scholarly journals Fatores intrínsecos do risco de queda de idosos no domicilio: estudo descritivo

2018 ◽  
Vol 16 (4) ◽  
pp. 480
Author(s):  
Izabel Cristina Luiz ◽  
Ana Karine Ramos Brum

Goal: to associate the intrinsic factors for risk of fall with the occurrence of falls in the home environment in elderly people with chronic diseases. Method: a descriptive study with a quantitative approach, conducted between June and July 2015 with 36 octogenarian elderly, participants of a multidisciplinary chronic disease monitoring program in the state of Rio de Janeiro. We applied the Downton Scale for data collection. Results: all the elderly underwent the Mini Mental State Examination and presented a 27 point average score; 86.1% presented high intrinsic risk for falls, although sensorial handicap (P = 0.09), previous falls (p = 0.35), drug use (p = 1) and ambulation (p = 1) did not present any significant association with the occurrence of the fall during the six months of follow-up. Conclusion: There was a high intrinsic risk of falling in the elderly population studied. Among the most prevalent factors were the previous falls and use of medications, especially hypotensive drugs.

Author(s):  
Élcio Alves Guimarães ◽  
Kennedy Rodrigues Lima ◽  
Flávia Fernandes Oliveira ◽  
Renato Mota da Silva ◽  
Lucas Resende Sousa ◽  
...  

Background: Aging is a dynamic, progressive and physiological process, accompanied by morphological and functional changes, as well as biochemical and psychological changes, resulting in a decrease in the functional reserve of organs and system. With aging, functional losses occur, so the elderly have a greater predisposition to falls. Objective: To compare the propensity to falls between elderly men and women correlating with the level of cognition and balance. Methods: The sample consisted of 60 elderly people, of which 30 were male and 30 were female both aged 65 to 80 years. The propensity to falls was assessed using the “Timed Up and Go” and “Functional Reach” tests, and the state of cognition was assessed by the test “Mini-Mental State Examination”. Results: The results obtained with Time Up and Go, Functional Reach and the Mini-Mental State Examination, indicated that, as the values of one of the variables increase, the values of the other variable increase too; as the values of one of the variables decrease, the values of the other variable increase too. Conclusions: It can be concluded that there was no increased risk of fall when compared the genders; but the female presented altered cognitive deficit.


2017 ◽  
Vol 44 (5-6) ◽  
pp. 320-324 ◽  
Author(s):  
Shoujiang You ◽  
Xia Wang ◽  
Richard I. Lindley ◽  
Thompson Robinson ◽  
Craig S. Anderson ◽  
...  

Background: Data on cognitive impairment after acute intracerebral hemorrhage (ICH) are limited. This study is aimed at determining the frequency and predictors of cognitive impairment among participants of the pilot phase, Intensive Blood Pressure (BP) Reduction in Acute Cerebral Hemorrhage Trial (INTERACT1). Methods: INTERACT1 was an open randomized trial of early intensive (target systolic BP <140 mm Hg) compared with contemporaneous guideline-recommended BP lowering in 404 patients with elevated systolic BP (150–220 mm Hg) within 6 h of ICH onset. Cognitive impairment was defined by scores ≤24 on the Mini-Mental State Examination (MMSE) assessed by interview on follow-up at 90 days. Results: A total of 231 (64.5%) of 358 90-day survivors had MMSE scores for analyses, and 75 (32.5%) had cognitive impairment. In multivariable analysis, older age (OR 2.48, 95% CI 1.73–3.56 per 10-year increase; p < 0.001), female sex (OR 2.06, 95% CI 1.00–4.23; p = 0.049), prior ICH (OR 2.87, 95% CI 1.08–7.65; p = 0.035), high baseline National Institute of Health Stroke Scale score (OR 1.06, 95% CI 1.00–1.13; p = 0.044), and high mean systolic BP over the first 24 h post-randomization (OR 1.34, 95% CI 1.07–1.68/10 mm Hg increase; p = 0.011) were independently associated with cognitive impairment. Conclusions: One third of patients have significant cognitive impairment early after ICH, which is more frequent in the elderly, females, those with prior ICH, and more severe initial neurological deficit and with persistently high early systolic BP.


2021 ◽  
Vol 18 ◽  
Author(s):  
Christian Sandøe Musaeus ◽  
Christer Nilsson ◽  
Chris Cooper ◽  
Milica G. Kramberger ◽  
Ana Verdelho ◽  
...  

Background: Patients with dementia have an increased risk of developing epilepsy, es- pecially in patients with vascular dementia and Alzheimer’s disease. In selecting the optimal an- ti-epileptic drug (AED), the possible side effects such as drowsiness and worsening of cognitive function should be taken into consideration, together with co-morbidities and type of epilepsy. Objective: The current systematic review investigates the efficacy, tolerability, and changes in cog- nitive function after administration of AED in patients with dementia and epilepsy. Methods: We searched six databases, including MEDLINE and CENTRAL, checked reference lists, contacted experts, and searched Google Scholar to identify studies reporting randomized trials. Studies identified were independently screened, data extracted, and quality appraised by two researchers. A narrative synthesis was used to report findings. Results: We included one study with 95 patients with Alzheimer’s disease randomized to either lev- etiracetam, lamotrigine, or phenobarbital. No significant differences were found for efficacy, but patients receiving levetiracetam showed an improvement in mini-mental state examination scores and had fewer adverse events. Conclusion: High-quality evidence in the form of randomized controlled trials to guide clinicians in choosing an AED in patients with dementia and concomitant epilepsy remains scarce. However, levetiracetam has previously been shown to possibly improve cognition in patients with both mild cognitive impairment and Alzheimer’s disease, is better tolerated in the elderly population, and has no clinically relevant interaction with either cholinesterase inhibitors or NMDA receptor antagon- ists.


Author(s):  
Hye-Jin Kim ◽  
Jin-Young Min ◽  
Kyoung-Bok Min

The association between longest-held lifetime occupation and late-life cognitive impairment: Korean Longitudinal Study of Aging (2006–2016). Backgrounds: Our study hypothesized that occupation in adulthood may be one of the modifiable factors in cognitive performance. This follow-up study aimed to examine whether there was an association between the longest-held occupation in a lifetime and cognitive impairment. Methods: This study used data from the 2006, 2012, and 2016 waves of the Korean Longitudinal Study of Aging, and a total of 1733 subjects aged over 65 were included. Longest-held occupation in a lifetime was classified into blue-collar, pink-collar, and white-collar. Cognitive function was evaluated using the Korean version of the Mini-Mental State Examination. Results: In males, no significant associations were observed. In females, on the contrary, risk of cognitive impairment in the blue-collar occupation was consistently higher than in the white-collar occupation over the 10-year follow-up (2006, OR = 2.49, 95% CI 1.05–5.88; 2016, OR = 2.17, 95% CI 1.02−4.65). Conclusions: Lifetime occupation should be taken into consideration in the process of screening for cognitive decline in the elderly, especially females. This study needs to be interpreted cautiously in view of inherent data and methodological limitations.


2000 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Lina Pezzuti ◽  
Caterina Laicardi ◽  
Marco Lauriola

Summary: An Elderly Behavior Assessment for Relatives (EBAR), updating the GERRI ( Schwartz, 1983 ), was administered to relatives (or significant others) of 349 elderly persons, from 60 to over 80 years of age, living at home, in good health and without cognitive impairment. A trained psychologist administered subjects the Life Satisfaction for Elderly Scale (LSES), the Instrumental Activity of Daily Living (IADL), the Mini Mental State Examination (MMSE), and personally answered to an overall elderly behavior rating scale (RA). EBAR items were first examined. The more attractive and less discriminative statements were excluded. A principal components analysis was carried out on the remaining EBAR items. Three factors were extracted. After varimax rotation they were tentatively labeled: Everyday Cognitive Functioning, Depression, and Hostility. Factor-driven EBAR subscales were designed, taking into account simpler items in the factor matrix. Results provide evidence for EBAR construct validity. Everyday Cognitive Functioning is connected to the IADL and the RA scores; Depression is very highly related to the LSES; Hostility is weakly related to RA, IADL, and MMSE, indicating that the scale needs further investigation.


2021 ◽  
pp. jnnp-2021-326043
Author(s):  
Alis Heshmatollah ◽  
Lisanne J. Dommershuijsen ◽  
Lana Fani ◽  
Peter J. Koudstaal ◽  
M. Arfan Ikram ◽  
...  

ObjectiveAlthough knowledge on poststroke cognitive and functional decline is increasing, little is known about the possible decline of these functions before stroke. We determined the long-term trajectories of cognition and daily functioning before and after stroke.MethodsBetween 1990 and 2016, we repeatedly assessed cognition (Mini-Mental State Examination (MMSE), 15-Word Learning, Letter–Digit Substitution, Stroop, Verbal Fluency, Purdue Pegboard) and basic and instrumental activities of daily living (BADL and IADL) in 14 712 participants within the population-based Rotterdam Study. Incident stroke was assessed through continuous monitoring of medical records until 2018. We matched participants with incident stroke to stroke-free participants (1:3) based on sex and birth year. Trajectories of cognition and daily functioning of patients who had a stroke 10 years before and 10 years after stroke and the corresponding trajectories of stroke-free individuals were constructed using adjusted linear mixed effects models.ResultsDuring a mean follow-up of 12.5±6.8 years, a total of 1662 participants suffered a first-ever stroke. Patients who had a stroke deviated from stroke-free controls up to 10 years before stroke diagnosis in cognition and daily functioning. Significant deviations before stroke were seen in scores of MMSE (6.4 years), Stroop (5.7 years), Purdue Pegboard (3.8 years) and BADL and IADL (2.2 and 3.0 years, respectively).ConclusionPatients who had a stroke have steeper declines in cognition and daily functioning up to 10 years before their first-ever stroke compared with stroke-free individuals. Our findings suggest that accumulating intracerebral pathology already has a clinical impact before stroke.


2018 ◽  
Vol 31 (5) ◽  
pp. 749-753 ◽  
Author(s):  
Neus Gual ◽  
Sarah J. Richardson ◽  
Daniel H. J. Davis ◽  
Giuseppe Bellelli ◽  
Wolfgang Hasemann ◽  
...  

ABSTRACTDiagnosing delirium superimposed on dementia (DSD) remains challenging because of a lack of specific tools, though motor dysfunction in delirium has been relatively under-explored. This study aimed to use dysfunction in balance and mobility (with the Hierarchical Assessment of Balance And Mobility: HABAM) to identify DSD. This is a cross-sectional multicenter study, recruiting consecutive patients ≥70 years admitted to five acute or rehabilitation hospitals in Ireland, Italy, Portugal, and Switzerland. Delirium was diagnosed using DSM-5 criteria; dementia was determined by the Mini-Mental State Examination and the Questionnaire of Cognitive Decline in the Elderly. HABAM score was recorded at admission. Out of 114 patients (mean age ± SD = 82 ± 7; 54% female), dementia alone was present in 24.6% (n = 28), delirium alone in 18.4% (n = 21) and DSD in 27.2% (n = 31). Patients with DSD had a mean HABAM score 7 points greater than those with dementia alone (19.8 ± 8.7 vs 12.5 ± 9.5; p < 0.001); 70% of participants with DSD were correctly identified using the HABAM at a cut off of 22 (sensitivity 61%, specificity 79%, AUC = 0.76). Individuals with delirium have worse motor function than those without delirium, even in the context of comorbid dementia. Measuring motor function using the HABAM in older people at admission may help to diagnose DSD.


Author(s):  
Wendaline McEachern ◽  
Andrew Kirk ◽  
Debra G. Morgan ◽  
Margaret Crossley ◽  
Carol Henry

Background:Recent advances in telehealth have improved access to health care for those in rural areas. It is important that examinations conducted via telehealth are comparable to in-person testing. A rural and remote memory clinic in Saskatoon provided an opportunity to compare scores on the Mini-Mental State Examination (MMSE) administered in-person and via telehealth.Methods:After an initial one day assessment in Saskatoon, patients were seen in follow-up at 6 and 12 weeks. Individual patients were randomly assigned to either in-person follow-up assessment in Saskatoon or telehealth assessment in their home community. Patients who initially received in-person assessments were seen by telehealth for their next follow-up visit and vice-versa. The same neurologist administered MMSEs at all visits. The first 71 patients with both 6 and 12 week follow-up assessments were included in this study. The scores of in-person and telehealth MMSE administrations were compared using the methods of Bland and Altman as well as a paired t-test.Results:MMSE scores did not differ significantly between telehealth (22.34 +/- 6.35) and in-person (22.70 +/- 6.51) assessments.Conclusion:Telehealth provides an acceptable means of assessing mental status of patients in remote areas.


2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Sharon Gondodiputro ◽  
Dahlia Santika Hutasoit ◽  
Lina Rahmiati

Prevalence of chronic diseases and disability will increase at the advancing age. In the future, the need for the caregiver will increase. Only few studies about the expectations of the elderly towards the sociodemographics status of the caregiver found. Unfulfilled expectations of the elderly towards their caregivers may cause both health and non-health issues. The purpose of this study was to explore the elderly expectations of the caregiver’s sociodemographic preferences. A qualitative study was carried out to 7 elderly aged 64–77 years old from July to August 2018 in Bandung city. These elderly selected from 7 integrated care posts (pos pembinaan terpadu/posbindu) that met the inclusion criteria: aged 60 years old and above; male or female; capable of communicating adeptly, and no dementia by undergoing the mini-mental state examination (MMSE). A one-on-one interview was conducted at the residence of the elderly using an interview guide consisted of several opened questions related to the caregiver’s sociodemographic preferences. A content analysis was carried out. This study discovered that the elderly preferred their family members or relatives whom they can trust to become their caregivers (their children and grandchildren). Most of these elderly also preferred daughters who live with them and has a decent income. If the family members could not become their caregiver then their neighbor or a community volunteer/cadre, they knew well, and trust to be their caregiver. It concluded that the elderly prefer their daughters who live with them and has a decent income to be their caregivers. EKSPEKTASI USIA LANJUT TERHADAP STATUS SOSIODEMOGRAFI CAREGIVER: SUATU PENDEKATAN KUALITATIFPrevalensi penyakit kronis dan disablilitas akan meningkat dengan pertambahan usia. Hal ini berdampak pada kebutuhan terhadap caregiver akan meningkat pula. Penelitian tentang ekspektasi usia lanjut terhadap status sosiodemografi caregiver belum banyak dilakukan. Ekspektasi usia lanjut merupakan faktor penting karena bila ekspektasi tersebut tidak terpenuhi maka akan berisiko timbul masalah kesehatan dan nonkesehatan. Tujuan penelitian ini mengeksplorasi ekspektasi usia lanjut terhadap status sosiodemografi caregiver. Studi kualitatif dilakukan terhadap 7 orang usia lanjut berusia 64–77 tahun pada Juli hingga Agustus 2018 di Kota Bandung. Para usia lanjut berasal dari 7 pos pembinaan terpadu (posbindu) yang memenuhi kriteria inklusi, yaitu usia ≥60 tahun, laki-laki atau perempuan, dapat berkomunikasi dengan baik, dan tidak demensia dengan dilakukan mini-mental state examination (MMSE). Wawancara dilakukan di kediaman informan masing-masing menggunakan panduan wawancara terkait pertanyaan dengan preferensi sosiodemografi caregiver. Analisis konten dilakukan. Studi ini menemukan bahwa usia lanjut lebih memilih anggota keluarga mereka yang dapat dipercaya untuk menjadi caregiver terutama anak dan cucu. Anak perempuan yang tinggal bersama usia lanjut dan memiliki penghasilan layak menjadi pilihan utama. Jika anggota keluarga tidak dapat menjadi caregiver maka tetangga atau kader yang mereka kenal baik dan dipercaya menjadi pilihan. Simpulan, pilihan utama caregiver bagi usia lanjut, yaitu anak perempuan mereka yang tinggal bersama dan memiliki penghasilan layak.


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