Functional capacity of elderly patients with HIV/AIDS: an epidemiological study

Objetivo: avaliar a capacidade funcional dos portadores de HIV/AIDS na faixa etária de 60 anos ou mais da cidade de Santos/SP. Método: descritivo, transversal e quantitativo, desenvolvido por inquérito epidemiológico observacional. Para avaliar a capacidade funcional foram aplicados os domínios da saúde mental e das atividades de vida diária do Brazilian OARS (Orlder Americans Resources and Services) Multidimensional Functional Assessment Questionnaire, e o miniexame do estado mental que avalia cognição. A população estudada ficou representada por 142 idosos. Resultados: 56,30% do sexo masculino e 43,70% do feminino, 74,76% de 60 a 69 anos de idade e a média de idade na data do diagnóstico foi de 56 anos. 82,39% tinham AIDS e 17,60%, HIV. 71,70% contaminados em relações heterossexuais com múltiplos parceiros, a maioria de viúvos, solteiros ou separados, 33,10% com oito anos de estudo e 35,20% com mais de nove anos, 65,40% aposentados, 77,40% com renda fixa. 28,90% tiveram tuberculose, seguida de hepatite B, pneumonia, hepatite C, sífilis e gonorreia. 85,80% nunca abandonaram a terapia antirretroviral e quase a metade iniciou o tratamento há mais de 15 anos. O aumento de T CD4+ e T CD8+ em relação ao ano do diagnóstico foi significativo. 52,50% eram hipertensos e 23,40% depressivos. No índice de massa corpórea, 57% eram eutróficos. Referiram ter boa saúde 65,70% e 45,30% disseram que a saúde deles era igual à saúde de outras pessoas da mesma idade. 71,83% não apresentaram déficit cognitivo, 75,88% não mostraram screening positivo de saúde mental, tipo distimia, e 61,26% não tinham nenhuma dificuldade para executar as 15 atividades de vida diária; 16,90% tinham pouca dificuldade entre uma a três atividades, 9,15% tinham muita dificuldade para executar de quatro a seis atividades e 12,67% não realizavam sete ou mais atividades. Conclusões: a maioria era de viúvos, solteiros ou separados, vivendo em domicílio unipessoal e com boa escolaridade. O comportamento sexual foi o principal fator de risco na contaminação pelo HIV e a idade mostrou que eles tinham mais de 50 anos no ano do diagnóstico. Quase a metade dos idosos estava em tratamento há mais de 15 anos, e o aumento de linfócitos T CD4+ e T CD8+ foi significativo. Os dados indicativos da funcionalidade desses idosos portadores de HIV/AIDS se mostraram semelhantes à avaliação da cognição, da saúde mental e da independência para atividades de vida diárias dos idosos representativos da população em geralObjective: estimate the functional capacity of HIV/AIDS patients aged 60+ years old in Santos/SP. Method: Descriptive, transversal, and quantitative, developed by observational epidemiological investigation. To evaluate the functional capacity were applied the mental health dominions and the daily living activities from the Brazilian OARS Multidimensional Functional Assessment Questionnaire, and the mental state mini examination which estimates cognition. The studied population was represented by 142 elderly patients. Results: 56,30% male and 43,70% female patients, 74,76% of whom between 60 and 69 years old and the median age at the time of diagnosis was 56 years old. 82,39% had developed AIDS and 17,6%, HIV+. 71,70% became infected in heterosexual relationships with multiple partners, and most patients were widowers, unmarried or separated, 33,10% with eight years of schooling and 35,20% with more than nine years, 65,40% were retired, 77,40% had fixed income. 28,90% had developed tuberculosis, followed by pneumonia, hepatitis B, hepatitis C, syphilis and gonorrhea. 86% had never abandoned antirretroviral therapy and nearly half had started the treatment more than 15 years ago. The increase in TCD4+ and TCD8+ in relation to the year of diagnosis was significant. 52.5% had high blood pressure while 23.4% suffered from depression. Based on their body mass index, 57% were eutrophic. 66% reported to be in good health and 45% said that their health was similar to the health of other people at same age. 71.83% did not show any cognitive deficit, 75.88% did not show positive mental health screening, like dysthymia, and 61.26% had no difficulty to perform the 15 activities of daily living; 16.90% had little difficulty between one to three activities, 9.15% had a lot of difficulty to perform four to six activities and 12.67% didn’t perform seven or more activities. Conclusions: most patients were widowers, unmarried or separated, living in a single family residence and had good education. Sexual behavior was the main risk factor in HIV contamination risk and the age showed that they were over 50 years old in the year of diagnosis. Nearly half of the elderly patients had been undergoing treatment for more than 15 years, and the increase of TCD4 and TCD8 lymphocytes was significant. The indicative data of functionality of these elderly patients carrying HIV/AIDS were similar to the cognition estimate, the mental health and the independence for daily living activities of elderly people representative of the population in genera

Fatores de risco para doença arterial coronariana em jovens: revisão integrativa da literatura brasileira

A doena arterial coronariana se caracteriza pelo estreitamento das artrias coronrias em decorrncia da formao e acmulo de placas de ateroma, embora as manifestaes clnicas venham a ser mais prevalentes entre a populao adulta o processo aterosclertico comea a se desenvolver na infncia. O objetivo deste trabalho foi identificar os fatores de risco para doena arterial coronariana em jovens. Trata-se de uma metodologia descritiva e exploratria de carter quantitativo baseado na reviso integrativa da literatura brasileira. O levantamento bibliogrfico foi realizado em todas as bases de dados indexadas na Biblioteca Virtual em Sade e foi utilizado a combinao das palavras chaves fatores de risco, doena coronariana e jovem. Os resultados mostraram 15 trabalhos que atendiam aos critrios de incluso. Foram determinadas duas categorias para os fatores de risco, na categoria fator de risco no modificvel foi identificado apenas histria familiar e na categoria fator de risco modificvel foram identificados a dislipidemia, obesidade, hipertenso arterial, sedentarismo, tabagismo, padro alimentar, diabetes mellitus, contraceptivo oral, estresse e valores elevados de protena C reativa. Consideramos ainda que polticas pblicas de sade precisam ser implementadas voltadas diretamente para jovens com intuito de reduzir os riscos de complicaes cardiovasculares em adultos

EXPERT SYSTEM MODELING FOR THE MULTIDIMENSIONAL EVALUATION OF AGED PEOPLE

Objective: to describe the modeling of an Expert System for the Multidimensional Evaluation of aged people.Method: the study was carried out from April 2021 to September 2022 by researchers from universities in the inland of Minas Gerais - Brazil. The following stages were conducted: literature review; survey of the System requirements; modeling; and implementation.Results: the System makes it possible to assess the physical, psychosocial and functional aspects; it identifies the geriatric-gerontological needs and classifies them according to severity levels, in addition to offering suggestions for therapeutic interventions. The diverse information generated can be shared through instant messengers via apps, providing the basis for the development of a monitoring panel for aged people assisted in the municipality.Conclusion: the System presents itself as a technological solution given the importance of the multidimensional evaluation of aged people within the scope of care for this population segment and the lack of technological solutions to carry out the assessment

MODELAGEM DE SISTEMA ESPECIALISTA PARA AVALIAÇÃO MULTIDIMENSIONAL DE PESSOAS IDOSAS

Objetivo: descrever a modelagem de um Sistema Especialista para Avaliação Multidimensional de pessoas idosas.Método: realizado no período de abril de 2021 a setembro de 2022, sendo conduzido por pesquisadores de universidades do interior de Minas Gerais - Brasil. Percorreu-se pelas etapas: revisão de literatura, levantamento dos requisitos para o Sistema, modelagem e implementação.Resultados: o Sistema possibilita avaliação dos aspectos físico, psicossocial e funcional, identifica as necessidades geriátrico-gerontológicas e as classifica de acordo com níveis de gravidade, além de oferecer sugestões de intervenções terapêuticas. As informações geradas podem ser compartilhadas por meio de mensageiros instantâneos através de aplicativos, dando base para o desenvolvimento de um painel de monitoramento das pessoas idosas assistidas no município.Conclusão: o Sistema se apresenta como uma solução tecnológica dada a importância da avaliação multidimensional da pessoa idosa no âmbito do cuidado a essa população e a carência de soluções tecnológicas para realizar a avaliação

DISEÑO DE UN SISTEMA EXPERTO PARA LA EVALUACIÓN MULTIDIMENSIONAL DEL ADULTO MAYOR

Objetivo: describir el diseño de un Sistema Experto para la Evaluación Multidimensional del adulto mayor.Método: estudio realizado, de abril de 2021 a septiembre de 2022, por investigadores de universidades del interior de Minas Gerais, Brasil. Pasó por los pasos: revisión de la literatura, relevamiento de los requisitos del Sistema, diseño e implementación.Resultados: el Sistema permite evaluar aspectos físicos, psicosociales y funcionales, identifica necesidades geriátrico-gerontológicas y las clasifica según el nivel de gravedad, además ofrece sugerencias de intervenciones terapéuticas. La información generada podrá ser compartida a través de mensajería instantánea mediante aplicaciones, y sentará las bases para el desarrollo de un panel de seguimiento de los adultos mayores atendidos en el municipio.Conclusión: el Sistema es una solución tecnológica dada la importancia que tiene la evaluación multidimensional del adulto mayor en el ámbito de la atención de esta población y la falta de soluciones tecnológicas para realizar la evaluación

COVID-19 infodemic and impacts on the mental health of older people : cross-sectional multicenter survey study

Background: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary “infodemic” that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people’s reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. Objective: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). Methods: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. Results: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that “some” social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. Conclusions: Older people, especially women, were often exposed to COVID-19–related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care

IMPACT OF THE COVID-19 INFODEMIA ON THE MENTAL HEALTH OF THE ELDERLY: A SCOPE REVIEW.

Objective: to track scientific evidence on the repercussions of the COVID-19 infodemic on the mental health of the elderly. Method: this is a scope review, developed using the Joanna Briggs Institute (JBI) methodology, which included 5 articles. These articles were analyzed considering sex, age, education, time of exposure to news and information about COVID-19, main media used, signs and symptoms related to mental health and knowledge gaps. Results: 110 studies were found, after systematic reading of the titles and abstracts of the articles, 12 were selected because they met the established inclusion criteria. Among those selected, three were excluded because they were published in more than one database and four because they did not cover the theme in its entirety. The remaining five studies were analyzed and included in the survey, totaling the final sample. Conclusion: high stress was positively associated with generalized anxiety and depression, for this reason, there is an urgent need for educational resilience programs (online, if they cannot be carried out in person), aimed at susceptible individuals, to enable tools in the development of skills in coping with the stress and psychological impact of the COVID-19 pandemic. Strategies to boost access and digital literacy of the elderly population, enabling search, selection, analysis and decision-making skills, as well as the creation of media programs aimed at this age group, with the purpose of ceasing/reducing the dissemination of disinformation and that allows checking information in a simple and practical way

Diagnóstico tardio do Vírus da Imunodeficiência Humana e da Síndrome da Imunodeficiência Adquirida em Idosos

Elderly people, late diagnosed, have a higher risk of developing AIDS. With a CD4 count of less than 200 cells/ml3, they are on average more likely to die in the first year after diagnosis.&nbsp; In this sense, the objective of this scoping review is to map evidence related to the associated and risk factors of late diagnosis of HIV/AIDS in elderly people, but specifically, this review aims to answer the following questions: What are the associated factors of late diagnosis of HIV/AIDS in older people? What are the risk factors for late diagnosis of HIV/AIDS in older people? What is the context of late diagnosis of HIV/AIDS in older people? This review will be guided by the methodology of the Joanna Briggs Institute, which will be based on the participants definition strategy, concept and context. The results will be presented by the logical and descriptive summary, presented as a map of data extracted from the articles and aligned with the objective and questions of the scope review. It is expected that this scope review will contribute to the comprehensive analysis of the health care practices of elderly people.Las personas mayores, diagnosticadas tardíamente, tienen un mayor riesgo de desarrollar SIDA. Con un recuento de CD4 de menos de 200 células/ml3, tienen en promedio más probabilidades de morir en el primer año después del diagnóstico.&nbsp; En este sentido, el objetivo de esta revisión de alcance es mapear la evidencia relacionada con los factores asociados y de riesgo del diagnóstico tardío del VIH/SIDA en personas mayores, pero específicamente esta revisión tiene como objetivo responder a las siguientes preguntas: Cuáles son los factores asociados con el diagnóstico tardío del VIH/SIDA en las personas mayores? Cuáles son los factores de riesgo para el diagnóstico tardío del VIH/SIDA en las personas mayores? Cuál es el contexto del diagnóstico tardío del VIH/SIDA en las personas mayores? Esta revisión se guiará por la metodología del Instituto Joanna Briggs, que se basará en la estrategia de definición, concepto y contexto de los participantes. Los resultados se presentarán mediante un resumen lógico y descriptivo, presentado como un mapa de los datos extraídos de los artículos y alineados con el objetivo y las preguntas de la revisión del alcance. Se espera que esta revisión del alcance contribuya al análisis exhaustivo de las prácticas de atención sanitaria de las personas mayores.As pessoas idosas, diagnosticadas tardiamente, tem maior risco de desenvolver AIDS. Com a contagem de CD4 inferior a 200 células/ml3, elas apresentam em média mais chances de morrer no primeiro ano após o diagnóstico. &nbsp;Neste sentido, o objetivo desta revisão de escopo é mapear evidências relativas aos fatores associados e de risco do diagnóstico tardio de HIV/AIDS em pessoas idosas, mas especificamente, esta revisão quer dar resposta às seguintes questões: Quais são os fatores associados do diagnóstico tardio de HIV/AIDS em pessoas idosas? Quais são os fatores de riscos do diagnóstico tardio de HIV/AIDS em pessoas idosas? Que contexto o diagnóstico tardio de HIV/AIDS em pessoas idosas foi realizado? Esta revisão será orientada pela metodologia do Joanna Briggs Institute, que assentará na estratégia de definição dos participantes, conceito e contexto. Os resultados serão apresentados pelo resumo lógico e descritivo, apresentados, como um mapa de dados extraídos dos artigos e alinhado com o objetivo e as perguntas da revisão de escopo. Espera-se que esta revisão de escopo contribua para a análise compreensiva das práticas de cuidados à saúde das pessoas idosas

Diagnóstico tardío del Virus de la Inmunodeficiencia Humana y del Síndrome de Inmunodeficiencia Adquirida en Ancianos:: protocolo scoping review

Elderly people, diagnosed late, have a higher risk of developing AIDS. With a CD4 count of less than 200 cells / ml3, they are on average more likely to die in the first year after diagnosis. The purpose of this scope review is to map evidence regarding the associated risk factors of late diagnosis of HIV / AIDS in older people, but specifically, this review aims to address the following questions: What are the associated factors of late diagnosis of HIV / AIDS in elderly people? What are the risk factors for late diagnosis of HIV / AIDS in elderly people? In what context was the late diagnosis of HIV / AIDS in elderly people given? This review will be guided by the methodology of the Joanna Briggs Institute, which will be based on participant definition strategy, concept and context. Results will be presented by the logical and descriptive summary, presented as a map of data extracted from the articles and aligned with the objective and scope review questions. This scope review is expected to contribute to acomprehensive analysis of the health care practices of elderly peopleAs pessoas idosas, diagnosticadas tardiamente, tem maior risco de desenvolver AIDS. Com a contagem de CD4 inferior a 200 células/ml3, elas apresentam em média mais chances de morrer no primeiro ano após o diagnóstico. O objetivo desta revisão de escopo é mapear evidências relativas aos fatores associados e de risco do diagnóstico tardio de HIV/AIDS em pessoas idosas, mas especificamente, esta revisão quer dar resposta às seguintes questões: Quais são os fatores associados do diagnóstico tardio de HIV/AIDS em pessoas idosas? Quais são os fatores de riscos do diagnóstico tardio de HIV/AIDS em pessoas idosas? Que contexto o diagnóstico tardio de HIV/AIDS em pessoas idosas foi realizado? Esta revisão será orientada pela metodologia do Joanna Briggs Institute, que assentará na estratégia de definição dos participantes, conceito e contexto. Os resultados serão apresentados pelo resumo lógico e descritivo, apresentados, como um mapa de dados extraídos dos artigos e alinhado com o objetivo e as perguntas da revisão de escopo. Espera-se que esta revisão de escopo contribua para a análise compreensiva das práticas de cuidados à saúde das pessoas idosas.Las personas mayores, diagnosticadas tardíamente, tienen un mayor riesgo de desarrollar SIDA. Con un recuento de CD4 de menos de 200 células/ml3, tienen en promedio más probabilidades de morir en el primer año después del diagnóstico. El objetivo de esta revisión de alcance es mapear las evidencias relacionadas con los factores asociados y de riesgo del diagnóstico tardío del VIH/SIDA en personas mayores, pero específicamente esta revisión tiene como objetivo responder a las siguientes preguntas: ¿Cuáles son los factores asociados con el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuáles son los factores de riesgo para el diagnóstico tardío del VIH/SIDA en las personas mayores? ¿Cuál es el contexto del diagnóstico tardío del VIH/SIDA en las personas mayores? Esta revisión se guiará por la metodología del Joanna Briggs Institute, que se basará en la estrategia de definición, concepto y contexto de los participantes. Los resultados se presentarán mediante un resumen lógico y descriptivo, presentado como un mapa de los datos extraídos de los artículos y alineados con el objetivo y las preguntas de la revisión del alcance. Se espera que esta revisión del alcance contribuya al análisis exhaustivo de las prácticas de atención de la salud de los anciano

COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study

BackgroundThe COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary “infodemic” that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people’s reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. ObjectiveWe aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). MethodsThis cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. ResultsMajor proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that “some” social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. ConclusionsOlder people, especially women, were often exposed to COVID-19–related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care