Health profile of centenarians in Portugal: a census-based approach

Background: The number of centenarians is rapidly increasing in Europe. In Portugal, it has almost tripled over the last 10 years and constitutes one of the fastest-growing segments of the population. This paper aims to describe the health and sociodemographic characteristics of Portuguese centenarians as given in the 2011 census and to identify sex differences. Methods: All persons living in Portugal mainland and Madeira and Azores islands aged 100 years old at the time of the 2011 census (N = 1,526) were considered. Measures include sociodemographic characteristics and perceived difficulties in six functional domains of basic actions (seeing, hearing, walking, cognition, self-care, and communication) as assessed by the Portuguese census official questionnaires. Results: Most centenarians are women (82.1 %), widowed (82 %), never attended school (51 %), and live in private households (71 %). The majority show major constraints in seeing (67.4 %), hearing (72.3 %), and particularly in their mobility (83.7 % cannot/have great difficulties in walking/climbing stairs and 80.7 % in bathing/dressing). In general, a better outcome was found for reported memory/concentration and understanding, with 39.1 % and 42.5 % presenting no or mild difficulty, respectively. Top-level functioning (no/mild difficulties in all dimensions concurrently) was observed in a minority of cases (5.96 %). Women outnumber men by a ratio of 4.6, and statistically significant differences were found between men and women for all health-related variables, with women presenting a higher percentage of difficulties. Conclusion: Portuguese centenarians experience great difficulties in sensory domains and basic daily living activities, and to a lesser extent in cognition and communication. The obtained profile, though self-reported, is important in considering the potential of social and family participation of this population regardless of their functional and sensory limitations. Based on the observed differences between men and women, gender-specific and gender-sensitive interventions are recommended in order to acknowledge women’s worse overall condition

Versão Portuguesa da Escala Breve de Redes Sociais de Lubben (LSNS-6)

A avaliação das redes sociais na investigação e prática gerontológica requer o uso de instrumentos válidos e eficazes que sejam simples, concisos e de fácil aplicação na população idosa. A Escala de Redes Sociais de Lubben (LSNS) é um dos instrumentos mais utilizados para avaliar a integração social e o risco de isolamento social em idosos residentes na comunidade. Este artigo debruça-se sobre a tradução e validação da versão abreviada da escala (LSNS-6) para o Português Europeu e expõe as suas principais características psicométricas

Active Ageing: An Empirical Approach to the WHO Model

Background. In the beginning of the 21st century, the world summit on population taking place in Madrid approved active ageing, WHO (2002) as the main objective of health and social policies for old people. Few studies have been done on the scientific validity of the construct. This study aims to validate the construct of active ageing and test empirically the WHO (2002) model of Active Ageing in a sample of community-dwelling seniors. Methods. 1322 old people living in the community were interviewed using an extensive assessment protocol to measure WHO's determinants of active ageing and performed an exploratory factor analysis followed by a confirmatory factor analyses. Results. We did not confirm the active ageing model, as most of the groups of determinants are either not independent or not significant. We got to a six-factor model (health, psychological component, cognitive performance, social relationships, biobehavioural component, and personality) explaining 54.6% of total variance. Conclusion. The present paper shows that there are objective as well as subjective variables contributing to active ageing and that psychological variables seem to give a very important contribute to the construct. The profile of active ageing is expected to vary between contexts and cultures and can be used to guide specific community and individually based interventions

Perceived risk of institutionalization, hospitalization, and death in oldest old primary care patients

Objectives: This study aims to analyze the accuracy and predictive ability of the Risk Instrument for Screening in the Community (RISC) scored by general practitioners (GPs) in a sample of primary care patients aged 80+ with perceived mental health concerns. Method: GPs ranked the perceived risk of the three adverse outcomes (hospitalization, institutionalization and death) at 1 year in a five Likert scale (RISC score), where 1 is the lowest risk and 5 is the highest. Follow up contacts were conducted after 1 year of assessment in order to collect data on the three outcomes. Results: The 1-year proportion of institutionalization, hospitalization and death were 12.1 %, 25.2 % and 19.0 % respectively. Based upon the sensitivity and specificity from the Receiver Operating Characteristic (ROC) curves, we found an optimal cut-off point of ≥4 for the RISC. The RISC had fair accuracy for 1-year risk of in- stitutionalization (Area Under the ROC curve (AUC) = 0.75, 95% CI 0.43-0.68) and hospitalization (AUC = 0.65, 95% CI 0.52-0.78), but not for death (AUC = 0.55, 95% CI 0.43-0.68). Conclusions: The RISC as a short global subjective assessment is to be considered a reliable tool for use by GPs. Our results showed that RISC seems to be a good instrument to triage very old people at risk for in- stitutionalization but with poor accuracy at predicting hospitalization and limited predictive ability for death, suggesting further research and caution on this instrument’s use.publishe

Being successful aged at one hundred years old: alternative and subjective criteria

Age, i.e. being younger, has been the most consistent predictor of successful aging, indicating a dramatic drop of the rate of success with advancing age. However, emergent studies based on expanded psychological concepts have been revealing the admirable capacity of oldest old individuals to overcome adversities and adapting to the challenges of very advanced age. This study aims to explore alternative criteria to Rowe and Kahn successful aging model in centenarians. A sample of 70 individuals (Mage100.91, SD 1.37, 87.1%female) with cognitive capacity for answering self-report questions were selected from the population-based Oporto Centenarian Study (PT100). Perceived economic status, sub- jective health and happiness were considered as components to assess successful aging. Main findings revealed that 62.9% of the sample was able to meet economic needs, 44.3% was happy and 32.3% reported a positive self-perception of health. 12.9% of the participants satisfied all three criteria and 16.1% didnt fulfilled any. A previous study using the same alternative criteria found that 47.5% of centenarians were successful aged, whereas none of them satisfied all three objective components from Rowe and Kahn’s success- ful aging model (Cho et al., 2012). Thus, the higher propor- tion of centenarians with positive self-ratings demonstrate that they may feel successful despite not being objectively considered as so. The alternative criteria of perceived eco- nomic status, subjective health and happiness considered in this study seem to be suitable to approach successful aging in very advanced age.info:eu-repo/semantics/publishedVersio

Joint modelling of longitudinal and competing risks data in clinical research

Joint modelling of longitudinal and survival data has received much attention in the recent years and is becoming increasingly used in clinical studies. When the longitudinal outcome and survival endpoints are associated, the many well-established models with different specifications proposed to analyse separately longitudinal and time-to-event outcomes are not suitable to analyse such data and a joint modelling approach is required. Although some joint models were adapted in order to allow for competing endpoints, this methodology has not been widely disseminated. The present study has as main objective to model jointly longitudinal and survival data in a competing risk context, discussing the different parameterisations of systematic implementations of these models in the R, using a real data set as an example for the comparison between the different model approaches. The relevance of this issue is associated with the need to draw attention of the users of this statistical software to the different interpretations of model parameters when fitting these models. To reinforce the relevance of these models in clinical research, we give an example of a data set on peritoneal dialysis that was analysed in this context, where death/transfer to haemodialysis was the event of interest and renal transplant was the competing event. Joint modelling results were also compared to separate analysis for these data.- (undefined

Modelos lineares mistos na estimação do dispêndio energético em adultos

Páginas numeradas: II-VIII, 9-104Tese de mestrado. Estatística Aplicada e Modelação. Faculdade de Engenharia. Universidade do Porto, Instituto de Ciências Biomédicas Abel Salazar, Faculdade do Desporto. Universidade do Porto. 200