Irenio Gomes

Aims: Present and discuss, through a narrative review, possible benefits of Karate-Dõ practice on cognitive abilities in aging. Source of data: Were consulted the databases MEDLINE, SportDiscus, LILACS and SciElo in the period of January to August 2015, with searches from 2000, in the languages Portuguese, Spanish and English, with the words “Karate”, “Tai Chi”, “Martial Arts”, “Older People”, “Elderly” and "Cognition", with the help of Boolean operators (AND and OR); brackets for ordering operators and quotes to identify compound words. Summary of findings: The aging process is associated with several changes in the individual, as a reduction in physical abilities and cognitive aspects. This decrease is characteristic of aging, but it can be aggravated or mitigated due to lifestyle and physical activity has important role in maintaining this capabilities. Among the physical activities we highlight the use of martial arts as a means of systematic exercise, aimed at promoting health and (re)education of the body, both in the physical and cognitive aspects. The Karate-Dõ is a discipline of personal development that enables memorize and learn a large set of sequential movements and exercises, which indicates the presence of a demanding cognitive task. Conclusions: The literature is scarce and controversial in this issue, however, when working kihon techniques (fundament), kata (form) and kumite (fight/sparring), the karateka (fighter) is being encouraged to organize and maintain cognitive structures that facilitate and fix their learning, suggesting potential benefit to cognitive function.

Cognitive impairment (CI) has a multifactorial etiology. Some studies have suggested that inflammatory, oxidative and antioxidant status and physical activity are associated with CI. However, the evidence on this subject is still controversial. The goal of this study was to verify the association of caloric expenditure by physical activity, oxidative, antioxidant power and inflammatory biomarkers with CI in older adults. We performed a cross-sectional study of 424 elderly (224 with normal cognitive function and 200 with CI) patients from the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil. The variables investigated were sociodemographic, biochemical, inflammatory (hs-CRP, IL-6), oxidative (TBARS, AOPP), antioxidant power (FRAP) biomarkers, energy expenditure, and cognitive function. The instruments used were the Minnesota Leisure Time Physical Activity Questionnaire + Compendium of Physical Activities, classification of energy costs of human physical activities (for physical activity evaluation and measurement of energy expenditure in METs), and a battery of neuropsychiatric instruments (for cognitive ability assessment). We found statistically significant differences only with respect to HDL-c and age (higher averages in the CI group; P<0.05). We observed no differences between the groups with respect to biochemical, inflammatory, oxidative and FRAP biomarkers or caloric expenditure. Logistic regression showed that HDL-c (OR=1.02 [IC=95%; 1.01-1.04]; P=0.011), and age (OR=1.05 [IC=95%; 1.02-1.08]; P=0.004) are independent factors associated with CI. Our results suggest that the biochemical (except HDL-c), inflammatory, oxidative, and FRAP biomarkers investigated and caloric expenditure are not associated with CI in the elderly assisted at primary care.

Objetivo: Verificar o conhecimento de idosos atendidos na atenção básica sobre o Estatuto do Idoso (EI). Método: Trata-se de um estudo transversal envolvendo idosos da Estratégia Saúde da Família de Porto Alegre/RS. Para tanto, foi criado um instrumento com questões sócio-demográficas e outras relativas ao EI. Resultado: Foram entrevistados 361 idosos, sendo que a maioria era do sexo feminino (62,9%), com baixa escolaridade (81,4%), baixo rendimento pessoal mensal (53,2%), aposentados (62,9%) e com cor autorrelatada branca (67,0%). Em relação ao EI, a maioria dos idosos (72,3%) não o conhecia. Ao analisar a entre o conhecimento do EI e os dados sócio-demográficos foi possível verificar que há relação entre desconhecimento e baixa escolaridade (P=0,006). Não se observou associação com sexo, faixa etária e renda. Os direitos tutelados pelo EI mais frequentemente conhecidos eram direito à liberdade (94,5%), o fato de nenhum idoso poder ser objeto de negligência/violência/crueldade/opressão (91,7%) e conhecimento de algum direito referente aos meios de transportes (88,1%). Já os menos conhecidos eram relativos às medidas protetivas (6,1%), ao acesso à justiça (9,7%) e ao direito a alimentos (22,7%). Conclusões: Apesar do EI ser um importante instrumento legislativo que prima pela igualdade entre os idosos, levando mais proteção e resguardo para esta parcela vulnerável da população, a frequência de desconhecimento pelos idosos da atenção básica de saúde foi grande e associada à baixa escolaridade. Assim, faz-se necessária a busca por meios efetivos de divulgação do conteúdo do EI de forma equitativa para toda população para que o mesmo atinja seu propósito.

Introduction: The rapid aging process in low and middle-income countries poses a major challenge and has special repercussions for mental health. This is especially true for diseases that impair cognition and emotion regulation such as depression and dementia. In Brazil, caring for the elderly is a public health priority. Aims: To describe the scientific methodology and practical applicability of a mental health study tailored to seniors; to provide data to improve mental health assessment and care; to describe a primary care methodology that is replicable in other regions. Methods: A cross sectional study using stratified randomized sampling. Study participants were residents of Porto Alegre, over 60 years, and enrolled in the Family Health Strategy program. Study prioritized the examination of psychiatric and cognitive characteristics by using multiprofessional indicators of mental health. Data was collected in two phases: screening and specialized diagnosis. Conclusion: The paper provides a methodological model to assist researchers in similar studies. Striking an adequate balance between assistance and research is a major challenge. Protocols that prospect and examine the leading mental health problems in the elderly could close the gap between identification of older adults with early symptoms and those at risk of developing depression and dementia. A stratified approach to screening and diagnosing cognitive and mood and disorders for all levels in public health that uses low cost instruments in a real setting will benefit communities and can provide local empowerment.

This study aims to investigate the influence of sociodemographic characteristics on the performance of older people on two tasks of verbal fluency and provide normative data for a Brazilian population of healthy elderly individuals with different educational levels. The initial sample included 521 individuals aged from 60 years, participating in the Program Family Health Strategy. Participants who had scores suggestive of cognitive decline on the Mini-Mental State Examination, depressive symptoms in Geriatric Depression Scale and self-reported neurological or psychiatric disorders were excluded. The final sample consisted of 218 participants in phonemic verbal fluency task (letters F, A and S) and 265 participants for semantic verbal fluency task (animals). The performance in both tests was associated with age and education, but not with sex. Still, the education variable was shown to have a greater impact on scores in phonemic and semantic tests than age in both forms of evocation. The results of this study suggest the importance of providing normative data for elderly Brazilians appropriate to age and education on verbal fluency tasks.

The purpose of this study was to define the Healthy Eating Index (HEI) of the elderly of Southern Brazil and its association with energy, macronutrients and micronutrients intake. A cross-sectional study was conducted with 186 elderly aged 60 and older of the Geriatric Service of São Lucas Hospital, Porto Alegre, Brazil. Dietary data were collected by two 24-hour recalls, and diet quality was assessed by HEI adapted to the Brazilian population. The HEI total score was divided into three categories: inadequate diet (below 51 points), diet needs improvement (between 51 and 80 points), and healthy diet (over 80 points). The results showed that the mean HEI score was 58.8±10.5 points (ranging from 31.4 to 79.8). Most elderly (74.2%) showed a diet that needed modification and no elderly individual had a healthy diet. The quality of the diet was associated with greater intake of carbohydrates, and lower intake of total lipids, saturated fatty acids, cholesterol, and sodium. Consumption of vitamins C and D and calcium was shown to be positively correlated with the quality of the diet. Less than 1.1% of the elderly consumed a varied diet. The findings suggest that the diet of the majority of the elderly needs improvement, reinforcing the importance of care in relation to adequate nutrition in this population, and can help in guiding the activities and programs of nutritional education and public policies that stimulate increasingly healthy eating.

Objective: The aim of this study was to estimate prevalence and patterns of lifetime alcohol misuse. Method: This was a cross-sectional study of a representative sample of 1,078 individuals aged 60 or more. Structured interview included sociodemographic, lifestyle, health data, and the five alcohol misuse screening questions of the Self-Reporting Questionnaire. Results: Prevalence of misuse was 6.5%. Men, aged 60 to 69, low educational level, separated/divorced, and tobacco smoking were independently associated with lifetime alcohol misuse. Odds ratios show increasing association with levels of alcohol misuse groups in males, low-educated, and tobacco users. Persons aged 60 to 69, 4 to 7 education years, and non-White ethnicity were significantly associated with the major alcohol misuse score. Discussion: Younger elderly were more exposed to alcohol than previous cohorts. Thus, problems with alcohol in old age will possibly increase as they grow older. The results of this study call attention to a field of lacking evidence in alcohol-related problems of older persons.

In a sample of elderly individuals from Porto Alegre - RS, Brazil, to analyze the intrinsic and extrinsic factors that predispose them to the risk of falls and fractures. The study included a random sample of 267 elderly individuals, to whom two balance tests were applied: the Functional Reach Test (FRT) and the Timed Up and Go Test (TUG). The elderly also answered a questionnaire (13 questions divided into four categories) on sociodemographic and health factors. Elderly individuals from both genders (76.8% women), aged between 60 and 90 years (mean = 70.22 years, SD = ± 7.30 years) participated in the study. A statistically significant association (p < 0.05) was found between age, self-perception of eyesight, type of dwelling, last monthly income, and the FRT; the same was found between age range, self-rated health (p < 0.001) and the TUG. It was identified that, in the sample of elderly individuals living in Porto Alegre - RS, Brazil, the intrinsic factors that predispose to the risk of falls and fractures are older age, poor self-perception of eyesight, and poor selfrated health; the extrinsic factors are type of dwelling (living in a house) and a monthly income < one minimum wage.