Elderly Residents Of Long-stay Institutions Research Articles

Relação entre força muscular respiratória e funcionalidade em idosos residentes em instituições de longa permanência

No envelhecimento ocorre uma redução gradual da força muscular respiratória e da capacidade funcional, nesta perspectiva, o presente estudo tem por objetivo identificar a relação entre a força muscular respiratória e a funcionalidade em idosos residentes em instituições de longa de permanência. Trata-se de um estudo do tipo analítico com delineamento transversal e abordagem quantitativa, tendo como campo de pesquisa três instituições de longa permanência para idosos nos municípios de Vitória da Conquista e Jequié/BA, com amostra de 62 idosos. O instrumento de pesquisa foi constituído de cinco (5) partes: avaliação cognitiva, informações sociodemográficas, estado de saúde, força muscular respiratória (PImáx e PEmáx) e capacidade funcional (atividades básicas e instrumentais de vida diária). Os dados foram analisados por meio da análise estatística descritiva e aplicação do coeficiente de correlação de Spearman. Verificou-se que houve diferença estatística significativa entre PEmáx e atividades instrumentais de vida diária (p=0,000). Os resultados encontrados no presente estudo sugerem que os valores reduzidos da PEmáx estão associado ao comprometimento das atividades instrumentais de vida diária.

Prevalência, desempenho cognitivo e funcionalidade de idosos com Doença de Alzheimer em instituições de longa permanência de Bento Gonçalves

Aims: To determine the prevalence, cognitive performance and functionality of elderly people with Alzheimer's disease in long-stay institutions for the elderlyin the city of Bento Gonçalves. Methods: Cross-sectional study including 24 elderly residents in long-stay institutions for the elderly, sociodemographic datawere obtained, and the elderly were subjected to functional evaluation by the Functional Independence Measure and evaluation of cognitive performancethrough the mental state the Mini (MMSE). Results: Most of the residents were female (83%), as 54.2% schooling had completed junior high school, mostof the elderly (70.8%) was admitted by the will of the family, 100% of the elderly showed cognitive performance bad, and the smaller the more dependentcognitive performance was the individual. Conclusion: institutionalized elderly with Alzheimer's disease had negative results on cognitive performance,as well as deficits in their ability to perform activities of daily living, thus altering their functionality.Keywords: aging; functionality; cognition; Alzheimer Disease; long-stay institutions.

RELATIONSHIP OF POLYPHARMACY AND POLYPATHOLOGY WITH FALLS AMONG INSTITUTIONALIZED ELDERLY

ABSTRACT Objective: identify relationships of association between the risk of falls in institutionalized elderly people with polypharmacy and polypathy, as well as to outline the epidemiological profile of its casuistry. Method: a prospective obseracional study with 271 elderly residents in long-stay institutions in the Federal District (Brazil). The date were a actualized by inferencial statistics. Results: a monitoring of elderly confirmed the association between polypathology and falls (p: 0.0028), however, it did not follow the trend of other studies in identifying polypharmacy as a risk factor for falls (p: 0.141). Among the most prevalent comorbidities, changes in blood pressure levels (77.4%), followed by Diabetes Mellitus (27.37%), depression (17.7%) and dementia (46.8%) may be highlighted. The most identified drugs were antihypertensives (73.8%), sleep inducers (61.2%), diuretics (50.1%) and antidepressants (34.3%). Conclusion: multiple disabilities associated with chronic-degenerative diseases and the chronic use of medications may interfere with the incidence of falls, ratifying factors related to the diagnosis of risk for falls presented in the NANDA-I Taxonomy I. This contribution to the nurses’ diagnostic rationale ensures better evaluation of the elderly, ensuring a care plan focused on prevention and detection of risk conditions.

Cohort study of institutionalized elderly people: fall risk factors from the nursing diagnosis.

Objective: to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice. Method: this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors. Results: the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045), presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028), foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033) and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145). Conclusion: the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice.

Postural balance and falls in elderly nursing home residents enrolled in a ballroom dancing program

The aim of this study was to investigate the influence of a ballroom dancing program on the postural balance of institutionalized elderly residents. The sample consisted of 59 sedentary elderly residents of long-stay institutions who were randomly assigned to a ballroom dancing experimental group (EG, n=30) or a control group (CG, n=29). The ballroom dancing program consisted of three 50-min sessions each week on alternate days over a 12-week period. The dances included the foxtrot, waltz, rumba, swing, samba and bolero. The medical records of the subjects were reviewed to determine the number of falls they experienced in the three months prior to the intervention. Postural static balance was assessed using a Lizard (Med. EU., Italy, 2010) stabilometric and posturometric platform. Only patients in the EG lost a significant amount of weight (Δ=−2.85kg) when comparing the pre- and post-test postural balance assessments. The intergroup comparison revealed a reduced lower limb weight distribution difference in the EG post-test compared to the CG post-test (p=0.012). In the intragroup comparison, the EG patients experienced significantly fewer falls post-test relative to pre-test (p<0.0001). This improvement was not observed for patients in the CG. In the intergroup analysis, we observed fewer falls in the EG post-test compared to the CG post-test (p<0.0001). Therefore it was conclude that sedentary elderly people living in long-term institutions can improve their balance via a ballroom dancing program. This activity improved balance and reduced the number of falls in this elderly population.

Cognitive profile of elderly residents in Long-stay Institutions of Brasilia-DF

Aging exposes the individuals to a number of limitations, such as the physical, nutritional and cognitive, which can cause them to hospitalization in long-stay institutions. In this study, it was aimed to evaluate to evaluate the cognitive profile of elderly institutionalized through three instruments. Sixty institutionalized elderly people in long-stay institutions underwent assessment through the Mini Mental State Examination (MMSE), the Trail Making Test and the Clinical Dementia Rating. It was found that the percentage of seniors with cognitive impairment by the MMSE was 30% of the sample, being more prevalent in women (36.2% of cognitive loss) compared to men (7.7% of cognitive loss). There was no consistency between the results obtained by the MMSE with the other instruments tested.

Capacidade funcional de idosos com doenças crônicas residentes em Instituições de Longa Permanência

O estudo objetivou descrever o desempenho funcional e a presença de doenças crônicas em 164 idosos residentes em Instituições de Longa Permanência, em Recife-PE, Brasil. Foram aplicados um questionário sociodemográfico, a Medida de Independência Funcional, a escala de Lawton e o Mini-mental. A análise de variância foi utilizada para avaliar as diferenças dos resultados. Os idosos eram predominantemente solteiros, mulheres, com baixa escolaridade. Entre os motivos de admissão destacaram-se: abandono, saúde frágil e vivência em rua. Encontrou-se alto percentual de doenças crônicas; 70% dos idosos eram dependentes para as atividades de vida diária, e todos eram dependentes para as atividades instrumentais. A demência foi o que mais afetou a funcionalidade, seguida das doenças osteoarticulares e do transtorno mental. Entre as atividades comprometidas destacaram-se o uso de escadas e o controle de esfíncteres, sendo a alimentação a de melhor desempenho. Verificou-se que os idosos institucionalizados apresentaram comprometimento funcional e situação de vulnerabilidade social.

Cognitive Assessment in Elderly Residents of Long-Stay Institutions

Objective: To evaluate the cognitive performance of institutionalized elderly in the city of Natal, state of Rio Grande do Norte, Brazil. Methods: A descriptive, longitudinal study of 85 aged individuals via an interview conducted following the application of a classification form and the Mini-Mental State Examination (MMSE), with different cutoff points according to the level of education. The study was approved by the Research Ethics Committee of the Universidad Federal do Rio Grande do Norte (164/2011). Results: The mean age of the elderly studied was 76.8 years, 48.3% were single and 62.0% women, with an average of 3.27 children and 3 years of schooling; cognitive losses were recorded over a 6-month period following the 1st assessment, declining from 18.8 to 16.9% at the 2nd assessment for the following items: orientation to space (p = 0.02), language (p = 0.02) and repetition (p = 0.01). Conclusion: The results show significant cognitive changes among elderly subjects, with 64.6% exhibiting cognitive impairment. The findings suggest systematic evaluations in elders as a mean to establish prevention measures for health losses, taking into account that the referred deficits are capable of causing damage in the everyday life of these elderly residents of institutions.

Avaliação da fragilidade de idosos institucionalizados

OBJETIVO: Avaliar a presença de fragilidade e sua relação com as características sociodemográficas e clínicas em idosos institucionalizados. MÉTODOS: Estudo transversal com 54 idosos residentes em instituição de longa permanência da região Nordeste do Brasil. Os instrumentos de coleta utilizados foram a Escala de Fragilidade de Edmonton e outro de perfil socioeconômico e de saúde. Os dados foram analisados através da estatística descritiva e do teste do Qui-quadrado, com nível de significância 0,05. RESULTADOS: A média de idade foi de 72,4 (±8,5) anos, 61,1% eram do sexo masculino e 74,1% apresentaram algum nível de fragilidade. Houve correlações positivas entre fragilidade, sexo, idade, presença de comorbidades, índice de massa corporal e necessidade e quantidade de medicamentos. CONCLUSÃO: A fragilidade em idosos institucionalizados sofre influência das características sociodemográficas e clínicas.

Condições visuais autorrelatadas e quedas em idosos institucionalizados

OBJETIVO: Avaliar as condicoes visuais autorrelatadas por idosos institucionalizados e sua relacao com acidentes por quedas. METODOS: Estudo prospectivo em que foram entrevistados 59 idosos residentes em instituicoes de longa permanencia para idosos, em Goiânia, GO, entre 2005 e 2007. Foram realizados dois inqueritos com intervalo de dois anos para realizacao das avaliacoes propostas. As condicoes visuais no primeiro inquerito e o relato de quedas no seguimento foram autorrelatadas. Os idosos foram classificados segundo a presenca de deficit visual e comparados quanto a ocorrencia de queda com o teste Exato de Fisher. RESULTADOS: Deficit visual foi relatado por 48 (81,4%) dos idosos e os acidentes por quedas atingiram 32 (54,2%) dos mesmos, sendo estes mais prevalentes entre idosos com deficit visual. Apos o primeiro inquerito, no seguimento de dois anos, nao foi encontrada diferenca estatisticamente significativa (p=0,171) entre a variavel deficit visual autorrelatado e quedas. CONCLUSAO: Os dados encontrados sinalizam a necessidade de melhor investigacao clinica oftalmologica dos idosos. O diagnostico precoce de comprometimentos visuais e/ou a correcao dos mesmos pode beneficiar os idosos e evitar prejuizos funcionais futuros advindos destes e de consequencias como as quedas.

Salivary cortisol and frailty syndrome in elderly residents of long-stay institutions: A cross-sectional study

Analyze the relationship between frailty and cortisol in elderly residents of long-stay institutions. A cross-sectional study was conducted in the city of João Pessoa-PB-Brazil, on a sample of residents of long-stay institutions. Data were collected on frailty phenotype (weight loss, fatigue, slowness, weakness and low physical activity) and salivary cortisol (first measurement between 6 and 7a.m.; second measurement between 11 and 12a.m.; third measurement between 4 and 5p.m.). Statistical analysis applied Pearson's correlation test, Chi-square test, ANOVA and linear regression. The sample was composed of 69 elderly subjects, 37.7% men and 62.3% women, with a mean age of 77.5 (±7.8) years. The percentage of frail elderly was 45.8%. Frail aged subjects achieved higher cortisol values on the third measurement (p=0.04) and frailty load was significantly associated to the first measurement (r=0.25, p=0.04). Simple linear regression analysis showed a rate of determination (R2=0.05) between frailty load and the first cortisol measurement. Greater cortisol values in the morning and before bed among frail aged individuals suggest a positive correlation may exist between cortisol levels and frailty in elderly residents of long-stay institutions.

P2-156 The Vulnerable Elders Survey (VES-13) as a screening instrument in elders of Brazilian long-stay institutions

IntroductionThe Comprehensive Geriatric Assessment (CGA) is an evaluation conducted on older people to detect limitations of health in multiple domains. However, CGA is a time-consuming assessment and so the use...

SP1-37 The use of the Abbreviated Comprehensive Geriatric Assessment (aCGA) as a screening instrument in older individual living in long-stay institutions in Brazil

IntroductionThe Comprehensive Geriatric Assessment (CGA) is used in the care of older person for performing a multidimensional evaluation. However, CGA is a time-consuming assessment and abbreviated screening instruments have been...

SP1-38 Prevalence of ADL and IADL dependence and associated factors in elders living in long-stay institutions in Brazil

IntroductionHealth conditions and functionality problems related to ageing affect the ability to live independently, leading to the placement of elders in a long-stay institution. This phenomenon has been increasing in...

SP1-52 Prevalence of frailty in elders living in long-stay institutions in Brazil: correlations among four instruments of evaluation

IntroductionThe term frailty characterises elders at higher risk for the occurrence of adverse health outcomes in situations of environmental stress. We still do not have an assessment instrument that could...

SP1-20 Prevalence of cognitive impairment and depression and associated factors in elders living in long-stay institutions in Brazil

IntroductionCognitive impairment and depression are among the health conditions that affect the ability of the elders to live independently, leading to their placement at long-stay institutions. This phenomenon has been...

Osmoregulation in clinical disorders of thirst appreciation

Thirst and drinking are essential components of normal osmoregulation in healthy man. Abnormalities of thirst appreciation, in particular hypodipsia, have profound implications for water homeostasis. The combination of cranial diabetes insipidus and hypodipsia can have particularly serious consequences, with the potential for life-threatening hyponatraemia. Although the tools for measuring thirst are subjective and lack true specificity, their use in clinical research has contributed greatly to our understanding of the physiology of thirst appreciation and the abnormal control of thirst in osmoregulatory disorders. The precise neural control of thirst appreciation remains unknown, and perhaps as a result of this, satisfactory therapies for the treatment of disorders of thirst have not yet been developed; behavioural modification and retraining of drinking habits remain the rather limited cornerstones of management.

Some applications of latent trait analysis to the measurement of ADL.

The use of latent trait methods for detection of biased items used in scales is discussed and two examples given. In the first, items measuring functional impairment in elderly community residents are tested for possible sex bias, and items predicted on the basis of clinical judgment to be clearly sex-biased are correctly identified. In the second example, taken from a cross-national study of elderly residents in long-stay institutions in New York and London, scale items suspected of bias due to interviewer variability and to cross-national differences in institutional environments are identified. It is shown that estimated rates of impairment are affected by presence of variant (biased) items. We argue that latent trait methods are useful for identifying biased items and may have wide application in gerontological research.

A longitudinal study of elderly residents of long-stay institutions: I. Early response to institutional care.

A longitudinal study of elderly residents of long-stay institutions: I. Early response to institutional care.