Fatores Sociodemográficos E De Saúde Associados à Mortalidade Em Idosos Residentes Na Comunidade

The objective of this study is to identify factors associated with mortality, with emphasis on gender and age differences. METHODS This is a cross-sectional study, which uses data from the FIBRA-2008-2009 network in Campinas, State of São Paulo, Brazil, with information on non-institutionalized residents of the urban area and the Mortality Information System. The dependent variable has been death, in 2013. The associations have been tested by odds ratio (OR) and their 95% confidence intervals, and the analyses have been conducted using the program Stata 12.0. RESULTS Average age has been 72.3 years, 69.3% have been women, and 8.9% have died. We have found greater OR for mortality in individuals aged ≥ 75 years, classified as pre-frail or frail, and in those who have reported heart disease. CONCLUSIONS In this study, the analysis of specific subgroups has allowed us to better understand the relationship between the factors associated with death in the elderly. With the exception of age, strategies based on primary and secondary care, focused on priority groups, can have a positive impact on the reduction of mortality among the elderly.5

O PROGRAMA DE PÓS-GRADUAÇÃO EM GERONTOLOGIA DA FACULDADE DE CIÊNCIAS MÉDICAS, DA UNIVERSIDADE ESTADUAL DE CAMPINAS (1997-2021).

Objetivo: realizamos uma revisão narrativa e histórico-crítica da criação e da consolidação do Programa de Pós-Graduação em Gerontologia da Faculdade de Ciências Médicas, da Universidade Estadual de Campinas (PPGG/FCM/Unicamp) (1997-2001), levando em conta as mudanças populacionais, científicas e políticas que presidiram a instalação e o amadurecimento dos primeiros programas de pós-graduação de natureza interdisciplinar no Brasil.  Metodologia: foram utilizados documentos oficiais sobre a pós-graduação brasileira e sobre o Comitê Interdisciplinar, relatórios das avaliações periódicas do PPGG/Unicamp e registros da memória da primeira autora, que liderou o processo de instalação do programa na Unicamp, presenciou e se envolveu com os embates acadêmicos em torno do conceito e da prática da interdisciplinaridade na universidade e na CAPES. Resultados: a interdisciplinaridade em Gerontologia é uma forma produtiva e em constante processo de construção de geração de conhecimentos úteis à população. O desenvolvimento de linhas de pesquisa interdisciplinar e de projetos temáticos integrados e de longo prazo por equipes não hierarquizadas revela-se como forma produtiva de se realizar a interdisciplinaridade. O PPGG/FCM/Unicamp organiza-se em três linhas de pesquisa (qualidade de vida e saúde; velhice bem-sucedida, personalidade e sociedade; envelhecimento e doenças crônicas) e nove projetos interdisciplinares, que nucleiam sua produção acadêmico-cientifica. Conclusões: a interdisciplinaridade em Gerontologia tem sido um processo de construção coletiva e continuada que excede os limites dos 20 anos de sua existência na pós-graduação brasileira, influenciada por variáveis históricas, institucionais e pessoais. De seus progressos, depende, em parte, o bem-estar dos idosos diante dos desafios da expansão da longevidade

Sociodemographic and health factors associated with mortality in community-dwelling elderly

OBJETIVO Identificar fatores associados à mortalidade, com ênfase nas diferenças de gênero e idade. MÉTODOS Trata-se de estudo transversal, utilizando dados provenientes da rede FIBRA-2008-2009 em Campinas, SP, com informações de pessoas não institucionalizadas residentes na área urbana e pelo Sistema de Informações de Mortalidade. A variável dependente foi a ocorrência de óbito, verificada em 2013. As associações foram testadas pelas razões de chances (OR) e respectivos intervalos de confiança de 95%, e as análises conduzidas no programa Stata 12.0. RESULTADOS A média de idade foi 72,3 anos, 69,3% eram mulheres e 8,9% foram a óbito. Encontrou-se maior OR para mortalidade nos indivíduos com idade ≥ 75 anos, nos classificados como pré-frágil ou frágil e naqueles que referiram doença do coração. CONCLUSÕES Neste estudo, a análise para os subgrupos específicos permitiu melhor compreender a relação entre fatores que se associam ao óbito no idoso. Com exceção da idade, estratégias baseadas no cuidado específico de atenção primária e secundária, direcionadas a grupos prioritários, podem ter um impacto positivo na redução da mortalidade entre os idosos.OBJECTIVE The objective of this study is to identify factors associated with mortality, with emphasis on gender and age differences. METHODS This is a cross-sectional study, which uses data from the FIBRA-2008-2009 network in Campinas, State of São Paulo, Brazil, with information on non-institutionalized residents of the urban area and the Mortality Information System. The dependent variable has been death, in 2013. The associations have been tested by odds ratio (OR) and their 95% confidence intervals, and the analyses have been conducted using the program Stata 12.0. RESULTS Average age has been 72.3 years, 69.3% have been women, and 8.9% have died. We have found greater OR for mortality in individuals aged ≥ 75 years, classified as pre-frail or frail, and in those who have reported heart disease. CONCLUSIONS In this study, the analysis of specific subgroups has allowed us to better understand the relationship between the factors associated with death in the elderly. With the exception of age, strategies based on primary and secondary care, focused on priority groups, can have a positive impact on the reduction of mortality among the elderly

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This study analyzed common mental disorders in the elderly according to demographic and socioeconomic characteristics, health-related behavior, and disease history. This was a cross-sectional, population-based study with a cluster sample using data from a health survey conducted in Campinas, São Paulo State, Brazil, in 2008. SRQ-20 was used to evaluate common mental disorders. Adjusted prevalence ratios were estimated using multiple Poisson regression. Prevalence of common mental disorders was 29.7%, and higher rates were associated with female gender, age 80 years or older, lower income, not working, sedentary lifestyle, poor self-rated health, and greater number of chronic diseases. Prevalence ratios were higher in the subscale of depressive thinking. The results provide direct backing for planning interventions focused on health of the elderly, with an emphasis on elderly that work and follow healthy lifestyles. The study highlights the need for attention by health professionals to depressive disorder in the elderly.Analisou-se o transtorno mental comum em idosos segundo variáveis demográficas, socioeconômicas, de comportamentos relacionados à saúde e morbidades. Trata-se de estudo transversal de base populacional, com amostra por conglomerados. A pesquisa utilizou dados de inquérito de saúde realizado em Campinas, São Paulo, Brasil, em 2008. Foi usado o questionário SRQ-20 para avaliar o transtorno mental comum. Foram estimadas razões de prevalências ajustadas por meio de regressão múltipla de Poisson. A prevalência de transtorno mental comum foi 29,7% e significativamente mais elevada no sexo feminino, nos idosos com 80 anos ou mais, menor renda, que não trabalhavam, sedentários, que avaliaram sua saúde como ruim/muito ruim e com maior número de doenças crônicas. Maiores razões de prevalências foram detectadas na subescala de pensamentos depressivos. Os resultados trazem subsídios para o planejamento de intervenções voltadas à saúde dos idosos, com ênfase nos idosos que trabalham e com hábitos de vida saudáveis. Apontam a necessidade de atenção dos profissionais para o quadro depressivo na terceira idade.Se analizaron los trastornos mentales comunes en ancianos, de acuerdo con los comportamientos demográficos, socioeconómicos, de salud y morbilidad. Se realizó un estudio transversal, basado en la población de muestreo por conglomerados de los datos de una encuesta de salud realizada en Campinas, São Paulo, Brasil, en 2008. Se utilizó el SRQ-20 para evaluar la trastornos mentales comunes. Calculamos razones de prevalencia ajustadas por regresión de Poisson múltiple. La prevalencia de trastornos mentales comunes fue de 29,7%, significativamente mayor en las mujeres, las personas mayores de 80 años, de bajos ingresos, que no trabajan, sedentarias, que calificaron su salud como mala/muy mala y con más enfermedades crónicas. Mayores tasas de prevalencia fueron encontradas en las subescalas de trastornos depresivos. Proporcionan información para la planificación de intervenciones centradas en la salud de las personas mayores, con énfasis en las personas y el trabajo con hábitos de vida saludables. Indican la necesidad de atención profesional para los trastornos depresivos en ancianos

Dimensões da autoavaliação de saúde em idosos

OBJECTIVE To analyze the association between negative self-rated health and indicators of health, wellbeing and sociodemographic variables in older adults. METHODS Cross-sectional study that used data from a population-based health survey with a probability cluster sample that was carried out in Campinas, SP, Southeastern Brazil,, in 2008 and 2009. The participants were older adults (≥ 60 years) and the dependent variable was self-rated health, categorized as: excellent, very good, good, bad and very bad. The adjusted prevalence ratios were estimated by means of Poisson multiple regression. RESULTS The highest prevalences of bad/very bad self-rated health were observed in the individuals who never attended school, in those with lower level of schooling, with monthly per capita family income lower than one minimum salary. Individuals who scored five or more in the physical health indicator also had bad self-rated health, as well as those who scored five or more in the Self-Reporting Questionnaire 20 and those who did not refer feeling happiness all the time. CONCLUSIONS The independent effects of material life conditions, physical and mental health and subjective wellbeing, observed in self-rated health, suggest that older adults can benefit by health policies supported by a global and integrative view of old age.OBJETIVO Analisar associação entre autoavaliação negativa de saúde e indicadores de saúde, bem-estar e variáveis sociodemográficas em idosos. MÉTODOS Estudo transversal utilizando dados de inquérito de saúde de base populacional com amostra probabilística por conglomerados, realizado em Campinas, SP, em 2008 e 2009. Os participantes eram idosos (≥ 60 anos) e a variável dependente foi autoavaliação de saúde, categorizada em: excelente, muito boa, boa, ruim e muito ruim. As razões de prevalências ajustadas foram estimadas por meio de regressão múltipla de Poisson. RESULTADOS Maior prevalência de autoavaliação de saúde como ruim/muito ruim foi observada nos indivíduos que nunca estudaram, naqueles com menor escolaridade, com renda familiar per capita mensal inferior a um salário mínimo. Tiveram também pior autoavaliação de saúde aqueles com pontuação igual ou maior a cinco no indicador de saúde física, cinco ou mais no Self Reporting Questionnaire 20 e os que não referiram sentimento de felicidade todo o tempo. CONCLUSÕES Os efeitos independentes das condições materiais de vida, saúde física e mental e bem-estar subjetivo, observados sobre a autoavaliação de saúde, sugerem que idosos podem ser beneficiados por políticas de saúde apoiadas numa visão global e integrativa da velhice

Prevalência e coocorrência de fatores de risco modificáveis em adultos e idosos

OBJECTIVE: To estimate the co-occurrence of the major risk factors for chronic diseases in adults (18-59 years old) and older people (≥ 60 years old) living in Brazilian state capitals and the Federal District. METHODS: Cross-sectional study with population-based data from 35,448 adults and 18,726 older people collected in the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (System of Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey – Vigitel) in 2015. The prevalence of each of the five risk factors (smoking, overweight, physical inactivity, alcohol and unhealthy diet) was estimated, as well as their co-occurrence for the different possible combinations, according to socioeconomic and health self-assessment variables. The independent associations were verified via multinomial logistic regression to obtain the estimates of the odds ratio (OR) and corresponding 95% confidence intervals. RESULTS: At least two risk factors were present in 38.5% of the adults and 37.0% of the older participants. The male adults and older participants who did not have private health insurance and classified their health as average or poor/very poor were more likely to have two or more concurrent risk behaviors. The greater chance of co-occurrence of smoking and alcohol abuse in adults (adjusted OR = 3.52) and older people (adjusted OR = 2.94) stands out. CONCLUSIONS: The subgroups with increased risk of developing multiple unhealthy behaviors and the most prevalent behaviors were identified. These findings are expected to contribute to the better targeting of health promotion and preventive care. It is worth noting that, for the adoption of healthy lifestyle habits, macro-social and inter-sectoral policies are more effective.OBJETIVO: Estimar a coocorrência dos principais fatores de risco para doenças crônicas não transmissíveis em adultos (18 a 59 anos) e idosos (≥ 60 anos) residentes nas capitais dos estados brasileiros e Distrito Federal. MÉTODOS: Estudo transversal de base populacional com dados de 35.448 adultos e 18.726 idosos coletados no Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) em 2015. Estimaram-se as prevalências de cada um dos cinco fatores de risco (tabagismo, excesso de peso, inatividade física, uso de álcool e alimentação não saudável), assim como sua coocorrência para as diferentes combinações possíveis, segundo variáveis socioeconômicas e autoavaliação da saúde. As associações independentes foram verificadas por meio de regressão logística multinomial para obter as estimativas do odds ratio (OR) e respectivos intervalos de confiança de 95%. RESULTADOS: Ao menos dois fatores de risco estavam presentes em 38,5% dos adultos e 37,0% dos idosos. Adultos e idosos do sexo masculino, que não possuíam plano de saúde privado e que avaliaram sua saúde como regular ou ruim/muito ruim apresentaram maiores chances de ter dois ou mais comportamentos de risco simultâneos. Destaca-se a maior chance de coocorrência de tabagismo e uso abusivo de álcool em adultos (OR ajustado = 3,52) e idosos (OR ajustado = 2,94). CONCLUSÕES: Foram identificados subgrupos com maior risco de desenvolver múltiplos comportamentos não saudáveis e os comportamentos mais prevalentes. Almeja-se que esses resultados contribuam para o melhor direcionamento de ações de promoção de saúde e assistência preventiva. Destaca-se que, para a adoção de hábitos de vida saudáveis, as políticas macrossociais e intersetoriais são mais efetivas

Morbidities, Self-reported Health, Purpose, and Satisfaction with Life in Older Adults

Abstract This study aims to estimate the prevalence of overall satisfaction with life regarding sense of purpose in life, morbidities, and self-reported health, and to identify their direct and indirect associations among the domains in community-dwelling older adults. The research has a cross-sectional design, and we evaluated 419 older adults. Morbidities were assessed using a dichotomous question; self-reported health and satisfaction with life were assessed using a 5-point Likert scale; and sense of purpose was assessed using the Ryff and Keyes 10-item scale. An analysis of structural equations was conducted using Path Analysis. The relationship between morbidities and overall satisfaction with life was mediated by self-reported health; purpose in life mediated the relationship between self-reported health and overall satisfaction with life. Beyond managing chronic illnesses, subjective assessments of health and well-being are key to successful aging

Number of ideas in spontaneous speech predicts cognitive impairment and frailty in community-dwelling older adults nine years later

Objective: To investigate the associations between linguistic parameters in spontaneous speech at baseline and cognitive impairment and frailty nine years later. Methods: A prospective analysis was carried out on data of the Frailty in Brazilian Older People Study (FIBRA) Study, a population-based study on frailty. From a probabilistic sample of 384 individuals aged 65 and older at baseline (2008–2009), 124 aged 73 years and older at follow-up were selected, as they had scored above the cutoff values of cognitive screening for dementia adjusted by years of schooling at baseline and had answered to the question What is healthy aging and had no frailty at baseline. Verbal responses were submitted to content analysis and had its ideas and words counted. Number of ideas corresponded to the frequency of meaning categories and number of words to all identified significant textual elements in the text constituted by the sample answers to that question. Results: Multivariate logistic regression analyses, controlling for the effects of age, sex, and education, showed that individuals with a high number of ideas at baseline had lower chance of having cognitive impairment (OR = 0.39; 95% CI 0.22 − 0.69) and frailty (OR 0.66; 95% CI 0.44 − 0.99) nine years later than those with low number of ideas. Conclusions: Higher number of ideas, but not number of words, in spontaneous speech seems to be associated to a more positive prognosis in mental and physical health nine years later. Linguistic markers may be used to predict cognitive impairment and frailty in older individuals

Relationship between chronic pain, depressive symptoms, and functional disability in community-dwelling older adults:mediating role of frailty

BACKGROUND: Borim et al. showed that older adults with chronic pain exhibited more depressive symptoms and frailty components. Depressive symptoms were associated with more frailty components, and those with more depressive symptoms and frailty faced greater limitations in IADL performance. Frailty appears to mediate the pathway from chronic pain to functional impairment Chronic pain is directly associated with depressive symptoms and frailty. Chronic pain is not directly associated with functional disability. Depression and frailty are both directly associated with functional disabilities. Frailty mediates the association between chronic pain and functional disability. Depression; Disability evaluation; Frailty; Frail elderly.OBJECTIVE: To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults.METHODS: Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p&lt;0.05.RESULTS: Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities.CONCLUSION: The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components.</p

Relationship between chronic pain, depressive symptoms, and functional disability in community-dwelling older adults:mediating role of frailty

BACKGROUND: Borim et al. showed that older adults with chronic pain exhibited more depressive symptoms and frailty components. Depressive symptoms were associated with more frailty components, and those with more depressive symptoms and frailty faced greater limitations in IADL performance. Frailty appears to mediate the pathway from chronic pain to functional impairment Chronic pain is directly associated with depressive symptoms and frailty. Chronic pain is not directly associated with functional disability. Depression and frailty are both directly associated with functional disabilities. Frailty mediates the association between chronic pain and functional disability. Depression; Disability evaluation; Frailty; Frail elderly.OBJECTIVE: To evaluate the direct and indirect effects of chronic pain, depressive symptoms, frailty components, and functional disability through a pathway analysis approach in a sample of community-dwelling older adults.METHODS: Data of 419 participants were cross-sectionally evaluated for the presence of depressive symptoms (Geriatric Depression Scale [15 items]), physical frailty components (phenotype criteria), chronic pain, and limitations in performing instrumental activities of daily living (functional disability scale by Lawton and Brody). Structural equation modeling via path analysis was used to explore the direct and indirect effects among these four variables. Statistical significance was set at p&lt;0.05.RESULTS: Of the total participants, 69.8% were women and 59.3% had low education (1-4 years); the mean age was 80.3±4.6 years. Chronic pain and depressive symptoms were directly related and were associated to frailty. The number of frailty components and depressive symptoms were directly associated with functional disability. Frailty had an indirect effect on the association between chronic pain, depressive symptoms, and functional disabilities.CONCLUSION: The pathway from chronic pain and depressive symptoms to functional disability is potentially mediated by the number of frailty components.</p