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ABSTRACT. Stress during aging is not uncommon and dysfunctional family relationships are important sources of stress in the elderly. Considering the potential stressor that family dysfunction represents, it is questioned whether prolonged exposure to dysfunctional family arrangements can contribute to cognitive decline in aging. Objective: To verify whether family dysfunction is a predictive factor of cognitive decline in aging. Methods: Secondary study with analysis of existing data from the longitudinal, population-based study “Health, Wellbeing and Aging” (SABE). Data from 791 elderly people from two cohorts of the SABE study between 2006 and 2015 were analyzed. Family dysfunction was assessed using the Apgar family instrument, while cognitive performance was assessed using the Mini-Mental State Examination (MMSE), verbal fluency (animals) and digit length in reverse order. Cognitive decline was measured by the difference in scores in the period between 2006 and 2015. Results: Approximately 10% of the sample had family dysfunction. The familial Apgar score was not associated with decline on MMSE (p=0.732), verbal fluency (p=0.852) and digit span scores (p=0.718). Scores related to cognition and family functionality, such as age, education, living alone, depression and family Apgar, do not explain cognitive decline. Conclusion: The findings indicate that family functioning is not associated with cognitive decline in community-dwelling elderly. New studies will be needed to analyze the qualitative characteristics of family relationships in the cognitive performance of the elderly.

Background: Social networks can modulate physiological responses, protects against the detrimental consequences of prolonged stress, and enhance health outcomes. Family ties represent an essential source of social networks among older adults. However, the impact of family support on cognitive performance and the biological factors influencing that relationship is still unclear. We aimed to determine the relationship between family support, cognitive performance and BDNF levels.Methods: Cross-sectional data from three-hundred, eight-six individuals aged on average 60 years enrolled in the Health, Wellbeing and Aging Study (SABE), a population-cohort study, were assessed for family support, community support and cognitive performance. Structural and functional family support was evaluated based on family size and interactions allied to scores in the Family APGAR questionnaire. Community assistance (received or provided) assessed the community support. Cognitive performance was determined using the Mini-Mental State Examination (MMSE), verbal fluency (animals per minute) and backward digital span. Blood samples were obtained to determine BDNF levels.Results: Multivariate analysis showed that functional family support, but not structural, was associated with higher MMSE, verbal fluency and digit span scores, even controlling for potential cofounders (p < 0.001). Providing support to the community, rather than receiving support from others, was associated with better cognitive performance (p < 0.001). BDNF concentration was not associated with community support, family function, or cognitive performance.Conclusion: These findings suggest that emotional components of functional family and community support (e.g., loving and empathic relationship) may be more significant to cognitive health than size and frequency of social interactions.

RESUMO: Introdução: O uso de prótese e a perda dentária em idosos estão associados a impactos significativos na saúde geral e na qualidade de vida. A avaliação contínua do perfil de saúde bucal dessa população é importante para o planejamento das ações e políticas da área. Objetivo: Foram objetivos deste trabalho avaliar a prevalência de perda dentária e uso de próteses entre idosos em diferentes períodos, verificar as características sociodemográficas associadas à dentição funcional (mais de 20 dentes) e avaliar o impacto do uso de prótese e da perda dentária na autoavaliação da saúde bucal. Métodos: A amostra foi composta por pessoas de 60 anos ou mais, participantes do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). A avaliação da prevalência de perda dental e uso de próteses foi feita a partir da comparação dos dados coletados nos anos de 2000, 2006 e 2010. As análises dos fatores associados à dentição funcional e autoavaliação de saúde bucal foram realizadas com base nos dados coletados no ano de 2010. A comparação do perfil de saúde bucal ao longo dos três períodos foi feita por meio de análises descritivas e comparação de intervalos de confiança. Realizou-se análise de regressão logística múltipla para avaliar os fatores associados à dentição funcional e à autoavaliação da saúde bucal. Resultados: A prevalência de perda dental e uso de próteses se manteve constante ao longo dos três anos analisados. A dentição funcional foi significativamente associada à escolaridade, sexo e cor/gênero. Idosos com necessidade de próteses e bolsa periodontal apresentaram mais chances de autoavaliação ruim. Conclusão: Não houve redução da prevalência de perda dentária e uso de próteses ao longo de dez anos na população estudada. A dentição funcional está associada a desigualdades sociodemográficas. A autoavaliação de saúde bucal está associada à necessidade de próteses.

BACKGROUND: Age-associated changes in the immune system cause decreased protection after vaccination and increased rates of infections and tumor development. METHODS: Lymphocyte percentages were compared by gender and age to establish differences between subtypes. Three mL blood samples were obtained from 218 randomly selected individuals (60-101 years old) who live in São Paulo city. Blood was lysed with Tris phosphate buffer and stained for 30 minutes with monoclonal antibodies (CD3PerCP, CD4FITC, CD8Pe, CD19Pe) for analysis by flow cytometry. Statistical analysis was by ANOVA. RESULTS: The percentage of CD4+ T cells (p-value = 0.005) and the CD4/CD8 ratio (p-value = 0.010) were lower in men, whereas the percentage of CD8+ T cells was lower (p-value = 0.002) in women; the percentage of B cells (CD19+ ) was similar between groups. Individuals grouped by gender and age range and compared showed a drop in CD4+ cells in 75 to 79-year-old men (female: 46.1% ± 8.1% and male: 38.8% ± 10.5%; p-value = 0.023). Also, the 80 to 84-year-old group of men had a higher percentage of CD8+ (female: 20.8% ± 8.2%, and male: 27.2% ± 8.2%; p-value = 0.032). Low percentages of B cells were detected in men in the 75 to 79-year-old (p-value = 0.003), 85 to 89-year-old (p-value = 0.020) and older than 90 year old (p-value = 0.002) age ranges. CONCLUSION: Elderly men present with more changes in lymphocyte subsets compared to elderly women. These findings could demonstrate impairment in the immune response since the lower CD4+ in men would provide less help to B cells (also lower in men) in terms of antibody production. In addition, the increase in CD8+ cells in this group could represent chronic inflammation observed during the aging process.

The changes that occur during aging are accompanied by limitations in functional performance that impair elderly people's social participation and consequently harm their quality of life. In the SABE Study (São Paulo, Brazil), the results indicated relationships between life expectancy without disabilities and demographic and social variables. This article sought to evaluate these and other variables together as explanatory factors for the presence or absence of difficulties in instrumental activities of daily living (IADL), directly related to the possibility of more efficient community participation. Five of the eight questions relating to IADL that were applied to the sample of 2,143 elderly individuals in the municipality of São Paulo in 2000 were considered. Odds ratios were calculated using logistic regression. All the socio-demographic variables analyzed (age, income, ethnicity, schooling, and gender) were significant, with the exception of "sufficient money". All the variables in the "health" group (one or two or more diseases reported, and depression) were also significant. The two other variables that entered the model were physical activity and alcohol consumption.As alterações que ocorrem no envelhecimento são acompanhadas por limitações no desempenho funcional que comprometem a participação social da pessoa idosa, conseqüentemente prejudicando sua qualidade de vida. No Estudo SABE (São Paulo, Brasil), os resultados apontaram relações entre a esperança de vida sem incapacidades e variáveis demográficas e sociais. Neste artigo buscou-se uma avaliação conjunta dessas e outras variáveis como explanadoras da presença ou não de dificuldades em atividades instrumentais da vida diária diretamente relacionadas com a possibilidade de uma participação comunitária mais eficiente. Foram consideradas cinco das oito questões relativas às atividades instrumentais da vida diária, aplicadas à amostra de 2.143 idosos do Município de São Paulo, em 2000. Razões de chance foram calculadas por regressão logística. Todas as variáveis sócio-demográficas analisadas (idade, renda, etnia, escolaridade e sexo) com exceção de "suficiência de dinheiro" foram significantes, bem como todas as variáveis do grupo "saúde" (uma, duas ou mais doenças referidas e depressão). As duas outras variáveis que entraram no modelo foram atividade física e consumo de álcool.