740 research outputs found
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Food consumption among older adults: differences between men and women
No full textObjective: To describe the eating habits of older men and women who live in Brazilian state capitals and the Federal District.
Methods: This cross-sectional study was based on data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel, 2018) (n = 15 338 older adults, age ≥ 65 years). Diet was assessed as consumption of healthy foods (vegetables, fruits, natural juice, and natural/minimally processed foods) and unhealthy foods (soft drinks/artificial juice, soft drinks, and ultra-processed foods) weekly, daily, and/or the day before the interview. Food consumption prevalence was estimated according to sex, and associations were determined using the Wald test and adjusted logistic regression.
Results: The sample was 60.70% women. Women were more likely than men to consume raw vegetables, cooked vegetables, fruits, and juice and they were less likely to consume soft drinks during any given week. Regarding daily consumption, women were more likely than men to consume fruit and less likely to consume raw vegetables, juice, or soft drinks. On the day prior to the interview, more women reported having consumed natural or minimally processed foods more than men, except for beans and cereals. Regarding ultra-processed foods, the participants reported consuming more dairy drinks and bread than soft drinks, cookies, and processed meats.
Conclusions: Food consumption among older adults differs according to sex, indicating that nutritional education strategies aimed at promoting adequate and healthy eating are needed, especially among men.</p
Deprescribing psychotropic drugs in a geriatric psychiatry outpatient clinic
No full textOBJECTIVE: To describe the psychotropic drug deprescription process in older patients of a geriatric psychiatry outpatient clinic.
METHODS: We conducted a quasi-experimental study of people aged ≥  60 years who were treated at Hospital São Lucas' Geriatric Psychiatry Outpatient Clinic, which is affiliated with Pontifícia Universidade Católica do Rio Grande do Sul, Brazil. Data on 150 older people were collected from March 2021 to August 2022 and were evaluated by the pharmacists. The inclusion criteria were age ≥ 60 years, being a patient of the hospital's Geriatric Psychiatry Outpatient Clinic, use of at least one psychotropic drug, and agreeing to participate in the study. Those unable to report their medications and those who only came to the first appointment were excluded.
RESULTS: Overall, deprescription of at least one psychotropic drug was indicated in 61.3% (n = 92) of the participants, and it was effectively implemented in 68.5% (n = 63) of this group. Deprescribing, which was more frequent in the youngest age group (60–69 years) (p = 0.049), was indicated for 37.4% (n = 136) of psychotropic drugs, 67.6% (n = 92) of which were effectively deprescribed. The main classes indicated for deprescription were hypnotics and sedatives (90.0%; n = 18) and anxiolytics (73.3%; n = 11).
CONCLUSIONS: At least 1 psychotropic drug was indicated for deprescription in the majority of the patients, and in most cases it was effectively implemented. One-third of the prescribed psychotropic drugs were indicated for deprescription, and more than half were successfully deprescribed.</p
Effects of multicomponent training on the intrinsic capacity of community-dwelling older adults: quasi-experimental study protocol
No full textOBJECTIVE: This is a protocol for assessing the effects of multicomponent exercise on the intrinsic capacity of older adults.
METHODS: Older adults (≥ 60 years old) will be selected for a multicomponent training program in Porto Alegre, RS, Brazil to evaluate the 5 domains of intrinsic capacity: vitality (handgrip strength, body mass index, and nutrition) sensory perception (self-reported questions), psychology (the 15-item Geriatric Depression Scale), cognition (the Montreal Cognitive Assessment) and locomotion (the sit-to-stand test and the Timed Up and Go test). The composite intrinsic capacity score will be obtained by summing the domains, with total scores ranging from 0 to 10 points. After 12 weeks of the multicomponent exercise intervention, the participants will be reassessed. Student’s t-test and ANOVA will be used to compare the effects of different types of training on intrinsic capacity. This study was approved by the research ethics committee of the involved institution.
EXPECTED RESULTS: After the 12-week multicomponent exercise intervention, we expect scores for composite intrinsic capacity and its domains, especially locomotion, to increase.
RELEVANCE: The risk of dependence, falls, and mortality increases with reduced intrinsic capacity, indicating a need for interventions to limit these negative outcomes. Multicomponent exercise, a simple, widely recommended, and effective strategy with good adherence, is designed to prevent intrinsic capacity decline in older people and improve their health and functionality.</p
Dimensions of quality of life in patients with heart failure and sarcopenia: a scoping review protocol
No full textOBJECTIVE: To map the dimensions of quality of life in patients with heart failure (HF) and sarcopenia.
METHODS: The scoping review will adhere to the JBI Manual for Evidence Synthesis methodology and will be reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Searches will encompass MEDLINE/PubMed, SCOPUS, EMBASE/Elsevier, LILACS, IBECS, BDENF (BVS), SciELO, Core Collection (Clarivate Analytics), CINAHL, Academic Search Premier (EBSCO), PsycINFO (APA), Cochrane Library, Epistemonikos, and academic search engines: Google Scholar and Bielefeld Academic Search Engine (BASE), without language or date restrictions. Inclusion criteria: Population — adults with HF and sarcopenia; Concept — Dimensions of quality of life including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression — defined based on the EQ-5D-3L questionnaire; Context — any health care setting. Two independent reviewers will select studies and extract data, with a third reviewer consulted in cases of discrepancies. Findings will be presented graphically with a narrative summary.
EXPECTED RESULTS: We aim to uncover key dimensions of quality of life in individuals with HF and sarcopenia through this scoping review. Anticipated outcomes include insights into mobility, self-care, usual activities, pain/discomfort, and anxiety/depression across diverse health care settings.
RELEVANCE: This review sheds light on the interplay between HF and sarcopenia and its impact on quality of life. The findings may guide interventions, inform evidence-based decision-making, and contribute to targeted strategies to improve the well-being of individuals managing both conditions. Review registration: Open Science Framework [https://archive.org/details/osf-registrations-jn387-v1].</p
Risk and protective factors for reduced life-space mobility among older adults with joint disease in Colombia: analysis of secondary data from a nationwide population-based survey
No full textOBJECTIVE: To determine the association between life space and self-reported joint disease in the 2015 SABE Colombia survey.
METHODS: Cross-sectional observational study of secondary data collected during the SABE Colombia 2015 survey. Life space was considered the dependent variable, and self-reported joint disease as an independent variable. An ordinal probit model was used to determine the different influences of each variable including biological, sociodemografic, health condition and geriatric syndromes on the life space of each respondent, categorized as follows: 1=Confined to bedroom, 2=Confined to home, 3=Neighborhood, 4=Around town, 5=Out of town.
RESULTS: 6158 respondents reported joint disease, corresponding to an overall prevalence of 25.99% (95%CI 24.53–28.81%), stratified by life space as follows: confined to room, 3.73%; housebound, 10.31%; neighborhood, 13.64%; town, 49.24%; and out of town, 23.08%. Among female respondents, 78.26% were confined to their homes. The mean (SD) age of this population was 71.8 (8.3) years; respondents confined to their sleeping quarters were on average older. Men were less likely to have reduced life-space mobility, with the probability decreasing by 1.00% compared to women. Having the frailty phenotype increased the probability of having one’s life space confined to the bedroom by 0.69% compared to nonfrail respondents.
CONCLUSION: Our findings suggested that being female, older, having a lower score on the Lawton scale, and being frail are factors that were associated with reduced life spaces. On the other hand, being male, having a higher socioeconomic status, higher educational attainment, good self-perception of health, and belonging to social groups were associated with a greater likelihood of having unlimited life-space mobility.</p
Effects of physical exercise on cognition and glymphatic system of patients with mild cognitive impairment or Alzheimer’s disease – study protocol
No full textOBJECTIVE: To evaluate the impact of a multicomponent physical exercise program on clinical variables associated with the glymphatic clearance system, sleep-awake patterns, and cognitive function in individuals with mild cognitive impairment or mild Alzheimer’s disease.
METHODS: This is a single-center parallel randomized controlled trial involving pre- and post-intervention assessments. The intervention consists of a 12 (±3)-week multicomponent aerobic and resistance physical exercise program of moderate intensity divided into 2 groups: an experimental group (undergoing multicomponent training) and a control group (no intervention). Eligible participants are those diagnosed with probable mild cognitive impairment or mild Alzheimer’s disease.
EXPECTED RESULTS: Anticipated outcomes suggest that the multicomponent training protocol, incorporating both aerobic and resistance physical exercises at a moderate intensity, will yield improvements in glymphatic clearance dynamics, sleep-awake parameters, and performance on cognitive, functional, and behavioral tasks among eligible patients.
RELEVANCE: The need to move beyond cognitive clinical testing justifies our trial, which proposes an assessment employing neuroimaging techniques and the analysis of biomarkers present in cerebrospinal fluid in conjunction with clinical tests for physical and cognitive assessment.</p
Assessment of intrinsic capacity in the Brazilian older population and the psychometric properties of the WHO/ICOPE screening tool: a multicenter cohort study protocol
No full textINTRODUCTION: The World Health Organization (WHO) has proposed to monitor intrinsic capacity (IC) in the older population as a public health strategy through the Integrated Care for Older People (ICOPE) program. Although the program has been developed based on solid concepts, scientific evidence on its practical applicability is still scarce.
OBJECTIVES: To evaluate IC in Brazilian older adults, its progress over time, and its association with sociodemographic and health factors and outcomes. To evaluate the psychometric properties of the WHO/ICOPE screening tool.
METHODS: This is a prospective multicenter cohort study with a 36-month follow-up. We will recruit 3838 people aged ≥ 60 years, registered in the health care units included in the study by the participating centers. We will collect sociodemographic and health data and will administer tools to assess IC domains, both those provided for in the ICOPE screening tool and the sequence of confirmatory assessments provided for in the program. Participants will be reassessed every 6 months for 36 months.
EXPECTED RESULTS: To establish the profile of IC in the study population and to understand its progress and the variables associated with the clinical outcomes of interest. To reveal the diagnostic and psychometric properties of the WHO/ICOPE screening tool. The project is funded by the Brazilian National Council for Scientific and Technological Development (CNPq).
RELEVANCE: Understanding the potential use of the ICOPE public health strategy proposed by the WHO within the scope of the Brazilian Unified Health System (SUS) by integrating several research centers in the field of Geriatrics and Gerontology throughout Brazil.</p
Relationship between active aging and the Human Development Index: particularities of aging in Brazil
No full textOBJECTIVE: To examine the correlation between the Brazilian Active Aging Index (AAI-Brazil) and the Human Development Index (HDI) at both national and regional levels.
METHODS: Based on the original AAI developed by the United Nations Economic Commission for Europe in response to the World Health Organization's program to promote more active and healthy aging, we calculated the total and domain-specific (AAI-independence, AAI-employment, AAI-capacity, and AAI-participation) scores of the AAI-Brazil for Brazil and its regions. Data were obtained from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and analyzed in relation to the overall HDI and its indicators (HDI-education, HDI-income, and HDI-longevity) using linear regression. Statistical significance was set at p < 0.05.
RESULTS: The overall AAI-Brazil score was 34%, with domain-specific scores of 57% for independence, 39% for employment, 14% for capacity 14%, and 9% participation. The Central-West region had the highest score (36%), followed by the South and Southeast (both 35%). The North and Northeast regions had the lowest overall scores (34% and 32%, respectively), as well as the lowest scores across all domains. A positive and significant relationship was found between the AAI-Brazil and total HDI (p = 0.029), HDI-education (p = 0.011), and HDI-income (p = 0.035); as well as between AAI-capacity and total HDI (p = 0.004), HDI-education (p = 0.016), HDI-income (p = 0.008), and HDI-longevity (p = 0.003).
CONCLUSION: Regions with higher AAI-Brazil scores were associated with higher HDI levels. This finding suggests that human development disparities affect the healthy and active aging of the Brazilian population.</p
Megestrol acetate for appetite stimulation and weight gain in older adults with unintentional weight loss: a systematic review and meta-analysis
No full textUnintentional weight loss in older adults is linked to multiple factors, being most often associated with comorbidities such as cancer, dementia syndromes, chronic obstructive pulmonary disease, and chronic kidney disease. Difficulty in managing this condition can quickly lead to malnutrition and, consequently, a state of cachexia. There is a dearth of studies in the literature regarding pharmacotherapeutic interventions for this population, with megestrol acetate (MA) being the most commonly studied medication. In this systematic review, we evaluated the use of MA to improve appetite and treat unintentional weight loss and/or the anorexia-cachexia syndrome in older adults. Randomized studies published up to December 2023 in three languages (Portuguese, Spanish, or English) were retrieved from five databases. We included 25 studies, most of which addressed the use of MA for treatment of patients diagnosed with cancer and the anorexia-cachexia syndrome. We used the PEDro scale to assess methodological quality of the included studies and calculated measures of heterogeneity, such as the tau-squared (τ2), I-squared (I2), and Q test, to assess consistency across studies. Although the studies selected for the systematic review suggest that patients with the anorexia-cachexia syndrome secondary to cancer may benefit from MA therapy, a meta-analysis of 8 selected studies (total n = 592) did not confirm this effect (p = 0.104). The indication of MA for treatment of patients with weight loss required further studies with better methodological designs to evaluate the efficacy and safety profile of this medication in older adults.
PROSPERO registry number CDR42024497640.</p
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