Lipids and All-Cause Mortality among Older Adults: A 12-Year Follow-Up Study

This is a 12-year follow-up cohort study with 800 people (60–85 years old). The association between lipid disorders and mortality was analysed by Cox proportional hazard adjusted model. All-cause mortality was considered the dependent variable, and lipid disorders as independent variables: total cholesterol (TC) >200 and <170 mg/dl, HDL-c <35 and 40, LDL-c >100 and 130, and triglycerides (TG) >50. An initial analysis of all subjects was performed and a second was carried out after having excluded individuals with a body mass index (BMI) <20 kg/m2 or mortality in ≤2 years. The mortality showed a positive association with low TC and a negative association with high TC and high LDL-c. After the exclusion of underweight and premature mortality, there was a positive association only with TC <170 mg/dl (HR = 1.36, CI95%: 1.02–1.82). The data did not show a higher risk with high levels of TC, LDL-c, and TG. However, they showed higher mortality among older adults with low TC

Frequência e fatores associados a quedas em adultos com 55 anos e mais

OBJETIVO Analisar a frequência e fatores associados à ocorrência de quedas em adultos de 55 anos ou mais. MÉTODOS Estudo inserido em outro de base populacional com amostra representativa de pessoas com 40 anos ou mais da área urbana de município de médio porte do Paraná em 2011. Foram obtidos dados demográficos e socioeconômicos, características referentes aos hábitos de vida, às condições de saúde e à capacidade funcional (n = 1.180). Em 2012, selecionaram-se todas as pessoas com idade igual ou superior a 55 anos (n = 501). Foram estimadas a força de preensão palmar e a ocorrência de queda desde a última entrevista em 80,6% delas. Foram calculadas odds ratios (OR) brutas e ajustadas por regressão logística segundo modelo hierarquizado. RESULTADOS A frequência de queda foi de 24,3%. Após ajustes, observaram-se chances maiores de queda entre mulheres (OR = 3,10; IC95% 1,79–5,38), entre pessoas com idade igual ou superior a 65 anos (OR = 2,39; IC95% 1,45–3,95), com qualidade do sono ruim (OR = 1,78; IC95% 1,08–2,93) e com baixa força de preensão palmar (OR = 2,31; IC95% 1,34–3,97). CONCLUSÕES Qualidade ruim do sono e a baixa força muscular podem ser indicadores de maior risco de quedas e merecem avaliações e intervenções visando à prevenção desse agravo.OBJECTIVE The objective of this study is to analyze the frequency and factors associated with falls in adults aged 55 years or more. METHODS This is a study inserted into another population-based study with representative sample of persons aged 40 years or more of the urban area in a medium-sized municipality of the State of Paraná, Brazil, in 2011. That study obtained demographic and socioeconomic data and characteristics related to life habits, health conditions, and functional capacity (n = 1,180). In 2012, we selected all persons aged 55 years or more (n = 501). We have estimated grip strength and the occurrence of a fall since the last interview in 80.6% of the adults. The crude and adjusted odds ratios (OR) have been calculated by logistic regression according to a hierarchical model. RESULTS The rate of fall was 24.3%. After adjustments, we could observe higher chances of falls among women (OR = 3.10; 95%CI 1.79–5.38), among persons aged 65 years or more (OR = 2.39; 95%CI 1.45–3.95), with poor sleep quality (OR = 1.78; 95%CI 1.08–2.93), and with low grip strength (OR = 2.31; 95%CI 1.34–3.97). CONCLUSIONS Poor sleep quality and low muscle strength can be indicators of increased risk of falls and need assessments and interventions aimed at preventing them

Incidence of Cognitive Decline and Association with Changes in Sociodemographic, Lifestyle, and Health Indicators in Individuals aged 50 years and older: Prospective Cohort

Objectives: To identify the incidence of cognitive decline (CD) in an urban community-dwelling population aged 50 years and older in a 4-year follow-up period and its prospective association with sociodemographic factors, lifestyle and health conditions as well as with changes in these factors. Methods: This is a prospective cohort with a representative sample of people aged 50 years and older (n = 206) from Cambé, PR, where baseline data collection occurred in the year 2011 and the follow-up occurred in 2015. The incidence of CD was the outcome of this study, and its evaluation occurred through the Mini-Mental State Examination. Results: The incidence of CD was 13.1% over the 4 years of follow-up, and adjusted Poisson regression models (sex, age and age range) showed that this condition was prospectively associated with depression (adjusted relative risk (RR) = 3, 50, 95% CI = 1.65-7.43). When analyzing the effect of sociodemographic factor changes on CD, it was verified that the risk of CD was 2.86 times higher among the group that stopped having a companion in the 4 years of follow-up when compared to the group that maintained a companion in that same period, independent of confounding factors. Conclusion: The data suggest that the CD process begins before the age of 60 y and that aggravation is associated with potentially modifiable factors that can be approached by health services from the perspective of promotion, prevention and care

Polifarmácia no idoso: um estudo de caso/ Polypharmacy in the elderly: a case study

É cada vez mais frequente o advento de casos de polifarmácia entre a população idosa. Consiste na administração de mais de cinco medicações ou de um maior número de medicamentos clinicamente necessários. O presente estudo de caso procura demonstrar, por meio de um relato de caso de uma moradora de instituição de longa permanência que a avaliação por uma equipe multidisciplinar, identificação e manejo do quadro trazem benefícios expressivos sobre o bem-estar e saúde do idoso. A avalição constante por uma esquipe multidisciplinar é importante, haja vista doenças limitantes, fragilidade e baixa funcionalidade do idoso. Neste caso torna-se fundamental a identificação e manejo precoce

Influenza vaccination as a quality of life promoting strategy

Influenza has a great impact on elderly morbidity and mortality rates. Vaccination is the most effective measure to prevent these diseases complications. It is effective preventing hospital admission for influenza and pneumonia and all-cause mortality. Moreover, it is associated with reductions in the risk of hospitalization for cardiovascular disease. Although ageing has consequences that diminish vaccine effectiveness, the great benefits of vaccination occur in this population. Even though, there are some groups with characteristics associated with lower rates of vaccination. The leading reasons given worldwide for not vaccinating are: fear of adverse effects, lack of credibility in the vaccine and beliefs that it is unnecessary. However, the vaccine causes few adverse effects. Nevertheless non vaccinated elderly say they would have been vaccinated if a doctor had proposed this to them, the vaccine isn't part of medical routine. The whole health team should be more active to elucidate the real benefits of vaccination. Then, more elderly people would beneficiate from this and achieve a better quality of life.</p