Diss. (sammanfattning) Umeå : Univ., 2006. / Härtill 4 uppsatser.

Diss. Luleå : Luleå tekniska univ., 2008. / Härtill 4 uppsatser.

Thesis (Ph. D.)--Florida State University, 2006. / Advisor: Robin E. Perry, Florida State University, College of Social Work. Title and description from dissertation home page (viewed June 13, 2006). Document formatted into pages; contains ix, 162 pages. Includes bibliographical references.

Thesis (Ph. D.)--Virginia Commonwealth University, 2006. / Prepared for: Dept. of Physical Therapy. Bibliography: leaves 169 - 193. Also available online.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Objective: To evaluate the effect of exercise (EXE) alone or exercise combined with dietary supplements (EXE-SUPPL) on body composition and physical performance in subjects 60 years and older with sarcopenic obesity. Methods: A systematic review was carried out of studies identified through five search engines up to April 15, 2018. We searched for randomized controlled trials (RCTs) evaluating EXE or EXE-SUPPL in elderly individuals with sarcopenic obesity for at least six weeks. Primary outcomes were percentage of body fat mass, appendicular skeletal muscle mass, and hand grip strength. Random effects meta-analyses with the inverse variance method were used to evaluate the effects of interventions on outcomes. Effects were expressed as mean differences (MD) and their 95% confidence intervals (CI). Risk of bias was assessed with the Cochrane tool. Results: Nine papers reporting seven RCTs (with a total of 558 participants) were included in the review. EXE alone and EXE-SUPPL increased grip strength (MD 1.30 kg; 95% CI 0.58–2.01), gait speed (MD 0.05 m/s; 95% CI 0.03–0.07) and appendicular skeletal muscle mass (MD 0.40 kg; 95% CI 0.18–0.63). EXE alone and EXE-SUPPL reduced waist circumference (MD −1,40 cm; 95% CI −1.99 to −0.81), total fat mass (MD −1,77 kg; 95% CI −2.49 to −1.04), and trunk fat mass (MD −0.82 kg; 95% CI −1.22 to −0.42). Conclusion: EXE alone and EXE-SUPPL improved muscle-related outcomes and reduced fat-related outcomes in subjects with sarcopenic obesity. There is a need for better-designed RCTs with systematic assessment of both different exercise regimes and dietary supplements in sarcopenic obese subjects. / Revisión por pares

This research study is concerned with the projected, significant rise in the number of older people in the next 20 to 30 years with a consequent growth in demand for health, social care and specialised housing. There is also an added challenge of meeting this growing demand alongside government policy requirements on ‘choice’ and ‘voice’, as they operate in Wales, as well as current and projected fiscal challenges. In the context of the challenges posed by an increasing older people population this research study will explore the concept of choice and specifically whether housing choice exists for older people in maintaining their independence in old age. The significance of independent living in the context of this research study, relates to an individual’s ability to maintain choice and control over their daily lives within their home environment. The research findings indicate that decisions made, or not made, by individuals in terms of planning ahead for old age, can potentially impact on their ability to sustain independence as they age in the home of their choice. The tendency for older people to ‘discount the future’ is explored by the researcher highlighting the potential to influence such behaviour by encouraging older people to ‘count the future’ and plan for it in terms of their individual needs. The impact on individual housing choice of decisions made by organisations, in particular local authorities, the NHS and Registered Social Landlords, is also explored within the Literature Review and discussion of the research findings. The consequences of a growing elderly population will be explored by focusing on how the housing choices available to older people with a long term condition, and potentially increasing care needs as they age, may be influenced by decisions made at an individual and organisation level. The findings of this qualitative, exploratory study are based on data collected and analysed from 22 one to one, semi-structured interviews with 2 groups of older people. The Prospective Group (forward looking to potential changes in their housing needs) comprised 10 older people aged between 57 to 80 years, all of whom live in their own home in the community, and the Retrospective Group (looking back to the circumstances that prompted changes in their housing needs) comprised 12 older people aged between 66 to 84 years, all of whom have moved in to sheltered housing. The research findings were also reviewed and discussed with a number of community based groups and a Focus Group. Analysis and discussion of the research findings enabled the identification of a number of themes which the researcher has distilled in to 3 overarching themes: • Enabling informed choice • Issues for organisations • Issues for Individuals The findings of this research study are important because they illustrate that, while most if not all Individuals wish to remain independent in the home of their choice as they age, achievement of this outcome is usually left to chance. The researcher argues that this will continue to be the case unless action is taken at a national and local level to clarify the role of organisations and individuals in supporting and achieving independent living in to old age. The findings point to potentially significant implications for individuals and organisations in terms of an erosion of choices available for sustaining independence in to old age, at an individual level, and an inability to sustain services, at an organisation level. Emerging policy and continued national and local debate on the issues explored by this research study illustrate an increased focus on the consequences of an ageing population. The researcher suggests that future planning of housing and communities will need to more effectively reflect the diverse needs, wants and expectations of current and future generations of older people in terms of the homes they wish to live in.

O Brasil é um país permeado pela diversidade religiosa e em relação aos idosos, a religião é reconhecida como fonte de apoio, pois ajuda a encontrar sentido em situações negativas, aceitar a si mesmo e a se aproximar de religiosos que podem oferecer apoio emocional e ajudá-los a encontrar sentido no sofrimento. Este estudo teve como objetivo conhecer o perfil religioso e a importância dada à religião pelos idosos residentes no município de São Paulo e sua associação com condições de saúde. É um estudo longitudinal, descritivo e exploratório, com abordagem quantitativa, que faz parte do Estudo SABE Saúde, Bem estar e Envelhecimento, realizado com idosos no município de São Paulo, em 2000, que foram reentrevistados em 2006. Os dados foram coletados através de questionário padronizado, com a intenção de traçar o panorama religioso e a importância dada à religião pelas pessoas idosas. Foi utilizado o Qui-Quadrado de Pearson para as análises, ajustado pelo Rao Scott e o nível de confiança estabelecido foi de 95%. Em 2000 foi obtida uma amostra de 2143 idosos e, em 2006, esta foi composta por 1115 idosos. A maioria dos idosos pertence a alguma religião tanto em 2000 (97,6%) como em 2006 (98,0%), e se concentram principalmente na religião católica, evangélica e espírita. Em relação ao gênero, os homens são predominantes nas religiões católica e judaica, enquanto há maior referência de mulheres entre os evangélicos/protestantes, espíritas e orientais/budistas. Quanto à idade entre os longevos, há maior proporção de católicos e uma queda entre aqueles que referiram não ter nenhuma religião com o passar dos anos (2,4% em 2000 e 1,7% em 2006). A maioria dos idosos refere um credo religioso, sendo predominante entre as mulheres (p=0,0000 em 2000 e p=0,0155 em 2006) e entre os viúvos (p=0,0426). O maior número de doenças e a pior condição de saúde foram relacionados principalmente aos idosos sem credo religioso. A importância atribuída à religião é maior entre as mulheres, os mais idosos, e aqueles que referem melhor condição de saúde. Apesar da importância atribuída à religião em 2000 (88,8%), ela passa a ser mais relevante ainda em 2006 (92,7%). A maioria dos idosos refere que encontra na religião fortalecimento (89,3%), auxílio para enfrentar dificuldades (87,2%) e que ela oferece total ou muito sentido a vida dos mesmos (87,9%). Portanto, conclui-se que a religião tem se tornado cada vez mais importante para os idosos e tem sido identificada como fonte de apoio social e enfrentamento para as dificuldades da vida, além de significado de vida diante do processo de saúde e envelhecimento. / Brazil in a country permeated by religious diversity, and in relation to the elderly, religion is known as a source of support because it helps to find a way to face negative situations, accept themselves and approaching religious people who can offer emotional support and help them to find a meaning in suffering. The aim of this study was to know the religious profile and the importance given to religion by the elderly residents in São Paulo city- Brazil, and its association with health status. It´s a longitudinal, descriptive and exploratory study, with quantitative approach, part of the SABE Study- Saúde, Bem-estar e Envelhecimento- Health, Wellbeing and Aging, in English-, performed with elderly people in São Paulo in the year 2000 and again in 2006. Data were collected by a standard questionnaire, with the intention of mapping religious landscape and the importance given to religion by the elderly. For the analyses, Pearson´s chi-square test, adjusted by Rao Scott, was used and the confidence level was 95%. In 2000, the sample was composed by 2143 elderly and in 2006, by 1115. Most seniors have any religion in 2000 (97,6%) and in 2006 (98,0%). Catholicism, Spiritualism and Evangelical are the main religions. In relation to gender, men are predominant in Catholicism and Judaism and women are the majority in Evangelical, Spiritualism and Buddhism/Oriental religions. In relation to age, among the oldest old, there is a higher proportion of Catholics, and decrease of those that reported having no religion over the years (2,4% in 2000 e 1,7% in 2006). Most seniors refers to have religion beliefs, being more prevalent among women (p=0,0000 in 2000 e p=0,0155 in 2006) and among widowed (p=0,0426). The greatest number of diseases and the worst status of health are related, principally, to elderly with no religion belief. The importance given to religion is higher among women, oldest old, and those who reported better health status. Despite the relevant given importance to religion in 2000 (88,8%), it becomes even more relevant in 2006 (92,7%). Most of elderly refers that religion gives strengthening (89,3%), assistance to face difficulties (87,2%), and meaning to life (87,9%). Therefore, it is concluded that religion has becoming increasingly important for the elderly and has been identified as a source of social support and coping with the life´s difficulties, and meaning to life facing health and aging process.

Vivências de perda e luto de idosos residentes em uma instituição asilar de longa permanência em Ribeirão Preto-SP. 2008. 64f. Dissertação (Mestrado) - Escola de Enfermagem de Ribeirão Preto/USP, Ribeirão Preto, 2008. A institucionalização acarreta perdas ao idoso que devem ser elaboradas por um processo de luto, de caráter patológico quando insatisfatório, sendo, certamente, a maior causa de depressão na idade avançada. Idosos residentes em instituições de longa permanência apresentam uma multiplicidade de perdas. O presente estudo objetivou investigar situações de perda e luto de idosos institucionalizados. Trata-se de estudo qualitativo; descritivo e exploratório. Os critérios de inclusão foram: idade igual ou superior a 60 anos, capacidade de entendimento e comunicação verbal e concordância com o Termo de Consentimento Livre e Esclarecido. Foram realizadas entrevistas semiestruturadas, com seis idosos, que foram gravadas em fita cassete e submetidas à análise de conteúdo. Foram elaboradas três categorias: perda por morte, perda por separação e outras perdas; sendo a perda por separação dividida em três subcategorias: separação conjugal, separação da família e separação de companheiros da instituição. A morte de pessoas queridas aproxima o idoso de sua própria mortalidade dificultando o processo de luto; porém, a separação é muito mais difícil de ser elaborada por ser uma perda entre vivos, com possibilidade de se perder o significado da vida junto com o outro. Assim, a separação pode ser mais temida que a própria morte. Considera-se, portanto, que é fundamental aos cuidadores asilares conhecer as diversas situações de perdas e luto do idoso institucionalizado, a fim de auxiliá-lo em seu processo de enfrentamento, fornecendo subsídios para que o asilamento não seja vivenciado como uma experiência desagradável. / For the elderly, life in a nursing home may result in a multitude of losses which must be addressed by the individual through the process of grief. This process, when pathologic, may not be sufficient, becoming a major catalyst for depression among seniors. The objective of this study was to investigate situations of loss and grief among institutionalized seniors. It is a qualitative, descriptive and exploratory research. Including criteria: individuals 60 years or older who had the ability to comunicate and understand, agreeing with the Consent Term. Half-structured interviews conducted with six people were recorded and submitted to \"contents analysis\" (Minayo\'s method). Three categories of emotional loss were created: loss by death, loss by separation and other losses. Loss by separation was further divided into three subcategories: marriage separation, family separation and separation of peers living in the nursing home. The death of a loved one reminds the elderly individual of his/her own mortality, complicating the process of mourning. Separation, however, is much more difficult to overcome because there is a loss among the living, with the possibility to lose the meaning of life with the other one. Therefore, separation may cause more fear than death itself. Finally, understanding loss and grief among the elderly people is fundamental for nursing care, in order to help them with the process of coping and to prevent institutionalization to become an unpleasant experience.

Introdução: Fragilidade é uma síndrome clínica caracterizada pela diminuição da reserva de energia e pela resistência diminuída aos estressores, resultando em maior vulnerabilidade às condições adversas. A identificação do impacto causado pelo tabagismo na fragilidade permite uma melhor definição sobre a participação dos aspectos multidimensionais da síndrome e colabora na identificação de hábitos nocivos na proposta de abordagem terapêutica da fragilidade. Objetivo: Avaliar a associação entre tabagismo e fragilidade em idosos do município de São Paulo. Métodos: Estudo transversal de base populacional, com amostragem probabilística representativa, onde foram avaliados 1.413 pessoas com idade igual e superior a 60 anos em 2006. Foi adotado o fenótipo de fragilidade proposto por Fried e colaboradores (não frágil= nenhum componente, pré-frágil = 1 a 2 componentes; frágil = 3 ou mais componentes). O tabagismo foi mensurado em carga tabágica e status tabágico (fumante, ex fumante e não fumante). Os fatores associados foram obtidos por meio de análise do modelo de regressão logística multinomial a um nível de significância de 5 por cento no Stata/SE ® 10.0 for Windows. Resultados: Idosos fumantes apresentaram 1.54 vezes mais chance de serem pré-frágeis (p0,05). Foram identificados 14 por cento fumantes, 34,04 por cento ex-fumantes e 51,95 por cento não fumantes. Dentre os fumantes, 50,82 por cento estavam em processo de fragilização (4,35 por cento de frágeis e 46,47 por cento pré frágeis), enquanto que entre os não fumantes, 50,25 por cento estavam nesse processo (39,95 por cento pré-frágeis e 10,30 por cento frágeis). Conclusão: Foi encontrada associação significativa entre status tabágico e a condição de pré-fragilidade. Fumar não deve ser considerado uma forma eficaz de prevenir a fragilidade / Introduction: Frailty is a clinical syndrome characterized by decreased energy reserve and decreased resistance to stressors, resulting in increased vulnerability to adverse conditions. The identification of the impact caused by smoking in the fragility allows a better definition of the participation of the multidimensional aspects of the syndrome and collaborates in the identification of harmful habits in the proposal of a therapeutic approach to fragility. Objective: To evaluate an association between smoking and frailty in the elderly in São Paulo. Methods: This was a population-based, longitudinal observational study with representative probabilistic sampling, in which 1413 individuals aged 60 years or older were obtained in 2006. The frailty phenotype proposed by Fried et al. was used (non-frail = No component, pre-frail = 1 to 2 components; frail = 3 or more components). Smoking was measured in dose rate (pack-year) and smoking status (smoker, ex-smoker and non-smoker). The models were obtained through hierarchical logistic regression analysis and a significance level of 5 per cent in Stata / SE ® 10.0 for Windows. Results: Elderly smokers presented 1.54 times the chance of being pre-frail (p0.05). 14 per cent smokers, 34.04 per cent former smokers and 51.95 per cent non-smokers were identified. Among smokers, 50,82 per cent were in the frailty process (4,35 per cent frail and 46,47 per cent pre-frail), versus 50,25 per cent of non-smokers (10,30 per cent frail and 39,95 per cent pre-frail). Conclusion: There was an association between smoking status and pre-frailty. Smoking should not be considered an effective way to prevent frailty

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / No Brasil, a populaÃÃo de idosos està em crescimento contÃnuo, causando um aumento da demanda por instituiÃÃes de longa permanÃncia para idosos. PorÃm, estudos no Nordeste brasileiro sobre a saÃde bucal em idosos institucionalizados sÃo praticamente inexistentes. Este estudo teve como objetivo analisar as condiÃÃes de saÃde bucal em idosos institucionalizados de 65 anos e mais em um asilo no MunicÃpio de Fortaleza / CE, Brasil. Foi realizado um estudo transversal com 160 indivÃduos (95,2% da populaÃÃo-alvo), consistindo de consulta aos prontuÃrios, aplicaÃÃo de um questionÃrio estruturado prÃ-testado e exame bucal. Na anÃlise estatÃstica, foram utilizados testes T, Kruskal-Wallis e regressÃo linear mÃltipla. A idade mÃdia foi de 76,6 anos. O Ãndice CPO-D (29,73) dos idosos asilados foi elevado. O componente dente perdido apresentou o maior valor (28,42); 109 (68,1%) idosos nÃo possuÃam nenhum dente hÃgido; 93 (58,1%) eram totalmente desdentados e 56 (35,0%) apresentavam dentes com raÃzes expostas. Dos 573 dentes presentes, 256 (44,6%) necessitavam de algum tipo de tratamento, sendo 194 (75,8%) para extraÃÃo dentÃria. Dos idosos, 112 (70%) nÃo faziam uso de prÃtese superior e 130 (81,3%) de prÃtese inferior. Quanto à necessidade de prÃtese, 135 (84,4%) necessitavam de algum tipo de prÃtese superior e 142 (88,7%) de prÃtese inferior. A maioria dos sextantes examinados (83,8%) apresentava cÃlculo dentÃrio. Sobre os cuidados e prÃticas em saÃde bucal, apenas 17 idosos (10,6%) nÃo faziam higiene oral. Poucos idosos tinham visitado o dentista nos Ãltimos trÃs meses. A extraÃÃo dentÃria predominou como o motivo da Ãltima visita ao dentista. Idade, instruÃÃo educacional e higiene oral apresentaram significÃncia (p<0,05) para o CPO-D mÃdio na regressÃo linear mÃltipla. Os dados mostram que a maioria dos idosos apresenta saÃde bucal precÃria. Assim, sÃo indispensÃveis intervenÃÃes focalizadas nessas populaÃÃes, como educaÃÃo em saÃde e tratamento precoce. / In Brazil, the elderly population has been growing continuously, leading to a higher demand for long-term institutions for the elderly. In spite of that, studies on the oral health of institutionalized elderly in northeast Brazil are virtually non-existent. The objective of the present study was to analyze the oral health conditions in institutionalized elderly of 65 year-olds or older in a nursing home in the city of Fortaleza / CE, Brazil. A cross-sectional study was conducted with 160 individuals (95.2% of the target population), consisting of the analysis of patient records, application of a questionnaire and oral examination. In statistic analysis, T-Student, Kruskal-Wallis and multiple linear regression tests were performed. Their mean age was 76.6 years. The DMFT index (29.73) was high. Lost teeth represented the highest proportion (28.42); 109 (68.1%) elderly did not have any healthy teeth; 93 (58.1%) were total edentates and 56 (35.0%) had teeth with exposed roots. Of 573 teeth present in total, 256 (44.6%) required some kind of treatment, and 194 (75.8%) of them dental extraction. Of the study population, 112 (70%) did not use any upper prosthesis, and 130 (81.3%) did not use any lower prosthesis. The need of an upper prosthesis was detected in 135 elderly (84.4%) and of a lower prosthesis in 142 (88.7%). The majority of sextants examined (83.8%) had dental calculus. About practices and care in oral health, only 17 individuals (10.6%) did not clean their mouth. Few elderly had visited the dentist at last three months. The dental extraction predominated as the reason at last time of going to dentist. Age, educational level and oral hygiene entered in the multiple linear regression. These data show that most of the elderly had poor oral health. Interventional measures focused on these populations, such as health education and preventive treatment, are, therefore, necessary.