Proprioceptive neuromuscular facilitation does not increase blood pressure of healthy elderly women

Proprioceptive neuromuscular facilitation (PNF) is an attractive method to increase strength and proprioception of elderly individuals. However, a major clinical concern about the prescription of PNF is the belief that it can cause a cardiovascular overload, because it involves close-to-maximal loads and isometric contractions. Yet the acute effect of a PNF training session on cardiovascular response in elderly individuals is still unknown. Hence, the objective of this study was to evaluate the effect of PNF on diastolic and systolic blood pressure of healthy elderly people. Fifteen older women (mean age 72.40±6.82 years) performed three sets (five repetitions each) of three different PNF techniques (rhythmic initiation, dynamic reversion, and isotonic combination), executing a single movement pattern. Diastolic and systolic blood pressure (DBP and SBP) were evaluated by means of a manual sphygmomanometer immediately before and during the last two repetitions (last set) of each technique. A two-way ANOVA test (time and technique) was performed to investigate the PNF effect on blood pressure. No time (preexercise to postexercise) (p=0.33 for DBP; p=0.06 for SBP) or PNF technique (p=0.75; p=0.81) effect were observed. In conclusion, we can state that the execution of these PNF techniques is safe for the cardiovascular system of healthy elderly women, because no blood pressure increases were found. Copyright © Informa Healthcare USA, Inc.

Oral health of the elderly with Alzheimer's disease

Objective: The objective of this study was to describe the oral health of elderly people diagnosed with Alzheimer's disease (AD). Study Design: Thirty elderly subjects with AD (mild, moderate, and severe) and 30 without AD (controls) were included in the study. Volunteer-reported oral health data were collected using the General Oral Health Assessment Index (GOHAI). Demographic and oral characteristics were assessed, including the number of natural teeth; number of decayed, missing, and filled teeth (DMTF); oral health index (OHI); removable prosthesis conditions; and oral pathologies. Results: GOHAI values were similar for both groups. Compared with the controls, the subjects with AD had a higher age, DMTF, OHI, and number of oral pathologies and a lower educational level and number of natural teeth. Conclusions: Elderly subjects with AD had poorer oral health than those without the disease. Despite the positive self-perception of their oral health, the oral health of subjects with AD tended to decline as their disease progressed. © 2012 Elsevier Inc.

Effects of probiotic bacteria on Candida presence and IgA anti-Candida in the oral cavity of elderly

Imbalance in the resident microbiota may promote the growth of opportunistic microorganisms, such as yeasts of Candida genus and the development of diseases, especially in aged people. This study evaluated whether the consumption of the probiotic Yakult LB® (Lactobacillus casei and Bifidobacterium breve) was able to influence on the specific immunological response against Candida and on the presence of these yeasts in the oral cavity of 42 healthy aged individuals. Saliva samples were collected before and after the probiotic use for 30 days, 3 times a week. The samples were plated in Dextrose Saboraud Agar with chloramphenicol, the colony-forming units (CFU/mL) were counted and the Candida species were identified. Anti-Candida IgA analysis was conducted using the ELISA technique. ANOVA and Student's t-test were used for normally distributed data and the Wilcoxon test was used for data with non-normal distribution (α=0.05). The results showed a statistically significant reduction (p<0.05) in Candida prevalence (from 92.9% to 85.7%), in CFU/mL counts of Candida and in the number of non-albicans species after consumption of the probiotic. Immunological analysis demonstrated a significant increase (p<0.05) in anti-Candida IgA levels. In conclusion, probiotic bacteria reduced Candida numbers in the oral cavity of the elderly and increased specific secretory immune response against these yeasts, suggesting its possible use in controlling oral candidosis.

Endurance training does not change the relative intensity at lactate threshold in elderly

Aim. The aim of the study was to verify whether endurance training may induce changes on the percentage of peak heart rate (% peak HR) at the lactate threshold (LT) intensity in untrained elderly. Methods. Sixteen healthy men (64.3 ± 4.1 yrs) underwent an incremental test on cycloergometer to determine the LT and the corresponding % peak HR at LT intensity. Afterwards, they were randomly distributed into two groups (n = 8 each): endurance training (ET) and control (C). The ET exercised 3 days a week for 12 weeks. The training session was divided into warm-up (5 min at 50% of LT;), a main part, and a cool-down (5 min 50% below of LT). The main part had a gradual increased volume through the weeks of 2 min. The initial volume on the 1st week was 25 min reaching 47 min at the 12th week. The relative intensity was kept constant (90 to 100% of LT). Results. After 12 weeks, the % peak HR at LT did not change significantly for both groups P > 0.05 (ET 82.9 ± 4.1 vs. 82.5 ± 3.4 and Ç 80.2 ± 7.1 vs. 81.8 ± 7.1). Conclusion. We conclude that endurance training proposed does not change the relative intensity at LT in elderly.

Ricinus communis treatment of denture stomatitis in institutionalised elderly

This study compared the effectiveness of Ricinus communis (RC) with Nystatin (NYS) and Miconazole (MIC) in the treatment of institutionalised elderly with denture stomatitis (DS). They (n = 30) were randomly distributed into three groups: MIC, NYS or RC. Clinical and mycological evaluations were performed prior to the use of the antifungal (baseline) and repeated after 15 and 30 days of treatment. The sample was clinically examined for oral mucosal conditions. Standard photographs were taken of the palate, and the oral candidiasis was classified (Newton's criteria). Mycological investigation was performed by swabbing the palatal mucosa, and Candida spp. were quantified by counting the number of colony-forming units (cfu mL-1). The clinical and mycological data were analysed, respectively by Wilcoxon and Student's t-test (α = 0·05). Significant improvement in the clinical appearance of DS in the MIC and RC groups was observed between the 1st and 3rd collections (MIC - P = 0·018; RC - P = 0·011) as well as between the 2nd and 3rd collections (MIC - P = 0·018; RC - P = 0·011). Neither groups showed a statistically significant reduction in cfu mL-1 at any time. Although none of the treatments decreased the cfu mL-1, it was concluded that Ricinus communis can improve the clinical condition of denture stomatitis in institutionalised elderly patients, showing similar results to Miconazole. © 2013 Blackwell Publishing Ltd.

Influenza among the elderly in the Americas: A consensus statement

Influenza exacts a heavy burden on the elderly, a segment of the population that is estimated to experience rapid growth in the near future. In the past decade most developed and several developing countries have recommended influenza vaccination for those > 65 years of age. The World Health Organization (WHO) set a goal of 75% influenza vaccination coverage among the elderly by 2010, but it was not achieved. In 2011, the Technical Advisory Group at the Pan American Health Organization, Regional Office of WHO for the Americas, reiterated the influenza vaccine recommendation for older adults. Relatively little information has been compiled on the immunological aspect of aging or on reducing its impact, information particularly relevant for clinicians and gerontologist with firsthand experience confronting its effects. To fill this data gap, in 2012 the Americas Health Foundation (Washington, D.C., United States) and the nonprofit, Fighting Infectious Diseases in Emerging Countries (Miami, Florida, United States), convened a panel of Latin American clinicians and gerontologists with expertise in influenza to discuss key issues and develop a consensus statement. The major recommendations were to improve influenza surveillance throughout Latin America so that its impact can be quantified; and to conduct laboratory confirmation of influenza for all patients who have flu-like symptoms and are frail, immunosuppressed, have comorbidities, are respiratory compromised, or have been admitted to a hospital. The panel also noted that: since evidence for antivirals in the elderly is unclear, their use should be handled on a case-by-case basis; despite decreased immunological response, influenza vaccination in older adults is still crucial; indirect immunization strategies should be encouraged; and traditional infection control measures are essential in long-term care facilities.

Potentially inappropriate medications used by the elderly: Prevalence and risk factors in Brazilian care homes

Abstract. Background: The use of potentially inappropriate medications (PIM) among the elderly is a serious public health problem because it is intrinsically linked to increased morbidity and mortality, causing high costs to public health systems. This study's objective was to verify the prevalence of and the factors associated with the use of PIMs by elderly Brazilians in institutional settings. Methods. We performed a transversal study, by consulting the case files of elderly people living in Long Term Care for the Elderly (LTC) in towns in the State of São Paulo, Brazil, as well as structured interviews with the nurses responsible for them.We identified PIMs using the list of recently updated Beers criteria developed by a group of specialists from the American Geriatrics Society (AGS), who reviewed the criteria based on studies with high scientific evidence levels. We defined the factors studied to evaluate the association with PIM use prior to the statistical analyses, which were the chi-square test and multiple logistic regression. Results: Among the elderly who used drugs daily, 82.6% were taking at least one PIM, with antipsychotics (26.5%) and analgesics (15.1%) being the most commonly used. Out of all the medications used, 32.4% were PIMs, with 29.7% of these being PIMs that the elderly should avoid independent of their condition, 1.1% being inappropriate medication for older adults with certain illnesses or syndromes, and 1.6% being medications that older adults should use with caution. In the multivariate analysis, the factors associated with PIM use were: polypharmacy (p = 0.0187), cerebrovascular disease (p = 0.0036), psychiatric disorders (p < 0.0001) and dependency (p = 0.0404). Conclusions: The results of this study showed a high prevalence of PIM use in institutionalized elderly Brazilian patients. and the associated factors were polypharmacy, psychiatric disorders, cerebrovascular diseases and dependency. © 2013 Lima et al.; licensee BioMed Central Ltd.

The relationship between training status, blood pressure and uric acid in adults and elderly

Background: Hypertension can be generated by a great number of mechanisms including elevated uric acid (UA) that contribute to the anion superoxide production. However, physical exercise is recommended to prevent and/or control high blood pressure (BP). The purpose of this study was to investigate the relationship between BP and UA and whether this relationship may be mediated by the functional fitness index.Methods: All participants (n = 123) performed the following tests: indirect maximal oxygen uptake (VO2max), AAHPERD Functional Fitness Battery Test to determine the general fitness functional index (GFFI), systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI) and blood sample collection to evaluate the total-cholesterol (CHOL), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), triglycerides (TG), uric acid (UA), nitrite (NO2) and thiobarbituric acid reactive substances (T-BARS). After the physical, hemodynamic and metabolic evaluations, all participants were allocated into three groups according to their GFFI: G1 (regular), G2 (good) and G3 (very good).Results: Baseline blood pressure was higher in G1 when compared to G3 (+12% and +11%, for SBP and DBP, respectively, p<0.05) and the subjects who had higher values of BP also presented higher values of UA. Although UA was not different among GFFI groups, it presented a significant correlation with GFFI and VO2max. Also, nitrite concentration was elevated in G3 compared to G1 (140±29 μM vs 111± 29 μM, for G3 and G1, respectively, p<0.0001). As far as the lipid profile, participants in G3 presented better values of CHOL and TG when compared to those in G1.Conclusions: Taking together the findings that subjects with higher BP had elevated values of UA and lower values of nitrite, it can be suggested that the relationship between blood pressure and the oxidative stress produced by acid uric may be mediated by training status. © 2013 Trapé et al.; licensee BioMed Central Ltd.

Oral manifestations of secondary syphilis in the elderly - A timely reminder for dentists

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. Cases of syphilis have increased in frequency and are challenging when affecting the elderly. The main causes of increased prevalence of syphilis are sexual promiscuity, lack of knowledge about the disease and decreasing use of barrier protection. Clinically, the oral manifestation of syphilis may resemble other entities, which hampers the correct diagnosis. We report a case of a 79-year-old male with weight loss and feeding difficulties. In the oral cavity there were ulcerative lesions in the hard palate and bilaterally in the buccal mucosa. The incisional biopsy revealed only a non-specific ulceration of the oral mucosa. After 20 days, the patient was re-evaluated and presented maculopapular lesions in the palmar and plantar areas. Positive serological venereal disease reference laboratory (VDRL) tests confirmed the diagnosis of secondary syphilis. The patient was treated with Benzathine penicillin G. After two weeks of treatment the oral lesion disappeared and the patient returned to normal feeding and gained weight. This case report reinforces the need to alert physicians and dentists to include sexually transmitted infections such as syphilis in the differential diagnosis of oral ulcerative lesions in elderly sexually active patients. © 2013 Australian Dental Association.

Inclusão digital: estratégia de co-participação de idosos no lazer virtual = Digital inclusion: strategies for elderly co-participation in virtual leisure

Pós-graduação em Ciências da Motricidade - IBRC

Association between oxidative stress and nutritional status in the elderly

O envelhecimento é um processo dinâmico e progressivo que se caracteriza pela ocorrência de modificações morfológicas, bioquímicas, funcionais e psicológicas do organismo. O objetivo do presente artigo é fornecer conceitos atualizados sobre estresse oxidativo, abordando sua importância no envelhecimento, assim como o estado nutricional e suplementação com antioxidantes (substâncias que evitam ou atenuam a oxidação de substratos oxidáveis, como lipídeos, proteínas, carboidratos e o ácido desoxirribonucleico) na população geriátrica. Evidências sugerem que existe uma relação inversa entre estresse oxidativo e estado nutricional em indivíduos idosos. Embora seja comprovado o aumento do estresse oxidativo nas doenças crônicas associadas ao envelhecimento, como doença de Parkinson e doença de Alzheimer, não há, até o momento, evidências clínicas consistentes que comprovem a eficiência da suplementação com antioxidantes contra o estresse oxidativo. Nesse contexto, a suplementação não é recomendada. Por outro lado, idosos devem ser encorajados a ingerir alimentos antioxidantes, como, por exemplo, frutas e vegetais. A manutenção do peso dentro da faixa de normalidade (índice de massa corpórea entre 23 e 28 kg/m2) também deve ser estimulada.

Revendo estudos sobre a assistência domiciliar ao idoso

Home care presents itself as a new modality of care for the elderly, especially in Brazil , and has been inserted into public policies. This study aims to identify scientific productions about home care, in order to ascertain which are the contributions of this social dynamic in the elderly. The research was conducted in the databases MEDLINE and LILACS, with articles published between the years 2001- 2011, in Portuguese and English. The combination of keywords used was home care and elderly , elderly and care, and elderly and caregiver, and correspondents in Portuguese. The discussion highlighted the importance of home care, especially for lonely or neglected elderly. The review revealed few studies concerning the social dynamics in the home care of the elderly and the need to broaden the discussion beyond the field of health.

Factors associated with the prevalence of hypertension and control practices among elderly residents of São Paulo city, Brazil

The aim of this study was to analyze the prevalence of hypertension and control practices among the elderly. The survey analyzed data from 872 elderly people in São Paulo, Brazil, through a cluster sampling, stratified according to education and income. A Poisson multiple regression model checked for the existence of factors associated with hypertension. The prevalence of self-reported hypertension among the elderly was 46.9%. Variables associated with hypertension were self-rated health, alcohol consumption, gender, and hospitalization in the last year, regardless of age. The three most common measures taken to control hypertension, but only rarely, are oral medication, routine salt-free diet and physical activity. Lifestyle and socioeconomic status did not affect the practice of control, but knowledge about the importance of physical activity was higher among those older people with higher education and greater income. The research suggests that health policies that focus on primary care to encourage lifestyle changes among the elderly are necessary.

Análise de protocolos com intervenção motora domiciliar para pacientes com doença de Alzheimer: uma revisão sistemática

The regular practice of physical therapy is indicated as a non-pharmacological treatment of Alzheimer's disease by promoting cognitive, behavioral and functional benefits. However, little is known about the protocols with home-based motor intervention for this population. Thinking about it, this review aimed to investigate and analyze the protocols for home-based motor intervention for elderly with Alzheimer's disease described in scientific articles. A systematic search was performed in the following databases: Web of Science, PubMed, PsycINFO, and Scopus, using the following keywords and Boolean operators: home-based exercise OR home-based physical exercise OR home-based physical fitness OR home-based rehabilitation OR home-based physical therapy OR home-based physical activity OR home-based engine Intervention and AD OR Alzheimer's disease OR AlzheimerOR Alzheimer's dementia. We also conducted a manual search of reference lists of selected articles. Of the five articles that met the inclusion criteria adopted, three performed a protocol for home motor intervention, achieving good compliance with the program, improvement of general health and reduction of depressive symptoms. The other two studies were limited to describing the protocols. Although more studies are needed, with detailed protocols, this review allowed to show that protocols for home motor intervention can also produce positive effects for both patients and caregivers.

Association between bone mass and functional capacity among elderly people aged 80 years and over

Objetivo:Analisar a associação entre a massa óssea e capacidade funcional de idosos com 80 anos ou mais.Métodos:A amostra foi composta por 93 idosos entre 80 e 91 anos (83,2 ± 2,5 anos), 61 mulheres (83,3 ± 2,7 anos) e 32 homens (83,1 ± 2,2 anos) da cidade de Presidente Prudente. A avaliação da massa óssea foi feita pela absorptiometria de dupla energia de raios X (DXA), na qual foram mensurados os valores de conteúdo mineral ósseo (BMC) e densidade mineral óssea (BMD) do fêmur e da coluna (L1-L4). A capacidade funcional foi avaliada por meio dos testes de velocidade para caminhar, equilíbrio estático e força de membros inferiores contidos no questionário Saúde, Bem-Estar e Envelhecimento (Sabe). As variáveis da massa óssea e capacidade funcional foram categorizadas de acordo com os valores de mediana e a pontuação obtida nos testes, respectivamente. Para tratamento estatístico fez-se o teste qui-quadrado, o software usado foi SPSS (13.0) e o nível de significância estabelecido foi de 5%.Resultados:Os idosos do sexo masculino com maior desempenho nos testes funcionais apresentaram maiores valores de BMC de fêmur comparados com os de menor desempenho, resultado não encontrado quando avaliadas as mulheres.Conclusão:Dessa forma, a massa óssea do fêmur para idosos longevos do sexo masculino está associada à capacidade funcional. A avaliação constante da massa mineral óssea e a prática de atividade física ao longo da vida seriam medidas para prevenção das quedas em idosos.