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Resumo Estudos mostram que, a despeito da queda das taxas de mortalidade e das melhorias nas condições de saúde, os trabalhadores têm saído mais cedo da atividade econômica. Esperar-se-ia que uma vida mais longa aumentasse os retornos aos investimentos em capital humano. A literatura associa a saída precoce do mercado de trabalho à cobertura da seguridade social. O adiamento da idade à aposentadoria é considerado uma alternativa para conter o desequilíbrio fiscal em muitos países. No entanto, estudos sugerem a existência de barreiras que inibem a permanência do trabalhador mais velho na atividade econômica. Entre elas, cita-se o preconceito por parte dos empregadores. O objetivo deste trabalho é buscar entender a não participação de homens brasileiros de 50-64 anos nas atividades econômicas, aí incluídos os que não estão aposentados (nem-nem). São o primeiro grupo a ser afetado pela reforma previdenciária proposta pelo governo. A proporção desses no total desta faixa etária aumentou de 3,5% para 10,2%, entre 1984 e 2017. Baixa escolaridade e piores condições de saúde em relação aos demais homens podem dificultar essa inserção. Isso sugere uma discriminação com relação aos trabalhadores mais velhos e a falta de políticas públicas que visem reforçar a capacidade destes indivíduos para conseguir um emprego.

Introduction The Curitiba (Brazil)-based Project, A Hora é Agora (AHA), evaluated a comprehensive HIV control strategy among men who have sex with men (MSM) aimed at expanding access to HIV rapid testing and linking HIV-positive MSM to health services and treatment. AHA’s approach included rapid HIV Testing Services (HTC) in one mobile testing unit (MTU); a local, gay-led, non-governmental organization (NGO); an existing government-run health facility (COA); and Internet-based HIV self-testing. The objectives of the paper were to compare a) number of MSM tested in each strategy, its positivity and linkage; b) social, demographic and behavioral characteristics of MSM accessing the different HTC and linkage services; and c) the costs of the individual strategies to diagnose and link MSM to services. Methods We used data for 2,681 MSM tested at COA, MTU and NGO from March 2015 to March 2017. This is a cross sectional comparison of the demographics and behavioral factors (age group, race/ethnicity, education, sexually transmitted diseases, knowledge of AHA services and previous HIV test). Absolute frequencies, percentage distributions and confidence intervals for the percentages were used, as well as unilateral statistical tests. Results and discussion AHA performed 2,681 HIV tests among MSM across three in-person strategies: MTU, NGO, and COA; and distributed 4,752 HIV oral fluid tests through the self-testing platform. MTU, NGO and COA reported 365 (13.6%) HIV positive diagnoses among MSM, including 28 users with previous HIV diagnosis or on antiretroviral treatment for HIV. Of these, 89% of MSM were eligible for linkage-to-care services. Linkage support was accepted by 86% of positive MSM, of which 66.7% were linked to services in less than 90 days. The MTU resulted in the lowest cost per MSM tested ($137 per test), followed by self-testing ($247). Conclusions AHA offered MSM access to HTC through innovative strategies operating in alternative sites and schedules. It presented the Curitiba HIV/AIDS community the opportunity to monitor HIV-positive MSM from diagnosis to treatment uptake. Self-testing emerged as a feasible strategy to increase MSM access to HIV-testing through virtual tools and anonymous test kit delivery and pick-up. Cost per test findings in both the MTU and self-testing support expansion to other regions with similar epidemiological contexts.

We assessed the impact of focal therapy on perioperative, oncologic and functional outcomes in men who underwent salvage robotic assisted radical prostatectomy compared to primary robotic assisted radical prostatectomy.Focal therapy was performed in patients presenting with Gleason score 3 + 3 or 3 + 4, clinical stage cT2a or less, serum prostate specific antigen 15 ng/ml or less, unilateral positive biopsy, maximum length of any positive core less than 10 mm and life expectancy greater than 10 years. Focal therapy was defined as target ablation of the index lesion plus a 1 cm safety margin in the normal ipsilateral prostatic parenchyma. The salvage group included 22 men who underwent salvage prostatectomy after focal therapy failure. The primary group was defined using matched pair 1:2 selection of 44 of 2,750 patients treated with primary prostatectomy. The primary and secondary end points were the between group differences in functional and oncologic outcomes, respectively.Complication rates were comparable (p0.05). Pad-free probability was comparable between the groups at 1 and 2 years (p = 0.8). Recovery of erectile function was significantly lower after salvage robotic assisted radical prostatectomy (p = 0.008), which also showed a significantly lower probability of cumulative biochemical recurrence-free survival compared to primary robotic assisted radical prostatectomy (56.3% vs 92.4% at 2 years, p = 0.001). Salvage prostatectomy demonstrated a significantly increased risk of biochemical recurrence (HR 4.8, 95% CI 1.67-13.76, p = 0.004). Study limitations included the retrospective nature, the lack of randomization and the short followup.Salvage robotic assisted radical prostatectomy after focal therapy failure is feasible with acceptable complication rates. However, patients assigned to primary focal therapy should be advised about a poorer prognosis in terms of oncologic control and lower erectile recovery rates in case of a future salvage surgery.

Several studies show that despite a decline in mortality and improvements to health conditions, workers have left the economic activities early. The literature associates precocious exit from the labour market to the widespread coverage of Social Security. One alternative to contain the fiscal imbalance in most countries has been to postpone the minimal age to be entitled to a pension benefit. Nevertheless, many studies suggest the existence of barriers that make it difficult for older workers to remain in economic activity. Among them are prejudices among employers.This paper aims to understand the non-participation of Brazilian men aged 50-64 in economic activities. The focus on this age group is because they would be the first group to be affected by the pension reform proposed by the Government. These are those who are neither in the labour market nor retired (neither-nor). The proportion of these men of the total number of men in this age group increased from 3.5% to 10.2% between 1984 and 2015. Very low schooling and worse health conditions compared to other men can contribute to difficulties for insertion. This suggests discrimination in relation to the older worker and the lack of public policies aimed at reinforcing the ability of these individuals to obtain a job.Estudos mostram que, a despeito da queda das taxas de mortalidade e das melhorias nas condições de saúde, os trabalhadores têm saído mais cedo da atividade econômica. Esperar-se-ia que uma vida mais longa aumentasse os retornos aos investimentos em capital humano. A literatura associa a saída precoce do mercado de trabalho à cobertura da seguridade social. O adiamento da idade à aposentadoria é considerado uma alternativa para conter o desequilíbrio fiscal em muitos países. No entanto, estudos sugerem a existência de barreiras que inibem a permanência do trabalhador mais velho na atividade econômica. Entre elas, cita-se o preconceito por parte dos empregadores. O objetivo deste trabalho é buscar entender a não participação de homens brasileiros de 50-64 anos nas atividades econômicas, aí incluídos os que não estão aposentados (nem-nem). São o primeiro grupo a ser afetado pela reforma previdenciária proposta pelo governo. A proporção desses no total desta faixa etária aumentou de 3,5% para 10,2%, entre 1984 e 2017. Baixa escolaridade e piores condições de saúde em relação aos demais homens podem dificultar essa inserção. Isso sugere uma discriminação com relação aos trabalhadores mais velhos e a falta de políticas públicas que visem reforçar a capacidade destes indivíduos para conseguir um emprego.

The “A Hora è Agora” (AHA) project was implemented in Curitiba/Paraná, Brazil to increase the access of men who have sex with men (MSM) to HIV testing and treatment. The objective of this study was to evaluate the access of MSM to the Center for Counseling and Guidance (COA) and its linkage to treatment, in the view of users, health professionals and managers. The results show that there was an increase of 54.7% of tests performed on MSM in the COA after AHA. There was a high level of schooling of the users served. Stigma and discrimination are still obstacles in the COA. It can be concluded that the AHA has modified the access of MSM to the COA, in addition to providing trained and mobilized professionals to facilitate the start of early treatment in the HIV’s SUS care network. El proyecto A Hora é Agora (AHA) se implementó en Curitiba/Paraná, Brasil, para aumentar el acceso de los hombres que tienen sexo con hombres (HSH) a la prueba del HIV y facilitar el tratamiento. El objetivo de este estudio fue evaluar el acceso de HSH al Centro de Orientación y Asesoramiento (COA) y su vinculación con el tratamiento, en la visión de usuarios, profesionales de la salud y gestores. Los resultados muestran que hubo un aumento del 54,7% en las pruebas realizadas a HSH en el COA, después de la AHA. Hubo un alto nivel de educación de los usuarios atendidos. El estigma y la discriminación siguen siendo obstáculos en la realidad de la COA. Se puede concluir que la AHA modificó el acceso de HSH en el COA, además de brindar profesionales capacitados y movilizados para facilitar el inicio de tratamiento temprano en la red de atención de HIV/Aids por parte del SUS. O projeto A Hora é Agora (AHA) foi implantado em Curitiba/Paraná, Brasil, para ampliar o acesso dos Homens que fazem Sexo com Homens (HSH) à testagem do HIV e facilitar o tratamento. O objetivo desse estudo foi avaliar o acesso dos HSH no Centro de Orientação e Aconselhamento (COA) e a sua vinculação ao tratamento, na visão dos usuários, profissionais de saúde e gestores. Os resultados mostram que houve um aumento de 54,7% de testes realizados em HSH homens no COA, após o AHA. Observou-se um alto nível de escolaridade dos usuários atendidos. O estigma e a discriminação ainda são obstáculos na realidade do COA. Pode se concluir que o AHA modificou o acesso de HSH no COA, além de ter proporcionado profissionais capacitados e mobilizados para facilitar o início do tratamento precoce na rede de atenção ao HIV/Aids pelo SUS.

É típico da população idosa a prevalência elevada de doenças crônicas, que comprometem a sua autonomia. Um exemplo são as síndromes demenciais. O objetivo deste trabalho é projetar o número de idosos demenciados. Para isto estimou-se o número atual, aplicando medidas de prevalência por grupos de idade à população de 65 anos e mais, enumerada pelo Censo Demográfico de 2010. Estas medidas fora\m obtidas nos levantamentos encontrados na literatura. Para se obter uma medida nacional, utilizou-se uma média ponderada das prevalências estimadas. Foram obtidas taxas de prevalência por idade e sexo para a população idosa brasileira. Pesquisas existentes mostram que a demência cresce acentuadamente com a idade. As mulheres e os analfabetos apresentam uma prevalência mais elevada. A prevalência brasileira média apresenta-se mais alta que a mundial. Projeções para a população brasileira apontam para um pequeno crescimento na taxa de prevalência de demência na população com 65 anos e mais, de 7,6% para 7,9% entre 2010 e 2020, ou seja, 55.000 novos casos por ano. As demências constituem uma questão de saúde pública e trazem uma preocupação bioética com o envelhecimento: a perda da autonomia das pessoas afetadas e a responsabilidade do sistema de saúde para atendê-las. It is only to be expected that the elderly population manifests a high prevalence of chronic diseases that jeopardize their autonomy. One example is syndromes of dementia. The scope of this paper is to make projections of the number of elderly individuals with dementia. An estimate of the current number is made by applying age-related prevalence data to the population of 65 and over, by age-group, with the figures from the Brazilian Demographic Census of 2010. The data were obtained from assessments found in the literature. For a national measure, a weighted average of the estimated prevalence was used. Prevalence rates by age and gender were calculated for the elderly Brazilian population. Current investigations show a steep increase of dementia with age. Women and illiterate individuals have a higher prevalence. The mean prevalence in Brazil is higher than that found in the rest of the world. Projections for the Brazilian population point to a small increase in the prevalence of dementia in the 65+ age-group, from 7.6% to 7.9% between 2010 and 2020, which means 55,000 new cases a year. Dementia is a public health issue, and elicits a strong bioethical concern with aging, due to the loss of autonomy of the affected individuals and the responsibility of the health system to provide adequate care.

As causas de morte evitáveis tornaram-se um importante indicador para avaliar os serviços de saúde. São óbitos que não deveriam ocorrer diante de adequadas ações de prevenção, tratamento, diagnóstico precoce e adoção de tecnologias apropriadas. Neste artigo, analisam-se o padrão e a magnitude das causas de morte evitáveis das principais causas de morte entre idosos com até 74 anos, por sexo, no Estado de São Paulo, Brasil. Estimou-se, ainda, o impacto das causas de morte evitáveis sobre a expectativa de vida dos idosos e observou-se que 62,5% dos óbitos entre idosos com até 74 anos, em São Paulo, ocorreram por essas causas. As principais causas de morte evitáveis constituíram 82,6% do total de óbitos evitáveis, destacando-se a hipertensão e os tumores associados ao tabagismo. A expectativa de vida aos 60 anos aumentaria em 20% se esses óbitos não ocorressem. A sobremortalidade masculina foi observada em quase todas as causas de morte evitáveis analisadas, o que pode estar relacionado à maior exposição a fatores de risco e à menor utilização dos serviços de saúde pelos homens. Recomenda-se que as ações de prevenção e promoção de saúde considerem as acentuadas diferenças de sexo e gênero. Avoidable causes of death have become an important indicator for evaluating health services. Such deaths would not occur if there were adequate prevention, early diagnosis, and treatment and the adoption of appropriate technologies. This article analyzes the pattern and magnitude of avoidable causes of death for the principal causes of death among elderly individuals up to 74 years of age, by gender, in São Paulo State, Brazil. The study further estimated the impact of avoidable causes of death on life expectancy among the elderly, and 62.5% of the deaths among elderly up to 74 years in São Paulo were due to these causes. The principal avoidable causes of death constituted 82.6% of all avoidable deaths, featuring hypertensions and tobacco-associated tumors. Life expectancy at 60 would increase by 20% if these deaths were avoided. Male excess mortality was observed in nearly all of the avoidable causes of death analyzed here, which could be related to greater exposure to risk factors and less use of health services by men. Prevention and health promotion measures should take these sharp gender differences into account. Las causas de muerte evitables se convirtieron en un importante indicador para evaluar los servicios de salud. Son óbitos que no deberían ocurrir ante adecuadas acciones de prevención, tratamiento, diagnóstico precoz y adopción de tecnologías apropiadas. En este artículo, se analiza el padrón y la magnitud de las causas de muerte evitables entre las principales causas de muerte de ancianos con hasta 74 años, por sexo, en el Estado de São Paulo, Brasil. Se estimó, incluso, el impacto de las causas de muerte evitables sobre la expectativa de vida de los ancianos y se observó que un 62,5% de los óbitos entre ancianos con hasta 74 años, en São Paulo, se produjeron por esas causas. Las principales causas de muerte evitables constituyeron un 82,6% del total de óbitos evitables, destacándose la hipertensión y los tumores asociados al tabaquismo. La expectativa de vida a los 60 años aumentaría en un 20% si esos óbitos no se produjesen. La sobremortalidad masculina fue observada en casi todas las causas de muerte evitables analizadas, lo que puede estar relacionado con una mayor exposición a factores de riesgo y a una menor utilización de los servicios de salud por los hombres. Se recomienda que las acciones de prevención y promoción de salud consideren las acentuadas diferencias de sexo y género.

RESUMO – Dentro do processo de envelhecimento populacional, destaca-se a feminização da velhice, ou seja, o predomínio de mulheres na população idosa. Porém, viver mais pode não ser sinônimo de viver melhor. O objetivo deste estudo foi caracterizar o perfil socioeconômico, pessoal e familiar das idosas do “Clube da Vovó”, em Viçosa/MG, além de identificar os tipos de riscos sociais enfrentados por elas associados a esse perfil. O estudo de caso foi realizado no ano de 2014. Tratou-se de um estudo qualitativo e quantitativo em que foram entrevistadas 40 idosas. Utilizou-se para a análise dos dados o SPSS e a análise de conteúdo. Destacou-se o número significativo de octogenárias e viúvas. Aspectos como a baixa renda e a baixa escolaridade foram encontrados. O estado de saúde das idosas foi majoritariamente avaliado como bom. Esses fatores, associados à percepção da velhice pelas idosas, revelaram que o envelhecimento feminino acarreta consequências que permitem inferir que elas estão em potencial risco social.Palavras-chave – Envelhecimento. Feminização da velhice. Risco social.ABSTRACT – An important aspect in the aging process of the population is the feminization of old age, that is, the predominance of women in the elder population. However, living longer not necessarily means to live better. The aim of this study was to characterize the socioeconomic, personal and family profiles of the elderly women from the “Clube da Vovó” in Viçosa/MG. Besides, we intended to identify the types of social risks faced by that population that are related to this subject. The study was conducted in 2014 and was qualitative and quantitative. 40 elderly women were interviewed. The analysis of the data was carried out through the usage of the SPSS software and content analysis. The major point was the significant number of octogenarians and widows. Aspects such as low income and low education were unveiled. The health status of the elderlies was mostly rated as good. These factors, associated with the perception of old age by the women, revealed that the aging of women brings consequences that allow us to infer that they are in a potential social risk.Keywords – Aging. Feminization of old age. Social Risk.

The objective of this article is to present the results of a study on the evaluability of the Program to Value Primary Healthcare Professionals (PROVAB in the Portuguese) that was created by the Brazilian Ministry of Health in 2011. The Program is part of the Manage Healthcare Work and Educationstrategy which seeks to invest in a number of measures aimed at improving and valuing the work carried out by primary healthcare teams. The research, which used qualitative methods, was carried out between February and November 2013 and involved five stages: (a) analysis of documents; (b) identification of potential users; (c) strategic analysis; (d) modelling of the intervention; (e) sharing of lessons learned. Data collection took place in three iterative phases: document analysis, key informant interviews and a workshop. The activities of the program were grouped into three areas: functional and working conditions, teaching/learning and management. The results showed that the program can be evaluated, since it was possible to specify its feasibility by means of a logical model. The potential and priority areas were mapped for future evaluations, whose central focus is to address the problem of unequal distribution of Brazilian health professionals.

O Brasil, como na maioria dos países do mundo, políticas de reposição de renda pela perda da capacidade laborativa são baseadas na invalidez constatada e na invalidez presumida pela idade avançada. O objetivo deste trabalho é discutir as contradições das políticas que objetivam repor a renda da população idosa. Reconhece-se o grande avanço na expansão da cobertura da seguridade social como resultado da implementação das medidas estipuladas pela Constituição Federal de 1988. Estas permitiram a dissociação entre envelhecimento e pobreza. No entanto, a sua legislação aponta algumas contradições, como o descompasso entre as variações na idade à aposentadoria e o aumento da esperança de vida; a volta do aposentado para o mercado de trabalho sem nenhuma restrição, o que é permitido pela legislação; as diferenças na legislação da aposentadoria para homens e mulheres; e o fato de o benefício assistencial devido à idade avançada não ser vitalício. In Brazil, as in most countries, income replacement policies for the loss of labor capacity are based on observed disability and on presumed disability caused by advanced age. The objective of this paper is to discuss the contradictions of the policies target to compensate the elderly population for the loss of their labor capacity. We acknowledge the great progress in the widespread coverage of the social security as a result of the implementation of the measures set by the 1988 Constitution. These allowed the dissociation between aging and poverty. However, their legislation points out some contradictions as the mismatch between the changes in the retirement age and increasing life expectancy, the return of retired persons to the labor market without any restriction, which is allowed by law, differences in the retirement legislation for men and women and the fact that the assistance benefit due to old age is not a lifetime benefit as the other benefits are.

It is only to be expected that the elderly population manifests a high prevalence of chronic diseases that jeopardize their autonomy. One example is syndromes of dementia. The scope of this paper is to make projections of the number of elderly individuals with dementia. An estimate of the current number is made by applying age-related prevalence data to the population of 65 and over, by age-group, with the figures from the Brazilian Demographic Census of 2010. The data were obtained from assessments found in the literature. For a national measure, a weighted average of the estimated prevalence was used. Prevalence rates by age and gender were calculated for the elderly Brazilian population. Current investigations show a steep increase of dementia with age. Women and illiterate individuals have a higher prevalence. The mean prevalence in Brazil is higher than that found in the rest of the world. Projections for the Brazilian population point to a small increase in the prevalence of dementia in the 65+ age-group, from 7.6% to 7.9% between 2010 and 2020, which means 55,000 new cases a year. Dementia is a public health issue, and elicits a strong bioethical concern with aging, due to the loss of autonomy of the affected individuals and the responsibility of the health system to provide adequate care.

Avoidable causes of death have become an important indicator for evaluating health services. Such deaths would not occur if there were adequate prevention, early diagnosis, and treatment and the adoption of appropriate technologies. This article analyzes the pattern and magnitude of avoidable causes of death for the principal causes of death among elderly individuals up to 74 years of age, by gender, in São Paulo State, Brazil. The study further estimated the impact of avoidable causes of death on life expectancy among the elderly, and 62.5% of the deaths among elderly up to 74 years in São Paulo were due to these causes. The principal avoidable causes of death constituted 82.6% of all avoidable deaths, featuring hypertensions and tobacco-associated tumors. Life expectancy at 60 would increase by 20% if these deaths were avoided. Male excess mortality was observed in nearly all of the avoidable causes of death analyzed here, which could be related to greater exposure to risk factors and less use of health services by men. Prevention and health promotion measures should take these sharp gender differences into account.

This study identifies geographic, demographic, and socioeconomic differences in the quality of data on underlying causes of death in the Brazilian elderly population. We used three quality indicators: the proportion of ill-defined causes, the proportion of unspecified causes, and the two proportions combined. We analyzed the main ill-defined and unspecified causes and the association between these indicators and individual characteristics on death certificates (DC) and characteristics of the municipalities. Unspecified causes exceed ill-defined causes, and both increase with age. Schooling, race, size of municipality, and per capita GDP were associated with quality of data (especially with ill-defined as compared to unspecified causes). Having received medical care decreased the odds of cause of death being recorded as ill-defined and increased the odds of unspecified records. Programs to improve quality of information on death certificates should focus on ill-defined and unspecified causes in the elderly.

Uma das maiores conquistas sociais da segunda metade do século XX em quase todo o mundo em desenvolvimento foi a redução da mortalidade em todas as idades, o que resultou no aumento da esperança de vida e em que mais e mais pessoas alcançassem as idades avançadas. Esta mudança foi seguida da queda da fecundidade. Ambas ocorreram num curto período de tempo e acarretaram transformações rápidas no ritmo de crescimento da população e na distribuição etária. Devido a isto, é necessário que projeções sejam sempre atualizadas. O trabalho compara resultados de cinco projeções realizadas anteriormente e apresenta os resultados de uma nova, que incorpora os dados da Pesquisa Nacional por Amostra de Domicílios (PNAD) de 2007. Todas as projeções apontam para uma desaceleração no ritmo de crescimento populacional e para um processo acelerado de envelhecimento, inclusive do próprio segmento com 80 anos e mais de idade. No entanto, as taxas de crescimento, bem como as proporções dos diversos grupos etários no total da população, variam em função da intensidade assumida para a queda da fecundidade. Em relação aos totais populacionais, quanto mais recente a projeção, menor é o volume esperado. Isso é explicado pelas diferentes taxas de fecundidade assumidas nas hipóteses realizadas. Diferenças expressivas também são encontradas na composição etária, principalmente, na proporção da população menor de 15 anos. Foi mostrado que é a fecundidade a variável que desempenha o papel mais importante na dinâmica de uma população. A mortalidade exerce um impacto menor.Parece claro que, para a primeira metade deste século, o movimento da população brasileira é de rápida contração e de superenvelhecimento. Ela deverám atingir o seu ponto máximo nos próximos 20 anos. Isto só não ocorrerá se a fecundidade voltar a crescer. Por outro lado, dado que projeções populacionais são consideradas como insumos importantes para fundamentar estudos que dimensionem demandas de serviços públicos e privados, é de grande importância que haja a contínua atualização das mesmas. One of the most important social achievements that took place in the second half of XX century in almost all the developing countries was the mortality reduction. This benefited all age groups and brought about a large increase in life expectancy. Also, this has resulted that more and more people reached advanced ages. This change was followed by a marked fertility decline. Both had occurred in a short period of time andaffected the speed of the population growth rate (diminishing it) and the age distribution (ageing it). Due to this, it is necessary that projections should be always updated. The paper compares the results of five population forecasts previously done bythe authors and presents the results of a new one. All the projections point to a reduction in population growth rates and a fast population ageing, including, here,the ageing of very old population (80 years and plus). However, the population growth rates and also the proportions of the population of the several age groups in the total of the population varies according to the intensity assumed for the fertility decline. As regard the figures of the total population, the more recent population forecasts point to a lower expected figure compared to the older ones. This difference is explained by the different fertility rates that were assumed. Marked differences are also found in the age composition, mainly, in the proportion of population aged less than15 years. It was shown that fertility is the variable that plays the most important role in the population dynamics. Mortality exerts a lesser impact It seems clear that for the first half of this century, the movement of the Brazilian population is that of fast contraction and over ageing. It will have to reach its maximum point in the next 20 years. This will not occur only if fertility resumes to grow. On the other hand, given that population forecasts are considered as important inputs to estimate demands of public and private services, they should be continuously update.

Tendo como pano de fundo as rápidas transformações experimentadas pelapopulação brasileira ao longo do século XX, tais como a redução da imigraçãointernacional e a queda da mortalidade e da fecundidade, o trabalho analisa adinâmica populacional brasileira no passado recente e apresenta dois cenários deevolução futura para essa população.Os resultados apresentados consistem em projeções para os qüinqüênioscompreendidos entre 2000 e 2020, desagregados por sexo, grupos qüinqüenais deidade e situação de domicílio. O método utilizado para projetar a população foi o doscomponentes, que utiliza a projeção separadamente das três variáveis demográficas:fecundidade, mortalidade e movimentos migratórios do tipo rural-urbano. Foirealizada uma hipótese para cada um dos componentes demográficos, com exceção dafecundidade. Para essa variável, foram consideradas duas hipóteses, o que distingueos dois cenários.Segundo a hipótese 1, a população brasileira poderá atingir 217,4 milhões depessoas em 2020. A hipótese 2 prevê um contingente de 209,5 milhões de pessoas em2020. Nos dois cenários, as taxas de crescimento continuarão no seu processo dedecréscimo, podendo atingir valores próximos a 1,0% a.a. ou 0,7% a.a. no final doperíodo da projeção, respectivamente para as hipóteses 1 e 2.ABSTRACTThe paper analyses the marked changes experienced by the Brazilian populationthroughout the end of the XXth century. It also presents two sets of populationprojections for the quinquenium comprised between 2000 and 2020. They aredisaggregated by sex, age groups and place of residence (rural and urban).The projection was done using the component method. The start up is theprojection of each demographic component, fertility, mortality and rural-urbanmigration, separately. A single hypothesis was done for each component except forfertility. For it, two hypotheses were done which differentiated the two sets ofprojections.According to hypothesis 1, the Brazilian population would reach 217.4 millioninhabitants in 2020. The second hypothesis forecasts 209.5 million persons for thatyear. In both scenarios, population growth rates will continue to decline throughoutthe projection horizon. They would get values close to 1.0% a.a. or 0.7% a.a. in2015-2020 under respectively hypotheses 1 and 2.

The question addressed in this paper is how families with elderly living in are organizing themselves to face populational ageing, a major children economic dependency and the reduction of the role of the State. Are they "empty nests"? Co-residence and elderly increase in family size may be a familiar strategy utilized to benefit both older and younger generations. In Brazil, this seems to be related to better living conditions. It benefits elderly and children, but there are indications that the younger generations are the most beneficiaries. In Brazil, elderly in general live with children. In 86% of families with elderly living in, elderly are the heads or spouses. A minor proportion of elderly lives in relative's households. These are older, poorer, work-lesser, report worse health conditions and less autonomy. There is indication that in some degree that they need the help of children. This dependency may be associated to the ageing, the up-rise of chronicle diseases and physical disability. One conclusion is that the relationship between ageing and "dependency" is not clear. A question raised is about the definition of elderly population. Old age is considered to start at 60. This is based on the definition given by the Elderly National Policy. Nevertheless, it does not mean that all such people have similar levels of vulnerability and dependence. Actually, a great proportion of the elderly are still playing social roles, such as continuing on with their economic activities and caring for grandchildren. It is assumed here, that the elderly group is a heterogeneous group composed of people who participate in the economic process and by others in need of care, support, etc. To finalize, it is assumed that the relationship between co-residence and well-being depends on the socio-economic context, the social policies as well as on individual characteristics and preferences.