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Resumo Objetivo Verificar o efeito da dor crônica no estresse e nos sintomas depressivos de idosos cuidadores de idosos no decorrer de quatro anos. Método Estudo longitudinal, com coleta de dados em 2014 e 2018, com 104 indivíduos com idade igual ou superior a 60 anos, que realizavam cuidado a outro idoso que morava no mesmo domicílio e residentes nas áreas urbanas do município de São Carlos-SP, cadastrados nas Unidades de Saúde da Família (USF). Para as análises estatísticas, foram utilizados o modelo de regressão linear com efeitos mistos (efeitos aleatórios e fixos) e a análise de covariância (ANCOVA). Todos os modelos foram ajustados por sexo idade, escolaridade, número de medicamento e número de doenças. Resultados Participantes com dor crônica apresentaram média de 5,21 pontos maior no escore de estresse (p=0,019; IC: -9,823 – -0,604) na segunda avaliação (2018) e um aumento de 1,3 no escore dos sintomas depressivos na primeira avaliação (2014), e 1,8 na segunda avaliação (2018) (=0,020; IC:-2,530 - - 0,225 e p=0,003; IC: -3,016 - -0,640, respectivamente). A intensidade da dor esteve associada ao estresse (p=0,019; IC= 0,179- 1,958) e sintomas depressivos na primeira e segunda avaliação (p=0,001; IC: 0,218- 0,772; p=0,013; IC: 0,066- 0,538). Por meio da análise da ANCOVA, verificou-se que, quanto maior a diferença na intensidade da dor, maior a diferença nos sintomas depressivos ao longo do tempo. Conclusão É necessário realizar uma ação efetiva para o manejo da dor crônica em cuidadores idosos para minimizar os agravos relacionados ao estresse e sintomas depressivos.

Resumo Objetivo analisar o efeito da sobrecarga, do estresse e dos sintomas depressivos sobre as características de saúde de idosos cuidadores de idosos. Métodos estudo quantitativo e longitudinal com 127 idosos cuidadores. As variáveis utilizadas foram caracterização de saúde; sobrecarga; sintomas depressivos e estresse. Realizou-se modelo de regressão linear, teste de Poisson, com nível de significância de 5%. Resultados observou-se que um ponto a mais no escore na escala de sobrecarga aumenta em 0,030 o número de doenças (p=0,020) e risco de dor crônica (p=0,005); um ponto a mais no escore na escala de estresse aumenta em 0,058 o número de doenças (p=0,001) e risco para avaliação de saúde regular/ruim (p=

Resumo Objetivo Avaliar o efeito da Educação em Neurociência da Dor aliada ao Pilates na catastrofização da dor em idosos com lombalgia crônica inespecífica. Métodos Ensaio clínico controlado randomizado com 80 participantes divididos em dois grupos: Grupo Pilates combinado com Educação em Neurociência da Dor – GPE, e Grupo Pilates– GP. As medidas foram feitas no início, pós-intervenção e após seis meses (seguimento). O protocolo incluiu três sessões individuais de Educação em Neurociência da Dor (END) de 30 min (somente para o GPE) e, posteriormente, oito semanas de Pilates (duas vezes por semana, 50 min/sessão, para ambos os grupos). Resultados Comparações das diferenças pré-pós e de seguimento em catastrofização, cinesiofobia, incapacidade e intensidade da dor não mostraram evidências de que a END teve efeitos adicionais em comparação com os exercícios isoladamente. Uma vantagem provável do presente protocolo de END foi que as taxas de abandono para o GPE foram menores do que para o GP, mostrando que a END aumentou a adesão ao exercício. Conclusão A relevância clínica do estudo é que o Pilates é uma intervenção segura para idosos com dor lombar crônica inespecífica e a END pode aumentar a adesão ao exercício nessa população.

ABSTRACT Objective: to identify factors associated with depressive symptoms in elderly caregivers with chronic pain. Method: the study included people 60 years of age or older who reported chronic pain and cared for another elderly person living in the same household (n=186). Statistical analyzes were performed using the Mann-Whitney test, univariate and multiple logistic regression. Results: most participants had no depressive symptoms (70.4%), 24.2% had mild depressive symptoms and 5.4% had severe symptoms. Univariate analysis showed that the variables family income, number of diseases, number of medications in use, pain intensity, overload and perceived stress were associated with depressive symptoms. Multivariate analysis found an association with perceived stress (95% CI 1.101-1207) and number of medications (95% CI 1.139-1.540) in use. Conclusion: factors associated with depressive symptoms in elderly caregivers with chronic pain were stress and the number of medications in use.

Abstract Objective: to analyze the profile of a population of caregivers from a city in a rural area of the state of São Paulo, Brazil, and identify their health complaints and the characteristics of care provided. Method: a prospective cross-sectional study was performed based on a domicile survey of 99 caregivers and their elderly care recipients. Information about the profile, context of care and health complaints of the caregivers was collected. The caregivers responded to the Zarit Burden Inventory and the Geriatric Depression Scale-15 and the elderly underwent a cognition and functionality assessment. The chi-squared test with odds ratio (OR) was performed to test associations. Result: the majority of the caregivers were women (n=76), elderly (n=83), with a median age 65.8 (±10.4) years and 4.9 (±4.2) years of formal schooling. The most frequent health complaints were pain, systemic hypertension, insomnia, back problems and vision problems. The elderly care recipients were men (n=75), with an average age of 72.0 (±8.2) years. Analysis of associations revealed that caregivers who received emotional support had a lower chance of being highly overburdened (OR=0.37; CI95% 0.15-0.90). Caring for over five years was associated with arthritis (OR=2.50; CI95% 1.0-6.56). Caring of an elderly person with cognitive impairment was strongly associated with peripheral vascular diseases (OR=2.70; CI95% 1.11-6.85) and other diseases (OR=6.94; CI95% 1.43-33.63). Conclusion: A better understanding of the reality of care in rural and remote areas and the identification of factors related to the health care of caregivers provides better care management for the elderly and caregivers, who themselves are aging.

Abstract OBJECTIVE Comparing the differences in the sociodemographic, care and health profiles of elderly caregivers of the elderly living in urban, rural, and high social vulnerability contexts. METHOD A cross-sectional study developed with elderly caregivers enrolled in the Family Health Units of a municipality in the interior of São Paulo. Household interviews and evaluations were conducted on: Activities of Daily Living (ADL), self-reported pain, frailty, cognition, life satisfaction, family functionality, burden, stress and hope. RESULTS A total of 343 elderly caregivers of elderly individuals participated in the study, of which 55.1% lived in an urban context, 23.6% in rural areas, and 21.3% in a context of high social vulnerability. The majority of elderly caregivers were women across the three contexts, with a median age of 67 years and caring for their spouse. Caregivers from regions of high social vulnerability had lower education level, received less emotional and material help to care, were less satisfied with life, more fragile, in more cognitive decline, had worse family functionality and a lower level of hope when compared to caregivers of urban and rural contexts (p≤0.05). However, caregivers from areas of high vulnerability were more independent for ADL. CONCLUSION Professionals working in Primary Care should consider these differences when planning interventions aimed at the specific group of caregivers.

Abstract OBJECTIVE Understanding and characterizing chronic pain in elderly caregivers, verifying the cognitive performance of the elderly of the sample and verifying whether there is difference in the cognitive performance of elderly caregivers with and without chronic pain. METHOD Participants were people aged 60 years or older who lived with another elderly person in the same household and who were registered in Family Health Units. Data collection took place at participants' homes. Pain was assessed by the EMADOR and cognition was assessed by ACE-R. Statistical analyzes were performed using Shapiro-Wilk's and Mann-Whitney U tests. RESULTS The study included 187 elderly caregivers with chronic pain and 133 without chronic pain, with a higher frequency of women. Chronic pain was present in 58.4% of the participants. Regarding the sociodemographic variables, there was no difference between the groups except for the gender variable (p=0.025). No difference was found in cognitive performance among the elderly with chronic pain and those without chronic pain for any domain of the ACE-R instrument. CONCLUSION The results contradicted the initial hypothesis that there would be a difference between the groups; however, there is a gap in the scientific knowledge on chronic pain and cognition, especially in elderly caregivers, opening perspectives for future investigations.

ABSTRACT. The degree of burden related to the demands of daily care provided to a dependent older adult is important to evaluate due to the negative influence exerted on caregivers’ physical and psychological health. Objective: To analyze the validity of the 12-item version of the Zarit Burden Interview administered to older caregivers of community-dwelling older dependent individuals and suggest a cut-off score based on quartiles. Methods: Three hundred and forty-one older caregivers (mean age: 69.6±7.1 years; 76.8% women) registered with primary healthcare centers were evaluated using the ZBI-12. Additional evaluations addressed stress (Perceived Stress Scale [PSS]), depressive symptoms (Geriatric Depression Scale [GDS]) in the older caregivers and the degree of dependence of the older care recipients (Lawton and Brody [L&B]). Results: Cronbach’s alpha demonstrated very good internal consistency (α=0.81). Correlations were found between all ZBI-12 items and overall score on the PSS (r=0.53; p

Abstract Objectives: To explore the socioeconomic, demographic and psychosocial factors associated with cognitive performance in elderly caregivers from Brazil. Methods: We evaluated 351 Brazilian elderly caregivers attending primary healthcare services regarding sociodemographic and care variables. Addenbrooke's Cognitive Examination-Revised (ACE-R) domains of orientation/attention, memory, verbal fluency, language and visuospatial were used as dependent variables in the Tobit model. Results: Literacy and family income were positively associated with all ACE-R domains. Age, gender, time of care (days/week) were negatively associated with some cognitive domains. Moreover, receiving emotional help and the level of hope were positively associated with specific domains. Discussion: The results may be useful for planning interventions aimed at elderly caregivers in order to prevent deficits in the different cognitive domains.

ABSTRACT Changes in patterns of performance for the cognitive functions of memory, processing speed, and focused attention are expected in old age. Objective: The main goal of this systematic review was to analyze the use of ERP in healthy elderly in studies evaluating the P300 components. Methods: A systematic review was carried out based on recommendations for nursing research on the databases LILACS, PsycINFO, PubMed, SCOPUS and Web of Science. Results: 26 studies involving 940 healthy elderly were identified, most of which sought to identify and determine the influence of age on the P300. Conclusion: Although there is consensus in the literature that P300 latency is significantly longer in elderly with psychiatric disorders compared to healthy elderly, it was not possible to conclude P300 associations with gender, education and other cognitive tests.

OBJECTIVE: The aim of this study was to analyze the relationship between cognition and frailty in the elderly. METHODS: A systematic review on the currently existing literature concerning the subject was carried out. The search strategy included LILACS, SCOPUS, SciELO, PsycINFO, PubMed and Web of Science databases. RESULTS: A total of 19 studies were selected for review, from which 10 (52.6%) were cross-sectional and 9 (47.4%) longitudinal, and the majority Brazilian. All of the studies established a link between cognition and frailty. There was a relationship between components of frailty and the cognitive domains. Risk of Mild Cognitive Impairment (MCI), dementia and mortality were all evidenced in the relationship between frailty and cognitive impairment. CONCLUSION: The theory remains limited, but results show the variables that appear to be linked to cognition and frailty in elderly. This data can help in implementing actions to improve the quality of life among elderly.

ABSTRACT Cognitive aging is dynamic and heterogeneous in elderly, thus adequate tools such as paper-based tests are relevant to describe the cognitive profile of this population. Objective: To describe different paper-based cognitive assessments tests in elderly people stratified by age and education. Methods: A cross-sectional study of 667 elderly (≥60 years) living in the community was conducted. Sociodemographic information was collected. Global cognition was assessed by the Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini Addenbrooke’s Cognitive Examination (M-ACE) and Mini-Mental State Examination (MMSE). The data were analyzed using descriptive statistics, the t-test and Pearson’s Correlation Coefficient. Results: The findings showed a predominance of women (53.8%), mean age of 71.3 (±7.7) years and 3.6 (±3.5) years of education. The best global cognitive performance and cognitive domain assessment scores were found in the group with higher formal educational level. Each year of education was associated with an increase of up to 10% in scores on the M-ACE and MMSE and up to 11% in ACE-R scores. The mean values of the scores varied according to age, where the 60-69 years group had better scores than other age groups. The correlation matrix between the cognitive tests showed that near perfect correlations (r=1) were frequent in the subgroup with higher education. Conclusion: Younger elderly and those with higher educational level had greater global and domain scores. This study describes the scores of elderly for different strata of education and age. In practice, it is important to choose the most suitable screening instrument, considering the characteristics of the elderly.

ABSTRACT Objective: Identifying prevalence of frailty in elderly caregivers inserted in a high social vulnerability context and its correlation with sociodemographic and health aspects. Method: Descriptive, correlational and cross-sectional study. Forty elderly caregivers were evaluated with: questionnaire for caregiver characterization, Mini Mental State Examination, Katz Index, Lawton instrumental activities of daily living scale, Geriatric Depression Scale and the frailty phenotype proposed by Fried. Interviews were conducted at their residences and scheduled in advance. All ethical precautions were observed. Data were analyzed with the Stata statistical program version 11.0. Results: 10% of elderly caregivers were frail. There was a significant correlation between frailty and sex, instrumental activities of daily living and cognition. Conclusion: Female caregivers, partially dependent individuals regarding instrumental activities of daily living and with worse cognitive state deserve a special attention from health services.

ABSTRACT Objective: evaluate the factors associated with the risk of diabetes mellitus in older caregivers. Method: this is a cross-sectional study conducted with 326 older caregivers enrolled in Family Health Units. Data were collected using a sociodemographic characterization questionnaire, clinical and care information, and the Finnish Diabetes Risk Score to assess the risk of developing diabetes. Results: 35.5% of the caregivers presented a high risk of developing diabetes. The factors associated with the risk of developing diabetes were: use of medication (OR = 3.88), satisfactory or poor health assessment (OR = 1.72), and the fact of being female (OR = 0.48). Conclusion: more than one third of older caregivers present high risk of developing diabetes. Therefore, being female, living with other people, using medication, and having a poor health assessment are factors associated with increased risk of developing diabetes.

Objetivo: avaliar a dor em pessoas que vivem com o vírus da imunodeficiência humana/síndrome da imunodeficiência adquirida e relacionar com fatores sociodemográficos, clínicos, sintomas depressivos e qualidade de vida relacionada à saúde. Método: estudo descritivo, analítico, observacional, de corte transversal e de caráter quantitativo. Participaram trezentas e duas (302) pessoas de um serviço de atendimento especializado. Foram utilizados instrumentos para avaliação de dados sociodemográficos, clínicos, sintomas depressivos e qualidade de vida relacionada à saúde. Empregou-se análise descritiva, bivariada e regressão logística múltipla. Resultados: foram encontrados 59,27% de presença de dor de intensidade leve, recorrente na cabeça, com interferência no humor, a maioria do sexo feminino e em indivíduos sem/baixa escolaridade. As mulheres apresentaram maior probabilidade de ter dores moderadas ou severas. Pessoas de 49 a 59 anos apresentaram maior intensidade de dor do que as de 18 a 29 anos. Sintomas depressivos e dor são variáveis diretamente proporcionais. Quanto maior o nível da qualidade de vida relacionada à saúde e escolaridade, menor a possibilidade da presença de dor. Conclusão: a presença de dor encontrada é preocupante e possui associação com o sexo feminino, sem/baixa escolaridade, pior nível da qualidade de vida relacionada à saúde e presença de sintomas depressivos.

Resumo OBJETIVO Comparar o perfil de saúde física, cognitiva e psicológica e o contexto de cuidado de idosos cuidadores de idosos em diferentes arranjos de moradia. MÉTODO Estudo quantitativo e transversal realizado com 349 cuidadores divididos em arranjos de moradia unigeracional, bigeracional e multigeracional. Para avaliação foram utilizados questionários sociodemográfico e de cuidado, e instrumentos de avaliações da saúde física, cognitiva e psicológica. Para análises dos dados foram utilizados os testes Qui-quadrado e U Mann Whitney. RESULTADOS Os idosos cuidadores de lares unigeracionais eram mais velhos e independentes para as atividades instrumentais de vida diária. Nos arranjos de moradia multigeracionais houve proporção significativamente maior de cuidadores que consideravam a renda familiar insuficiente, recebiam ajuda emocional e sentiam-se mais sobrecarregados e estressados. CONCLUSÃO As diferenças identificadas entre os grupos podem contribuir para elaboração de políticas de cuidado e promoção da saúde de idosos cuidadores.

Resumo Objetivo: Caracterizar os cuidadores idosos que cuidam de outros idosos em contexto de alta vulnerabilidade social. Métodos: Estudo descritivo e transversal, realizado com 40 cuidadores idosos utilizando-se: questionário para caracterização do cuidador, Mini Exame do Estado Mental, Índice de Katz, Escala de atividades instrumentais de vida diária de Lawton, Escala de Depressão Geriátrica e o fenótipo de fragilidade proposto por Fried. Para as análises, utilizou-se o Stata versão 11.0, de forma descritiva. Resultados: Houve predomínio do sexo feminino, da faixa etária de 60 a 69 anos, de indivíduos casados, com ensino primário, aposentados. Não possuíam plano de saúde. A maioria era pré-frágil, hipertensa e independente tanto para as atividades instrumentais quanto para as atividades básicas de vida diária. Não apresentavam indícios de sintomas depressivos, nem de alterações cognitivas. Conclusão: Conhecer o perfil dos cuidadores idosos é imprescindível para subsidiar os serviços de saúde no planejamento de uma assistência de qualidade.