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Lopes MJ, de Pinho LG, Fonseca C, Goes M, Oliveira H, Garcia-Alonso J, Afonso A. Functioning and Cognition of Portuguese Older Adults Attending in Residential Homes and Day Centers: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137030. [PMID: 34209339 PMCID: PMC8297339 DOI: 10.3390/ijerph18137030] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/14/2022]
Abstract
The functioning and cognition of older adults can be influenced by different care contexts. We aimed to compare the functioning profiles and cognition of institutionalized and noninstitutionalized older adults and to evaluate the effect of sociodemographic factors on the functioning and cognition. This is a cross-sectional study that included 593 older adults. The data were collected using the Elderly Nursing Core Set and Mini Mental State Examination. Women, older adults who did not attend school and those live in Residential Homes are more likely to have a higher degree of cognitive impairment than men, those who attended school and those frequent Day Centre. The chances of an older adult with moderate or severe cognitive impairment increases with age. Older women, older adults who did not attend school, and older adults who live in Residential Homes had a higher degree of functional problem than men, those who attended school and those who frequent a Day Centre, independently to age. It is necessary to promote the health literacy of older adults throughout life. The implementation of social and health responses should allow older adults to remain in their homes, given the influence of functioning and cognition on self-care and quality of life.
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Affiliation(s)
- Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Correspondence: (M.J.L.); (L.G.d.P.); Tel.: +351-266-730-300
| | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, 7000-801 Évora, Portugal;
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
| | - Margarida Goes
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
| | - Henrique Oliveira
- Comprehensive Health Research Centre (CHRC), Universidade de Évora, 7000-801 Évora, Portugal; (M.G.); (H.O.)
- Escola Superior de Saúde, Instituto Politécnico de Beja, 7800-111 Beja, Portugal
- Instituto de Telecomunicações, 1049-001 Lisboa, Portugal
| | - José Garcia-Alonso
- Department of Computer Systems and Telematics Engineering, University of Extremadura, 10003 Cáceres, Spain;
| | - Anabela Afonso
- Departamento de Matemática, Escola de Ciências e Tecnologia, Universidade de Évora, 7000-671 Évora, Portugal;
- Centro de Investigação em Matemática e Aplicações, Universidade de Évora, 7000-671 Évora, Portugal
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Fonseca C, de Pinho LG, Lopes MJ, Marques MDC, Garcia-Alonso J. The Elderly Nursing Core Set and the cognition of Portuguese older adults: a cross-sectional study. BMC Nurs 2021; 20:108. [PMID: 34162387 PMCID: PMC8220736 DOI: 10.1186/s12912-021-00623-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The aging population and its associated health needs require specific nursing care. The aim of this study was to draw an epidemiological profile of Portuguese elderly adults attending in residential homes and day centers and to evaluate the association between the functioning and cognition of these older adults and their sociodemographic characteristics and presence of multimorbidity. METHODS This was a cross-sectional study of 613 older adults. Functioning was assessed using the Elderly Nursing Core Set, and cognition was assessed using the Mini Mental State Examination. Descriptive and inferential analyses were performed. RESULTS The mean age was 85.73 years; the majority of the participants were female (69.3 %), widowed (67.0 %) and over 85 years old (60.4 %). A total of 68.2 % of the sample presented multimorbidity. A total of 54.5 % had cognitive impairment, and the average functional profile was classified as "moderate difficulty". Institutionalized older adults had more diseases than those who attended the day center. Women, those who were illiterate, those who were institutionalized and older adults who had diseases of the nervous system had a worse functional profile and greater cognitive impairment. Those with multimorbidity had a worse functional profile, and those without a spouse had greater cognitive impairment. CONCLUSIONS Given the functional and cognitive profile of older adults, it is necessary to adopt care practices focused on the rehabilitation/maintenance of self-care and affective relationships. This care must be provided by highly qualified professionals. Therefore, it is necessary to increase the ratio of nurses per older adult in these institutions.
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Affiliation(s)
- César Fonseca
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Lara Guedes de Pinho
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal.
- Comprehensive Health Research Centre (CHRC), Évora, Portugal.
| | - Manuel José Lopes
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
| | - Maria do Céu Marques
- Escola Superior de Enfermagem São João de Deus, Universidade de Évora, Largo do Sr. da Pobreza, 2B, 7000 - 811, Évora, Portugal
- Comprehensive Health Research Centre (CHRC), Évora, Portugal
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Burlacu A, Mavrichi I, Crisan-Dabija R, Jugrin D, Buju S, Artene B, Covic A. "Celebrating old age": an obsolete expression during the COVID-19 pandemic? Medical, social, psychological, and religious consequences of home isolation and loneliness among the elderly. Arch Med Sci 2020; 17:285-295. [PMID: 33747263 PMCID: PMC7959044 DOI: 10.5114/aoms.2020.95955] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/26/2020] [Indexed: 12/24/2022] Open
Abstract
Since epidemiological arguments favouring self-isolation during the COVID-19 pandemic are widely recommended, the consequences of social isolation/loneliness of older people considered to be at higher risk for severe illness are neglected. We identified and described medical, social, psychological, and religious issues, indirectly generated by the COVID-19 lockdown. Mortality induced by SARS-CoV-2 and death from other "neglected" issues were put in balance. Arguments for strict lockdown from most European countries are compared with a relaxed approach, as has been applied in Sweden. Social isolation affects disproportionally the elderly, transforming it into a public health concern. One witnesses openly ageist discourse, while painful decisions to prioritising ventilation for younger patients deepens the sense of hopelessness. Fear has led to anxiety disorders and depression. Various religious practices provide resources for coping with isolation/overcoming loneliness. Higher levels of mortality/morbidity due to "COVID-19 versus non-COVID-19" polarisation oblige the healthcare community to find ways to provide proper care for its elders.
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Affiliation(s)
- Alexandru Burlacu
- Department of Interventional Cardiology - Cardiovascular Diseases Institute, Iasi, Romania
- ‘Grigore T. Popa’ University of Medicine, Iasi, Romania
| | - Ionut Mavrichi
- Sociology Department, Faculty of Theology, University of Bucharest, Bucharest, Romania
| | - Radu Crisan-Dabija
- ‘Grigore T. Popa’ University of Medicine, Iasi, Romania
- Pulmonology Department, Clinic of Pulmonary Diseases, Iasi, Romania
| | - Daniel Jugrin
- Center for Studies and Interreligious and Intercultural Dialogue, University of Bucharest, Bucharest, Romania
| | - Smaranda Buju
- Department of Teacher Training, ‘Gh. Asachi’ Technical University, Iasi, Romania
| | - Bogdan Artene
- Department of Interventional Cardiology - Cardiovascular Diseases Institute, Iasi, Romania
| | - Adrian Covic
- ‘Grigore T. Popa’ University of Medicine, Iasi, Romania
- Nephrology Clinic, Dialysis, and Renal Transplant Center - ‘C.I. Parhon’ Hospital, Iasi, Romania
- Academy of Romanian Scientists (AOSR)
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Goes M, Lopes MJ, Oliveira H, Fonseca C, Marôco J. A Nursing Care Intervention Model for Elderly People to Ascertain General Profiles of Functionality and Self Care Needs. Sci Rep 2020; 10:1770. [PMID: 32019984 PMCID: PMC7000781 DOI: 10.1038/s41598-020-58596-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/15/2020] [Indexed: 11/09/2022] Open
Abstract
A core set of International Classification of Functioning, Disability and Health codes was used to ascertain general profiles of functionality as a function of biological and sociodemographic characteristics and to develop structured nursing interventions in accordance with self care deficits identified by studying self care behavior for elderly people living in both extensively and sparsely populated rural areas. Data were collected by health professionals in the participants' houses. An exploratory factor analysis enabled reduced data dimensions, and factorial validity was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify general profiles of functionality as a function of age. A bar graph was used as a measurement tool for nursing care needs as a function of self care behavior and functional profile level. No functional problems were expected among people under the age of 74 years, while mild functionality problems were expected among people older than 74 years. Regarding nursing care needs, the results of the constructed model suggested that the functional concept "Support and Relationships" is associated with higher levels of functional problems and thus a greater need for self care interventions and that people aged 85 years and older always show therapeutic self care deficits.
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Affiliation(s)
- Margarida Goes
- Escola Superior de Saúde, Instituto Politécnico de Beja, Beja, Portugal
| | - Manuel José Lopes
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | | | - César Fonseca
- Escola Superior de Enfermagem de São João de Deus, Universidade de Évora, Évora, Portugal
| | - João Marôco
- ISPA - Instituto Universitário de Ciências Psicológicas Sociais e da Vida, Lisbon, Portugal
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The impact of treatment for iron deficiency and iron deficiency anemia on nutritional status, physical performance, and cognitive function in geriatric patients. Eur Geriatr Med 2018; 9:493-500. [PMID: 34674483 DOI: 10.1007/s41999-018-0065-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 05/02/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Iron deficiency in older people is common and affects physical and cognitive performance. The effects of iron deficiency on nutrition and cognitive status are well established. However, there are few studies demonstrating the impact of iron deficiency treatment on functional and cognitive outcomes in the geriatric population. The aim of this study was to determine whether iron replacement treatment was associated with an improvement in the nutritional, cognitive, and functional status of older patients with iron deficiency (ID) and iron deficiency anemia (IDA). METHODS Geriatric patients with iron deficiency and iron deficiency anemia presenting to the geriatric clinic were included in the study. Comprehensive geriatric assessment (CGA) and blood samples to investigate iron deficiency were performed at baseline and 6 month later. 81 patients were included in the study and were evaluated at follow-up in the 6th month. The CGA included the following tests: the Katz Index of Independence in Activities of Daily Living Scale (Katz ADL), the Lawton-Brody Instrumental Activities of Daily Living Scale (IADL), the Mini-Mental State Examination (MMSE), and the Mini Nutritional Assessment Short-Form (MNA-SF), as well as the assessments of hand grip strength and walking speed. RESULTS Of the 81 participating patients, 69.1% were women and 30.9% were men. The mean age was 76.8 ± 7.28 years. Follow-up after iron supplementation treatment was performed with a mean of 6.23 ± 1.58 months. Improvements occurred in the following geriatric and laboratory assessments: Lawton-Brody (IADL), MNA-SF, MMSE, hand grip strength, and walking speed evaluations and the levels of hemoglobin, iron, total iron-binding capacity, transferrin saturation, and ferritin. CONCLUSIONS It was shown that iron replacement treatment has a positive impact on functional and cognitive status and nutritional parameters in older patients with ID and IDA.
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Advinha A, Henriques A, Guerreiro M, Nunes C, Lopes M, de Oliveira-Martins S. Cross-cultural validation of the Drug Regimen Unassisted Grading Scale (DRUGS) to assess community-dwelling elderly's ability to manage medication. Eur Geriatr Med 2016. [DOI: 10.1016/j.eurger.2016.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Araújo RAD, Silva TMD, Ramos VP. Self-care agency and quality of life in the preoperative period of coronary artery bypass graft surgery. Rev Esc Enferm USP 2016; 50:232-8. [DOI: 10.1590/s0080-623420160000200008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/30/2016] [Indexed: 11/21/2022] Open
Abstract
Resumo OBJETIVO Analisar os fatores condicionantes básicos do autocuidado e a qualidade de vida relacionada à saúde, associando-os à capacidade de autocuidado em indivíduos no pré-operatório de revascularização miocárdica. MÉTODO Estudo descritivo com abordagem quantitativa, ancorado teórico-metodologicamente na Teoria de Enfermagem do Déficit de Autocuidado. Coleta de dados realizada entre março e agosto de 2013, utilizando-se da Escala para Avaliação do Autocuidado e do Medical Outcomes 36 Item Short Form Health Survey. RESULTADOS Há correlação entre capacidade de autocuidado e a qualidade de vida no pré-operatório de revascularização miocárdica. CONCLUSÃO Entre os participantes do estudo pode ocorrer uma redução na qualidade de vida, tendo em vista a convivência com doenças e agravos não transmissíveis e, mesmo assim, os indivíduos buscam as melhores maneiras de cuidar de si.
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