Association between cognitive impairment and criteria for frailty syndrome among older adults

OBJECTIVE: The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. To analyze the association between cognitive impairment and the criteria for frailty. METHODS: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled 'Variables associated to cognition in elderly caregivers' involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. RESULTS: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. CONCLUSION: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty

Comparison of cognitive performance and aspects of the care context in elderly caregivers in Brazil: a follow-up study

Cognitive health is important for the quality of life and well-being of elderly caregivers. Cognitive impairments can negatively affect the ability to care for oneself and others. Objective: To compare cognitive performance and aspects of the care context in elderly caregivers of older adults in a three-year follow-up investigation Methods: A longitudinal study was conducted of 61 elderly caregivers treated in primary care in a city in the interior of the state of São Paulo with data collected in 2014 and 2017. Sociodemographic characteristics, the care context, cognition, performance for activities of daily living, burden and depressive symptoms were collected in individual interviews. Data analysis was performed to compare categorical and continuous variables. Results: Significant increases were found between baseline and follow-up for the language domain score of the cognitive evaluation (p=0.024), receipt of material support (p=0.020), time providing care (p=0.045) and dependence of elderly care recipient for basic activities of daily living (p=0.042). Conclusion: Elderly caregivers performed better on the domain of language, received more material/financial support, spent more time on care and reported greater dependence of the elderly care recipient

Living with the elderly is related to a better performance in the recognition of facial expressions of emotion among older individuals

Background: Cohabitation with the elderly may bring benefits to social relationships and exert an influence on the recognition of facial expressions of emotion. Objective: Compare emotion recognition skills between a cohabitation group (CHG) of older adults who live with a dependent elderly individual and a non-cohabitation group (NCHG) of older adults who do not live with an elderly individual. Methods: Interviews were conducted with 62 older adults in the CHG and 56 in the NCHG. The two groups were similar with regard to gender, age, schooling, degree of dependence, cognitive performance, and depressive symptoms. A dynamic task with six emotions (anger, disgust, happiness, surprise, sadness, and fear) and four levels of intensity was administered to evaluate the recognition of facial emotions. Results: The CHG performed better than the NCHG regarding the correct identification of emotions, specifically surprise (60%), disgust (60%, 80%, and 100%), fear (80%), and sadness (80% and 100%). Discussion: Cohabitation with an elderly individual seems to offer benefits to older adults in terms of recognizing facial expressions of emotion

Idosos cuidadores em diferentes arranjos de moradia: comparação do perfil de saúde e de cuidado

Objetivo: Comparar o perfil de saúde física, cognitiva e psicológica e o contexto decuidado de idosos cuidadores de idosos em diferentes arranjos de moradia.Método: Estudo quantitativo e transversal realizado com 349 cuidadores divididos emarranjos de moradia unigeracional, bigeracional e multigeracional. Para avaliação foramutilizados questionários sociodemográfico e de cuidado, e instrumentos de avaliações dasaúde física, cognitiva e psicológica. Para análises dos dados foram utilizados os testesQui-quadrado e U Mann Whitney.Resultados: Os idosos cuidadores de lares unigeracionais eram mais velhos eindependentes para as atividades instrumentais de vida diária. Nos arranjos de moradiamultigeracionais houve proporção significativamente maior de cuidadores queconsideravam a renda familiar insuficiente, recebiam ajuda emocional e sentiam-se maissobrecarregados e estressados.Conclusão: As diferenças identificadas entre os grupos podem contribuir para elaboraçãode políticas de cuidado e promoção da saúde de idosos cuidadores.Palavras-chave: Idoso. Cuidadores. Família. Relações familiares

Factors associated with the hope of elderly caregivers of elderly

The longevity associated with chronic degenerative health problems, contributes to the increase of older people with functional limitations, disabilities and the need for care. The role of caregiver can trigger a series of impacts on the physical and mental health. However, hope can be psychosocial feature of these caregivers to deal with the difficulties on the experience of care. The objective this study is identify factors associated with the hope of elderly caregivers of elderly. This is a quantitative study, descriptive and crosssectional. The sample consisted of 301 subjects who played role of caregivers registered in the Family Health Units in a city in São Paulo state. Data were collected through individual interviews, using the following instruments: Characterization of the Subjects; Herth Hope Index (HHI); Pinto Pais - Ribeiro Spirituality Scale (PP-RSS); Geriatric Depression Scale (GDS); Evaluation of Fragility; Perceived Stress Scale; Mini-Mental State Examination (MMSE); Inventory of Coping Strategies; Zarit Caregiver Burden Interview (ZBI). Analyses were performed using multivariate statistics (multinomial logistic regression). The results showed that the mean score of EEH was 40.9 (± 5.4). As for PP-RSS, mean the belief domains and hope / optimism were 3.85 and 3.39, respectively. The most widely used coping strategy was "the expression of negative emotions", averaging 19.8 points. In GDS, the majority (77.8%) had no depressive symptoms. As for the perceived stress, the average score was 19.0 points. In the MMSE, the majority (61%) showed evidence of cognitive impairment. The average obtained in the ZBI was 17.9 and in the evaluation of fragility, the majority (56.8%) was pre-fragile. With regard to factors associated with hope, according to the regression model were: spirituality, stress, old age, caregiver without income, not receive help affective / emotional and care for 6- 10 hours a day. Therefore highlights the need for public policies and care actions to these elderly caregivers elderly, as well as interventions aimed at stimulating hope with emphasis in the associated factors identified.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)A longevidade associada à problemas de saúde crônico-degenerativos contribui para o aumento de idosos com limitações funcionais, incapacidades e necessidade de cuidados. Cuidar pode desencadear uma série de impactos na saúde física e psíquica do cuidador. A esperança pode ser recurso psicossocial do cuidador para lidar com as dificuldades na experiência do cuidar. O objetivo geral deste estudo foi identificar fatores associados à esperança dos idosos cuidadores. Trata-se de um estudo quantitativo, descritivo, de corte transversal. A amostra foi composta por 301 sujeitos que desempenhavam papel de cuidadores cadastrados nas Unidades de Saúde da Família de uma cidade no interior paulista. Os dados foram coletados, por meio de entrevista individual, realizada no domicílio dos cuidadores e utilizando-se os seguintes instrumentos: Caracterização sociodemográfica, de saúde e de cuidado; Escala de Esperança de Herth (EEH); Escala de Espiritualidade de Pinto e Pais- Ribeiro (EEPP-R); Escala de Depressão Geriátrica (EDG); Avaliação da Fragilidade; Escala de Estresse Percebido (EEP); Mini-Exame do Estado Mental (MEEM); Inventário de Estratégias de Enfrentamento; Escala de Sobrecarga de Zarit. As análises foram realizadas por meio de estatística multivariada (regressão logística multinomial). Os resultados apontam que o escore médio da EEH foi de 40,9 pontos (±5,4). Quanto a EEPP-R, as médias nos domínios crença e esperança/otimismo foram de 3,85 e 3,39 pontos, respectivamente. A estratégia de enfrentamento mais utilizada foi “expressão de emoções negativas”, com média de 19,8 pontos. No EDG, a maioria (77,8%) não apresentava sintomas depressivos. Quanto ao estresse percebido, a pontuação média foi de 19,0 pontos. No MEEM, a maioria (61%) apresentou indícios de alterações cognitivas. A média obtida na sobrecarga foi de 17,9 pontos e na avaliação da fragilidade, a maioria (56,8%) era pré-frágil. Os fatores associados à esperança foram: espiritualidade, estresse, idade avançada, cuidador sem renda, não receber ajuda afetiva/emocional e cuidar de 6 a 10 horas por dia. Portanto, evidencia-se a necessidade de políticas públicas e ações de assistência a estes idosos cuidadores de idosos, bem como, intervenções que visem estimular a esperança com ênfase nos fatores associados identificados

Stress and optimism of elderlies who are caregivers for elderlies and live with children

ABSTRACT Objective: to evaluate the relation between stress and optimism of elderlies who are informal caregivers for elderlies and live with children. Method: cross-sectional study on 50 elderlies who provide care to elderlies, live with children, and are registered in the primary health care. The interviews occurred in the participant's residence and we evaluated characteristics of the care-dependent elderly and of the children, sociodemographic characteristics, stress through the Perceived Stress Scale and optimism through the Pinto and Pais-Ribeiro Spirituality Scale, in the elderly caregiver. For statistical analysis we used the Spearman correlation test. Results: the mean level of stress was 23.9 points and of optimism was 3.3 points. Correlation analysis showed that the higher the level of optimism the significantly lower the level of perceived stress of elderlies who provided care to elderlies and lived with children. Conclusion: inversely proportional correlation was identified between stress and optimism

RELAÇÃO ENTRE A ESPERANÇA E A ESPIRITUALIDADE DE IDOSOS CUIDADORES

Objetivo : analizar la relación entre la esperanza y la espiritualidad de las personas mayores que juegan el papel de los cuidadores. Método : estudio de correlación de corte transversal. La muestra fue de 301 cuidadores de ancianos, registradas en las Unidades de Salud de la Familia. Los instrumentos utilizados en la recolección de datos fueron la Escala de Esperanza Herth y la Escala de Espiritualidad de Pinto Pais-Ribeiro. Resultados : los datos apuntan a la existencia de una correlación positiva de magnitud débil entre la esperanza de escala y las ̈creencias ̈ (r=0,174) y correlación positiva y fuerte entre la escala de esperanza y los dominios “esperanza/optimismo” (r=0,615) de la escala espiritualidad, con significancia estadística (p <0,01). Conclusión : hubo confirmación de la relación entre el nivel de la esperanza y la espiritualidad, así, que se pueden considerar factores positivos importantes para los cuidadores de personas mayores en la actividad asistencial