Condições de saúde bucal e capacidade funcional em idosos

Population aging is one of the greatest challenges to contemporary public health and, in this perspective, the functional capacity emerges as an important feature in geriatric assessment. The oral health of elderly, in turn, deserves special attention because, historically, in the dental services, this population group was not considered a priority for attention, which is verified by high rates of edentulism found even among these individuals. The present study proposes to examine the relationship between oral health status and functional capacity in an elderly population. To this end, intra-oral epidemiological examination was performed to assess the degree of dental caries, periodontal status, use and need of prosthesis and the presence of lesions. Functional capacity was assessed by the Independence in Activities of Daily Living, which considers the independence or not in the performance of six self-care functions. Socioeconomic and demographic characteristics and general health status were also investigated, in view of the possibility of intervention of these variables in the investigated relation. An factor analysis of the principal components was conducted which resulted four indicators of oral health conditions, representative of the population studied. 441 seniors were enrolled with mean age of 71.7 (± 8.7) years, the majority being female (68%). Functional capacity was dichotomized into completely independent individuals (89.6%) and dependent on at least one of the functions considered (10.4%). There was an association between functional capacity and the indicators related to the presence of many teeth and dental caries, and to that associated with the use and need of prostheses. These associations in turn, lost statistical significance when adjusting for confounding variables, combined in separate models for each indicator. Some of these variables, however, remained associated with functional capacity. It is considered that the study of oral health status of elderly, associeted with the search for an association with functional capacity is important in the construction of indicators necessary for planning preventive and therapeutic interventions that reduce the risk for loss of ability in daily physical functions and their consequences, as the harm in the oral self-care

Características sociodemográficas, hábitos de sono, estado cognitivo e funcional após acidente vascular cerebral

ABSTRACT Introduction: The cerebrovascular accident (CVA) is an important cause of neurological impairment. Few data about the factors associated with morbidity of cerebrovascular accident are found in Brazil. Objectives: Evaluate sociodemographic characteristics, sleep habits, cognitive and functional status of patients with cerebrovascular accident. Methods: The patients evaluated through questionnaire Step 1 to survey the sociodemographic characteristics and Modified Rankin Scale for functional assessment. The neurological degree was evaluated by the National Institutes of Health Stroke Scale (NIHSS), the sleep Habits questionnaire for sleep and cognitive status by the Mini-Examination of the Mental State (MEMS). The data were analyzed using the chi-square test to determine differences in proportions of variables and linear regression analysis. Results: 305 patients were evaluated and the larger number of subjects was between 50 and 69 years (40%), most patients had no formal education (40.3%) and had ischemic type of cerebrovascular accident (72.5%). In the analysis of the functionality it was found that most patients had moderate impairment (55.1%). The results of the sleep habits showed that 63,6% of patients had one more person in the bedroom,12,3% complained about too much noise in the 11 room and 35% of too much light. From these patients 5,8% were smokers, 7,8% and 70,1% drank coffee drinkers, 28,6% had difficulty in initiate to sleep and woke up 37,6% in the middle of the night. Were showed complaints about nightmares (11%), feeling of suffocation (37,7%) and 35% felt very sleepy during the day. In addition, 95% were unemployed, 80,5% did not perform physical activities and 95,4% did not perform mental activities. The cognitive screening conducted a determined association of cognitive status with age and education level and neurological status. Conclusion: The study showed a high frequency of cases of cerebrovascular accident with functional dependence in a moderate degree, identified that many patients do not follow hygienic measures of sleep and found that the assessment of cognitive deficits must take into consideration the age, educational level and degree of neurological patients. We suggest the need for programs of assistance to victims of cerebrovascular accident patients, with a multidimensional approach including the rehabilitation team, the role of sleep medicine and Neuropsychology, so that patients have access to a more appropriate functional rehabilitation, develop a lifestyle that ensures a good sleep quality and are evaluated and rehabilitated with regard to cognitive impairment

Análise comparativa na influência da técnica de moldagem funcional em arcos parcialmente edêntulos sobre os pontos de contato oclusais, a integridade da fibromucosa e a extensão da base da prótese

There is a lack of clinical studies evaluating techniques of functional impression for partially edentulous arches. The aim of this double-blind non-randomized controlled clinical trial was to compare the efficacy of altered cast impression (ACI) and direct functional impression (DFI) techniques. The efficacy was evaluated regarding the number of occlusal units on denture teeth, mucosa integrity at 24-hour follow-up and denture base extension. The sample included 51 patients (female and male) with mean age of 58.96 years treated at Dental Department of UFRN. The patients, exhibiting edentulous maxilla and mandibular Kennedy class I, were divided into two groups (group ACI, n=29; group DFI, n=22). Clinical evaluation was based on the number of occlusal units on natural and/or artificial teeth, mucosa integrity at 24-hour follow-up, and denture base extension. Statistical analysis was conducted using the software SPSS 17.0® (SPSS Inc., Chicago, Illinois). Student T-test was used to reveal association between number of occlusal units and impression technique while chi-square test showed association between mucosa integrity and impression technique. Fischer s exact test was applied for association between denture base extension and impression technique at 95% level of significance. No significant difference was observed between the groups regarding number of occlusal units, mucosa integrity and denture base extension. The altered cast technique did not provide significant improvement in comparison to the direct technique when the number of occlusal units, mucosa integrity and denture base extension

Influência das condições de saúde bucal no desempenho das atividades diárias de adolescentes escolares

Instruments are used in odontology to measure the Quality of Life Related to Oral Health (OHRQoL) to scale how the oral condition interferes with functional areas, of the people s psychological and social life. This cross-sectional study, held in Natal/RN, with 215 students from the Federal Institute of Education, Science and Technology of Rio Grande do Norte (IFRN) has investigated the association between the performance of daily activities and oral health status of school adolescents from 15 to 19 years of age, through the normative index DMFT (permanent teeth decayed, missing and filled), CPI (Community Periodontal Index) and DAI (dental Aesthetic Index) and subjective questionnaire assessment of quality of life related oral health OIDP index (oral impacts on daily performance). It was also carried out the socioeconomic characteristics of students through IFRN own data. Concerning the analysis of data was performed a descriptive analysis of the variables by their absolute and relative frequencies and measures of central tendency. The chi-square test was used to assess the association between the dependent variable and the independent categorical variables and the Student t test for quantitative. It was also conducted a further multiple analysis out using Poisson regression with robust variance between the outcome "presence of impact" and the independent variables that showed p <0.20. It was used for all the statistical tests a significance level of 5%. Among the adolescents surveyed, 51.16% reported that at least one activity assessed by OIDP had hampered its implementation due to some dental problem. The difficulties were more pronounced in the activities of eating (31.6%), oral hygiene (25.6%) and smile (25.1%).The tooth position, followed by toothache, were the causes of the impacts reported by most teenagers. There was a significant association between the presence and impact of the presence of one or more decayed teeth (p = 0.012), the presence of gum bleeding (p = 0.012) and for orthodontic treatment (p = 0.003), independently of other variables. There was no significant association between oral health status and socioeconomic and demographic characteristics of the adolescents. The survey results showed that there is an association between oral health status of the population studied and reports of difficulties in carrying out daily activities evaluated. The worse the oral health status, the greater the impact of this condition on the adolescents quality of life

Relação entre desempenho funcional e indicadores de doença arterial obstrutiva periférica em idosas

The presence of peripheral arterial disease (PAD) increases the risk and vulnerability to adverse clinical outcomes in the elderly. Like this, we investigated the relationship between functional performance and indicators of PAD in elderly women. METHODS: Cross-sectional study in which 54 elderly were assessed by questionnaire mini mental state examination, Short Phisical Performance Battery (SPPB), ankle-brachial index (ABI), human activity profile (HAP) and Edinburgh questionnaire. Statistical analysis was performed using ANOVA, t test and Pearson correlation. We considered p <0.05 as significance level. RESULTS: The mean age SPPB and ABI were 69.2 (± 6.9) years, SPPB 9.42 (± 2.55) and ABI 1.04 (± 0.14). The prevalence of PAD was 16.3%. There was a significant correlation between ABI and gait speed (r = 0.75, p = 0.001) and between PAH with SPPB (p = 0.001). CONCLUSIONS: It is suggested that the decline in functional performance in older, expressed in gait velocity component of the SPPB, is related to the presence of PAD