Sintomatologia depressiva e avaliação de níveis de TNFα IL-2 em indivíduos idosos e com doença pulmonar obstrutiva crônica

The aim of the present study was to assess the presence of depressive symptomatology among elderly residents in long-stay institutions (LSI) and in the community of Recife, Brazil. In total, 81 long-stay elderly patients (mean age of 75.55 ± 9.18 years) and 132 elderly (mean age of 73.14 ± 8.27 years) individuals from the community were evaluated. Depressive symptomatology was assessed by the Geriatric Depression Scale (GDS-15), cognitive status by the Mini Mental State Examination (MMSE) and capacity to perform the activities of daily living (ADL) by the Katz Index. Comorbities and the use of medication were recorded. The LSI elderly exhibited more depressive symptoms (p < 0.001) and more dependency (p< 0.001). We observed no differences in MMSE (p = 0.058). The elderly in the community displayed more comorbidities and the LSI elderly consumed more medication (p < 0.001 and p < 0.001, respectively). According to multivariate analysis (logistic regression), being male, having no spouse and having a low schooling level are risk factors for depressive symptoms. In conclusion, most elderly with depressive symptoms received no medication fordepression.

Sintomatologia depressiva e concentrações do cortisol em idosos residentes na comunidade: um estudo transversal

Introdução: Vem sendo crescente o número de pesquisas que buscam o entendimento das relações entre os desfechos adversos à saúde e as concentrações do cortisol salivar, o qual é um marcador de estresse biológico. O cortisol parece seguir dois estágios de resposta: em situações de baixo/moderado estresse ocorre ativação do eixo Hipotálamo-Pituitária-Adrenal, aumentando o nível do cortisol, entretanto, quando o estresse persiste, o eixo HPA parece tornar-se hipoativo. A sintomatologia depressiva parece ter relação com as concentrações do cortisol, no entanto, essa relação é controversa na literatura. Objetivo: Analisar a relação entre sintomatologia depressiva e concentrações do cortisol em uma amostra de idosos do Nordeste brasileiro, residentes na comunidade. Métodos: Estudo observacional analítico, de caráter transversal, em uma amostra de 256 idosos (≥ 65 anos), residentes na comunidade. A sintomatologia depressiva foi avaliada pela versão brasileira da Center for Epidemiologic Studies-Depression Scale (≥ 16) e as concentrações do cortisol através da coleta salivar (ao acordar, 30 minutos após acordar, 60 minutos após acordar, às 15 horas e antes de dormir), além de medidas compostas. Como co-variáveis foram avaliadas condições sociodemográficas e de saúde. Para análise das medidas do cortisol entre idosos com e sem presença da sintomatologia depressiva, e entre os sexos, foi realizado o teste t de Student. Para verificar as diferenças entre as medidas do cortisol em cada curva foi utilizada a Análise de Variância (ANOVA) de medidas repetidas, com teste post-hoc de Bonferroni. Resultados: Houve diferença significativa para a medida de cortisol salivar ao acordar, entre os idosos com presença e ausência da sintomatologia depressiva (p=0,04). Não houve significância em relação ao sexo. Na análise entre as medidas de cada curva, foi observado que nos idosos com sintomatologia depressiva a 1ª medida não teve diferença significativa em relação à 2ª e 3ª medidas. Além disso, não houve diferença significativa da 4ª medida em relação à 5ª, demonstrando um maior nível noturno de cortisol para os idosos com sintomatologia depressiva, sem declínio, com aspecto plano da curva. Conclusão: Parece existir relação entre sintomatologia depressiva e hipocortisolismo. Entretanto, no Brasil, as condições adversas de vida podem levar ao estresse crônico e serem fatores fortes suficientes para sobrepor maiores diferenças que pudessem existir em relação à presença da sintomatologia depressiva

Tradução, adaptação cultural e propriedades psicométricas da versão brasileira do mobility assessment tool physical activity (MAT-PA) em idosos comunitários brasileiros

Objetivo: Traduzir e avaliar as propriedades psicométricas do Mobility Assessment Tool Physical Activity (MAT-PA) em idosos comunitários brasileiros. Métodos: Trata-se de um estudo tradução, adaptação cultural, e acurácia do instrumento MAT-PA, no qual foram avaliados 329 idosos, com idade mínima de 60 anos, residentes na comunidade. Os indivíduos submeteram-se a um formulário de avaliação composto por: questionário sócio-demográfico e de saúde percebida; avaliação física; Prova Cognitiva de Leganés (PCL); Center for Epidemiologic Studies Depression Scale (CES-D); International Physical Activity Questionnaire (IPAQ); Mobility Assessment Tool Physical Activity (MAT-PA). Dessa amostra total, 42 idosos utilizaram o acelerômetro durante 8 dias. Para verificar a confiabilidade teste-reteste do MAT-PA, reaplicou-se esse instrumento em 34 idosos 8 dias após a primeira avaliação. A análise estatística utilizada foi a correlação de Spearman, o Coeficiente de Correlação Intra-classe, o coeficiente α de Cronbach, o Bland-Altman e o teste T pareado. Resultados: As correlações dos dados IPAQ e acelerômetro versus o escore total do MAT-PA foram significativas e apresentaram um coeficiente de correlação de Spearman de 0,13 e 0,41, respectivamente. Analisou-se também a confiabilidade que apresentou as seguintes medidas: consistência interna, pelo coeficiente alfa de Cronbach (α= 0,70); Concordância teste-reteste, pelo coeficiente de correlação intra-classe (CCI=0,53; p<0,001). Conclusão: A versão brasileira do Mobility Assessment Tool Physical Activity (MAT-PA) como um instrumento de avaliação da atividade física de idosos, mostrou ser um método válido e confiável.

Mulheres com lúpus eritematoso sistêmico: sintomas depressivos e apoio social percebido

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease, rare, multisystem, with a very heterogeneous clinical and serological manifestations standard. The patient, in addition to suffering injuries on his physical and physiological functioning, may also face a number of psychosocial problems. Research indicates that SLE can cause significant damage to the psychological realm, especially with the presence of anxiety and depression. In 1999, the American College of Rheumatology (ACR), proposed the establishment of 19 neuropsychiatric clinical syndromes attributed to SLE. Depression lies between mood disorders and is one of the most common psychiatric manifestations in this group, being found more frequently in these patients than in the general population. Studies also suggest that social support plays an important role in the development of coping strategies, in SLE management and depression. This study has as main objective verify the association between depressive symptoms and perceived social support in patients with SLE. The specific objectives turned to: investigte the prevalence of depressive symptoms; investigate the perceived social support and verify if there is an association between depression, social support and sociodemographic variables. We used a sociodemographic questionnaire, the Beck Depression Scale, and the Perceived Social Support Scale. The analysis was performed through descriptive and inferential statistics. The final sample could count with 79 SLE women, with an average age of 35.7 years. 44 (55.7%) of the participants were married. Only 6 (7.59%) had completed higher education and 32 (40.51%) have not finished high school. Seventy-one (89.87%) had an income below three minimum salaries and 71 (89.87) practiced a religion, and the Catholic (67.71%) was the most mentioned by them. Of the total sample, 37 (46.74%) had been diagnosed SLE more than 7 years before, and 25 (31.65%) had the disease for more than 10 years. Only 19 (24.05%) had some work activity. Forty-two of them (53.17%) had depressive symptoms levels from mild to severe, and 51 (64.46%) reported pain levels of 5, or above. The study found a significant association between depressive symptoms and pain (p = 0.013) and depressive symptoms and work activity (p = 0.02). When we examined the perception of social support, the results showed high levels among participants. Using the Spearman correlation test we found a strong correlation between depressive symptoms and social support (p= 0,000037). It means that the higher the frequency of support, the lower the score of depression. These findings are relevant because depressive symptoms in patients with SLE have a multicausal and multifactorial character and may remain unnoticed, since many of them are confused with the manifestations of the disease. This fact requires a careful assessment from professionals, not only in the clinical setting, but also considering other psychosocial reasons, that may be influencing the emergence or worsening of symptoms. These results also corroborate other studies, which not only confirm the predictive role of social support in the physical wellbeing, but also in the psychological.

Mulheres com lúpus eritematoso sistêmico: sintomas depressivos e apoio social percebido

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease, rare, multisystem, with a very heterogeneous clinical and serological manifestations standard. The patient, in addition to suffering injuries on his physical and physiological functioning, may also face a number of psychosocial problems. Research indicates that SLE can cause significant damage to the psychological realm, especially with the presence of anxiety and depression. In 1999, the American College of Rheumatology (ACR), proposed the establishment of 19 neuropsychiatric clinical syndromes attributed to SLE. Depression lies between mood disorders and is one of the most common psychiatric manifestations in this group, being found more frequently in these patients than in the general population. Studies also suggest that social support plays an important role in the development of coping strategies, in SLE management and depression. This study has as main objective verify the association between depressive symptoms and perceived social support in patients with SLE. The specific objectives turned to: investigte the prevalence of depressive symptoms; investigate the perceived social support and verify if there is an association between depression, social support and sociodemographic variables. We used a sociodemographic questionnaire, the Beck Depression Scale, and the Perceived Social Support Scale. The analysis was performed through descriptive and inferential statistics. The final sample could count with 79 SLE women, with an average age of 35.7 years. 44 (55.7%) of the participants were married. Only 6 (7.59%) had completed higher education and 32 (40.51%) have not finished high school. Seventy-one (89.87%) had an income below three minimum salaries and 71 (89.87) practiced a religion, and the Catholic (67.71%) was the most mentioned by them. Of the total sample, 37 (46.74%) had been diagnosed SLE more than 7 years before, and 25 (31.65%) had the disease for more than 10 years. Only 19 (24.05%) had some work activity. Forty-two of them (53.17%) had depressive symptoms levels from mild to severe, and 51 (64.46%) reported pain levels of 5, or above. The study found a significant association between depressive symptoms and pain (p = 0.013) and depressive symptoms and work activity (p = 0.02). When we examined the perception of social support, the results showed high levels among participants. Using the Spearman correlation test we found a strong correlation between depressive symptoms and social support (p= 0,000037). It means that the higher the frequency of support, the lower the score of depression. These findings are relevant because depressive symptoms in patients with SLE have a multicausal and multifactorial character and may remain unnoticed, since many of them are confused with the manifestations of the disease. This fact requires a careful assessment from professionals, not only in the clinical setting, but also considering other psychosocial reasons, that may be influencing the emergence or worsening of symptoms. These results also corroborate other studies, which not only confirm the predictive role of social support in the physical wellbeing, but also in the psychological.