization Quality of Life-bref and World Health Organization Quality of Life Olders. A descriptive analysis, Pearson correlation and t-Student test (p<0.05) were undertaken.

RESULTS

Predominant patient characteristics were: women between the age of 60 and 70, married, four to eight years of formal education, income of one minimum wage, living with their partners. The time of diagnosis was associated with lower quality of life in the physical domain. Elderly patients who used Inhibitors and Angiotensin Converting Enzyme and who did not use AT1 blocker had lower scores in relation to functioning of the senses. Those who used calcium channel blocker scored higher in relation to autonomy.

CONCLUSION

there is a need for actions to control systemic arterial hypertension and its associated complications, with the purpose of improving quality of life.