Relationship between functional fitness, medication costs and mood in elderly people

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt

The association between the functional incapacity of the older adult and the family caregiver's burden

OBJECTIVE: to identify the association between the older adult's functional capacity and the caregiver's burden. METHOD: a cross-sectional, quantitative study, undertaken in a municipality in the north of the Brazilian state of Paraná, with 178 older adults with functional incapacity, and their caregivers. The Functional Independence Measure was used for evaluating the older adults' functional capacity, and the Zarit Burden Interview was used for evaluating the caregiver burden, with the results being analyzed quantitatively. The majority of the older adults were females, widowed, with a mean age of 79.9 years old, and needing assistance for up to 50% of the daily living tasks. The majority of the caregivers were females, daughters, married, and had a mean age of 56.7 years old. RESULT: the majority of the caregivers reported moderate burden; the men presented higher probabilities of lower burden than the women; and the more independent the older adult was, the higher the probabilities of the caregiver having low burden. CONCLUSION: encouraging actions directed at the promotion of active and healthy ageing centered on the maintenance of functional capacity and the older adult's autonomy, and implanting strategies for the organizing of care in the home which include the caregiver's health, can contribute to minimizing the effects of burden and improve quality of life

A novel whole blood assay to quantify the release of T cell associated cytokines in response to Bordetella pertussis antigens.

BACKGROUND: Bordetella pertussis continues to cause whooping cough globally even in countries with high immunisation coverage. Booster vaccinations with acellular pertussis vaccines are thus used in children, adolescents, and adults. T cell immunity is crucial for orchestrating the immune response after vaccination. However, T cell assays can be expensive and difficult to implement in large clinical trials. In this study, a whole blood (WB) stimulation assay was developed to identify secreted T cell associated cytokines in different age groups after acellular pertussis booster vaccination. MATERIAL AND METHODS: Longitudinal WB samples were collected from a small set of subjects (n = 38) aged 7-70 years participating in a larger ongoing clinical trial. For assay development, samples were diluted and incubated with purified inactivated pertussis toxin (PT), filamentous haemagglutinin (FHA), inactivated B. pertussis lysate, and complete medium (M) as stimulating conditions, with anti-CD28 and anti-CD49d as co-stimulants. Different timepoints around the vaccination (D0, D7, D14, D28), WB dilution factor (1:2, 1:4) and incubation time (24 h, 48 h, 72 h) were compared. Responses to 15 cytokines were tested with Luminex/multiplex immunoassay. RESULTS: The optimized assay consisted of WB incubation with M, PT, and FHA (including the two co-stimulants). After 48 h incubation, supernatants were collected for measurement of seven selected T cell associated cytokines (IL-2, IL-5, IL-10, IL-13, IL-17 A, IL-17F, and IFN-y) from samples before and 28 days after vaccination. PT stimulation showed a trend for upregulation of IL-2, IL-13, and IL-17 A/F for adult subjects, whereas the responses of all cytokines were downregulated for the paediatric subjects. Furthermore, PT and FHA-stimulated WB showed diverse cytokine producing profiles. CONCLUSIONS: The developed WB-based cytokine assay was shown to be less costly, easy to perform, and functional in differently aged individuals. Further, it requires only a small amount of fresh blood, which is beneficial especially for studies including infants. Our results support the use of this assay for other immunological studies in the future

Quality of life and burden in carers for persons with Chronic Obstructive Pulmonary Disease receiving oxygen therapy

OBJECTIVE:to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden.METHOD:this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables.RESULTS:the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden.CONCLUSION:it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.OBJETIVO:evaluar la calidad de vida y la sobrecarga de cuidados experimentada por cuidadores de portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar Prolongada e investigar los factores que influencian esa sobrecarga.MÉTODO:se trata de estudio transversal analítico, con 80 portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar en el ambulatorio especializado de la Universidad Federal de São Paulo y de sus respectivos cuidadores, aplicando los instrumentos: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS), índice de Katz y variables sociodemográficas y clínicas.RESULTADOS:los puntajes del cuestionario de calidad de vida de los cuidadores más comprometidos fueron la Vitalidad y la Salud Mental. El Ambiente fue el dominio del Caregiver Burden Scale que generó mayor sobrecarga de cuidados. Con excepción del Envolvimiento Emocional, todos los dominios de calidad de vida fueron influenciados de forma negativa por los dominios de sobrecarga de cuidados.CONCLUSIÓN:se demostró que la calidad de vida y la sobrecarga de cuidados, de los cuidadores, estaban comprometidos, confirmando que cuidar a los portadores de Enfermedad Pulmonar Obstructiva Crónica, es un importante interviniente en la calidad de vida del cuidador.OBJETIVO:avaliar a qualidade de vida e a sobrecarga de cuidados, vivenciada por cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica, em uso de Oxigenoterapia Domiciliar Prolongada, e investigar os fatores que influenciam essa sobrecarga.MÉTODO:trata-se de estudo transversal analítico, com 80 portadores de Doença Pulmonar Obstrutiva Crônica em uso de Oxigenoterapia Domiciliar do ambulatório especializado da Universidade Federal de São Paulo e seus respectivos cuidadores, aplicando-se os instrumentos: Medical Outcomes Studies 36, Caregiver Burden Scale, índice de Katz e variáveis sociodemográficas e clínicas.RESULTADOS:os escores do questionário de qualidade de vida dos cuidadores mais comprometidos foram vitalidade e saúde mental. O ambiente foi o domínio do Caregiver Burden Scale que gerou maior sobrecarga de cuidados. Com exceção do envolvimento emocional, todos os domínios de qualidade de vida foram influenciados de forma negativa pelos domínios de sobrecarga de cuidados.CONCLUSÃO:demonstrou-se comprometimento da qualidade de vida e sobrecarga de cuidados dos cuidadores, confirmando que assistir portadores de Doença Pulmonar Obstrutiva Crônica é um importante interveniente na qualidade de vida do cuidador.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Hospital São PauloUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, Hospital São PauloSciEL