Objective To examine the prevalence of generalized anxiety disorder (GAD) and its associations with sociodemographic and health factors. Methods A cross-sectional study with a population-based sample of 578 individuals aged 60 years or older from the Family Health Strategy (FHS) program of Porto Alegre, RS, Brazil. Home visit screening and general data collection were made by trained Community Health Workers (CHWs). Diagnoses of psychiatric disorders were made by board-certified psychiatrists using the Mini International Neuropsychiatric Interview plus (MINIplus) in the Hospital São Lucas of the Pontifical University of Rio Grande do Sul (PUCRS). Results GAD was found in 9% of the sample (n = 52; CI 95% = 6.9-11.6). The main results of the multivariate analysis show associations between GAD and retirement (PR: 0.43, CI: 0.25-0.76), history of falls (PR: 2.52, CI: 1.42-4.49), cohabitation with four or more people (PR: 1.80, CI: 1.04-3.13), having more than one hospitalization in the last year (PR: 2.53, CI: 1.17-5.48) and self-perception of health as regular (PR: 2.75, CI: 1.02-7.47). Retirement in the elderly shows 2.32x less risk of GAD, although confounding factors may have overestimated this finding and underestimated the association with female gender (PR: 1.61, CI: 0.83-3.10). Conclusions We estimate a high prevalence of GAD in this population. Associations were found between GAD and health self-perceived as regular, cohabitation with four or more people, history of falls and more than one hospitalization in the last year. These epidemiological data from the Family Health Strategy are important to develop further strategies for this age group that could improve the health care practice.
A violência contra a criança representa um importante problema de saúde pública, assim como o declínio cognitivo. A ligação entre essas variáveis vem sendo analisada cada vez mais, porque o estresse experimentado nos primeiros anos de vida pode estar relacionado a mudanças estruturais, funcionais e epigenéticas nas regiões cerebrais envolvidas na cognição. O objetivo deste estudo foi analisar essa associação, por meio de uma revisão integrativa da literatura, pelo meio da pesquisa bibliográfica das seguintes bases de dados: SciELO, LILACS, PUBMED e PsycINFO. O período de seleção dos artigos compreendeu os últimos cinco anos. No total, foram 33 artigos, dos quais dez eram artigos originais que focaram na relação entre maus-tratos na infância e declínio cognitivo em idosos. A presença de maus-tratos na infância possui associação com o declínio da função cognitiva no idoso, agravando-o sobremaneira e inclusive podendo colocar os indivíduos em risco de declínio cognitivo acentuado. Uma das limitações deste estudo foi a percepção de que a temática ainda carece de mais e melhores estudos que abordem esta relação na prática, por meio de estudos longitudinais.
AIMS: To verify the profile of the elderly and their main diagnoses in the geriatrics psychiatric outpatient clinic and the psychiatric hospitalization unit of a tertiary hospital. METHODS: A cross-sectional study of population-based was performed in a tertiary referral hospital, with individuals aged ≥55 years attending the geriatric psychiatric outpatient clinic and psychiatric hospitalization, from 2014 to 2018. Data were collected through interviews. The studied variables were sociodemographic and clinical aspects. RESULTS: A total of 497 individuals were evaluated, 269 from the psychiatric outpatient clinic and 228 from the psychiatric hospital. The mean age was 69.34±8.87 years. Most of the patients were female (75.8%), had no partner (56.3%), had primary education (50.3%), lived in Porto Alegre (75.6%) and were retired (66.5%). According to the clinical variables studied, 89.6% of the individuals had some morbidity, 36.9% had already been admitted to the psychiatric ward, the most common diagnosis was depression (40.8%), followed by bipolar disorder (19%) and anxiety (14.1%). CONCLUSIONS: With the population aging, it is expected to increase morbidity and mental disorders, requiring more specific diagnostic tools and better treatment approaches. There are still no consistent data on the management of mood disorders in the elderly, so our study can guide a better care for elderly and aging individuals, improving the planning of health services and policies.
AIMS: To establish the frequency potentially inappropriate medications use and the associated factors, such as signs and symptoms of depression and cognitive deficit among middle-aged and elderly people.METHODS: A cross-sectional population study was performed with 2,350 people, aged between 55-103 years, registered in the primary health care. Potentially inappropriate medications were defined by updated 2019 Beers criteria. Studied variables were sociodemographic, lifestyle and health, and signs and symptoms of depression and cognitive deficit. Multinomial regression analysis was executed.RESULTS: The frequency of potentially inappropriate medications use was 65.4%. Former and current smokers, regular self-perception of health, polypharmacy, and individuals with signs and symptoms of depression and cognitive deficit were significantly associated with potentially inappropriate medications use. Antiarrhythmics, antihistamines and antiadrenergic agents were the highest potentially inappropriate medications classes used for individuals with signs and symptoms of depression and cognitive deficit.CONCLUSIONS: The frequency of use of potentially inappropriate medications is high among middle-aged people, a population that was previously under-researched, as well as among elderly people. Cognitive impairment alone or together with depression symptoms were associated factor for a potentially inappropriate medications use. Knowledge of the pharmacoepidemiology of potentially inappropriate medications is an important for the promotion of the rational use of drugs in public health.
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