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OBJECTIVE To examine whether religiousness mediates the relationship between sociodemographic factors, multimorbidity and health-related quality of life of older adults. METHODS This population-based cross-sectional study is part of the Survey on Health, Well-Being, and Aging (SABE). The sample was composed by 911 older adults from Sao Paulo, SP, Southeastern Brazil. Structural equation modeling was performed to assess the mediator effect of religiousness on the relationship between selected variables and health-related quality of life of older adults, with models for men and women. The independent variables were: age, education, family functioning and multimorbidity. The outcome variable was health-related quality of life of older adults, measured by SF-12 (physical and mental components). The mediator variables were organizational, non-organizational and intrinsic religiousness. Cronbach’s alpha values were: physical component = 0.85; mental component = 0.80; intrinsic religiousness = 0.89 and family APGAR (Adaptability, Partnership, Growth, Affection, and Resolve) = 0.91. RESULTS Higher levels of organizational and intrinsic religiousness were associated with better physical and mental components. Higher education, better family functioning and fewer diseases contributed directly to improved performance in physical and mental components, regardless of religiousness. For women, organizational religiousness mediated the relationship between age and physical (β = 2.401, p < 0.01) and mental (β = 1.663, p < 0.01) components. For men, intrinsic religiousness mediated the relationship between education and mental component (β = 7.158, p < 0.01). CONCLUSIONS Organizational and intrinsic religiousness had a beneficial effect on the relationship between age, education and health-related quality of life of these older adults. OBJETIVO : Analisar se a religiosidade exerce efeito mediador na relação entre fatores sociodemográficos, multimorbidade e qualidade de vida relacionada à saúde em idosos. MÉTODOS : Este estudo transversal, de base populacional, é parte do estudo Saúde, Bem-Estar e Envelhecimento (SABE). A amostra foi composta por 911 idosos da cidade de São Paulo, residentes na comunidade. A modelagem de equações estruturais foi realizada para verificar o efeito mediador da religiosidade na relação entre variáveis selecionadas e a qualidade de vida relacionada à saúde dos idosos, com modelos para homens e mulheres. As variáveis independentes foram: idade, escolaridade, funcionalidade familiar e multimorbidade. A variável de desfecho foi a qualidade de vida relacionada à saúde, medida pelo SF-12 (componentes físico e mental). As variáveis mediadoras foram a religiosidade organizacional, a não organizacional e a intrínseca. Os coeficientes alfa de Cronbach foram: componente físico = 0,85; componente mental = 0,80; religiosidade intrínseca = 0,89 e Apgar familiar = 0,91. RESULTADOS : Maiores níveis de religiosidade organizacional e intrínseca estiveram associados a melhor componente físico e mental para os idosos. Maior escolaridade, melhor funcionalidade familiar e menor número de doenças contribuíram diretamente para melhor desempenho nos componentes físico e mental, independente da religiosidade. Para as mulheres, a religiosidade organizacional mediou a relação entre a idade e os componentes físico (β = 2,401; p < 0,01) e mental (β = 1,663; p < 0,01). Para os homens, a religiosidade intrínseca mediou a relação entre a escolaridade e o componente mental (β = 7,158; p < 0,01). CONCLUSÕES : A religiosidade organizacional e intrínseca exercem efeito benéfico sobre a relação entre idade, escolaridade e a qualidade de vida relacionada à saúde desses idosos.

Possessing active social networks seems to positively influence the functional performance of elderly people.To verify the association between the characteristics of social networks of the elderly people and the emergence of functional impairment.This is a longitudinal population-based study, which used the 2006 (n = 1,413) and 2010 (n = 990) cohorts of the Health, Well-Being, and Aging (SABE) Study. To characterize the social networks, the following variables were used: number of members in the network; living arrangements; sex and age of the members; coresidence with children or only elderly individuals; satisfaction with the relationships; and receiving and offering social support (financial, material, emotional, performing tasks inside and outside the home, providing companionship, and personal care). Logistic regression was used to analyze the data. All ethical guidelines were followed.The social networks of the elderly people had an average of 8.15 members and consisted predominantly of family members aged between 15 and 59 years. Dependent elderly people received more material support, help in performing household tasks and those outside the home, and personal care, while the independent elderly people received more emotional support and companionship. Provision of social support (OR = 0.32, 95%CI 0.14 - 0.71) decreased the chances of developing dependency, independent of sociodemographic and health conditions.The strengthening of social networks in old age should be encouraged since confidence in informal care offered, mainly by families, may not be the best option for dealing with the growing demand for care that accompanies the aging of the population.Possuir redes sociais ativas parece influenciar positivamente o desempenho funcional de idosos.Verificar a associação entre as características das redes sociais de idosos e o surgimento de comprometimento funcional.Estudo longitudinal de base populacional que utilizou as coortesde2006 (n = 1.413) e 2010 (n = 990) do Estudo Saúde, Bem-Estar e Envelhecimento (SABE). Para caracterização das redes sociais utilizou-se as seguintes variáveis: número de integrantes da rede; arranjo domiciliar; sexo e idade dos integrantes; co-residência com criança ou apenas com idosos; satisfação com a relação; recebimento e oferecimento de apoio social (financeiro, material, emocional, realização de tarefas dentro e fora de casa, companhia e cuidados pessoais). Utilizou-se regressão logística para a análise dos dados. Todos os cuidados éticos foram observados.As redes sociais dos idosos possuem, em média, 8,15 integrantes e são constituídas predominantemente por familiares com idade entre 15 e 59 anos. Idosos dependentes recebem mais apoio material, para realização de tarefas domésticas, fora de casa e cuidados pessoais, enquanto os idosos independentes recebem mais apoio emocional e companhia. Oferecer apoio social (OR = 0,32; IC95% 0,14-0,71) diminuiu as chances de desenvolver dependência, independente de condições sociodemográficas e de saúde.Deve-se estimular o fortalecimento das redes sociais na velhice, uma vez que a confiança no cuidado informal, oferecido, principalmente pelas famílias, pode não ser a melhor opção para lidar com a demanda de cuidado crescente que acompanha o envelhecimento da população brasileira.

To analyze the influence of demographic, health condition, and lifestyle factors on body balance disorders among elderly subjects living in the city of São Paulo, Brazil, in 2006.Thestudy was developed based on information provided by the Health, Well-being, and Aging (SABE) Study. Itincluded 60-year-old subjects, both men and women, or those over this age. The sample comprised 1,226 subjects that represented 930,639 elderly subjects. The dependent variable was the elderly's body balance disorder, which was measured using part of the Short Physical Performance Battery (SPPB). The independent variables were divided into three groups: demographic, health conditions, and lifestyle. The multiple binary logistic regression analysis was applied to estimate the association between balance disorders and demographic, health, and lifestyle variables in the elderly.Age, difficulties in at least one mobility, and performance of regular physical activities showed a significant influence on the elderly's body balance (p0.05). Age was the strongest related determiner. Being aged 75-79 years and 80 years or more increased 3.77 and 5.31 times, respectively, the chances of the elderly subjects present balance disorders in comparison with the 60- to 64-years-old.Preventive measures that aim at reversing a body instability condition should be preconized and incorporated in the elderly's health-care schedule.O objetivo deste estudo foi investigar a influência dos fatores demográficos, de condições de saúde e de estilo de vida nas alterações do equilíbrio corporal dos idosos residentes no município de São Paulo em 2006.O estudo foi desenvolvido com base em dados provenientes do Estudo Saúde,Bem-Estar e Envelhecimento (SABE). Foram selecionados todos os indivíduos com 60 anos e mais de idade, de ambos os sexos. A amostra considerada era de 1.226 indivíduos, representando 930.639 idosos. A variável dependente foi a alteração de equilíbrio corporal do idoso. Para mensurá-la utilizou-se parte do Short Physical Performance Battery (SPPB). As variáveis independentes foram classificadas em três grupos: demográficas, de condições de saúde e de estilo de vida. Para estimar a associação entre as alterações de equilíbrio com as variáveis demográficas, de saúde e de estilo de vida em idosos foi realizada uma análise de regressão logística binária múltipla.Idade, dificuldades em pelo menos uma mobilidade e realização de atividade física regular exercem uma significativa influência no equilíbrio corporal dos idosos (p0,05). A idade foi o determinante mais fortemente relacionado. Ter idade entre 75 a 79 anos e 80 anos e mais aumenta em 3,77 e 5,31vezes a chance, respectivamente, de os idosos apresentarem alterações de equilíbrio em comparação às idades de 60 a 64 anos.Medidas preventivas e que visam reverter um quadro de instabilidade corporal devem ser preconizadas e incorporadas na agenda de atenção à saúde dos idosos.

To verify the association between the incidence of DM and predictors, in a cohort of elderly people. Elderly people (≥ 60 y) were analyzed, of both genders, participants of the SABE Survey, carried out in the city of São Paulo, Brazil, in 2000 (n = 2,143) and 2006 (n = 1,115). The study variables were: DM; demographic (gender, age group, education level, companionship in the residence), nutritional status (risk for obesity, body obesity, and high abdominal fat), clinical (number of reported diseases), and lifestyle (alcohol consumption, smoking, intake of meat and fruit and vegetables). Multiple logistic regression (p0.05) was used to verify the association between variables of this study, with the statistical software Stata/SE 10.1. In 2006, 914 subjects, survivors of 2000, were analyzed and 72 were identified as new cases of DM (7.7/1.000 person-years). It was found that body obesity (OR = 1.67, CI = 1.00 to 2.81) and high abdominal fat (OR = 2.32, CI = 1.47 to 3.67) were predictors of the incidence of DM in the elderly (p0.000). It was concluded that body obesity and abdominal fat are the variables which contribute to the development of DM in the elderly.Verificar a associação da incidência de diabetes melito (DM) e variáveis determinantes em coorte de idosos. Foram analisados idosos, participantes do Estudo SABE – Saúde, Bem-Estar e Envelhecimento, realizado no município de São Paulo, em 2000 (2.143 idosos), e em 2006 (1.115 idosos). As variáveis de estudo foram: DM; sociodemográficas (sexo, grupo etário, escolaridade, companhia no domicílio), estado nutricional (risco para obesidade, obesidade e gordura abdominal), clínicas (número de doenças referidas) e de estilo de vida (ingestão de bebida alcoólica, hábito de fumar, ingestão de carnes e de frutas, legumes e verduras). Utilizou-se regressão logística múltipla para verificar a associação entre variáveis de estudo, utilizando o programa Stata/SE 10.0. Em 2006, 914 idosos, sobreviventes de 2000, foram analisados, dos quais 72 constituíram os novos casos de DM (incidência de 7,7/1.000 pessoas-ano). Verificou-se associação (p0,000) entre incidência de DM com obesidade corporal (OR = 1,67; IC = 1,00–2,81) e gordura abdominal elevada (OR = 2,32; IC = 1,47-3,67). Concluiu-se que a obesidade corporal e a gordura abdominal elevada foram as variáveis que contribuem para o desenvolvimento da DM em idosos.

To estimate the prevalence of depressive symptoms in the elderly in São Paulo city, Brazil (SABE Study), in 2006 and to identify risk factors associated with the 2006 prevalence and protective factors among those who did not have depressive symptoms in the assessments conducted in 2000 and 2006.In this cross-sectional and longitudinal study, the Geriatric Depression Scale was used for inclusion in the cohort in 2000 and also in 2006.The prevalence of depressive symptoms in 2006 was 14.2% (95%CI 11.8 - 16.7), and 74.8% of the participants did not present depressive symptoms in 2000 neither in 2006. Logistic regression models were constructed, with different groups of variables (socio-demographic variables, status and perception of health and memory) adjusted for sex and age. In the final logistic regression model, the following factors were associated with depressive symptoms: self-assessment of vision, oral health, memory and of general health as poor, dependence for basic activities of daily living, and moderate or severe family dysfunction. Protective factors against presenting depressive symptoms in the 2000 and 2006 phases were: being male, absence of pulmonary disease and positive self-assessment of health.Depressive symptoms were frequent among the elderly, and were associated with health problems, dependence and family dysfunction. These factors should be addressed in health policy planning for the care of these elderly.Estimar a prevalência de sintomas depressivos em idosos do município de São Paulo, Brasil (Estudo SABE), em 2006 e identificar fatores de risco associados a essa prevalência em 2006 e fatores de proteção entre os idosos que não apresentaram sintomas depressivos nas avaliações realizadas em 2000 e 2006.Estudo transversal e longitudinal que utilizou a Escala de Depressão Geriátrica na inclusão da coorte em 2000 e em 2006.A prevalência de sintomas depressivos em 2006 foi de 14,2% (IC95% 11,8 - 16,7) e 74,8% dos participantes não apresentaram sintomas depressivos em 2000 nem em 2006. Foram construídos modelos de regressão logística, tendo como exposição diferentes grupos de variáveis (sociodemográficas; condições e percepção de saúde e memória) ajustando-se para sexo e idade. No modelo final da regressão logística, associaram-se a sintomas depressivos: autoavaliação da visão, da saúde bucal, da memória e da saúde geral como ruins, dependência para atividades básicas de vida diária e disfunção familiar moderada ou grave. Os fatores de proteção para não ter apresentado sintomas depressivos nas fases de 2000 e 2006 foram: sexo masculino, não referir doença pulmonar e avaliar positivamente a saúde.Sintomas depressivos nos idosos estudados foram frequentes e se associaram com piores condições de saúde, dependência e disfunção familiar e tais fatores devem ser considerados no planejamento de políticas de saúde para prestação de cuidados a esses idosos.

The Health, Wellbeing and Aging Study (SABE) began in 2000 under the coordination of the Pan American Health Organization as a multicenter study developed in seven urban centers of Latin America and the Caribbean, to determine the health and living conditions of elderly in this region. In Brazil, the study was developed in the city of São Paulo, where 2,143 individuals (cohort A) aged 60 years or older were selected through probabilistic sampling. In 2006, 1,115 of these individuals were interviewed a second time, and a new probabilistic cohort of individuals aged 60 to 64 years was added (cohort B; n=298). Thus the SABE Study - Brazil was transformed into a multi-cohort longitudinal study, with the objective of identifying changes that occur in the aging process among different generations. In 2010, a longitudinal follow-up was developed with cohorts A and B, with the addition of a new cohort of individuals aged 60 to 64 years (cohort C; n=355). Thethree surveys (2000, 2006 and 2010) involved the application of a questionnaire, anthropometric evaluation and functional tests, with the subsequent inclusion of blood collection for the evaluation of biochemical, immunological and genetic variables, as well as an accelerometer for the measuring of caloric expenditure.O Estudo Saúde, Bem-Estar e Envelhecimento (SABE) teve início em 2000 sob coordenação da Organização Pan-Americana da Saúde como um estudo multicêntrico desenvolvido em sete centros urbanos da América Latina e Caribe para traçar o perfil das condições de vida e saúde das pessoas idosas na região. No Brasil, foi realizado na cidade de São Paulo, onde foram entrevistadas 2.143 pessoas (coorte A), com idade igual ou superior a 60 anos, por amostra probabilística. Em 2006, o Estudo SABE - Brasil transformou-se em longitudinal. Nesse momento, foram localizadas e reentrevistadas 1.115 pessoas, introduzindo-se uma nova amostra probabilística de idosos com idade de 60 a 64 anos (coorte B, n = 298), o transformando em longitudinal de múltiplas coortes com o objetivo principal de identificar as transformações que ocorrem no processo de envelhecimento entre as diferentes gerações. No ano 2010 foi desenvolvido o seguimento longitudinal das coortes A e B e introduzida nova coorte de 60 a 64 anos (coorte C, n = 355). Nas três coletas (2000, 2006 e 2010) utilizou-se um instrumento sob a forma de questionário, avaliação antropométrica e testes funcionais, introduzindo-se a coleta de sangue para avaliação de parâmetros bioquímicos, imunológicos e genéticos e, também, o acelerômetro para medir objetivamente o gasto calórico dos idosos.

The concomitance of smoking and poor dietary habits represents a worsened prognosis of health and quality of life for elderly. The aim of this study was to characterize the nutritional status of elderly who were smokers and former smokers and residents of São Paulo city.A cross-sectional study was conducted in 2010 with a representative sample of 1,345 individuals aged 60 years and over, who were part of the elderly cohort monitored at the SABE Study. Sociodemographic, health, and nutritional aspects of the elderly were described, according to their tobacco use in life.The proportion of smokers and former smokers was 12.9 and 54.7%, 11.0 and 25.2%, and 11.8 and 37.2% for male, female, and total population, respectively. For both genders, increasing age decreased the proportion of smokers. The proportion of proper fruit intake was smaller for female smokers. Poorer nutritional status was observed in smokers, who had fewer meals per day and greater frequency of underweight compared with elderly nonsmokers.Considering the impact of inappropriate eating habits and smoking on health, elderly smokers deserve special attention on their nutritional status.A concomitância de fumo e maus hábitos alimentares representa uma piora no prognóstico da saúde e na qualidade de vida dos idosos. O objetivo deste estudo foi caracterizar o estado nutricional de idosos fumantes e ex-fumantes residentes na cidade de São Paulo.Foi realizado um estudo transversal em 2010, com uma amostra representativa de 1.345 indivíduos com 60 anos ou mais, que fazem parte da coorte de idosos acompanhados pelo Estudo Saúde, Bem-Estar e Envelhecimento (SABE). Foram descritos os aspectos sociodemográficos, de saúde e nutricionais dos idosos de acordo com o uso de tabaco na vida.A proporção de fumantes e ex-fumantes foi de, respectivamente, 12,9 e 54,7% para o sexo masculino; 11,0 e 25,2% para o sexo feminino; e de 11,8 e 37,2% para a população total do estudo. Para ambos os sexos, com o aumento da idade, diminuiu a proporção de fumantes. A proporção de idosas fumantes com ingestão adequada de frutas foi menor. Fumantes apresentaram pior estado nutricional, com menos refeições por dia e maior frequência de baixo peso.Considerando-se o impacto do hábito alimentar inadequado e de fumar sobre a saúde, os fumantes idosos merecem atenção especial sobre o seu estado nutricional.

This study provides the prevalence, by gender and age-groups, of observed physical performance test (PPT) assessing functional limitation for representative samples of elderly Brazilian subjects living in São Paulo city. This cross-sectional epidemiological study, both population- and household-based, is part of a multicenter survey (SABE) undertaken in seven Latin American and Caribbean countries and coordinated by the Pan-American Health Organization. From January 2000 to March 2001, 2,143 elderly individuals (> 60 years) of both sexes were examined. Of this total, 1,894 participated in the study. PPT included handgrip strength, standing balance, timed repeated "chair stand", and "pick up a pen". Results have shown (based on chi-square) that the prevalence relating to the performance differed according to sex, age group, and from one test to another. With increasing age, there was a reduction (p = 0.000) in both males and females in the proportion of individuals that had better results on the tests. The male group, on every test, when compared to women from the same age group, had a more individuals with better scores. Data suggest that older individuals and women have more functional limitations. Em amostra representativa de idosos residentes no Município de São Paulo, Brasil, foram utilizados testes de desempenho motor (TDM) com objetivo de verificar a proporção de indivíduos, de acordo com sexo e grupo etário, quanto à limitação funcional. Trata-se de estudo epidemiológico transversal, de base populacional e domiciliar, parte de pesquisa multicêntrica (SABE), coordenada pela Organização Pan-Americana da Saúde. A SABE abrangeu 2.143 idosos (> 60 anos), de ambos os sexos, no período de janeiro/2000 a março/ 2001; sendo que 1.894 (88,4%) participaram deste estudo. Os seguintes TDM foram utilizados: força de preensão manual; "sentar e levantar" e "agachar e pegar uma caneta" (avaliados por tempo) e; teste de equilíbrio estático. A prevalência quanto ao desempenho (qui-quadrado) foi específica para sexo, grupo etário e teste utilizado. O percentual de homens e mulheres com melhor escore foi menor (p = 0,000) nos grupos etários mais avançados. Quando comparados às mulheres, os homens, em todos os grupos etários, apresentaram melhores resultados nos testes. O presente estudo fornece evidências de que a limitação funcional é mais freqüente no sexo feminino e nos indivíduos mais idosos.

El presente documento reseña la metodología de la encuesta SABE y los desafíos que impone a la sociedad en general y a los servicios de salud en particular el rápido envejecimiento de la población en América Latina y el Caribe. La Región esta envejeciendo a un ritmo que no se ha observado en el mundo desarrollado, y la evaluación de problemas de salud y discapacidad indica que los adultos mayores están envejeciendo con más limitaciones funcionales y peor salud que sus semejantes en países desarrollados. Además, las redes familiares están cambiando rápidamente y tienen menos capacidad de suplir la falta de protección social institucional. El estudio multicéntrico SABE se creó con el objetivo de evaluar el estado de salud de las personas adultas mayores de siete ciudades de América Latina y el Caribe: Buenos Aires, Argentina; Bridgetown, Barbados; La Habana, Cuba; Montevideo, Uruguay; Santiago, Chile; México, D.F., México y São Paulo, Brasil. La encuesta SABE establece el punto de partida para la investigación sistemática del envejecimiento en zonas urbanas de la Región de América Latina y el Caribe. Se recomienda que estudios de estas características y con este ánimo comparativo se extiendan a otros países, zonas y regiones, para enriquecer el conocimiento sobre las personas adultas mayores.This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and São Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.

This document outlines the methodology of the Salud, Bienestar y Envejecimiento (Health, Well-Being, and Aging) survey (known as the "SABE survey"), and it also summarizes the challenges that the rapid aging of the population in Latin America and the Caribbean imposes on society in general and especially on health services. The populations of the countries of Latin America and the Caribbean are aging at a rate that has not been seen in the developed world. The evaluation of health problems and disability among older adults in those countries indicates that those persons are aging with more functional limitations and worse health than is true for their counterparts in developed nations. In addition, family networks in Latin America and the Caribbean are changing rapidly and have less capacity to make up for the lack of protections provided by social institutions. The multicenter SABE study was developed with the objective of evaluating the state of health of older adults in seven cities of Latin America and the Caribbean: Bridgetown, Barbados; Buenos Aires, Argentina; Havana, Cuba; Mexico City, Mexico; Montevideo, Uruguay; Santiago, Chile; and Sao Paulo, Brazil. The SABE survey has established the starting point for systematic research on aging in urban areas of Latin America and the Caribbean. Comparative studies of these characteristics and with this comparative nature should be extended to other countries, areas, and regions of the world in order to expand the knowledge available on older adults.

OBJETIVO: Apresentar os resultados do Projeto Saúde, Bem-Estar e Envelhecimento na América Latina e Caribe (SABE) no que tange ao desempenho funcional, às demandas assistenciais e aos arranjos familiares dos idosos do Município de São Paulo, Brasil. MÉTODOS: Em 2000, foram entrevistados 2 143 indivíduos com 60 anos ou mais, utilizando-se o questionário padronizado do SABE. A amostra foi obtida em dois estágios, utilizando-se setores censitários com reposição e com probabilidade proporcional à população. A complementação da amostra de pessoas de 75 anos ou mais foi realizada através da localização de moradias próximas aos setores selecionados. Os dados finais foram ponderados, de forma a serem expandidos. O desempenho funcional foi medido pela capacidade dos idosos de executar atividades básicas de vida diária (ABVD, atravessar um cômodo da casa, comer, deitar-se e levantar da cama, usar o vaso sanitário, vestir-se e despir-se e tomar banho) e atividades instrumentais de vida diária (AIVD, comprar e preparar alimentos, realizar tarefas domésticas leves e pesadas, ir a outros lugares sozinho, usar o telefone, tomar os próprios medicamentos e manejar dinheiro), sendo a limitação funcional (demanda assistencial) definida como a necessidade de ajuda para executar pelo menos uma dessas atividades. Os 66 tipos de arranjos domiciliares identificados foram agrupados em sete categorias, de acordo com a presença ou não de co-residentes e o grau de parentesco entre o idoso e os co-residentes. RESULTADOS: Dos entrevistados, 19,2% apresentaram limitações funcionais nas atividades básicas e 26,5% nas atividades instrumentais, sendo a maior proporção entre mulheres e na velhice avançada. A proporção de idosos com limitações que recebeu ajuda variou, nas atividades básicas, de 25,6% (para deitar-se e levantar da cama) a 70,5% (para comer), e nas instrumentais, de 79,7% (para a execução de tarefas domésticas leves) a 97,8% (para comprar alimentos). Quanto aos arranjos familiares, a maioria dos idosos morava com o cônjuge e os filhos ou apenas com os filhos (32,1%) ou somente com o cônjuge (20,0%). O arranjo domiciliar em que a maior proporção de idosos com limitação funcional recebia ajuda (56,4%) foi aquele no qual o idoso residia também com não-familiares. CONCLUSÃO: Os idosos com limitações funcionais não estão sendo assistidos suficientemente pela família ou co-residentes, e as políticas públicas não suprem esse déficit assistencial. Dado o acelerado processo de envelhecimento da população, o sistema de assistência corre o risco de se tornar não só insuficiente, mas caótico.OBJECTIVES: To describe the functional performance, need for assistance, and living arrangements of elderly persons in the city of São Paulo, Brazil, as part of a project called Health, Well-being, and Aging in Latin America and the Caribbean (the "SABE project"). METHODS: In 2000, 2 143 individuals 60 years of age or older were interviewed, using the standardized SABE questionnaire. The sample was obtained in two stages, using census sectors with replacement and probability proportional to population. To have the desired number of respondents 75 or older, additional homes close to the selected census sectors were found, with weighting of the final results. The functional performance of the elderly persons was measured in terms of their ability to perform basic activities of daily living (walking across a room, eating, lying down on a bed and getting up from it, using the bathroom, dressing and undressing, and bathing) and to carry out instrumental activities of daily living (buying and preparing food, performing light and heavy household chores, using the telephone, taking medications, and handling money). Functional impairment was defined as the need for assistance in performing at least one of the basic or instrumental activities. There were 66 types of living arrangements (household composition) identified and grouped into seven categories, according to with whom an elderly person lived and whether the other residents of the household were relatives or not. RESULTS: Of the individuals interviewed, 19.2% presented a functional impairment in basic activities and 26.5% in instrumental activities. The impairments were more common among women and among persons 75 or older. The proportion of elderly persons with an impairment who received help with basic activities ranged from 25.6% (lying down on the bed and getting up) to 70.5% (eating). With instrumental activities, the proportion receiving assistance ranged from 79.7% (light domestic chores) to 97.8% (buying food). With respect to living arrangements, the single largest group (32.1%) of elderly persons lived with the spouse and children or with just the children; the next largest group (20.0%) lived with just the spouse. The living arrangement in which the highest proportion (56.4%) of elderly persons with functional impairments received help was living with nonrelatives. CONCLUSIONS: The elderly persons with functional impairments in São Paulo are not receiving enough assistance from their family members or other persons with whom they live. Further, there are no public policies in Brazil to fill this gap. Taking into account the country's aging population, the health care system in Brazil is at risk of becoming not only inadequate but chaotic.

OBJETIVO: Apresentar os resultados do Projeto Saude, Bem-Estar e Envelhecimento na America Latina e Caribe (SABE) no que tange ao desempenho funcional, as demandas assistenciais e aos arranjos familiares dos idosos do Municipio de Sao Paulo, Brasil. METODOS: Em 2000, foram entrevistados 2 143 individuos com 60 anos ou mais, utilizando-se o questionario padronizado do SABE. A amostra foi obtida em dois estagios, utilizando-se setores censitarios com reposicao e com probabilidade proporcional a populacao. A complementacao da amostra de pessoas de 75 anos ou mais foi realizada atraves da localizacao de moradias proximas aos setores selecionados. Os dados finais foram ponderados, de forma a serem expandidos. O desempenho funcional foi medido pela capacidade dos idosos de executar atividades basicas de vida diaria (ABVD, atravessar um comodo da casa, comer, deitar-se e levantar da cama, usar o vaso sanitario, vestir-se e despir-se e tomar banho) e atividades instrumentais de vida diaria (AIVD, comprar e preparar alimentos, realizar tarefas domesticas leves e pesadas, ir a outros lugares sozinho, usar o telefone, tomar os proprios medicamentos e manejar dinheiro), sendo a limitacao funcional (demanda assistencial) definida como a necessidade de ajuda para executar pelo menos uma dessas atividades. Os 66 tipos de arranjos domiciliares identificados foram agrupados em sete categorias, de acordo com a presenca ou nao de co-residentes e o grau de parentesco entre o idoso e os co-residentes. RESULTADOS: Dos entrevistados, 19,2% apresentaram limitacoes funcionais nas atividades basicas e 26,5% nas atividades instrumentais, sendo a maior proporcao entre mulheres e na velhice avancada. A proporcao de idosos com limitacoes que recebeu ajuda variou, nas atividades basicas, de 25,6% (para deitar-se e levantar da cama) a 70,5% (para comer), e nas instrumentais, de 79,7% (para a execucao de tarefas domesticas leves) a 97,8% (para comprar alimentos). Quanto aos arranjos familiares, a maioria dos idosos morava com o conjuge e os filhos ou apenas com os filhos (32,1%) ou somente com o conjuge (20,0%). O arranjo domiciliar em que a maior proporcao de idosos com limitacao funcional recebia ajuda (56,4%) foi aquele no qual o idoso residia tambem com nao-familiares. CONCLUSAO: Os idosos com limitacoes funcionais nao estao sendo assistidos suficientemente pela familia ou co-residentes, e as politicas publicas nao suprem esse deficit assistencial. Dado o acelerado processo de envelhecimento da populacao, o sistema de assistencia corre o risco de se tornar nao so insuficiente, mas caotico.

Aging has been associated with progressive molecular and structural changes causing loss of function in several organs. There is a general hypothesis that very old individuals suffer profound modifications where different domains (immune, metabolic and cognitive) loose the tight functional interconnection present in younger bodies. However, it is not clear how this interconnection is affected at the very early stage of ageing and whether gender plays a role. Therefore, our aim was to evaluate some biological markers in non-institutionalized “healthy individuals” at the very early stage of aging (60 to 65 years old, female and male). Blood was collected and serum creatinine, albumin and glucose were measured. In addition, we evaluated these individuals for lymphocytes phenotype (T CD4+, T CD8+, CD19+) by flow cytometry in peripheral mononuclear blood cells. It was observed that at the early stage of ageing male present higher creatinine and albumin serum levels compared to female. In addition, male had higher percentages of effector memory CD4+ and CD8+ T cells and lower percentages of naive CD8+ T cells. No differences were observed for B cells. These findings suggest that metabolic functions and immune system are compromised in male individuals at the very early stage of ageing and thus gender differences should be considered for the design of new therapies to the elderly.

Accurate interpretation of germline mutations of the rearranged during transfection (RET) proto-oncogene is vital for the proper recommendation of preventive thyroidectomy in medullary thyroid carcinoma (MTC)-prone carriers. To gain information regarding the most disputed variant of RET, ATA-A Y791F, we sequenced blood DNA samples from a cohort of 2904 cancer-free elderly individuals (1261 via Sanger sequencing and 1643 via whole-exome/genome sequencing). We also accessed the exome sequences of an additional 8069 individuals from non-cancer-related laboratories and public databanks as well as genetic results from the Catalogue of Somatic Mutations in Cancer (COSMIC) project. The mean allelic frequency observed in the controls was 0.0031, with higher occurrences in Central European populations (0.006/0.008). The prevalence of RET Y791F in the control databases was extremely high compared with the 40 known RET pathogenic mutations (P=0.00003), while no somatic occurrence has been reported in tumours. In this study, we report new, unrelated Brazilian individuals with germline RET Y791F-only: two tumour-free elderly controls; two individuals with sporadic MTC whose Y791F-carrying relatives did not show any evidence of tumours; and a 74-year-old phaeochromocytoma patient without MTC. Furthermore, we showed that the co-occurrence of Y791F with the strong RET C634Y mutation explains the aggressive MTC phenotypes observed in a large affected family that was initially reported as Y791F-only. Our literature review revealed that limited analyses have led to the misclassification of RET Y791F as a probable pathogenic variant and, consequently, to the occurrence of unnecessary thyroidectomies. The current study will have a substantial clinical influence, as it reveals, in a comprehensive manner, that RET Y791F only shows no association with MTC susceptibility.

Aim: To verify the association between the characteristics of social networks of the elderly people and the emergence of functional impairment. Method: This is a longitudinal population-based study, which used the 2006 (n = 1,413) and 2010 (n = 990) cohorts of the Health, Well-Being, and Aging (SABE) Study. To characterize the social networks, the following variables were used: number of members in the network; living arrangements; sex and age of the members; coresidence with children or only elderly individuals; satisfaction with the relationships; and receiving and offering social support (financial, material, emotional, performing tasks inside and outside the home, providing companionship, and personal care). Logistic regression was used to analyze the data. All ethical guidelines were followed. Results: The social networks of the elderly people had an average of 8.15 members and consisted predominantly of family members aged between 15 and 59 years. Dependent elderly people received more material support, help in performing household tasks and those outside the home, and personal care, while the independent elderly people received more emotional support and companionship. Provision of social support (OR = 0.32, 95%CI 0.14 – 0.71) decreased the chances of developing dependency, independent of sociodemographic and health conditions. Conclusion: The strengthening of social networks in old age should be encouraged since confidence in informal care offered, mainly by families, may not be the best option for dealing with the growing demand for care that accompanies the aging of the population.

Background: Some studies showed that grip strength predicts mortality. Both muscle mass and muscle strength decline with age, but it is not clear yet how body composition acts in the process. This article investigates the relationship between grip strength, body composition and mortality of inhabitants of São Paulo, Brazil, aged 60 and plus in 2006. Methods: 1423 participants were interviewed during the second wave (2006) of the SABE study. Handgrip strength was collected at baseline along with data on body mass index, (BMI) number of comorbidities, income and schooling. At the end of follow-up a Poisson regression was used to evaluate mortality rate ratios (IRR), adjusted for age and sex. Results: After 5.9 years there were 1080 survivors, 268 deaths and 65 (4.6%) lost to follow up. Death rate was 30.3 per 1000 person-years; death rates by Hand Grip Strength in men were 23.0 (normal strength) and 78.6 (reduced strength) - a rate ratio of 3.4. In women: 15.3 (normal) and 56.7 (reduced) a ratio of 3.7. Poisson regression showed that schooling, income and number of comorbidities had no significant IRRs. Low BMI proved different from Normal (IRR = 2.1), women differed from men (0.7); ages 75+ differed from ages 60–75 (IRR = 2.4). Reduced Hand Grip strength showed a mortality rate 2.3 greater than normal strength. Conclusions: This study showed that Hand Grip Strength is an important tool for prognostic of survival along with low category of BMI, independent of age, sex, income, education and number of comorbidities.

Scientific evidences show a relationship between chronic inflammation and quality of life (QoL). This study verified the impaired quality of life, in different domains, associated with elevated inflammatory biomarkers levels, in older adults. Cross-sectional population-based study (SABE Study), including older adults (≥ 60 years-old). The inflammatory biomarkers used were uric acid, fibrinogen e C-reactive protein serum levels determined by using sensitive regular immunoassays (ELISA). QoL was assessed using the SF12 questionnaire. Socio-demographic information and health conditions were: sex, age and educational level; number of non-communicable diseases, self-reported conditions (chronic pains, hypertension, diabetes and cardiovascular disease), functional capacity, body mass index and waist circumference, respectively, identified using questionnaire and specific measures. Multiple logistic regression was used to analyze this association. From the 1.344 older adults, 1255 were eligible to be part of this study. There was no association of uric acid and fibrinogen with QoL. When we regarded the levels of CRP, men showed a higher average, being that older men (≥75 years) had a decrease in levels of CRP. Older adults with one or more chronic diseases, hypertension and BMI higher than 30kg/m2 presented low values in the physical domain of SF12 and were associated with high levels of CRP. The adjusted model showed a strong relationship with the worst ratings in physical domain of SF12 and high BMI values. The joint associations of physical domain of quality of life and inflammation in older adults have a significant effect in chronic inflammation.

This study aimed to assess the impact of nutritional status on survival time in Brazilian elderly living in five years follow-up. Elderly (n=1,256) from the third wave of SABE Study (Health, Well-being, and Aging) conducted in 2010, were followed for 5 years, when they were contacted for the fourth wave. Survival functions were estimated according to nutritional status in four groups: 1) without nutritional alteration; 2) anemia only; 3) hypoalbuminemia only; 4) anemia and hypoalbuminemia (Anemia= hemoglobin

Childhood conditions can influence some aspects of development of an individual and thus affect health in adult life.To evaluateassociations between early life conditions and health, as reported by the survey SABE in 2000, 2006, and 2010.Early or previous conditions refer to the situations before 15 years of age of the interviewees, such as economic condition, famine, health assessment, medical conditions, and having lived in the countryside for over 5 years. The control variables were gender, education, andincome. The outcome was self-reported health as "good" or "bad." This study focused on ages between 60 and 65years.Bivariate analysis showed significant associations of the individual's origin in all the three cohorts. Economic and famine conditions were also significant for cohort B (2006). Multivariate Poisson regression was used with prevalence ratio as an element of comparison. Rural origin was the only significant early condition in the initial model. Thecontrol variables - gender, cohort, and education - were also significant. In the final model, the significant variables in the initial model were included, plus relation between rural origin and the number of diseases. Cohorts, gender, education, and the number of diseases were still significant factors when individuals had rural origin, but were not associated with the outcome if their origin was urban.There were connections between early conditions of life and the health of the elderly, and this might be an important tool for health care for both the individual and the community.Condições da infância podem influenciar peculiaridades individuais do desenvolvimento e assim afetar a saúde dos adultos.Avaliar associações entre condições pregressas e saúde, como informadas nas pesquisas SABE de 2000, de 2006 e de 2010.Condições pregressas referem-se a situações anteriores aos 15 anos: a condição econômica, a fome, a avaliação da saúde, a presença de doenças e ter vivido em ambiente rural por mais de cinco anos. As variáveis de controle foram o sexo, a escolaridade e a renda. O desfecho é a autoavaliação da saúde nas categorias “Boa” e “Má”. A análise abrangeu pessoas entre 60 e 65anos.A análise bivariada mostrou associações segundo a origem nas três coortes. Foram ainda significantes a condição econômica e ter passado fome, para os entrevistados em 2006. Na análise multivariada pela regressão de Poisson, o elemento de comparação foi a razão de prevalência. Origem rural foi a única entre as condições pregressas a apresentar significância no modelo inicial. As variáveis de controle- sexo, coorte, escolaridade - também apresentaram significância. No modelo final, foram consideradas as variáveis significantes no inicial e uma interação entre origem rural e número de doenças. Permaneceram significantes a coorte, o sexo, a escolaridade e o número de doenças quando o indivíduo teve origem rural. Estenúmero não foi associado ao desfecho se a origem fosse urbana.Há conexões entre as condições pregressas e a saúde do idoso, o que constitui em importante instrumento para a atenção à saúde, tanto para o indivíduo como para a comunidade.

To assess factors associated with the deterioration of self-rated chewing ability among adults aged 60 years and older over a 6-year period.We carried out a case-control study nested in a cohort involving 890 individuals living in the city of Sao Paulo from 2000 to 2006. The outcome was the reduction of self-rated chewing ability. Covariates on demographic, socioeconomic, behavior, cognitive, and functional and physical status variables were investigated. Simple and multiple analyses were carried out using unconditional logistic regression with hierarchical selection of variables.We analyzed 236 cases and 654 controls. In the unadjusted assessment, the reduction of self-rated chewing ability was associated with being aged older than 74 years, widowed, low schooling/income, not having a microwave oven or a car, physical inactivity, poor/regular self-rated health, to feel disgusted, poor/regular self-rated memory, one or more compromised daily life activities, dependence for daily life activities and to report less than half of teeth. Older adults aged older than 74 years and widowers had twice the odds of the outcome in the final model. Adjusted for demographic variables, individuals with lower income showed a similar increase of odds (OR 2.06 95% CI 1.31-3.23). To report poor/regular memory (OR 1.85 95% CI 1.28-2.67) and less than half remaining teeth (OR 1.76 95%CI 1.06-2.93) were significant factors in the adjusted model.Advanced age, low income, widowhood, poor/regular memory and less than half remaining teeth were important risk indicators for the reduction of self-rated chewing ability among individuals aged 60 years or older.

BACKGROUND:This study aimed to estimate coverage and identify factors associated to vaccination against influenza in the elderly population. METHODS:The study design was cross-sectional and population based. Data was collected in 2010 by the Health, Well-Being and Aging Study. Sample consisted of 1,341 community-dwelling elderly, in São Paulo, Brazil. Association between vaccination and covariates was evaluated by means of prevalence ratios estimated by Poisson regression models. RESULTS:Self-reported vaccination coverage was 74.2% (95% confidence interval: 71.3-76.9). Remaining physically active and having had recent interaction with health services, mainly with public units of healthcare, were the main incentives to increase vaccination coverage among the elderly; whereas lower age, living alone and absent interaction with health services were the main constraints to influenza vaccination at the community level. These covariates had already been reported to influence influenza vaccination of elders in previous years. CONCLUSION:Previous knowledge already available on the main constraints to influenza vaccination has not allowed to remove them. Influenza campaigns should be strengthened to increase vaccination coverage, especially in the group more reticent to vaccination. Instructing healthcare providers to recommend vaccine uptake is an important piece of this puzzle.

To estimate the prevalence of sarcopenia, dynapenia, and sarcodynapenia and associated factors in older adults in the city of São Paulo, Brazil.A population-based, cross-sectional study was conducted with 1,168 older adults who participated in the third wave of the Health, Well-being, and Aging study in 2010 (SABE study). Men and women with skeletal muscle mass ≤ 8.90 and ≤ 6.37 kg/m2, respectively, were considered sarcopenic. Men and women with grip strength30 and20 kg, respectively, were considered dynapenic. Those with both conditions were considered sarcodynapenic. Sociodemographic, behavioral, clinical, nutritional, and biochemical characteristics were investigated as factors associated with each of the three conditions using multinomial logistic regression.Theprevalence of sarcopenia, dynapenia, and sarcodynapenia was 4.8% (95%CI 3.6 - 6.3), 30.9% (95%CI 27.5 - 34.6) and 9.0% (95%CI 7.2-11.3), respectively. An increase in age and malnutrition was associated with all the three conditions. Cognitive impairment was associated with both dynapenia and sarcodynapenia. Schooling, current smoking habit, and not having a marital life were associated with sarcopenia. Osteoarthritis, schooling, being an ex-smoker, and low hemoglobin were associated with dynapenia. Smoking habit and the risk of malnutrition were associated with sarcodynapenia.Dynapenia is more prevalent among older adults, followed by sarcodynapenia, and sarcopenia. With the exception of age, schooling, and malnutrition, the factors associated with sarcopenia and dynapenia are different. However, there are similarities in some associations regarding the presence of sarcodynapenia.Estimar a prevalência e os fatores associados à sarcopenia, dinapenia e sarcodinapenia em idosos residentes no município de São Paulo.Estudo transversal de base populacional envolvendo 1.168 idosos pertencentes à terceira onda do Estudo SABE (Saúde, Bem-Estar e Envelhecimento), em 2010. Foramconsiderados sarcopênicos os idosos com índice de massa muscular esquelética ≤ 8,90 kg/m2 para homens e ≤6,37 kg/m2 para mulheres, dinapênicos aqueles com força de preensão manual30 kg para homens e20kg para mulheres, e sarcodinapênicos aqueles que apresentavam sarcopenia associada à dinapenia. Características sociodemográficas, comportamentais, condições clínicas, nutricionais e bioquímicas foram consideradas para determinar os fatores associados a cada uma das três condições por meio de regressão logística multinomial.A prevalência de sarcopenia, dinapenia e sarcodinapenia foi, respectivamente, 4,8% (IC95% 3,6-6,3), 30,9% (IC95% 27,5-34,6) e 9,0% (IC95% 7,2-11,3). O avanço da idade e a desnutrição foram associados às três condições analisadas. O prejuízo cognitivo foi associado à dinapenia e à sarcodinapenia. A escolaridade, ter o hábito de fumar e não ter vida conjugal foram associados à sarcopenia, enquanto osteoartrite, escolaridade, ser ex-fumante e apresentar valores baixos de hemoglobina foram associados à dinapenia. Foram associados à sarcodinapenia o hábito de fumar e o risco de desnutrição.Dinapenia é a condição mais prevalente na população idosa, seguida pela sarcodinapenia e sarcopenia. Exceto por idade, escolaridade e desnutrição, os fatores associados à sarcopenia e à dinapenia são distintos. Entretanto, há similaridades em algumas associações quando se trata da presença de sarcodinapenia.

OBJECTIVE To estimate life expectancy with and without depressive symptoms in older adults for the years 2000 and 2010. METHODS We evaluated individuals aged 60 years or older (n = 1,862 in 2000 and n = 1,280 in 2010), participants of the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Aging) study in in Sao Paulo, Southeastern Brazil. Depression was measured using the shorter version of the Geriatric Depression Scale (GDS-15); respondents scoring ≥ 6 were classified as having depression. Estimates of life expectancy with and without depression were obtained using the Sullivan method. RESULTS Data from 2000 indicate that 60-year-old men could expect to live, on average, 14.7 years without depression and 60-year-old women could expect to live 16.5 years without depression. By 2010, life expectancy without depression had increased to 16.7 years for men and 17.8 years for women. Expected length of life with depression differed by sex, with women expected to live more years with depression than men. CONCLUSIONS Between 2000 and 2010, life expectancy without depression in Sao Paulo increased. However, older adults in Brazil, especially older women, still face a serious burden of mental illness. RESUMO OBJETIVO Estimar a expectativa de vida com e sem sintomas depressivos em idosos para os anos 2000 e 2010. MÉTODOS Foram avaliados (n = 1,862 in 2000 e n = 1,280 in 2010) idosos (60 anos ou mais), participantes do estudo Saúde, Bem-Estar e Envelhecimento (SABE), coletado em São Paulo, Brasil. A versão mais curta da escala de depressão geriátrica (GDS-15) foi usada para classificar a depressão. Idosos com pontuação ≥ 6 foram classificados como tendo depressão. As estimativas de expectativa de vida com e sem depressão foram obtidas usando o método de Sullivan. RESULTADOS Os dados de 2000 indicaram que, em média, homens e mulheres de 60 anos de idade poderiam esperar viver, respectivamente, 14,7 e 16,5 anos sem depressão. Em 2010, a expectativa de vida sem depressão aumentou para 16,7 anos para homens e 17,8 anos para mulheres. A duração da vida com depressão diferiu por sexo – as mulheres idosas esperam viver mais anos com depressão do que os homens. CONCLUSÕES Entre 2000 e 2010, a expectativa de vida sem sintomas depressivos em São Paulo aumentou. Entretanto, os idosos no Brasil, sobretudo as mulheres, ainda enfrentam problemas relacionados às doenças mentais.

Objective: to analyze the changes in life expectancy (LE) and disability-free life expectancy (DFLE) in São Paulo's elderly population to assess the occurrence of compression or expansion of morbidity, between 2000 and 2010. Methods: cross-sectional and population survey, based on official data for the city of São Paulo, Brazil, and data obtained from the Health, Well-Being and Aging Survey (SABE). Functional disability was defined as difficulty in performing at least one basic activity of daily living. The Sullivan method was used to calculate LE and DFLE for the years 2000 to 2010. Results: from 2000 to 2010, there was an increase in disabled life expectancy (DLE) in all age groups and both sexes. The proportion of years of life free of disability, at 60 years of age, decreased from 57.94% to 46.23% in women, and from 75.34% to 63.65% in men. At 75 years of age, this ratio decreased from 47.55% to 34.54% in women, and from 61.31% to 56.01% in men. Conclusion: the expansion of morbidity is an ongoing process in the elderly population of the municipality of São Paulo, in the period of 2000-2010. These results can contribute to the development of preventive strategies and planning of adequate health services to future generations of seniors. Objetivo: analisar as mudanças na expectativa de vida (EV) e na expectativa de vida livre de incapacidade (EVLI) dos indivíduos idosos do município de São Paulo, de 2000 a 2010, de modo a avaliar a ocorrência de compressão ou expansão da morbidade nessa população. Métodos: estudo transversal repetido, de base populacional, utilizando dados oficiais secundários para o município de São Paulo e dados obtidos a partir do Estudo Saúde Bem-Estar e Envelhecimento (SABE). A incapacidade funcional foi definida como dificuldade para a realização de pelo menos uma atividade básica de vida diária. O método de Sullivan foi utilizado para o cálculo de EV e EVLI para os anos de 2000 e 2010. Resultados: de 2000 a 2010, observou-se um aumento da expectativa de vida com incapacidade (EVCI) em todas as faixas etárias, em ambos os sexos. A proporção de anos de vida livres de incapacidade, aos 60 anos, decresceu de 57,94% para 46,23% em mulheres, e de 75,34% para 63,65% em homens. Já aos 75 anos, esta proporção decresceu de 47,55% para 34,54% em mulheres, e de 61,31% para 56,01% em homens. Conclusão: a expansão da morbidade é um processo em curso na população idosa do município de São Paulo, no período de 2000 a 2010. Os resultados apresentados podem colaborar para a elaboração de estratégias preventivas e para o planejamento de serviços de saúde adequados às futuras gerações de idosos.

BACKGROUND The majority of studies on the effects of adiposity on mortality in the elderly have been conducted in developed countries with mixed results. We investigated the association between adiposity and mortality in a cohort of community-dwelling elderly in Sao Paulo, Brazil. METHODS Body mass index (BMI), waist circumference, waist-to-hip ratio, and type 2 diabetes were evaluated in 1,882 participants (mean age 71.0 ± 8.3 years old, 61% female). Mortality was confirmed by national vital statistics records during a maximum of 10 years of follow-up. Proportional hazards models were used to estimate hazard ratios (HRs) for mortality after adjusting for sociodemographics and comorbidities. In a subsample of 897 participants, the effects of changes in measures of adiposity on mortality were investigated during a median follow-up of 4.6 years. RESULTS Having type-2 diabetes at baseline was associated with increased mortality (HR = 1.44, 95% CI: 1.17-1.77), with a higher HR among men. When compared with normal weight participants (BMI = 20

Made available in DSpace on 2015-02-02T12:39:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-09-01Bitstream added on 2015-02-02T13:08:08Z : No. of bitstreams: 1 S0102-311X2014000901977.pdf: 195933 bytes, checksum: 4a2021a0857fd79d253c756638e2b8fa (MD5) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) O estudo objetivou identificar os fatores associados ao melhor desempenho cognitivo global em idosos do Município de São Paulo, Brasil. O estudo foi transversal com uma amostra composta por idosos não institucionalizados que participaram do Estudo Saúde, Bem-Estar e Envelhecimento (SABE) de 2006. A variável dependente foi o declínio cognitivo categorizado em: desempenho normal e melhor. As variáveis independentes incluíram condições sociodemográficas, estilo de vida e saúde. Realizou-se análise descritiva seguida de regressão logística múltipla, considerando-se um nível de significância de 5%. Desempenho acima da média foi observado em 28,4% da amostra, equivalente a 730.051 idosos. Idosos mais jovens; sem dificuldades nas atividades instrumentais de vida diária; com consumo não abusivo de álcool; autopercepção da renda como suficiente para atender as necessidades diárias e com contato social com familiares e amigos apresentaram mais chances de apresentarem melhor desempenho cognitivo acima da média. Conclui-se que desempenho cognitivo está associado à condições favoráveis de participação e independência. This study aimed to identify factors associated with optimal global cognitive performance among older adults in the city of Sao Paulo, Brazil. A cross-sectional study was carried out with a sample of community-dwelling older adults who participated in the SABE Study (Health, Well-Being and Ageing) in 2006. The dependent variable was cognitive performance, categorized as “normal” or “optimal”. The independent variables were socio-demographic data, lifestyle and health conditions. Data analysis involved descriptive statistics, followed by multiple logistic regression (significance set at 5%). Optimal cognitive performance was found in 28.4% of the sample, representing 730,051 older adults. Optimal performance was associated with a younger age, a report of no difficulties regarding instrumental activities of daily living, non-abusive alcohol intake, self-rated income sufficient to meet one’s daily needs and contact with family and friends. Optimal cognitive performance among older adults is associated with conditions favoring participation and independence. Este estudio tuvo el objetivo identificar los factores asociados con el rendimiento cognitivo global óptimo entre ancianos de São Paulo, Brasil. Este fue un estudio transversal con una muestra de ancianos no institucionalizados que participaron del Estudio Salud, Bienestar y Envejecimiento (SABE) en 2006. La variable dependiente fue el rendimiento cognitivo, clasificado como “normal” o “óptimo”. Las variables independientes fueron: datos sociodemográficos, estilo de vida y condiciones de salud. Rendimiento cognitivo encima de la média se encontró en un 28,4%, lo que representa 730.051 adultos mayores. El rendimiento encima de la média se asoció a una edad más temprana, ausencia de dificultad en las actividades instrumentales de la vida diaria, el consumo no abusivo de alcohol, el relato de ingresos suficientes para satisfacer las necesidades diarias y el contacto con amigos y familiares. El rendimiento cognitivo óptimo entre los adultos mayores se asoció con condiciones que favorecen la participación y la independencia. Universidade de São Paulo Faculdade de Saúde Pública Universidade de São Paulo Escola de Enfermagem Fundação Oswaldo Cruz Centro de Pesquisas René Rachou Universidade Estadual Paulista Faculdade de Medicina de Botucatu Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Universidade Estadual Paulista Faculdade de Medicina de Botucatu

Cardiometabolic diseases are prevalent in populations and are among the leading causes of death. Objective: This sub-study of the Health, Well-being and Aging (SABE) study describes the self-reported prevalence of diabetes mellitus (DM), hypertension, and atherosclerotic cardiovascular disease (CVD) for its three waves (2000, 2006, and 2010). It also analyses the associations with selected risk factors.Logistic regression models were performed.Predominance of women and average age (68 years) were maintained in all the waves. During the period, there was a general tendency of increasing prevalence of hypertension (53.1 to 66.7%), DM (16.7 to 25.0%), and CVD (23.0 to 27.2%); and stabilization of the CVD prevalence rate occurred only from 2006 to 2010. Women, with body mass index (BMI)27 kg/m2, and ex-smokers had consistently higher risk of self-reported hypertension across the three waves. BMI27kg/m2 was also associated with a higher probability of DM in the three waves, whereas with ex-smokers this occurred only in 2010. Ex-smokers presented higher risk of CVD in all the waves, but not excess weight. Wave pairs were analyzed to test changes in prevalence, and it was found a significant increase in diseases rates across the years.In summary, self-reported DM, hypertension, and CVD had high prevalence rates for participants of SABE Study, in São Paulo. The association of elevated BMI with cardiometabolic diseases suggests that body adiposity might favor their occurrence, although the study design does not guarantee a cause and effect relationship. Increased rates of affected individuals from the first to the third wave may reflect improvement in diagnostic conditions and/or control of these diseases' mortality during that period.Doenças cardiometabólicas são prevalentes nas populações, estando entre as principais causas de morte. Objetivos: Este subestudo do Saúde, Bem-Estar e Envelhecimento (Sabe) descreve as prevalências autorreferidas de hipertensão, diabete mellitus (DM) e doença cardiovascular aterosclerótica (DCV) nas suas três ondas (2000, 2006 e 2010) e analisa a associação com fatores de risco selecionados.Empregou-se regressão logística.O predomínio de mulheres e a idade (68 anos) foram mantidos nas três ondas. No período, verificou-se tendência geral de aumento nas prevalências de hipertensão (53,1 a 66,7%), DM (16,7 a 25%) e DCV (23,0 a 27,2%) - estabilização da prevalência de DCV apenas de 2006 a 2010. Indivíduos do sexo feminino, com índice de massa corporal (IMC)27 kg/m2 e ex-fumantes tenderam consistentemente à maior probabilidade de hipertensão autorreferida ao longo das ondas. Apresentar IMC27 kg/m2 associou-se à maior probabilidade de referir DM nas três ondas, enquanto com ex-fumantes isso aconteceu apenas em 2010. Ter sido fumante também se associou à DCV nas ondas, mas não o excesso de peso. Averiguando-se pares de ondas para testar alterações nas prevalências, viu-se que em geral houve elevação significativa nos percentuais das doenças com o tempo.Em suma, DM, hipertensão e DCV autorreferidos ocorreram com elevadas prevalências nos participantes do Sabe em São Paulo. A associação de IMC elevado com doenças cardiometabólicas sugere que adiposidade corporal pode favorecê-las, embora esta análise não permita assegurar relação causa × efeito. É possível que o aumento dos percentuais de doentes da primeira para a terceira onda reflita melhora nas condições de diagnóstico e/ou no controle dessas doenças no período.

Background The effects of birth cohorts reflect the historical differences in physical and social environments. The objectives of the present study were to describe the tobacco consumption and to evaluate the behavioral trends with respect to smoking in three different birth cohorts of a population-based sample of elderly individuals. Methods A series of three cross-sectional studies conducted with elderly individuals of 60–64 years of age interviewed in 2000 (birth cohort 1936–1940; n = 427), 2006 (birth cohort 1942–1946; n = 298) and 2011 (birth cohort 1947–1951; n = 355) in a population-based sample from the city of Sao Paulo, Brazil. The interviewees were participating in a prospective cohort study entitled Health, Well-Being and Aging (Saude, Bem-Estar e Envelhecimento [SABE]). Data on tobacco consumption were self-reported and interviewees were then classified as never smokers, former smokers or current smokers. Linear model for categorical data was used to test differences on tobacco consumption between three birth elderly cohorts. Findings Men were more likely than women to be smokers. Being evangelical and having more schooling constituted protective factors against smoking. Regarding trends, the tobacco consumption of the men did not change in any of the three cohorts studied (p = 0.7454), whereas there was an increase in the number of women smokers, principally former smokers, over the periods evaluated (p = 0.0189). Conclusions These results suggest that the anti-smoking policies implemented in Brazil were effective in women of this age group; however, different prevention strategies are required to target elderly men.

Alguns medicamentos são considerados impróprios para o idoso, devido a alterações na farmacocinética e farmacodinâmica, por falta de eficácia terapêutica ou por um risco aumentado de efeitos adversos superando seus benefícios. Verificou-se a prevalência do uso de medicamentos potencialmente inapropriados, segundo os critérios de Beers, por idosos do Município de São Paulo, Brasil, participantes do Estudo SABE. Trata-se de um estudo transversal, de base populacional, cuja amostra de 1.254 indivíduos com 60 anos ou mais representava a população idosa do município no ano de 2006. Verificou-se a prevalência de 28% de uso de medicamentos potencialmente inapropriados. No modelo de regressão logística múltipla, as variáveis associadas ao uso foram uso de cinco medicamentos ou mais (p = 0,001), presença de duas ou mais doenças (p = 0,011) e sexo feminino (p = 0,007). Identificou-se o uso de 36 medicamentos potencialmente inapropriados, a maioria de venda sob prescrição. São necessários critérios específicos para a população brasileira e ampla divulgação da farmacologia clínica do idoso. Protocolos ou softwares para prescrição também podem auxiliar a prescrição racional para esse grupo. Various medicines are considered unsuitable for older adults due to alterations in pharmacokinetics/pharmacodynamics, lack of therapeutic efficacy, and/or increased risk of adverse events exceeding potential benefits. The aim of this study was to determine the prevalence of potentially inappropriate medication among older adults in the city of São Paulo, Brazil. A population-based cross-sectional study was conducted in a sample of 1,254 individuals aged 60 years or older (participants in the SABE Study), representing the elderly population of the city in 2006. Potentially inappropriate medication was defined according to the Beers criteria. Prevalence of potentially inappropriate medication was 28%. Potentially inappropriate medication was associated with polypharmacy (p = 0.001), two or more diseases (p = 0.011), and female gender (p = 0.007). Thirty-six potentially inappropriate medicines were identified, the majority of which involving prescription medications. Specific criteria are needed for the Brazilian population, in addition to awareness-raising on clinical pharmacology in older adults. Prescription protocols and software programs could assist in the process of rational prescribing in this age group. Algunos medicamentos son considerados inapropiados para los ancianos, debido a alteraciones en la farmacocinética y en la farmacodinámica, por falta de eficacia terapéutica o por un riesgo de aumento de efectos adversos, superando sus beneficios. Se verificó la prevalencia del uso de medicamentos potencialmente inapropiados, según los criterios de Beers, por parte de ancianos del municipio de São Paulo, Brasil, participantes en el estudio SABE. Se trata de un estudio transversal de base poblacional, cuya muestra de 1.254 individuos con 60 años o más representaba a la población anciana en el municipio durante el año 2006. La prevalencia de uso de medicamentos potencialmente inapropiados fue de un 28%. En el modelo de regresión logística múltiple, las variables asociadas al uso fueron polifarmacia (p = 0,001), dos o más enfermedades (p = 0,011) y sexo femenino (p = 0,007). Se identificó el uso de 36 medicamentos potencialmente inapropiados, la mayoría de venta con prescripción. Son necesarios criterios específicos para la población brasileña y una amplia divulgación de la farmacología clínica del anciano. Protocolos o softwares para prescripción pueden auxiliar en la prescripción racional para este grupo.

The authors conducted a study to evaluate the association between changes in weight and waist circumference (WC) and oral health status among older adults in Brazil.The study sample consisted of community-dwelling people representing the population 60 years and older in the city of São Paulo who were enrolled in the Health, Well-being and Aging cohort study. Changes in weight and WC were classified as stable (within 5 percent of the second-wave weight and WC), loss (5 percent or more decrease since the second wave) and gain (5 percent or more increase since the second wave). The following baseline characteristics were the independent variables: sociodemographic variables (age, sex and education), general health data (number of self-reported chronic diseases, physical activity, weight, WC and smoking status) and oral health (edentulism, need for dental prostheses).The incidence of weight (33.2 percent) and WC (35.3 percent) gain was higher than that of loss (13.5 percent and 10.6 percent, respectively). Neither weight nor WC gains were associated with dental status. The risk of weight and WC loss was higher among edentulous participants than among dentate participants.The results of this study show that edentulism status was a significant predictor of weight and WC loss, independent of socioeconomic and general health status.Edentulism has a significant impact on weight and WC, which highlights the importance of an integrated approach to health care among health care professionals.

OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke, disables elderly men more, whereas early deficits regarding balance disable women more. OBJETIVO Analisar diferenças de gênero na incidência e determinantes de incapacidade em atividades instrumentais de vida diária em idosos. MÉTODOS Os dados são provenientes do Estudo Saúde, Bem-Estar e Envelhecimento. Em 2000, 1.034 idosos sem dificuldades nas atividades instrumentais de vida diária foram selecionados. As características verificadas na linha de base foram: sociodemográficas, comportamentais, estado de saúde, quedas e fraturas, internações, sintomas depressivos, cognição, força, mobilidade, equilíbrio e percepção de visão e audição. Atividades instrumentais, como fazer compras, cuidar do próprio dinheiro e da própria medicação, utilizar meios de transporte e telefone, foram reavaliadas em 2006 e os casos incidentes de incapacidade foram considerados como desfecho. RESULTADOS A densidade de incidência de incapacidade em atividades instrumentais de vida diária foi de 44,7/1.000 pessoas/ano para mulheres e 25,2/1.000 pessoas/ano para homens. A razão da densidade de incidência entre mulheres e homens foi 1,77 (IC95% 1,75;1,80). Após ajuste por condições socioeconômicas e clínicas, a razão da densidade de incidência foi 1,81 (IC95% 1,77;1,80), mostrando que mulheres com doenças crônicas e maior vulnerabilidade social apresentaram maior densidade de incidência de incapacidade em atividades instrumentais de vida diária. Foram determinantes da incidência de incapacidade: idade ≥ 80 anos e pior percepção de audição em ambos os sexos; acidente vascular encefálico entre homens e idade entre 70-79 anos entre mulheres. Melhor desempenho cognitivo foi fator protetor em ambos os sexos e melhor equilíbrio para mulheres. CONCLUSÕES A maior densidade de incidência de incapacidade em mulheres foi mantida mesmo após ajuste por condições clínicas e sociais adversas. Além da idade, o pior desempenho cognitivo e condições que adversamente afetam a comunicação incapacitam ambos os gêneros. Eventos agudos, como o acidente vascular cerebral, incapacitam mais os homens, enquanto déficit precoce no equilíbrio incapacita mais as mulheres.

The objectives of this study were to estimate influenza vaccination coverage in the elderly and identify factors associated with vaccination uptake. A cross-sectional population-based study was conducted with data collected in 2006 by the Health, Well-Being, and Aging study. The sample consisted of 1,399 elderly in the city of São Paulo, Brazil. The association between vaccine uptake and independent variables was assessed with prevalence ratios, estimated by Poisson regression. Self-reported vaccination was 73.8%. In the final explanatory model, influenza vaccination was associated with older age, presence of chronic diseases, and use of health care in the previous year. A negative association was observed with hospitalization during the previous year. The study concludes that it is necessary to encourage vaccination of elderly less than 70 years of age and those without chronic diseases, as well as to orient health professionals to expand coverage in groups with lower uptake during vaccination campaigns.

The aim of the present study was to examine the prevalence and factors associated with sarcopenia in older residents in São Paulo, Brazil.Cross-sectional study.São Paulo, Brazil.1,149 older individuals from the second wave of the Saúde, Bem-Estar e Envelhecimento (SABE) study from 2006.The definition of sarcopenia was based on the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which include three components: low muscle mass, assessed by a skeletal muscle mass index of ≤8.90 kg/m2 for men and ≤6.37 kg/m2 for women; low muscle strength, assessed by handgrip strength30 kg for men and20 kg for women; and low physical performance, assessed by gait speed0.8 m/s. Diagnosis of sarcopenia required presence of low muscle mass plus low muscle strength or low physical performance. Socio-demographic and behavioral characteristics, medical conditions and nutritional status were considered as independent variables to determine the associated factors using a logistic regression model.The prevalence of sarcopenia was 16.1% in women and 14.4% in men. Advanced age with a dose response effect, cognitive impairment, lower income, smoking, undernutrition and risk for undernutrition (p0.05) were factors associated with sarcopenia.The EWGSOP algorithm is useful to define sarcopenia. The prevalence of sarcopenia in the Brazilian elderly population is high and several associated factors show that this syndrome is affected by multiple domains. No differences were observed by gender in any age groups.

Estudo populacional transversal com idosos sem déficit cognitivo residentes na cidade de São Paulo, Brasil. O objetivo foi avaliar a associação entre dor crônica e autorrelato de quedas. Idoso com dor crônica foi considerado aquele com dor de duração há mais de um ano. Os dados foram coletados por entrevista domiciliar, e as análises foram realizadas no programa Stata 11.0. A prevalência de dor crônica foi 29,7% (IC95%: 25,4-33,9); a prevalência de queda, no último ano, entre idosos com dor foi 31,6% (IC95%: 26,4-37,5) e não diferiu da prevalência entre idosos sem dor (26,4%; IC95%: 23,1-30,0; p = 0,145). No entanto, quando havia dor e osteoporose ou dor e incontinência urinária, o risco de quedas foi 50% (p = 0,019) e 48% maior (p = 0,010), respectivamente. A associação dor crônica e osteoporose ou incontinência urinária elevou a chance de quedas em idosos.

The prognostic factors related to envenoming are not very well known. This study aims to identify prognostic factors for necrosis in envenoming by Bothrops jararaca. We analysed 779 medical records of patients bitten by B. jararaca and treated at the Hospital Vital Brazil, Butantan Institute, Sao Paulo, Brazil, between 1982 and 1990: 111 cases with necrosis were compared with the remaining cases. The length of the snake, the bite site, the month of the accident, pain, oedema, ecchymosis, blisters, systemic bleeding, shock, and the use of tourniquet were statistically associated with the presence of necrosis (P < 0.05) in the univariate analysis. The size of the snake, the bite site (leg and finger), the sex of the patient, the month of the accident, systemic bleeding, and the use of tourniquet were independent prognostic factors within the variables tested in the multivariate analysis. The size of the snake was the most important independent prognostic factor related to the presence of necrosis.

INTRODUÇÃO: Nos estudos epidemiológicos de morbidade é necessário se adotar um sistema de classificação de doenças. Na odontologia e nos traumatismos buco-maxilo-faciais pode-se usar a Classificação Internacional de Doenças em Estomatologia e Odontologia (CID-OE) mas, em alguns casos, esta classificação não é adequada. O objetivo deste estudo é comparar a aplicação da CID-OE com a aplicação da CID-10 na classificação de diagnósticos da área. MATERIAL E MÉTODOS: Foram analisados 2.372 casos atendidos em serviços de traumatismos buco-maxilo-faciais e emergências dentais no Município de São Paulo, Brasil, onde os diagnósticos encontrados foram codificados por ambas as classificações. RESULTADOS: A CID-OE especificou melhor 1.117 casos mas, em 267, não ofereceu possibilidade de codificação. Em 978 casos, o detalhamento dado pela codificação foi o mesmo em ambas as classificações.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Objective: To date, no evidence of robust genotype-phenotype correlation or disease modifiers for multiple endocrine neoplasia type 1 (MEN1) syndrome has been described, leaving the highly variable clinical presentation of patients unaccounted for.Design: As the CDKN1B (p27) gene causes MEN4 syndrome and it is transcriptionally regulated by the product of the MEN1 gene (menin), we sought to analyze whether p27 influences the phenotype of MEN1-mutated patients. the cohort consisted of 100 patients carrying germline MEN1 gene mutations and 855 population-matched control individuals.Methods: Genotyping of the coding p27 c.326T>G (V109G) variant was performed by sequencing and restriction site digestion, and the genotypes were associated with clinical parameters by calculating odds ratios (ORs) and their 95% CIs using logistic regression.Results: There were significant differences in p27 V109G allele frequencies between controls and MEN1-mutated patients (OR=2.55, P=0.019, CI=1.013-5.76). Among patients who are >= 30 years old carrying truncating MEN1 mutations, the T allele was strongly associated with susceptibility to tumors in multiple glands (three to four glands affected vs one to two glands affected; OR=18.33; P=0.002, CI=2.88-16.41). This finding remained significant after the Bonferroni's multiple testing correction, indicating a robust association. No correlations were observed with the development of MEN1-related tumors such as hyperparathyroidism, pituitary adenomas, and enteropancreatic and adrenocortical tumors.Conclusions: Our study suggests that the p27 tumor suppressor gene acts as a disease modifier for the MEN1 syndrome associated with MEN1 germline mutations. If confirmed in independent patient cohorts, this finding could facilitate the management of this clinically complex disease. Univ São Paulo, Sch Med, Endocrine Genet Unit, Lab Invest Med LIM 25, São Paulo, Brazil Univ São Paulo, Sch Med, Neuroendocrinol Unit, São Paulo, Brazil Univ São Paulo, Sch Med, Neuroendocrinol Neurosurg Unit, São Paulo, Brazil Univ São Paulo, Sch Med, Adrenal Unit LIM 42, São Paulo, Brazil Univ São Paulo, Sch Med, Gen Endocrinol Unit, São Paulo, Brazil Univ São Paulo, Sch Med, Expt Oncol Lab LIM 24, São Paulo, Brazil Univ São Paulo, Sch Med, Dept Pathol, São Paulo, Brazil Univ São Paulo, Sch Med, Sch Nursing, São Paulo, Brazil Univ São Paulo, Sch Med, Hosp Clin, Sch Publ Hlth, São Paulo, Brazil Brigadeiro Hosp, São Paulo, Brazil Univ São Paulo, Human Genome Res Ctr, São Paulo, Brazil Israelita Ensino & Pesquisa Albert Einstein, Inst Cerebro, São Paulo, Brazil NIA, NIH, Bethesda, MD 20892 USA Helmholtz Zentrum Munchen, Inst Pathol, Neuherberg, Germany Univ São Paulo, Inst Biomed Sci, São Paulo, Brazil Fed Univ São Paulo UNIFESP, Div Endocrinol, São Paulo, Brazil Fed Univ São Paulo UNIFESP, Div Endocrinol, São Paulo, Brazil Web of Science

In recent years, Brazil has demonstrated a new demographic pattern characterized by a reduction in both birth and mortality rates and a significant increase in the number of older adults. The purpose of the present study was to describe the frequency of alcohol intake in a representative sample community of older adults in the city of Sao Paulo, Brazil, followed over a six-year period. A prospective Saude, Bem-Estar e Envelhecimento (SABE [Health, Wellbeing and Aging]) cohort study conducted in 2000 and 2006 in City of Sao Paulo, Brazil. 2,143 individuals aged 60 years or older selected through multi-stage sampling in the year 2000 (41.4% male and 58.6% women) and 1,115 individuals belonging to the follow-up cohort evaluated in 2006. The frequency of alcohol intake in the previous three months was obtained through self-reports of interviewees. The results demonstrate that in 2000, alcohol consumption was less than one day a week among 79.7% of the sample, one to three days a week among 13.0% and four or more days a week among 7.3%. In agreement with findings on other populations, consumption four or more days a week was more frequent among the male gender as well as those with greater schooling and income and good self-rated health (p

Estimating the life expectancy with and without cognitive impairment in an older adult population is critical for understanding the burden of illness on individuals and their families, the health care system, and society at large. This paper presents and compares estimates of life expectancy with and without cognitive impairment for the noninstitutionalized population ages 60 years and older in São Paulo, Brazil, for the years 2000 and 2010. Life expectancy with and without cognitive impairment was calculated using the Sullivan method and prevalence estimates from data collection at two points (2000 and 2010) of the Health, Well-Being, and Aging (SABE) Study. Results indicate that 60-year-old men in São Paulo in 2000 could expect to live 14.8 years and women 17.9 years without cognitive impairment. By 2010, life expectancy without cognitive impairment had increased to 17.1 years for men and 20.0 years for women. Length of life with cognitive impairment differed by gender (2.3 years for men and 3.7 years for women at age 60 in 2010). However, the absolute number of years with cognitive impairment remained relatively constant with age. The results indicate a trend for improvements in life expectancy without cognitive impairment over time in São Paulo. Adults in Brazil still face many years of cognitive impairment in their older years, particularly when compared with estimates from developed countries.

Germline mutations in p27kip1 are associated with increased susceptibility to multiple endocrine neoplasias (MEN) both in rats and humans; however, the potential role of common polymorphisms of this gene in endocrine tumor susceptibility and tumorigenesis remains mostly unrecognized. To assess the risk associated with polymorphism rs2066827 (p27-V109G), we genotyped a large cohort of Brazilian patients with sporadic endocrine tumors (pituitary adenomas, n=252; pheochromocytomas, n=125; medullary thyroid carcinoma, n=51; and parathyroid adenomas, n=19) and 885 population-matched healthy controls and determined the odds ratios and 95% CIs. Significant associations were found for the group of patients with pituitary adenomas (P=0.01), particularly for those with ACTH-secreting pituitary adenomas (P=0.005). In contrast, no association was found with GH-secreting pituitary tumors alone or with the sporadic counterpart of MEN2-component neoplasias. Our in vitro analyses revealed increased colony formation and cell growth rate for an AtT20 corticotropin mouse cell line overexpressing the p27-V109G variant compared with cells transfected with the WT p27. However, the genotypic effects in genetic and in vitro approaches were divergent. In accordance with our genetic data showing specificity for ACTH-secreting pituitary tissues, the overexpression of p27-V109G in a GH3 somatotropin rat cell line resulted in no difference compared with the WT. Pituitary tumors are one of the major clinical components of syndromes associated with the p27 pathogenic mutations MENX and MEN4. Our genetic and in vitro data indicate that the common polymorphism rs2066827 may play a role in corticotropinoma susceptibility and tumorigenesis through a molecular mechanism not fully understood thus far.

OBJETIVO Analisar a associação entre a utilização de serviço de saúde por idosos com dor crônica e variáveis sociodemográficas e de saúde. MÉTODOS Estudo transversal com amostra populacional realizado por meio de inquérito domiciliar em São Paulo, SP, em 2006, com 1.271 idosos de 60 anos ou mais, sem déficit cognitivo, que relataram dor crônica. Dor crônica foi definida como aquela com duração ≥ 6 meses. O critério para uso do serviço de saúde foi ter feito mais de quatro consultas ou uma internação no último ano. Para os idosos com dor há pelo menos um ano, testou-se a existência de associação entre uso do serviço de saúde com as variáveis independentes (características da dor, sociodemográficas e doenças autorreferidas), por meio de análises univariadas (teste de Rao & Scott) e múltiplas (Regressão Múltipla de Cox com variância robusta). Utilizou-se o programa Stata 11.0 e adotou-se como valor de significância p < 0,05. RESULTADOS A prevalência de utilização do serviço de saúde nos idosos com dor foi 48,0% (IC95% 35,1;52,8) e não diferiu dos idosos sem dor (50,5%; IC95% 45,1;55,9). A chance de utilização do serviço de saúde foi 33,0% menor nos idosos com dor há mais de dois anos do que naqueles com dor entre um e dois anos (p = 0,002); 55,0% maior nos idosos com dor intensa (p = 0,003) e 45,0% maior entre os que relataram interferência moderada da dor no trabalho (p = 0,015) na análise múltipla. CONCLUSÕES A dor crônica foi frequente e esteve associada a maiores prejuízos na independência e mobilidade. A dor crônica mais intensa, a mais recente e a com impacto no trabalho resultaram em maior uso dos serviços de saúde. OBJETIVO Analizar la asociación entre la utilización de servicio de salud por ancianos con dolor crónico y variables sociodemográficas y de salud. MÉTODOS Estudio transversal con muestra poblacional realizado por medio de pesquisa domiciliar en Sao Paulo, SP-Brasil, en 2006, con 1.271 ancianos de 60 años o más, sin déficit cognitivo, que manifestaron dolor crónico. Dolor crónico fue definido como aquel con duración ≥ 6 meses. El criterio para uso del servicio de salud fue haber tenido más de cuatro consultas o una internación en el último año. Para los ancianos con dolor por al menos un año, se evaluó existencia de asociación entre uso del servicio de salud con las variables independientes (características del dolor, sociodemográficas y enfermedades auto-referidas), por medio de análisis univariados (prueba de Rao & Scott ) y múltiples (Regresión Múltiple de Cox con varianza robusta). Se utilizó el programa Stata 11.0 y se adoptó como valor de significancia p

OBJECTIVE: To determine whether the elimination of certain chronic diseases is capable of leading to the compression of morbidity among elderly individuals.METHODS: A population-based, cross-sectional study was carried out with official data for the city of Sao Paulo, Southeastern Brazil in 2000 and data from the SABE (Health, Wellbeing and Ageing) study. Sullivan's method was used to calculate disability-free life expectancy. Cause-deleted life tables were used to calculate the probabilities of death and disabilities with the elimination of health conditions.RESULTS: The largest gains in disability-free life expectancy, with the elimination of chronic illness, occurred in the female gender. Among individuals of a more advanced age, gains in disability-free life expectancy occurred as result of a relative compression of morbidity. Among men aged 75 years, all conditions studied, except heart disease and systemic arterial pressure, led to an absolute expansion of morbidity and, at the same time, to a relative compression of morbidity upon being eliminated.CONCLUSIONS: The elimination of chronic diseases in the elderly could lead to the compression of morbidity in elderly men and women. OBJETIVO: Avaliar se a eliminação de determinadas doenças crônicas é capaz de levar à compressão da morbidade em indivíduos idosos.MÉTODOS: Estudo transversal analítico de base populacional realizado com dados oficiais secundários para o Município de São Paulo, em 2000, e dados obtidos a partir do estudo SABE: Saúde, Bem-Estar e Envelhecimento. Foi utilizado o método de Sullivan para o cálculo de expectativas de vida livre de incapacidade. Tábuas de vida de eliminação de causas foram utilizadas para calcular as probabilidades de morte e incapacidade com a eliminação de doenças.RESULTADOS: Os maiores ganhos em expectativa de vida livre de incapacidade, com a eliminação de doenças crônicas, ocorreram no sexo feminino. Nos indivíduos de idade mais avançada, os ganhos dessa expectativa de vida ocorreram em função de um processo de compressão relativa da morbidade. Nos homens com idade de 75 anos, todas as doenças estudadas, com exceção da doença cardíaca e da hipertensão arterial sistêmica, levaram a um processo de expansão absoluta da morbidade, mas simultaneamente a um processo de compressão relativa da morbidade ao serem eliminadas.CONCLUSÕES: A eliminação de doenças crônicas na população idosa pode levar a uma compressão da morbidade em homens e mulheres idosos. OBJETIVO: Evaluar si la eliminación de determinadas enfermedades crónicas es capaz de generar disminución de la morbilidad en individuos ancianosMÉTODOS: Estudio transversal analítico de base poblacional realizado con datos oficiales secundarios para el municipio de Sao Paulo (Brasil), en 2000, y datos obtenidos a partir de estudio SABE: Salud, Bienestar y Envejecimiento. Se utilizó el método de Sullivan para el cálculo de expectativas de vida libre de incapacidad. Tablas de vida de eliminación de causas fueron utilizadas para calcular las probabilidades de muerte e incapacidad con la eliminación de enfermedades.RESULTADOS: Las mayores ganancias en expectativa de vida libre de incapacidad, con la eliminación de enfermedades crónicas, ocurrieron en el sexo femenino. En los individuos de edad más avanzada, las ganancias de esa expectativa de vida ocurrieron en función de un proceso de reducción relativa de la morbilidad. En los hombres con edad de 75 años, todas las enfermedades estudiadas, con excepción de la enfermedad cardíaca y de la hipertensión arterial sistémica, llevaron a un proceso de expansión absoluta de la morbilidad, pero simultáneamente a un proceso de reducción relativa de la morbilidad al ser eliminadas.CONCLUSIONES: La eliminación de enfermedades crónicas en la población anciana puede llevar a una reducción de la morbilidad en hombres y mujeres ancianos.

Objectives: To test the hypothesis that clinical oral health conditions are associated with frailty independent of socioeconomic and general health status. Design: Cross-sectional. Setting: Population-based cohort study of health, well-being, and aging. Participants: One thousand three hundred seventy-four community-dwelling individuals representing 998,528 individuals aged 60 and older in the city of Sao Paulo, Brazil. Measurements: Frailty was defined on the basis of five characteristics: weight loss, weakness, slowness, exhaustion, and low level of physical activity. Participants with three or more characteristics were classified as frail, with one or two as prefrail, and with zero as nonfrail. Oral health measures were number of teeth, use of dental prostheses, need for dental prostheses, presence of decayed teeth, clinical attachment loss of 4 mm or greater, and periodontal pocket of 4 mm or greater. Data on sociodemographic (age, sex, and schooling) and general health (number of self-reported chronic diseases and smoking status) data were assessed. Results: The prevalence of frailty was 8.5%, with 50.8% considered nonfrail. Elderly individuals with a need for dental prostheses were significantly more likely to be prefrail and frail. Participants with 20 or more teeth had a lower chance of being frail than edentulous individuals. Conclusion: The need for dental prostheses was significantly associated with frailty, independent of socioeconomic and general health status.

The objective of this paper is to present the characteristics and methodological procedures used in the study SABE (Health, Well-Being, and Aging). This is a longitudinal study with multiple cohorts, carried out in the city of São Paulo, Brazil, since 2000. Follow-ups are conducted every five years when the new cohort is initiated. The SABE study employed a stratified, multistage sampling design to obtain a representative sample of community-dwelling individuals aged 60 years or more in the city of Sao Paulo. Data were collected by a structured questionnaire and clinical measurements taken by trained and calibrated examiners. The questionnaire included information on socioeconomic and demographic conditions, cognitive function, general health, medication, use and access to health services, oral health, nutrition, social support, functionality and well-being. The baseline study included self-reported oral health measurements, and clinical oral health measures were introduced in 2006.

Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-27T11:29:32Z No. of bitstreams: 0Bitstream added on 2014-05-27T14:48:30Z : No. of bitstreams: 1 2-s2.0-84877963389.pdf: 1491753 bytes, checksum: 821bb3572c76be235ad7bd1274280930 (MD5) Made available in DSpace on 2014-05-27T11:29:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-05-27 The aim of the present study was to analyze the anthropometric changes in a home-based cohort of Brazilian older adults who participated in the SABE Survey, conducted in 2000 and 2006. A total of 1030 men and women were examined by age group: 60-69, 70-79, and ≥80 years. This representative sample consists of the survivors of the 2000 cohort. The following anthropometric variables were assessed: body mass, arm muscle, waist and calf circumferences, triceps skinfold thickness, body mass index, waist-hip ratio, and arm muscle area according to mean values and percentile distribution. Except for body mass and body mass index, a significant difference (P

Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:57:04Z No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:57:04Z No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Made available in DSpace on 2013-08-22T18:57:04Z (GMT). No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Previous issue date: 2013-04-01 Submitted by Guilherme Lemeszenski (guilherme@nead.unesp.br) on 2013-08-22T18:57:04Z No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Made available in DSpace on 2013-08-22T18:57:04Z (GMT). No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-08-22T18:57:04Z (GMT). No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-09-30T19:51:36Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-09-30T19:51:36Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-08-22T18:57:04Z (GMT). No. of bitstreams: 1 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) Previous issue date: 2013-04-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:24Z No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:24Z No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Made available in DSpace on 2014-05-20T15:13:24Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-09-30T19:51:36Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2014-05-20T15:13:24Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2013-09-30T19:51:36Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:24Z No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Submitted by Vitor Silverio Rodrigues (vitorsrodrigues@reitoria.unesp.br) on 2014-05-20T15:13:24Z No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Made available in DSpace on 2014-05-20T15:13:24Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Made available in DSpace on 2014-05-20T15:13:24Z (GMT). No. of bitstreams: 2 S0102-311X2013000400008.pdf: 120715 bytes, checksum: e6ae5b3cfde52aa5a8da121f5e00268e (MD5) S0102-311X2013000400008.pdf.txt: 39939 bytes, checksum: 8596de0349514d12e6c1bd6c45517d05 (MD5) Previous issue date: 2013-04-01 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) O objetivo foi estimar a incidência de deficiência auditiva referida por idosos em São Paulo, Brasil, e fatores de risco associados. Realizou-se estudo longitudinal em 2006, baseado na população com 60 anos ou mais entrevistada em 2000. A amostra foi obtida pelo método de amostragem por conglomerados, em dois estágios, sob critério de partilha proporcional ao tamanho, com reposição e probabilidade proporcional à população, para sujeitos com 75 anos ou mais. A análise estatística foi realizada pelo teste de razão de verossimilhança para a igualdade das curvas de sobrevivência e regressão de Cox. Foram entrevistados 765 idosos, com taxa de incidência de deficiência auditiva referida de 28,9/1.000 pessoas-ano e proporção da mesma de 17,4%. Os fatores de risco associados foram idade igual ou maior a 80 anos, sexo masculino, ocupações nos setores agropecuário, industrial ou de manutenção e osteoporose. Medidas de atenuação de risco devem ser elaboradas para a diminuição da incidência da deficiência auditiva entre os idosos, principalmente as relacionadas à prevenção do ruído ocupacional e de doenças, em especial a osteoporose. This study aimed to estimate the incidence of self-reported hearing loss among the elderly in the city of São Paulo, Brazil, and identify associated risk factors. A longitudinal study based on a representative sample of individuals aged 60 years and over interviewed in 2000 was conducted in 2006. The sample was obtained in two stages using the cluster sampling method, adopting the criterion distribution proportional to size, and replacement with probability proportional to population for subjects aged 75 years and over. Statistical analysis was performed using the likelihood ratio test to compare survival curves based on the Cox regression model. A total of 765 individuals were interviewed. The hearing loss incidence rate was 28.9/1,000 persons/year and proportional incidence was 17.4%. Associated risk factors were being aged 80 years and over, being male, having an occupation related to agricultural, industrial or maintenance sectors and having osteoporosis. Steps must be taken to reduce incidence by ameliorating the risks identified, particularly those related to occupational noise and specific diseases, notably osteoporosis. El objetivo fue estimar la incidencia de pérdida de audición auto-reportada por ancianos en São Paulo, Brasil, y factores de riesgo asociados. Se realizó estudio longitudinal en 2006, con base en la población de 60 años o más entrevistada en el año 2000. La muestra se obtuvo por el método de muestreo por conglomerados en dos etapas, según el criterio de reparto proporcional a su tamaño, y la sustitución con una probabilidad proporcional a la población, para los sujetos de 75 años o más. El análisis estadístico se realizó mediante la prueba de razón de verosimilitud para la igualdad de las curvas de supervivencia y regresión de Cox. Se entrevistaron 765 ancianos, con una tasa de incidencia de pérdida de audición auto-reportada de 28,9/1.000 personas-año y una proporción de 17,4%. Los factores de riesgo son la edad mayor o igual a 80 años, sexo masculino, ocupaciones en los sectores industrial, agrícola o de manutención, y la osteoporosis. Se deben desarrollar medidas de mitigación de riesgos para disminuir la incidencia de pérdida de audición entre los ancianos, especialmente las relacionadas con la prevención de ruido en el trabajo y de las enfermedades, especialmente, la osteoporosis. Universidade de Brasília (UnB) Faculdade de Ceilândia Universidade Estadual Paulista Faculdade de Medicina de Botucatu Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto Universidade de São Paulo Faculdade de Saúde Pública Universidade de São Paulo Escola de Enfermagem Universidade Estadual Paulista Faculdade de Medicina de Botucatu FAPESP: 05/54947-2

The scope of this study was to establish whether the elimination of certain chronic diseases is capable of leading to the compression of morbidity among elderly individuals in Sao Paulo (Brazil), 2010. A population-based, cross-sectional study was carried out with official data for the city of Sao Paulo (Brazil) in 2010 and data from the SABE (Health, Wellbeing and Ageing) study. A total of 907 elderly individuals were evaluated, 640 of whom were women (64.6%). Sullivan's method was used for the calculation of disability-free life expectancy (DFLE). Life tables for cause elimination were used to calculate the probabilities of death with the elimination of health conditions. In absolute terms, the gains in LE and DFLE were greater in the younger age group (60 to 74 years) in both genders. In relative terms (%DFLE in LE), the gains were higher among women aged 75 years or older and among men aged 60 years. If eliminated, heart disease was the condition that would most lead to the compression of morbidity in both genders. The elimination of chronic diseases from the elderly population could lead to a compression of morbidity in men and women at both 60 years of age and 75 years of age or older. O objetivo deste estudo é avaliar se a eliminação de determinadas doenças crônicas é capaz de levar à compressão da morbidade em indivíduos idosos de São Paulo (Brasil), 2010. Estudo transversal analítico, de base populacional, utilizando dados oficiais secundários para o Município de São Paulo, em 2010, e dados obtidos a partir do estudo Saúde, Bem-estar e Envelhecimento (SABE). Um total de 907 indivíduos idosos foram avaliados, sendo 640 do sexo feminino (64,6%). O método de Sullivan foi utilizado para o cálculo de expectativas de vida livre de incapacidade (E.V.L.I.). Tábuas de vida de eliminação de causas foram utilizadas para calcular as probabilidades de morte com a eliminação de doenças. Em termos absolutos, os ganhos em expectativa de vida (E.V.) e E.V.L.I. foram maiores nas idades mais jovens (60 a 74 anos), em ambos os sexos. Em termos relativos (% E.V.L.I. na E.V.), os ganhos foram maiores nas mulheres de 75 anos ou mais e nos homens aos 60 anos. A doença cardíaca apresentou-se como aquela que mais promoveria a compressão da morbidade, caso fosse eliminada, em ambos os sexos. A eliminação de doenças crônicas na população idosa poderia levar a uma compressão da morbidade em homens e mulheres, tanto na idade de 60 anos, quanto na de 75 anos ou mais.

Various medicines are considered unsuitable for older adults due to alterations in pharmacokinetics/pharmacodynamics, lack of therapeutic efficacy, and/or increased risk of adverse events exceeding potential benefits. The aim of this study was to determine the prevalence of potentially inappropriate medication among older adults in the city of São Paulo, Brazil. A population-based cross-sectional study was conducted in a sample of 1,254 individuals aged 60 years or older (participants in the SABE Study), representing the elderly population of the city in 2006. Potentially inappropriate medication was defined according to the Beers criteria. Prevalence of potentially inappropriate medication was 28%. Potentially inappropriate medication was associated with polypharmacy (p=0.001), two or more diseases (p=0.011), and female gender (p=0.007). Thirty-six potentially inappropriate medicines were identified, the majority of which involving prescription medications. Specific criteria are needed for the Brazilian population, in addition to awareness-raising on clinical pharmacology in older adults. Prescription protocols and software programs could assist in the process of rational prescribing in this age group.

Este trabalho tem como objetivo analisar, para a população com 60 anos e mais, residente no Município de São Paulo, Brasil, a associação entre mortalidade e estado marital. Para atingir o objetivo proposto, foram utilizados os dados do Estudo SABE: Saúde, Bem-estar e Envelhecimento (SABE), realizado nos anos 2000 e 2006, e modelos de Regressão de Poisson foram estimados, levando-se, em consideração, a variação do tempo de risco de morte. No geral, os resultados indicam que, entre os idosos paulistanos do sexo masculino, a taxa de mortalidade dos solteiros é 61% maior que a taxa de mortalidade observada para os casados. Por sua vez, a separação/divórcio ou a viuvez parece elevar a chance de morte das mulheres idosas analisadas. No geral, idosas separadas e viúvas apresentaram taxas de mortalidade 82% e 35% maiores que a observada para as casadas. Espera-se que este trabalho possa contribuir para um melhor entendimento dos fatores associados à sobrevivência dos idosos, além de subsidiar políticas de saúde voltadas para esse contingente populacional. This study aimed to analyze the association between mortality and marital status in the elderly population (60 years and older) in São Paulo, Brazil. The authors used data from the SABE Study (Health, Well-Being, and Aging) from 2000 and 2006. Statistical analysis used Poisson regression, considering variation in time of mortality risk. The mortality rate among single elderly males was 61% higher than among married men. Separation or divorce and widowhood increased the odds of death in elderly women (separated/divorced women and widows showed mortality rates 82% and 35% higher, respectively, than married women). It is hoped that the current study will improve our understanding of factors associated with survival in the elderly, in addition to supporting health policies for this population group. Este trabajo tiene como objetivo analizar la asociación entre el estado civil y la mortalidad, entre la población de 60 años o más que vive en São Paulo, Brasil. Para alcanzar ese objetivo, se utilizaron los datos del Estudio SABE (Salud, Bienestar y Envejecimiento), realizado en 2000 y 2006, y los modelos de regresión de Poisson se estimaron teniendo en cuenta la variación tiempo en el riesgo de muerte. En general, los resultados indican que, entre los ancianos de sexo masculino en São Paulo, la tasa de mortalidad de solteros es un 61% más alta que la tasa de mortalidad observada para los casados. A su vez, la separación/divorcio o viudez parece aumentar el riesgo de muerte de las mujeres ancianas. En general, las ancianas separadas y viudas presentaron tasas de mortalidad un 82% y un 35% mayores que la observada para las casadas. Se espera que este trabajo contribuya a una mejor comprensión de los factores asociados con la supervivencia de los ancianos, además de apoyar las políticas de salud dirigidas a este contingente de población.