Frailty is a clinical syndrome characterized by reduced energy reserve and diminished resistance to stressors, which results from the cumulative decline of physiological functions that cause increased vulnerability to adverse conditions. Although there isn't, so far, a consensus definition, Fried et al suggested, in 2001, a model of frailty identifiable from a phenotype with five measurable components (unintentional weight loss, exhaustion, low physical activity, reduced walking speed and strength decrease). This research is a part of SABE Studies -Health, Wellness and Aging -and it was developed with the aim of identifying the prevalence of frailty syndrome in the elderly living in São Paulo City in 2000, using adapted criteria based on the phenotype of frailty and its associated factors as well as to verify the occurrence of adverse outcomes related to the syndrome in 2006 (death, institutionalization, falls, hospitalization and functional impairment). The 2000 and 2006 databases of the aforementioned studies were used. The adaptation of the model was held and tested in the 2006 database reaching to a sensitivity of 81.8% and a specificity of 91.7%, which were considered adequate. The final adapted model was composed of four components, the "low physical activity" has been excluded, and it followed the categorization of frailty proposed by Ottenbacher et al (2005): no component = not frail, one component = pre-frail, two or more components = frail. Associated factors were obtained through logistic regression analysis to a significance level of 5%. With the implementation of the adapted model, in 2000, a prevalence of 34.5% of pre-frail elderly or in the process of frailty was observed and 16% of fragile as well, being more pronounced among women and among the ones at more advanced age (≥ 75 years). Statistical significance was observed in all outcomes (deaths, falls, institutionalization, hospitalization and functional impairment) among the youngest women (60-74 years), a relation also significant for the longer-lived ones (≥ 75 years) for outcomes such as death, institutionalization, and functional impairment. Among men, both younger and longer-lived, there was a statistically relevant association with the death outcome. The factors associated with frailty in this group were: advanced age, bad or very bad self-rated health conditions, comorbidities and depression symptoms, difficulty in performing instrumental activities of daily living and previous hospitalization. These results aim to contribute to the prevention and early detection of the syndrome of frailty among elderly in order to avoid the occurrence of adverse associated outcomes and thus contributing to a more active aging as well as a better quality of life.

No Brasil, efetivamente, o idoso surge como prioridade de Políticas Públicas de Saúde apenas em 2006 no Pacto pela Vida, que trouxe consigo a Política Nacional de Saúde da Pessoa Idosa (PNSI). Apenas neste momento, passa-se a incorporar o conceito de Envelhecimento Ativo, lançado em 2002 pela Organização Mundial da Saúde, com a intenção de conquistar uma visão positiva deste processo, promovendo vida mais longa, que deve ser acompanhada de oportunidades contínuas para saúde, a participação e segurança do idoso. Possibilita, portanto, que às pessoas percebam o seu potencial para o bem-estar físico, social e mental durante a vida. Além de permitir ganho de autonomia, independência e saúde em seu sentido mais amplo, durante todo o processo de envelhecimento. Na sequência, outras ações vieram, na intenção de colocar em práticas esse conceito e ainda, para os idosos mais dependentes, envolver a família no cuidado. Muitos desafios ainda persistem no sentido do preparo e direcionamento dos idosos e seus familiares para um envelhecimento saudável, com autonomia e qualidade de vida.

O Acidente Vascular Cerebral é menos frequente em crianças do que em adultos, porém possui um poder devastador para o futuro destes indivíduos, mesmo com indícios de melhor recuperação das alterações. O objetivo deste estudo é descrever os achados fonoaudiológicos de um caso de Acidente Vascular Cerebral infantil, evidenciando a evolução após 12 meses de terapia fonoaudiológica, iniciada precocemente, após lesão neurológica adquirida. Trata-se de um indivíduo de 11 anos, gênero masculino, com normalidade de desenvolvimento neuropsicomotor e independência para as atividades funcionais durante a primeira infância. Em março de 2015 sentiu um mal súbito, foi encaminhado para o hospital de urgência e diagnosticado com Acidente Vascular Cerebral, do tipo hemorrágico, em região fronto-parietotemporal esquerda. Foram realizados procedimentos cirúrgicos, e a internação durou 25 dias. No momento da alta hospitalar houve a orientação sobre a necessidade de atendimento fonoaudiológico. A primeira avaliação de linguagem evidenciou afasia adquirida do tipo emissiva, conforme as classificações propostas para crianças. Foram realizadas 91 sessões de terapia fonoaudiológica, com duração de 50 minutos, pelo período de 12 meses. Ao analisar as habilidades formais de linguagem que permaneceram alteradas, observa-se que as relacionadas à leitura e escrita são as de maior significância, interferindo no desempenho escolar e desenvolvimento comunicativo. Assim, além do atendimento fonoaudiológico até que seja possível uma comunicação funcional, é importante que haja o apoio escolar.

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OBJECTIVE: To analyze the perceived quality of life of older people living in the community and long-term care facilities, and correlate it with the presence of frailty. METHODS: This is a quantitative, analytical, cross-sectional study in which 136 older people were interviewed, half were living in the community and the other half were living in long-term care facilities. The Edmonton Frail Scale was used to identify frailty, and the World Health Organization Quality of Life – Bref (WHOQOL-BREF) and World Health Organization Quality of Life Assessment for Older Persons (WHOQOL-OLD) questionnaires were used to measure quality of life. Analysis of variance and Pearson correlation coefficients were used for intragroup analyses. RESULTS: A greater proportion of older people living in long-term care facilities were frail. Perceived quality of life was better among people living in the community, according to both questionnaires, particularly in the domains social relations, environment, and death and dying. The worst scores were observed in the autonomy domain, particularly among older people living in long-term care facilities. In the majority of domains, older people with frailty had worse perceived quality of life scores. CONCLUSIONS: The absence of frailty favors a better perception of the quality-of-life domains, as does living in the community.