<p>Major changes have occurred in South Africa over the past twelve years. The delivery of health care changed significantly. Community Health Centres (CHCs) became the main service delivery sites within districts. Due to socio-economic changes in the country, the care of dependants, particularly children and the aged, became problematic to families where most of the adult members have to work to secure an income. A focused literature search indicates that informal carers are ill prepared for their task, that there is a need to include these carers in the discharge planning of the dependants and that the carers need to be supported within their families and communities. The aim of this study was to explore the experiences of informal carers during the transition of their elderly dependants from hospital to home, within the home and across different social groupings in the metropolitan area of Cape Town, South Africa. In addition, the involvement of informal carers in the rehabilitation of the elderly was explored.</p>

<p>Major changes have occurred in South Africa over the past twelve years. The delivery of health care changed significantly. Community Health Centres (CHCs) became the main service delivery sites within districts. Due to socio-economic changes in the country, the care of dependants, particularly children and the aged, became problematic to families where most of the adult members have to work to secure an income. A focused literature search indicates that informal carers are ill prepared for their task, that there is a need to include these carers in the discharge planning of the dependants and that the carers need to be supported within their families and communities. The aim of this study was to explore the experiences of informal carers during the transition of their elderly dependants from hospital to home, within the home and across different social groupings in the metropolitan area of Cape Town, South Africa. In addition, the involvement of informal carers in the rehabilitation of the elderly was explored.</p>

Made available in DSpace on 2015-04-22T22:06:22Z (GMT). No. of bitstreams: 1 Bruna Monteiro.pdf: 1262834 bytes, checksum: bbc2c46a807ede6c1b0b2594cef83934 (MD5) Previous issue date: 2013-06-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Population aging is a global reality, due to the reduction in child mortality and fertility, increased life expectancy and technological advances in healthcare. On the other hand, elderly people have become largely dependent on drugs/medicine due to the increasing incidence of chronic diseases, which require prolonged and/or continuous treatment. Excessive and improper intake of medications may pose risks to the patient and is a concern for public health. The objective of this work was to identify the profile of drug use among elderly patients in the Centros de Atenção a Melhor Idade (CAIMI) in Manaus-AM. We conducted a descriptive observational study in which we interviewed 355 elderly patients in the three different units that provide unique and specialized care for elderly patients. Data on drug use in the past seven days was collected through a form, and these drugs were classified according to the Anatomical Therapeutic Chemical Classification System. To obtain information about drug interactions was used Micromedex® and inappropriate drugs were classified according to the update of the Beers Criteria conducted by the American Geriatrics Society. We then analysed the occurrence of polypharmacy, redundancy and self-medication. Among the most respondents, 83.1% were women, aged between 60 and 69 years (62.5%), married (43.7%) and had children (95.5%). The prevalence of drug use was 80.3% and was the most drugs were for cardiovascular system (43.7%). The prevalence of polypharmacy was 19.3%, being higher in women (78.9%), redundancy was observed in 14.7% and 13% of self-medication in the elderly. Potential drug interactions were observed in 42.5% of the users of drugs and medicines within the total, 122 (14.7%) were considered inappropriate for use in the elderly. Although with high standard of medication use were low prevalence of self-medication, polypharmacy, use redundant and inappropriate use of drugs was observed. Our study demonstrates positive results regarding the use of drugs, a specialized and exclusive health services for the elderly in combination with multidisciplinary care, can promote better quality of life and correct use of drugs associate with improved health care. / O envelhecimento populacional é uma realidade mundial, decorrente da redução da mortalidade infantil e da fecundidade, do aumento da expectativa de vida e dos avanços tecnológicos na área da saúde, o aumento da incidência de doenças crônico-degenerativas, as quais necessitam de tratamentos prolongados e/ou contínuos, o que torna os idosos grandes consumidores de medicamentos. O uso de medicamentos pode representar riscos ao paciente, principalmente se realizado de maneira inadequada, e por isso tornou-se uma preocupação para saúde pública. Assim, o objetivo deste trabalho foi identificar o perfil do uso de medicamentos entre idosos atendidos nos Centros de Atenção a Melhor Idade (CAIMI) em Manaus-AM. Realizou-se estudo descritivo-observacional de recorte temporal no qual foram entrevistados 355 pacientes idosos nas três unidades que fornecem serviço de atenção exclusivo e especializado para pacientes idosos. Os dados sobre os medicamentos utilizados nos últimos sete dias foram coletados por meio de um formulário, e estes medicamentos foram classificados de acordo com o Anatomical Therapeutical Chemical Classification System. Para obtenção de informações sobre interações medicamentosas foi utilizado o Micromedex® e os medicamentos inapropriados foram classificados de acordo com a atualização do Critério de Beers realizado pela American Geriatrics Society. Foram analisadas a ocorrência de polifarmácia, redundância e automedicação. Dentre os entrevistados, a maioria eram mulheres (83,1%), entre a faixa etária de 60 e 69 anos (62,5%), casados (43,7%) e possuíam filhos (95,5%). A prevalência do uso de medicamentos foi de 80,3% e os medicamentos mais consumidos foram os para sistema cardiovascular (43,7%). A prevalência de polifarmácia foi de 19,3%, sendo superior nas mulheres (78,9%), a redundância foi verificada em 14,7% e automedicação em 13% dos idosos. Possíveis interações medicamentosas foram verificadas em 42,5% dos usuários de medicamentos e dentre o total de medicamentos, 122 (14,7%) foram considerados inapropriados para uso em idosos. Embora com padrão elevado de uso de medicamentos foram baixas as prevalências de automedicação, polifarmácia, uso redundante e uso de medicamentos inapropriados. Os resultados positivos em relação ao uso dos medicamentos indica que os serviços de saúde especializados e exclusivos para os idosos, com atendimento multiprofissional, podem promover melhor qualidade de vida e uso correto dos medicamentos, em virtude do melhor atendimento e atenção à saúde.

Preventive care for the elderly originated with a study in Great Britain in 1964 that reported a large number of unmet health needs in the elderly and advocated early intervention. Subsequent randomised controlled trials (RCT) used a broad assessment of health including bio-medical, functional, psychological and social /environmental components but inconsistently demonstrated improved outcome for the elderly. 'Health checks' were introduced for all patients in British general practice in 1990. European and American models of care evolved similarly and justify a multidisciplinary team assessment, thorough training of assessment staff and medical supervision of recommendations. Two literature reviews published in 2000 have not reported sound evidence in favour of health assessments. Medicare funding of health assessments for the Australians aged 75 years and over was introduced in November 1999. A protocol for conducting 75+ Health Assessment (75+ HA) was developed and a pilot study was conducted in Yarrawonga in 1995 to initiate Australian research of this model of care. A RCT in the Adelaide Western Division of General Practice tested this model of care. The intervention group (n=50) had two 75+ HA one year apart. The control group (n=50) was left to usual care and had a 75+ HA one year later. Demographic data and the Short Form-36 were used to ensure both groups were comparable. Primary outcome measures did not demonstrate statistically significant reduction in problems nor mortality in the intervention (75+ HA) group compared to the control group. Significant improvements in secondary outcome measures in the intervention group were in self-rated health, depression score and decreased numbers reporting falls. 75+ HAs have been widely taken up by Australian general practitioners. It is no longer possible to conduct a RCT due to the inability to find a legitimate control group. Recommendations arising form this literature review and RCT include; evaluation studies of 75+ HA, concentration on a functional model of health and that nurses or allied health professionals should conduct the assessment in the elderly person's home. A consistent framework for analysis of 75+ HA is proposed. The elderly can be conceived to occupy one of 3 cohorts defined by their function state: No impairment of Activities of Daily Living (ADL), Impairment of Instrumental ADL only or Impairment of Basic ADL. The elderly without ADL impairment have not been demonstrated to benefit from 75+ HA and should be left to access the acute care stream of health services. The most disabled elderly with Basic ADL impairment have not consistently been shown to benefit from 75+ HA probably because they need a more intense level of community care. They should have Care Plans renewed regularly, as tested in the Australian Coordinated Care Trials. The cohort with Instrumental ADL impairment only seems most likely to benefit from annual 75+ HA. An evaluation of screening the elderly for Instrumental and Basic ADL impairment and providing appropriate services for each cohort is recommended. / Thesis (M.D.)--Department of General Practice, 2001.

O agente comunitário de saúde (ACS) tem um papel fundamental no trabalho com a comunidade e na implementação do sistema de saúde brasileiro vigente devido seu contato direto com a população, a qual se apresenta crescente quanto ao número de pessoas idosas e às alterações inerentes ao envelhecimento. O objetivo deste trabalho foi avaliar um programa de educação continuada para os ACS do município Monte Negro, Estado de Rondônia, quanto aos conhecimentos sobre o processo de envelhecimento e suas patologias relacionadas à área da Fonoaudiologia. A amostra foi composta por 29 indivíduos, sendo estes solicitados a preencher um questionário semi-estruturado, contendo conhecimentos relacionados à Fonoaudiologia e ao processo de envelhecimento, em um momento pré e pós realização do curso de capacitação, além de preencher um questionário socioeconômico validado. Para a análise do questionário sobre conhecimentos fonoaudiológicos e processos do envelhecimento foram convidados cinco avaliadores, que atuam em diferentes áreas do conhecimento em Fonoaudiologia, para responder o questionário oferecido aos ACS, posterior pontuação e análise do mesmo. Como resultados pode-se observar que a análise socioeconômica mostrou que 89,65% da amostra encontram-se na classe baixa superior, 79,31% residem na área rural e 44,83% possuem ensino médio completo. Após o programa de capacitação, apenas uma área da Fonoaudiologia sofreu piora da pontuação (Motricidade Orofacial) sendo que as demais apresentaram melhora na pontuação, havendo diferença estatisticamente significativa em duas áreas (Audiologia; Fala e Linguagem). Já com relação ao CD-ROM, a elaboração ocorreu em duas etapas, sendo a preparação do material escrito e a elaboração junto ao designer durante os meses após a realização do curso. Desta forma, conclui-se que o curso de capacitação atingiu seus objetivos transmistindo conhecimentos aos ACS para que possam atuar junto à comunidade proporcionando melhora na qualidade de vida desta. A elaboração do CD-ROM foi importante para registrar o conteúdo oferecido bem como para uma posterior consulta. / The community health agents (CHA) has a role in the community working and in the implementation of the current Brazilian health system because they are in direct contact with the population, which presents a growing number of elderly people and changes inherent to aging. The aim of this study was to evaluate a training program for CHA from Monte Negro, State of Rondonia, about aging and its aspects related in Speech-language and Hearing Pathology knowledge. The sample was constituted by 29 individuals, who were asked to complete a semi-structured questionnaire, containing knowledge related to Speech-language and Hearing Pathology and the aging process at a time before and after completion of the training course, and then filled a validated questionnaire about their socioeconomic status. For the knowledge analysis of speech-language and hearing questionnaire regarding aging processes participated five reviewers, who work in different areas of expertise in Speech-language and Hearing Pathology, to answer the questionnaire offered to CHA for later scoring and assessment. The results showed the socioeconomic analysis showed 89.65% of the sample was in the higher lower class, 79.31% lived in the rural area and 44.83% have completed high school. After the training program that only an area presented a worsening score (Orofacial Motricity) and the others showed an improvement, while statistically significant difference occurred only in two areas (Audiology; Speech and Language). Regarding to the CD-ROM development, its elaboration occurred in two phases, the writing and its designing preparation during the months after the end of the course. Thus, its been concluded that the training program met its objectives for the CHA forwarding knowledge for who needs to work with the community by providing quality of life improvements. The preparation of the CD-ROM was important to record the content offered as well as to a subsequent query.

Made available in DSpace on 2014-06-11T19:33:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T18:44:47Z : No. of bitstreams: 1 almeida_mel_dr_araca.pdf: 5518976 bytes, checksum: fe3472854cbbd3b7f0e664a249ade846 (MD5) / O envelhecimento populacional do país constitui-se em fato consumado e, embora tenha cada vez mais despertado o interesse de pesquisadores e profissionais da área socail e da saúde, ainda muito pouco tem sido feito em resposta a essa evidência. Os objetivos deste estudo foram investigar o significado do processo de envelhecimento e suas repercussões no corpo e, em particular, na boca dos idosos; e como os efeitos da assistência odontológica durante a vida repercutem na saúde bucal do idoso. A boca foi compreendida na expressão da bucalidade, conceito desenvolvido por Botazzo (2000) relativo à propriedade do bucal nas dimensões psíquica e cultural. Trata-se, pois, de compreender a boca nestas dimensões enquanto território corporal. a pesquisa pe de abordagem qualitativa de fundamentação fenomenológica, sendo os sujeitos entrevistados escolhidos intencionalmente. Foram selecionados cinco idosos residentes em Araçatuba/SP/Brasil. Utilizou-se entrevista semi-estruturada e diário de campo para coletar os dados. Para procedermos à análise dos dados, escolhemos a técnica de análise de conteúdo categorial. Os resultados mostraram que a dificuldade na mastigação e a perda da capacidade de saborear os alimentos foram citadas como problemas enfrentados pelos idosos. A ausência de dentes está intimamente ligada à insatisfação estética e é determinante para desencadear estímulos negativos na auto-estima dos indivíduos com repercussão nas relações sociais. A falta de entendimento das doenças que ocorrem na boca, como a cárie dentária e doença periodontal contribuem para a manutenção da crença que perda dentária esta relacionada ao envelhecimento. / The ageing of the Brazilian population as a whole is an incontestable fact, and although it has drawn the attention of researchers and professionals of health and social areas, very little has been done in response to this evidence. The aims of this study were to investigate the meaning of the ageing process and its repercussions in the body and, especially, in the mouth of the elderly; as well as how the effects of dental care during their lives affect the elderly's dental health. Mouth was understood in the expression of bucality, which is a concept that was developed by Botazzo (2000) and is related to oral features in the psychic and cultural dimensions. Therefore, this is about understanding the mouth through these dimensions while being corporal territory. This research has a qualitative approach of phenomenological basis, where the sample was intentionally decided. Five elderly people living in Araçatuba/SP/Brazil were selected. Recorded semi-structured interviews and report diary were used. To analyse the data collected, the technique of content analyses was chosen. The results showed that difficulty in chewing and loss of the ability of tasting food were mentioned as problems faced by the elderly. Teeth absence is closely related to aesthetics dissatisfaction and is a determinant fact to cause negative stimuli in the individuals' self-esteem with consequences in social relations. The lack of understanding about the diseases that happen in the mouth, as dental caries and periodontal disease, contribute for the maintenance of the false belief that tooth loss is related to ageing.

O agente comunitário de saúde (ACS) tem um papel fundamental no trabalho com a comunidade e na implementação do sistema de saúde brasileiro vigente devido seu contato direto com a população, a qual se apresenta crescente quanto ao número de pessoas idosas e às alterações inerentes ao envelhecimento. O objetivo deste trabalho foi avaliar um programa de educação continuada para os ACS do município Monte Negro, Estado de Rondônia, quanto aos conhecimentos sobre o processo de envelhecimento e suas patologias relacionadas à área da Fonoaudiologia. A amostra foi composta por 29 indivíduos, sendo estes solicitados a preencher um questionário semi-estruturado, contendo conhecimentos relacionados à Fonoaudiologia e ao processo de envelhecimento, em um momento pré e pós realização do curso de capacitação, além de preencher um questionário socioeconômico validado. Para a análise do questionário sobre conhecimentos fonoaudiológicos e processos do envelhecimento foram convidados cinco avaliadores, que atuam em diferentes áreas do conhecimento em Fonoaudiologia, para responder o questionário oferecido aos ACS, posterior pontuação e análise do mesmo. Como resultados pode-se observar que a análise socioeconômica mostrou que 89,65% da amostra encontram-se na classe baixa superior, 79,31% residem na área rural e 44,83% possuem ensino médio completo. Após o programa de capacitação, apenas uma área da Fonoaudiologia sofreu piora da pontuação (Motricidade Orofacial) sendo que as demais apresentaram melhora na pontuação, havendo diferença estatisticamente significativa em duas áreas (Audiologia; Fala e Linguagem). Já com relação ao CD-ROM, a elaboração ocorreu em duas etapas, sendo a preparação do material escrito e a elaboração junto ao designer durante os meses após a realização do curso. Desta forma, conclui-se que o curso de capacitação atingiu seus objetivos transmistindo conhecimentos aos ACS para que possam atuar junto à comunidade proporcionando melhora na qualidade de vida desta. A elaboração do CD-ROM foi importante para registrar o conteúdo oferecido bem como para uma posterior consulta. / The community health agents (CHA) has a role in the community working and in the implementation of the current Brazilian health system because they are in direct contact with the population, which presents a growing number of elderly people and changes inherent to aging. The aim of this study was to evaluate a training program for CHA from Monte Negro, State of Rondonia, about aging and its aspects related in Speech-language and Hearing Pathology knowledge. The sample was constituted by 29 individuals, who were asked to complete a semi-structured questionnaire, containing knowledge related to Speech-language and Hearing Pathology and the aging process at a time before and after completion of the training course, and then filled a validated questionnaire about their socioeconomic status. For the knowledge analysis of speech-language and hearing questionnaire regarding aging processes participated five reviewers, who work in different areas of expertise in Speech-language and Hearing Pathology, to answer the questionnaire offered to CHA for later scoring and assessment. The results showed the socioeconomic analysis showed 89.65% of the sample was in the higher lower class, 79.31% lived in the rural area and 44.83% have completed high school. After the training program that only an area presented a worsening score (Orofacial Motricity) and the others showed an improvement, while statistically significant difference occurred only in two areas (Audiology; Speech and Language). Regarding to the CD-ROM development, its elaboration occurred in two phases, the writing and its designing preparation during the months after the end of the course. Thus, its been concluded that the training program met its objectives for the CHA forwarding knowledge for who needs to work with the community by providing quality of life improvements. The preparation of the CD-ROM was important to record the content offered as well as to a subsequent query.

Orientador: Suzely Adas Saliba Moimaz / Banca: Íris do Céu Clara Costa / Banca: Maria Ercília de Araújo / Banca: Wilson Roberto Poi / Banca: Alício Rosalino Garcia / Resumo: O envelhecimento populacional do país constitui-se em fato consumado e, embora tenha cada vez mais despertado o interesse de pesquisadores e profissionais da área socail e da saúde, ainda muito pouco tem sido feito em resposta a essa evidência. Os objetivos deste estudo foram investigar o significado do processo de envelhecimento e suas repercussões no corpo e, em particular, na boca dos idosos; e como os efeitos da assistência odontológica durante a vida repercutem na saúde bucal do idoso. A boca foi compreendida na expressão da bucalidade, conceito desenvolvido por Botazzo (2000) relativo à propriedade do bucal nas dimensões psíquica e cultural. Trata-se, pois, de compreender a boca nestas dimensões enquanto território corporal. a pesquisa pe de abordagem qualitativa de fundamentação fenomenológica, sendo os sujeitos entrevistados escolhidos intencionalmente. Foram selecionados cinco idosos residentes em Araçatuba/SP/Brasil. Utilizou-se entrevista semi-estruturada e diário de campo para coletar os dados. Para procedermos à análise dos dados, escolhemos a técnica de análise de conteúdo categorial. Os resultados mostraram que a dificuldade na mastigação e a perda da capacidade de saborear os alimentos foram citadas como problemas enfrentados pelos idosos. A ausência de dentes está intimamente ligada à insatisfação estética e é determinante para desencadear estímulos negativos na auto-estima dos indivíduos com repercussão nas relações sociais. A falta de entendimento das doenças que ocorrem na boca, como a cárie dentária e doença periodontal contribuem para a manutenção da crença que perda dentária esta relacionada ao envelhecimento. / Abstract: The ageing of the Brazilian population as a whole is an incontestable fact, and although it has drawn the attention of researchers and professionals of health and social areas, very little has been done in response to this evidence. The aims of this study were to investigate the meaning of the ageing process and its repercussions in the body and, especially, in the mouth of the elderly; as well as how the effects of dental care during their lives affect the elderly's dental health. Mouth was understood in the expression of bucality, which is a concept that was developed by Botazzo (2000) and is related to oral features in the psychic and cultural dimensions. Therefore, this is about understanding the mouth through these dimensions while being corporal territory. This research has a qualitative approach of phenomenological basis, where the sample was intentionally decided. Five elderly people living in Araçatuba/SP/Brazil were selected. Recorded semi-structured interviews and report diary were used. To analyse the data collected, the technique of content analyses was chosen. The results showed that difficulty in chewing and loss of the ability of tasting food were mentioned as problems faced by the elderly. Teeth absence is closely related to aesthetics dissatisfaction and is a determinant fact to cause negative stimuli in the individuals' self-esteem with consequences in social relations. The lack of understanding about the diseases that happen in the mouth, as dental caries and periodontal disease, contribute for the maintenance of the false belief that tooth loss is related to ageing. / Doutor

Made available in DSpace on 2016-04-27T18:47:37Z (GMT). No. of bitstreams: 1 Sueli Erasma Gaspar Jardim.pdf: 1964828 bytes, checksum: f1a96b6db727113a2e1884de39d26170 (MD5) Previous issue date: 2010-05-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present study aims to investigate, within the elderly patients in inpatient units of the Hospital do Servidor Público Municipal HSPM (State Civil Servants Hospital), those suspected of being victims of maltreatments. The sample includes forty-eight (48) patients whose cases were submitted to the Special Action Group for Elderly Protection (GAEPO) between January, 2006 and December, 2008. Document research technique was utilized for data collection, against analysis of the medical records and the social study cards of these patients. Patients were characterized according to social-demographic variables, family conditions, hospitalization and suspect of maltreatment. An evaluation of the sample indicates that women are predominant (62.50%) and concentrated in the age group between 80 and 89 being this range a little lower for men, who stay between 70 and 79 years. Both genders had little education and low income. Neglect and abandonment were the main types of suspected violence committed. Reasons for admission were much varied, with predominance of dementia syndrome diagnosis, a fact rendering difficult the confirmation of occurrence of maltreatment. Only one aged patient did not present a pattern of dependence and more than one half was hospitalized for intervals longer than a month. The evolution, in most cases, consisted in transfer to other institutions better qualified to take care of aged patients. The objective of this study is to provide inputs to the team, for identification of signs of suspected abuse against the elderly in treatment at HSPM and thus contribute to the consolidation of denounces to the competent judicial bodies / O presente estudo tem como objetivo investigar, entre os pacientes idosos atendidos nas unidades de internação do Hospital do Servidor Público Municipal (HSPM), aqueles com suspeita de terem sido vítimas de maus-tratos. A amostra abrange quarenta e oito (48) pacientes cujos casos foram encaminhados ao Grupo de Atuação Especial de Proteção ao Idoso (GAEPI) entre janeiro de 2006 e dezembro de 2008. Para o levantamento de dados foi utilizada a técnica de pesquisa documental, mediante a análise dos prontuários médicos e das fichas de estudo social desses pacientes. Realizou-se a caracterização desses pacientes segundo as variáveis sociodemográficas, situação familiar, de internação e de suspeita de maus-tratos. Uma avaliação da amostra indica que as mulheres são predominantes (62,50%) e concentram-se na faixa etária entre 80 e 89 anos, faixa essa um pouco menor para os homens, entre 70 e 79 anos. Ambos os gêneros apresentaram pouca escolaridade e renda baixa. Negligência e abandono foram os principais tipos de suspeita de violência sofridos. Os motivos de internação foram os mais diversos, predominando o diagnóstico de síndrome demencial, o que dificulta a confirmação da ocorrência de maus-tratos. Apenas um idoso não apresentou um quadro de dependência e mais da metade ficou internada por intervalos de tempo maiores que um mês. A evolução na maioria dos casos consistiu na transferência para outras instituições capacitadas em cuidar de idosos. Objetiva-se com este estudo fornecer subsídios à equipe na identificação de sinais de suspeita de maus-tratos contra os idosos que são atendidos no HSPM e, consequentemente, contribuir para a consolidação da notificação aos órgãos judiciais competentes

Im Jahr 1986 wurde über das Gesundheitsreformgesetz ein zahnmedizinisches Bonusheft für gesetzliche Krankenversicherte eingeführt. Über dieses sollte mit der Möglichkeit einer erhöhten Zuzahlung bei Zahnersatz ein Anreiz für eine Individualprophylaxe in Form von regelmäßigen jährlichen zahnärztlichen Kontrolluntersuchung geschaffen werden. Im Gegensatz zur Einführung des Systems befundbezogener Festzuschüsse im Jahr 2005 wurde eine begleitende Evaluation des Systems nicht durchgeführt. Im Zuge des demographischen Wandels in Deutschland mit einer überproportionalen Zunahme der älteren Bevölkerung, bis 2060 werden 9 Millionen bzw. 13 % der Bevölkerung über 85 Jahre alt sein, kommt der Erforschung des Alterns eine hohe Bedeutung zu. Dieser widmet sich die Interdisziplinäre Längsschnittstudie des Erwachsenenalters (ILSE). Zum ILSE-Untersuchungszeitpunkt 2006 wurden soziodemographische und dentale Parameter, die Inanspruchnahme von zahnmedizinischen Leistungen und mundgesundheitsbezogenes Verhalten sowie das Vorhandensein des zahnmedizinischen Bonusheftes erhoben. Mit diesen Daten werden Beobachtungen, Auswirkungen und Effekte des Bonusheftes bei jungen Senioren auf ihre orale Gesundheit sowie das mundgesundheitsbezogene Verhalten untersucht. Hierzu wurden zwischen 2005 und 2006 insgesamt 240 Probanden aus Heidelberg und Leipzig mit den Geburtsjahren 1930-1932 mit einem Durchschnittsalter von 74 Jahren untersucht und befragt. Über eine Selektion von gesetzlich Versicherten mit der beantworteten Frage nach dem zahnmedizinischen Bonusheft ergaben sich 182 Probanden (88 Frauen, 94 Männer). Hiervon kamen 81 aus Heidelberg und 101 aus Leipzig. Alle Probanden ohne zahnmedizinisches Bonusheft, bis auf einen, waren in Heidelberg ansässig. Die soziodemographischen Faktoren umfassen das Geschlecht, Ort und Bildungsstand in Jahren. Zu dem Inanspruchnahme- und mundgesundheits-bezogenen Verhalten wurden die Parameter GOHAI, OHIP, Bedeutung der Mundgesundheit, Vorhandensein des eigenen Zahnarztes, Besuchsverhalten, Häufigkeit der Kontrollbesuche, Zurückliegen des letzten Zahnarztbesuchs und der Grund des Zahnarztbesuchs (Schmerzen, Wunsch auf neue Prothese, Kontrolle, Bonusheft) ausgewertet. Die dentalen Parameter beinhalten den DMF/T, mDMF/T, Anzahl vorhandener Zähne (28/32) und Zahnlosigkeit. Die statistische Auswertung erfolgte mit SPSS 15.0.1. Es wurden den Parametern entsprechend der exakte Test nach Fischer, der Odds Ratio und der Mann-Whitney-U-Test als statistische Testverfahren genutzt. Aufgrund des enggeschnittenen Alterslimits, der städtischen Region und der Ungleichverteilung der Studienteilnehmer ohne zahnmedizinisches Bonusheft sind Abweichungen möglich und Verallgemeinerungen auf die Gesamtbevölkerung nur eingeschränkt möglich. Zudem sind Fragen zum Ursache-Wirkung-Verhältnis wegen der retrospektiven Betrachtung der Daten nicht endgültig zu beantworten. Signifikant mehr zahnmedizinische Bonushefte besaßen Probanden aus Leipzig und solche mit einer längeren Bildungsdauer. Das Geschlecht hatte keinen Einfluss auf das Vorhandensein eines Bonushefts. In Bezug auf das Inanspruchnahmeverhalten von zahnmedizinischen Leistungen konnte festgestellt werden, dass Teilnehmende mit Bonusheft signifikant eher einen eigenen Zahnarzt haben, der Mundgesundheit eine höhere Bedeutung beimaßen und kontrollorientierter, mindestens einmal im Jahr, zum Zahnarzt gingen, als Probanden ohne Bonusheft. Der letzte Zahnarztbesuch lag für diese Gruppen im Median 4 zu 15 Monaten signifikant unterschiedlich lang zurück. Der Grund des letzten Zahnarztbesuchs war für Studienteilnehmer ohne Bonusheft signifikant eher Schmerzen oder der Wunsch nach einer neuen Prothese und weniger der Wunsch nach Kontrolle oder wegen des Bonushefts. Das Risiko, wegen Schmerzen zum Zahnarzt zu gehen, war für diese Probanden um 7,2 erhöht. Die Einschätzung der subjektiven Mundgesundheit ergab für Probanden mit Bonusheft für den GOHAI einen signifikant niedrigeren Wert und somit bessere Einschätzung der Mundgesundheit, wobei der OHIP nur einen tendenziellen Unterschied erkennen lies. Bei der Untersuchung der dentalen Parameter fiel eine signifikant höhere Zahnlosigkeit, ein höherer DMF/T sowie mDMF/T und eine geringere Anzahl von Zähnen bei Probanden ohne Bonusheft auf. So hatten diese Teilnehmer im Median 16 Zähne weniger und ein 6,8-fach erhöhtes Risiko zahnlos zu sein. Bemerkenswert war bei diesen Studienteilnehmern auch, dass der Median des DMF/T bzw. des mDMF/T beim jeweiligen Maximalwert von 28 bzw. 32 lag. Durch diese Ergebnisse zeigt das zahnmedizinische Bonusheft unter Berücksichtigung der Limitierungen dieser Studie einen positiven Effekt auf die orale Gesundheit und ein mundgesundheitsbewussteres Verhalten. Insgesamt handelt sich jedoch um ein rein reparatives System ohne zeitlichen Zusammen-hang zwischen Aktion und Bonus, welches erst einen Nutzen für den „Zahnkranken“ und nicht den „Zahngesunden“ hat. Eine Ausdehnung des Bonussystems um Leistungen, die auch „Zahngesunde“ in Anspruch nehmen können, wie z.B. professionelle Zahnreinigungen, wäre wünschenswert.