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BACKGROUND AND AIMS: Dysphagia is a swallowing disorder that affects mainly the older adults and can compromise quality of life, and increase the risk for malnutrition and aspiration. Early diagnosis is, therefore, essential to prevent adversities. We aimed to evaluate the validity of self-perceived dysphagia in community-dwelling older adults (60 years or older) from Pelotas, Brazil, participants in the "COMO VAI?" METHODS: The Eating Assessment Tool (EAT-10) was used as the reference tool to identify the risk for dysphagia and the self-perception of dysphagia was assessed using the following question: "Do you have swallowing difficulties?" (Yes/No). The parameters of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were described with 95% confidence intervals (95% CI) and according to independent variables (sex, age, economic level, and education). RESULTS: The prevalence of dysphagia risk according to EAT-10 and self-perception was 12.9% (95% CI 10.2-16.1) and 8.8% (95% CI 6.6-11.6), respectively. Sensitivity was 34.8% (95% CI 23.5-47.6) and the highest values were observed in women and the older individuals (80 years or older). Specificity was 95.1% (95% CI 92.6-96.9). PPV was 51.1% (95% CI 35.8-66.3), NPV 90.8% (95% CI 87.8-93.2) and accuracy 87.3%. CONCLUSIONS: Considering the low sensitivity and PPV, the self-perception of dysphagia analyzed with a single question should be used with caution, as an individual at risk for dysphagia may not realize their condition.

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ABSTRACT Background: Bariatric surgery is still controversial in elderly patients with severe obesity. Most publications focus on safety and early clinical outcomes. Food tolerance and nutritional postoperative risk is unknown for this population. Methods: Thirty-six elderly patients with severe obesity were recruited for an open-label randomized trial from September 2017 to May 2019 comparing laparoscopic sleeve gastrectomy (LSG) to Roux-en-Y Gastric Bypass (LRYGB). Food tolerance was accessed by Quality of Alimentation (QoA) questionnaire and data on weight loss, body composition, and nutritional risk were collected between 6 and 24 months after surgery. Results: Comparing LSG to LRYGB patients, the latter had higher total weight loss (22% vs 31%, P=0.01) and excess weight loss (53% vs 68%, P=0.01). Food tolerance to eight food groups was similar between groups (14 vs 15 points, P=0.270), as Suter score (23 vs 25, P=0.238). Daily protein intake was below recommendation in both groups (40 vs 51 g/d, P=0.105). Nutritional risk, evaluated through Standardized Phase Angle (-1.48 vs -1.99, P=0.027), was worse for LRYGB group. Conclusion: Food tolerance and adequacy of food consumption were similar in both groups. LRYGB patients had higher nutritional risk.

RESUMO Contexto: A cirurgia bariátrica ainda é controversa em pacientes idosos com obesidade grave. A maioria das publicações tem foco em segurança e desfechos clínicos precoces. A tolerância alimentar e o risco nutricional pós-operatório são desconhecidos para essa população. Métodos: Trinta e seis pacientes idosos com obesidade grave foram recrutados para um estudo clínico randomizado de setembro de 2017 a maio de 2019 comparando gastrectomia vertical com Bypass Gástrico em Y-de-Roux (BGYR). A tolerância alimentar foi avaliada pelo questionário de qualidade alimentar e dados sobre perda de peso, composição corporal e risco nutricional foram coletados entre 6 e 24 meses após a cirurgia. Resultados: Comparando os pacientes de gastrectomia vertical com BGYR, estes tiveram maior perda de peso total (22% vs 31%, P=0,01) e perda do excesso de peso (53% vs 68%, P=0,01). A tolerância alimentar para oito grupos foi similar entre grupos 14 vs 15 pontos, P=0,270), bem como o escore de Suter (23 vs 25, P=0,238). A ingestão diária de proteínas foi abaixo do recomendado para ambos os grupos (40 vs 51 g/d, P=0,105). O risco nutricional, avaliado através do ângulo de fase padronizado (-1,48 vs -1,99, P=0,027), foi pior para o grupo do BGYR. Conclusão: A tolerância alimentar e adequação do consumo alimentar foi similar entre os grupos. Pacientes submetidos a BGYR tiveram maior risco nutricional.

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To analyse the prevalence of dysphagia perception and associated factors among community-dwelling older adults in Pelotas, Brazil. A total of 1447 community-dwelling individuals aged 60 and older participated in a cross-sectional population-based study carried out in 2014. Dysphagia perception was assessed using the following question: "Do you have swallowing difficulties? (Yes/No)". Independent variables included sociodemographic, behavioural and health characteristics. Poisson regression was used to obtain prevalence ratios. Dysphagia perception prevalence was 8.1%, higher among women (PR 1.63, 95% CI 1.07; 2.46) and in subjects older than 80 years (PR 1.88, 95% CI 1.16; 3.03). Older adults with 1-7 years of schooling were more likely to present dysphagia (PR 1.62; 95% CI 1.09; 2.40). Those who did not use dental prosthesis (PR 1.85; 95% CI 1.08; 3.16), who presented dry mouth sensation (PR 4.10; 95% CI 2.59; 6.51) and multimorbidity (PR 30.0; 95% CI 4.09; 219.45) were more likely to present dysphagia perception. The participants who consumed alcohol were 60% less likely to report dysphagia perception (PR 0.43; 95% CI 0.22; 0.86). One out of twelve older adults presented dysphagia perception, and associations with sociodemographic characteristics and other health problems were found. Early identification of dysphagia should be a public health and clinical concern.

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ABSTRACT Objective To compare the availability of healthy and unhealthy foods in families with and without elderly and oldest-old people. Methods This is an observational, cross-sectional study with secondary data from the Household Budget Survey, conducted by the Brazilian Institute of Geography and Statistics between 2017 and 2018. Families were characterized based on the oldest member: Control (without elderly and oldest-old) or with elderly and oldest-old. The sociodemographic characteristics of the families and the foods purchased by the families were obtained, according to the Nova classification (in natura, processed and ultra-processed foods, in addition to culinary ingredients). Results Families with elderly and oldest-old people had greater availability of fresh foods and fewer ultra-processed foods. In contrast, young families showed greater acquisition of all ultra-processed food items. Conclusion The unfavorable nutritional transition process with fewer in natura foods seemed to be less evident in families with higher age groups. It is concluded that the presence of the elderly and oldest-old in the family could be related to a better quality of the family diet, with a greater presence of fresh foods and a lower acquisition of ultra-processed foods.

RESUMO Objetivo Comparar a disponibilidade de alimentos saudáveis e não saudáveis nas famílias com e sem idosos e longevos. Métodos É um estudo observacional, transversal com dados secundários da Pesquisa de Orçamento Familiar, realizada pelo Instituto Brasileiro de Geografia e Estatística entre 2017-2018. As famílias foram caracterizadas pelo integrante com maior idade: controle (sem idosos e longevos), com idosos e longevos. Foram obtidas características sociodemográficas das famílias e itens alimentares adquiridos pelas famílias, segundo a classificação Nova (alimentos in natura, processados e ultraprocessados, além de ingredientes culinários). Resultados As famílias com idosos e longevos apresentaram maior disponibilidade de alimentos in natura e menor em ultraprocessados. Enquanto que as famílias jovens apresentaram maior aquisição em todos os itens alimentares ultraprocessados. Conclusão O processo de transição nutricional desfavorável com menos alimentos in natura pareceu ser menos evidente em famílias com maiores faixas-etárias. Conclui-se que a presença de idosos e longevos na família pode estar relacionada à melhor qualidade alimentar familiar, com maior presença de alimentos in natura e menor aquisição de ultraprocessados.

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Physiological changes in elderly individuals (EI) can contribute to nutritional deterioration and comorbidities that reduce their quality of life. Factors such as diet can modulate some of these effects. The aim was to evaluate the functionality of foods added with Brosimum alicastrum Sw. seed flour in EI. EI (n = 23) living in nursing home conditions agreed to participate. A control stage was carried out (30 days) and subsequently, an intervention stage (30 days) was realized in which a muffin and a beverage, designed for EI, were added to the participants' their usual diet. In both stages, anthropometric parameters, body composition, nutritional status, dietary intake, sarcopenic status, cognitive and affective states, biometric parameters, and total phenolic compounds (TPC), and antioxidant capacity in foods and plasma of EI were determined. The results showed that the consumption of the foods improved the energy intake and preserved the muscle reserves of the EI. The EI gained body weight (+1.1 kg), increased their protein (+18.6 g/day; 1.5 g/kg BW/day), dietary fiber (+13.4 g/day), iron (+4.4 mg/day), zinc (+1.8 mg/day), folic acid (+83.4 µg/day) consumption while reducing their cholesterol (-66 mg/day) and sodium (-319.5 mg/day) consumption. LDL-C lipoproteins reduced (14.8%) and urea (33.1%) and BUN (33.3%) increased. The TPC increased (7.8%) in the plasma, particularly in women (10.7%). The foods improve the EI nutritional status, and this has a cardiovascular protective effect that can benefit the health of the EI.

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Avaliou-se a qualidade da alimentação de idosos longevos e sua relação com doenças crônicas não transmissíveis. Foi um estudo transversal, de base populacional, realizado em Viçosa, Minas Gerais, Brasil, o qual integra um projeto maior intitulado "Condições de saúde, nutrição e uso de medicamentos por idosos do município de Viçosa (MG): um inquérito de base populacional". As entrevistas com os idosos foram realizadas por meio de questionário semiestruturado, com a maioria das questões fechadas e pré-codificadas. Os dados do consumo alimentar foram obtidos por recordatório de ingestão habitual e a qualidade da dieta avaliada por meio do Índice de Alimentação Saudável Revisado (IAS-R), validado para a população brasileira. A amostra foi composta por 94 idosos longevos, a maioria do sexo feminino. Os mesmos apresentaram alta ingestão de sódio, baixa ingestão de cereais integrais e IAS-R = 62,22. Idosos diabéticos apresentaram maior ingestão de frutas totais, baixa ingestão de Gord_AA (açúcares, gorduras sólidas e álcool) e IAS-R total maior em comparação aos não diabéticos. As presenças de dislipidemia e hipertensão não alteraram o consumo de nenhum dos componentes. Os resultados indicaram a necessidade de adequação na ingestão alimentar. Assim, intervenções e orientações nutricionais específicas destinadas à promoção da saúde devem ser incentivadas.

The quality of the food of long-lived elderly and its relationship with non-communicable chronic diseases was evaluated. This a cross-sectional study with a population basis that was conducted in Viçosa, Minas Gerais, Brazil, which is part of a larger project entitled "Health, nutrition and drug use by older people in Viçosa (MG): a population-based survey". The interviews with the elderly was conducted through a semi-structured questionnaire, with most questions closed and pre-coded. Food intake data were obtained from the usual intake recall and the quality of the diet was assessed using the Revised Healthy Eating Index (HEI-R), validated for the Brazilian population. The sample consisted of 94 long-lived elderly, most of them female. They presented high sodium intake, low whole grains intake and HEI-R = 62.22. Diabetic older adults had higher total fruit intake, lower intake of Gord_AA (sugars, solid fats, and alcohol) and higher total HEI-R compared to non-diabetics. The presences of dyslipidemia and hypertension did not alter the consumption of any of the components. The results indicated the need for adequacy in food intake. Thus, specific nutritional interventions and guidelines for health promotion should be encouraged.

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CONTEXT: Sarcopenia, besides having an impact on functional capacity, has been associated with increased hospitalization and mortality, and stands out as an essential cause of disability among older people. OBJECTIVE: We conducted a systematic review and meta-analysis of published studies comparing the calories and nutrients ingested by elderly people with and without sarcopenia. DATA SOURCES: MEDLINE/PubMed, Scopus, LILACS, Cochrane Library, and Scielo databases were searched. STUDY SELECTION: Studies comparing calories and nutrient intake among elderly people diagnosed with sarcopenia and people without sarcopenia were included. DATA ANALYSIS: Mean differences and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using I2 test. RESULTS: A total of 23 studies fulfilled the inclusion criteria. The average number of calories and nutrients ingested were significantly lower in elderly study participants with sarcopenia compared with those without sarcopenia. The meta-analyses showed that the average number of calories ingested (n = 19 studies; mean difference, -156.7 kcal; 95%CI, -194.8 to -118.7) were significantly lower in those with sarcopenia than in elderly participants without sarcopenia. Compared to those without sarcopenia, elderly people with sarcopenia consumed lower amounts of proteins; carbohydrates; saturated fatty acids; vitamins A, B12, C, and D; and minerals such as calcium, magnesium, sodium, and selenium. CONCLUSIONS: The evidence so far available suggests a difference in caloric, macronutrient (ie, proteins, carbohydrates, saturated fatty acids), and micronutrient (ie calcium, magnesium, sodium, selenium, and vitamins A, B12, C, and D) intake among the elderly with and without sarcopenia. Additional studies are needed to define the best interventions to improve the consumption of calories and nutrients by the aging population.

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Objetivo: investigar os efeitos de intervenção do tipo Educação Alimentar e Nutricional baseada no Modelo Transteórico. Métodos: ensaio clínico aberto com 70 idosos. Avaliou­se qualidade da dieta, por meio de Recordatórios Alimentares e Índice de Qualidade da Dieta, e o comportamento alimentar, com análise comparativa do tipo pré­pós onde o grupo de comparação ou controle foi o próprio grupo selecionado para a intervenção. Resultados: melhora da dieta, com aumento do consumo de frutas, vegetais e hortaliças e do comportamento alimentar (evolução dos estágios de pré­contemplação para ação). Conclusão: mudança nos hábitos de idosos é difícil, considera­se que a intervenção foi efetiva.

Objective: to investigate the effects of intervention of the type of Food and Nutrition Education based on the Transtheoretical Model.Methods: open clinical trial with 70 elderly people. Diet quality was assessed through Food Recalls and Diet Quality Index and eating beha­vior was evaluated with comparative analysis of the pre­post type where the comparison or control group was the group selected for the intervention. Results: improved diet, with increased consumption of fruits and vegetables, and eating behavior (evolution from pre­contemplation stages to action). Conclusion: changing habits of the elderly is difficult, it is considered that the intervention was effective.

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Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer's disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression modelsadjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutritional status, regardless of gender, age, education, body composition, and metabolic condition. This association did not remain significant after adjustment for AD, a potential confounder in this association. Malnutrition or its risk was independently associated with high risk of fall; thus, malnutrition should be considered in the prevention of falls among the elderly population.

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ABSTRACT Objective: To verify the prevalence of violence among elderly community members and its relationship with nutritional status and sociodemographic characteristics. Method: Cross-sectional and analytical study developed with 159 community elderly registered at a Family Health Unit in Recife/Pernambuco between March 2016 and March 2017. The Brazil Old Age Schedule, Conflict Tactics Scales and Mini Nutritional Assessment were used as data collection instruments. Data received descriptive and inferential statistical treatment. Results: Among the elderly classified as with violence, there was a predominance of psychological violence (64.3%), and the majority were at risk for malnutrition (54.3%). There was an association between 'having a partner' and psychological (48.1%; p=0.02) and physical (48.1%; p=0.03) violence. Logistic regression demonstrated that being in a relationship or being malnourished increases the likelihood of suffering psychological violence (OR=2.63; OR=3.67), just as not being working increases the likelihood of physical violence (OR=5.61). Conclusion: Violence was negatively related to the nutritional status of elderly community members.

RESUMEN Objetivo: Verificar la prevalencia de violencia entre ancianos de la comunidad y su relación con el estado nutricional y las características sociodemográficas. Método: Estudio transversal and analítico realizado con 159 ancianos de la comunidad registrados en una unidad de salud familiar en Recife/Pernambuco. Se utilizó el Brazil Old Age Schedule; Conflict Tactics Scales y Mini Nutritional Assessment como instrumentos de recolección. Los datos recibieron tratamiento estadístico descriptivo e inferencial. Resultados: Entre los ancianos clasificados con violencia, predominaba la violencia psicológica (64,3%), y la mayoría de ellos están en riesgo de desnutrición (54,3%). Hubo una asociación entre 'tener pareja' y violencia psicológica (48,1%; p=0,02) y física (48,1%; p=0,03). La regresión logística demostró que estar en una relación o estar desnutrido aumenta la probabilidad de sufrir violencia psicológica (OR=2,63; OR=3,67), así como, no estar trabajando aumenta la probabilidad de violencia física (OR=5,61). Conclusión: La violencia se relacionó negativamente con el estado nutricional de los ancianos de la comunidad.

RESUMO Objetivo: Verificar a prevalência da violência entre idosos comunitários e sua relação com o estado nutricional e características sociodemográficas. Método: Estudo transversal, desenvolvido com 159 idosos comunitários cadastrados em Unidade de Saúde da Família em Recife/Pernambuco entre março de 2016 e março de 2017. Foram utilizados Brazil Old Age Schedule, Conflict Tactics Scales e Mini Nutritional Assessment como instrumentos de coleta. Os dados receberam tratamento estatístico descritivo e inferencial. Resultados: Dentre os idosos considerados com violência, houve predomínio da violência psicológica (64,3%), e a maioria possuía risco para desnutrição (54,3%). Verificou-se associação entre 'ter um companheiro' e a violência psicológica (48,1%; p=0,02) e física (48,1%; p=0,03). A regressão logística demonstrou que ter um companheiro ou estar desnutrido aumenta a probabilidade de sofrer violência psicológica (OR=2,63; OR=3,67), assim como não estar trabalhando aumenta a probabilidade de violência física (OR=5,61). Conclusões: A violência se relacionou negativamente ao estado nutricional dos idosos comunitários.

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Resumo Objetivo Analisar a relação entre a capacidade funcional, o estado nutricional e as variáveis sociodemográficas de idosos residentes em instituições de longa permanência. Método Trata-se de um estudo transversal conduzido com 82 idosos institucionalizados. Para a coleta de dados foram aplicados o Índice de Barthel para avaliação do grau de independência no desempenho das atividades básicas de vida diária e a Mini Avaliação Nutricional (MNA) para a avaliação do estado nutricional dos idosos. Os dados foram coletados em cinco instituições de longa permanência situadas na região Sul do Brasil. Análises de regressão logística ordinal foram realizadas para verificar as associações dos fatores contextuais com a capacidade funcional dos idosos institucionalizados Resultados A maioria dos participantes apresentou independência total no desempenho das atividades de vida diária (39,0%) e estado nutricional deficiente (59,8%). A análise de regressão ordinal multivariada demonstrou que idosos institucionalizados com maiores escores na avaliação nutricional estão associados com melhores indicadores de capacidade funcional (RC=1,33; IC 95%=1,15 a 1,54; p<0,001). Não se encontrou associação entre escolaridade, lesões por pressão, índice de massa corpórea e a capacidade funcional. Conclusão O estado nutricional é um importante preditor para a dependência de idosos institucionalizados.

Abstract Objective To analyze the relationship between functional capacity, nutritional status, and sociodemographic variables of older adults living in long-term care facilities. Method This is a cross-sectional study conducted with 82 institutionalized older adults. For data collection, we used the Barthel Index to assess the degree of independence in the performance of basic activities of daily living and the Mini Nutritional Assessment (MNA) to assess the nutritional status of older adults. Data were collected in five geriatric long-term care facilities located in southern Brazil. Ordinal regression analyses were performed to identify associations between contextual social factors, and nutritional status with the functional capacity of institutionalized older adults. Results Most participants showed complete independence in performing activities of daily living (39.0%) and poor nutritional status (59.8%). The multivariate ordinal regression analysis showed that older adults with higher scores in the nutritional assessment are associated with better indicators of functional capacity (OR=1.33; 95% CI=1.15 to 1.54; p<0.001). We did not find an association between educational level, pressure injuries, body mass index, and functionality. Conclusion Nutritional status is a significant predictor for dependency in institutionalized older adults.

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OBJETIVO: Identificar diagnósticos de enfermería para adultos mayores hospitalizados relacionados con la necesidad humana básica de nutrición, utilizando la Clasificación Internacional para la Práctica de Enfermería (CIPE®). MÉTODO: Investigación transversal con una muestra de 100 adultos mayores de un hospital. Para la recolección de datos se utilizó un instrumento semiestructurado que contiene datos sociodemográficos, anamnesis y examen físico. Las declaraciones de diagnóstico se construyeron a partir de la CIPE®. El análisis de los datos se realizó mediante estadística descriptiva para obtener la frecuencia absoluta y relativa. RESULTADOS: Se construyeron los siguientes títulos diagnósticos: Dentadura deteriorada; Condición nutricional, deteriorada; Condición nutricional, positiva; Habilidad para comer, deteriorada; Demacrado (delgado); Obesidad; Caquexia; Deglución deteriorada y paladar, deteriorado. CONCLUSIÓN: Se enfatiza la importancia de aplicar las etapas del Proceso de Enfermería, realizando una atención sistemática del adulto mayor. Los diagnósticos de enfermería enfocados en la nutrición del adulto mayor favorecen la formulación de intervenciones dirigidas a mejorar la calidad de vida y el funcionamiento del sistema gastrointestinal.

OBJETIVO: Identificar diagnósticos de enfermagem para idosos hospitalizados acerca da necessidade humana básica de nutrição, utilizando a Classificação Internacional para a Prática de Enfermagem (CIPE®). MÉTODO: Pesquisa transversal com amostra de 100 idosos de um hospital. Para coleta dos dados, utilizou-se um instrumento semiestruturado constando dados sociodemográficos, anamnese e exame físico. As afirmativas diagnósticas foram construídas a partir da CIPE®. A análise de dados foi realizada através da estatística descritiva para obtenção de frequência absoluta e relativa. RESULTADOS: Foram construídos os seguintes títulos diagnósticos: Dentição, prejudicada; Condição nutricional, prejudicada; Condição nutricional, positiva; Capacidade para alimentar-se, prejudicada; Emaciado (Emagrecido); Obesidade; Caquexia; Deglutição, prejudicada e Paladar, prejudicado. CONCLUSÃO: Enfatiza-se a importância da aplicação das etapas do Processo de Enfermagem, concretizando uma assistência sistematizada ao idoso. Os diagnósticos de enfermagem voltados à nutrição do idoso favorecem a formulação de intervenções com vistas a melhorar qualidade de vida e funcionamento do sistema gastrointestinal.

OBJECTIVE: To identify Nursing diagnoses for hospitalized older adults about basic human nutrition needs, using the International Classification for Nursing Practice (ICNP®). METHOD: A cross-sectional survey with a sample of 100 older adults from a hospital. For data collection, a semi-structured instrument was used, containing sociodemographic data, anamnesis and physical examination. The diagnostic statements were built from the ICNP®. Data analysis was performed using descriptive statistics to obtain absolute and relative frequency. RESULTS: The following diagnostic titles were constructed: Dentition, impaired; Nutritional condition, impaired; Nutritional condition, positive; Ability to eat, impaired; Emaciated (Thin); Obesity; Cachexia; Deglutition, impaired; and Taste, impaired. CONCLUSION: The importance of applying the stages of the Nursing Process is emphasized, providing systematic assistance to the older adult. Nursing diagnoses focused on nutrition for the older adult favor the formulation of interventions aimed at improving quality of life and functioning of the gastrointestinal system.

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Resumo Introdução A Atenção Primária à Saúde é imprescindível no cuidado ao idoso longevo, devido à heterogeneidade e a especificidade dessa população, principalmente em relação ao acesso. Objetivo Analisar a percepção sobre o acesso de longevos à Atenção Primária à Saúde na perspectiva dos profissionais da Estratégia Saúde da Família, em um município do Sul do Brasil. Método Abordagem qualitativa, exploratório, do qual participaram dez profissionais vinculados à Estratégia Saúde da Família. Os dados foram coletados por meio de entrevista, cujas perguntas sobre acesso foram adaptadas e norteadas pelo Primary Care Assessment Tool, realizando-se análise temática de conteúdo. Resultados Os participantes mencionaram como facilitadores do acesso a realização de visitas domiciliares, o acolhimento, o atendimento rápido e por demanda espontânea. Por outro lado, foram percebidas barreiras, como as unidades não estarem abertas em todos os momentos de necessidade dos longevos, falta de recepcionista, distância de outros serviços quando as unidades estão fechadas e falta de prioridade ao atendimento dos longevos. Conclusão Concluímos que na percepção dos profissionais de saúde muitos fatores do acesso estão relacionados ao processo de trabalho e há uma compreensão limitada de que o atendimento ao longevo deve ser específico devido às alterações fisiológicas e sociais nessa população.

Abstract Background Primary health care is vital in providing attention to the elderly lifelong, due to the heterogeneity and the specificity of this population, particularly in relation to access. Objective The objective of the present work was to analyze the perception of the oldest access to Primary Health Care from the perspective of professionals of the Family Health Strategy in a municipality in Southern Brazil. Method A qualitative study and exploratory, attended by ten professionals linked to the Family Health Strategy was carried out. The data were collected by means of interviews, whose questions about access were based and adapted from Primary Care Assessment Tool and analyzed according to the precepts of Thematic Content Analysis. Results The participants mentioned as facilitators of access to conducting visits, the reception and fast service and by spontaneous demand. On the other hand, there were perceived barriers, such as the units are not open at all times, lack of receptionist, far from other services when the units are closed and lack of priority to care of lived. Conclusion It is possible to conclude that, through the perception of health professionals, many factors of access are related to the process of work and there is a limited understanding of the elderly must be specific due to physiological changes and social in this population.

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Poor nutrition is a major risk factor for non-communicable diseases and nutritional deficiencies. Dietary interventions have been proposed to improve eating habits. The aim of this systematic review is to evaluate the efficacy of randomized clinical trials of nutritional interventions in food habits among older people. A systematic literature review using the MEDLINE, LILACS, Scopus, Cochrane Library, Web of Science and Google Scholar databases was conducted, according to PRISMA guidelines. The keywords were: food and nutrition education OR educación alimentaria y nutricional OR educação alimentar e nutricional AND clinical trial OR ensayo clínico OR ensaio clínico AND elderly OR aged OR anciano OR idoso AND human OR seres humanos. The pooled standardized mean differences (SMD) and 95 % confidence intervals (CIs) were estimated using a random-effects model. Heterogeneity among studies was assessed using I² tests. After screening based on the title and abstract, and a full-text assessment, 11 studies remained. Results of pooling eleven studies were as follows: SMD = 0.25 (95 % CI = 0.15 - 0.34; I² = 0,0%) for vegetable, SMD = 0.18 (95 % CI = 0.08 - 0.27; I² = 0,0%) for fruit and SMD = 0.27 (95 % CI = 0.18 - 0.36; I² = 58,3%) for fibre intake. Our results suggest that nutritional interventions were effective in increasing vegetable, fruit and fibre intake. However, these results should be analyzed carefully, due to the small number of studies included in the meta-analysis. Further studies should be encouraged due to the aging process.

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Nutrition is critical to the health of the elderly, since most of them have a deficiency in key nutrient. The use of whey protein may be a food strategy to increase protein intake. The objective of this work was to evaluate the ingestion of whey protein for the elderly and the association with physical performance and clinical outcomes. A systematic review was conducted in order to find papers that shed some light in the correlation between whey protein and the elderly. INCLUSION CRITERIA: population: elderly; intervention: use of whey protein when compared to control group; outcome: related to health, nutrition, or quality of life. DATABASE: PubMed, with papers published in the last 5 years. SEARCH STRATEGY: (elder OR senior OR elderly OR aging OR aged OR old OR older) AND (whey OR "whey protein"). 35 papers were selected of which 22 had a physical performance outcome and 13 had clinical outcomes. Studies indicate that whey protein supplements promote protein synthesis in the elderly, improving muscle performance and aerobic capacity, protecting against sarcopenia and reducing the risk for falls. In the papers studied, the age group considered to be elderly was ≥65 years in 27 papers and ≥60 years in the other 8 papers. Whey protein also appears to contribute to improved health, recovery from disease, prevention of cardiovascular and metabolic risks, and hepatic steatosis complications. Data suggest that whey protein supplements may be promising for the health improvement of the elderly.

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Objetivo: Avaliar a ocorrência de anemia e presença de enteroparasitos relacionados a condições socioeconômicas e demográficas em idosos atendidos na Estratégia Saúde da Família (ESF) no município de Aparecida de Goiânia, Goiás, Brasil. Métodos: Trata-se de um estudo transversal, realizado com idosos atendidos na ESF do município de Aparecida de Goiânia. Foram coletadas fezes frescas e recém-eliminadas, as quais foram processadas pela técnica de Hoffman, Pons e Janer de 24 horas e coletadas amostras de sangue analisadas no aparelho automatizado Pentra 60®. Realizou-se análise estatística pelo programa BioEstat® versão 5.1 com medidas de associação odds ratio entre a presença de parasitos com a anemia, e as variáveis pesquisadas com o intervalo de confiança de 95% (IC 95%) e nível de significância de 5% (p < 0,05). Resultados: Foram avaliados os materiais biológicos de 101 idosos, e, destes, 15 (14,8%) apresentaram anemia. O estado civil, sexo, renda familiar, número de pessoas em casa, ocupação, consumo de frutas, verduras e legumes e hábitos comportamentais não apresentaram significância em relação à anemia. As variáveis com associação significativa (p<0,005) foram: nível baixo de escolaridade (p=0,05) e sedentarismo com consumo de álcool e/ou tabaco (p=0,05). Na análise das fezes encontrou-se positividade em uma amostra com presença de ovo de Ascaris lumbricoides. Conclusão: Os dados sobre a ocorrência de anemia podem variar bastante, dependendo da região e população estudada. O presente estudo demonstrou os fatores socioeconômicos e geográficos associados e baixa ocorrência de anemia e associação com parasitoses. A anemia não deve ser uma condição negligenciada durante o envelhecimento, portanto merece atenção e tratamento adequado.

Objective: To evaluate the occurrence of anemia and presence of enteroparasites related to socioeconomic and demographic conditions in the elderly attending the Family Health Strategy (FHS) in the municipality of Aparecida de Goiânia, Goiás, Brazil. Methods: This is a cross-sectional study, conducted with elderly people attended at the FHS of Aparecida de Goiânia. Fresh, newly disposed stools were collected and processed by the 24-hour Hoffman, Pons, and Janer technique and blood samples were collected on the Pentra 60® automated device. Statistical analysis was performed using the BioEstat® version 5.1 program, with odds ratios, between the presence of parasites with the anemia and variables surveyed with the 95% confidence interval (95% CI) and level. significance level of 5% (p <0.05). Results: The biological materials of 101 elderly individuals were evaluated, of which 15 (14.8%) presented anemia. Marital status, gender, family income, number of people at home, occupation, consumption of fruits, vegetables and behavioral habits were not significant in relation to anemia. The variables with significant association (p <0.005) were: low level of education (p = 0.05) and physical inactivity with alcohol and / or tobacco consumption (p = 0.05). In the analysis of feces was found positivity in one sample, presence of egg Ascaris lumbricoides. Conclusion: Data on the occurrence of anemia may vary widely, depending on the region and population studied. We demonstrated the associated socioeconomic and geographic factors and low occurrence of anemia and association with parasites. Anemia should not be a neglected condition during aging, so it deserves proper attention and treatment.

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Resumo Objetivos Identificar o padrão alimentar de idosos longevos não frágeis e avaliar a associação desse padrão a composição corporal, força muscular e teste de velocidade de marcha. Métodos Estudo transversal com uma amostra de 96 idosos com idade ≥80 anos, não frágeis. O consumo alimentar foi analisado por meio de três registros alimentares não consecutivos e a massa muscular por meio da área muscular do braço. A força muscular foi medida por dinamometria. A análise de Cluster foi utilizada para distinguir os padrões alimentares. Realizou-se a análise bivariada e a Regressão de Poisson multivariado, explorando a relação dos padrões alimentares com as variáveis independentes específicas. Resultados Foram identificados dois padrões alimentares, rotulados de padrão saudável e padrão tradicional. A prevalência de baixo peso nos idosos do padrão tradicional foi 10% (IC95% 1,01-1,20) maior do que nos idosos do padrão saudável e está prevalência praticamente manteve-se (RP 1,09; IC 1,00-1,18) no modelo ajustado por funcionalidade. Quanto a classificação da área muscular do braço os idosos do padrão tradicional apresentaram 15% (IC95% 1,00-1,32) maior prevalência de baixa massa muscular, quando comparada com os idosos do padrão saudável. Essa prevalência no modelo ajustado por funcionalidade, deixou de ser estatisticamente significativa. Não foi encontrada associação do padrão alimentar com força muscular e teste de velocidade de marcha. Conclusões Os achados demonstraram que os idosos adeptos ao padrão alimentar saudável tem menor risco de baixo peso e que a baixa massa muscular está provavelmente mais associada a funcionalidade do que ao padrão alimentar.

Abstract Objectives To identify the dietary pattern of non-frail very old people and to evaluate the association of this pattern with body composition, strength, and gait speed. Methods Cross-sectional study with a sample of 96 old people aged 80 or over, non-frail. Food consumption was analyzed using three non-consecutive food records. Muscle mass was assessed using arm muscular area. Muscle strength was measured by grip strength. Cluster analysis was used to distinguish dietary patterns. Bivariate analysis and multivariate Poisson Regression were performed, exploring the relationship between dietary patterns and specific independent variables. Results Two dietary patterns were identified, labeled healthy and traditional. The prevalence of underweight among the old people of the traditional pattern was 10% (95%CI 1.01-1.20) higher than among the old people of the healthy pattern and this prevalence was practically maintained (PR 1.09; 95%CI 1.00-1.18) in the model adjusted by functionality. Regarding the classification of the arm muscular area, the old people of the traditional pattern presented 15% (95%CI 1.00-1.32) more prevalence of low muscle mass, when compared with the old people of the healthy pattern. This prevalence in the functionality-adjusted model was no longer statistically significant. No association was found between dietary pattern and strength and gait speed. Conclusions The findings showed that old people who adhere to healthy dietary patterns have a lower risk of underweight and that low muscle mass is probably more associated with functionality than with dietary patterns.

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Objetivo: avaliar a situação nutricional e dietética de idosos hospitalizados. Método: pesquisa do tipo descritiva, exploratória, transversal e quantitativa. Foi realizada com 44 idosos hospitalizados, de ambos os sexos, atendidos em um hospital público da cidade de Bocaiúva, Minas Gerais, Brasil. Para avaliar a situação nutricional e dietética dos idosos hospitalizados utilizou-se a mini avaliação nutricional. Resultados: verifica-se que 55% dos idosos apresentaram-se com baixo peso, com maior quantitativo no sexo masculino. Observou-se prevalência de hipertensão, diabetes e insuficiência cardíaca congestiva. Entre os participantes, 25% informaram que possuem alguma restrição na motilidade. Identificou que mais de 60% dos idosos utilizam acima de três medicamentos e bebem menos de cinco copos de água por dia. Conclusão: a realização de pesquisas sobre o estado nutricional de idosos e a associação de fatores que contribuem para agravar o quadro de desnutrição é fundamental para definir e acompanhar a qualidade de vida, bem como sustentar projetos terapêuticos.

Objective: to evaluate the nutritional and dietary situation of hospitalized elderly. Method: descriptive, exploratory, cross-sectional and quantitative research. It was carried out with 44 elderly inpatients, both genders, treated in a public hospital in the city of Bocaiúva, Minas Gerais, Brazil. To assess the nutritional and dietary status of the hospitalized elderly, the mini nutritional assessment was used. Results: 55% of the elderly were underweight, with higher numbers in males. Prevalence of hypertension, diabetes and congestive heart failure were observed. Among the participants, 25% reported to have some restriction on motility. Over 60% of the elderly were found to use more than three medications and drink less than five glasses of water per day. Conclusion: conducting research on the nutritional status of the elderly and the association of factors that contribute to aggravate malnutrition is fundamental to define and monitor quality of life, as well as to sustain therapeutic projects

Objetivo: valorar el estado nutricional y dietética de ancianos hospitalizados. Método: estudio descriptivo, exploratorio, transversal y el análisis cuantitativo. Se llevó a cabo con 44 ancianos hospitalizados, de ambos sexos, atendidos en un hospital público de la ciudad de Bocaiúva, Minas Gerais, Brasil. Para evaluar la situación dietética y nutricional de los ancianos hospitalizados utilizó el mini nutricional assessment. Resultados: el 55% de los ancianos tenían bajo peso, con un mayor número de hombres. Se observó prevalencia de hipertensión, diabetes e insuficiencia cardíaca congestiva. Entre los participantes, el 25% informó que tienen alguna restricción en la motilidad. Descubrió que más del 60% de las personas mayores usan más de tres medicamentos y beben menos de cinco vasos de agua al día. Conclusión: realizar investigaciones sobre el estado nutricional de los ancianos y la asociación de factores que contribuyen a agravar la desnutrición es fundamental para definir y controlar la calidad de vida, así como para sostener proyectos terapéuticos.

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INTRODUÇÃO: O Brasil apresenta um grande índice de envelhecimento populacional, característica que envolve grandes desafios, sendo um deles o processo de alimentação. Idosos que residem na zona rural possuem maior oferta de alimentos in natura, fato que ocorre pelo cultivo dos mesmos em suas residências. OBJETIVO: Avaliar o perfil alimentar da população idosa residente na zona rural do Município de Caxias do Sul. MÉTODOS: Estudo transversal cuja amostra se deu por conveniência, composta por 16 idosos de ambos os gêneros que participaram do projeto Conviver. Foi avaliado o estado mental dos participantes através do Mini Exame do Estado Mental e a ingestão alimentar por meio do recordatório alimentar de 24 horas com relato de três dias. Os dados foram analisados estatisticamente através do Teste t de Student e do Teste de Mann-Whitney através do software SPSS versão 22. RESULTADOS: O consumo de processados e ultraprocessados pelos idosos representou 30,28% do valor energético total. Os idosos apresentaram consumo acima do estabelecido pela DRI para carboidratos e abaixo para lipídios, cálcio, fibras, vitaminas A, B6 e B12. A ingestão de proteína, sódio, ferro e vitamina C estavam dentro das recomendações. CONCLUSÃO: Os idosos participantes do estudo apresentam uma alimentação rica em carboidratos, porém com deficiências de micronutrientes.

INTRODUCTION: Brazil presents a high index of population aging, a characteristic that involves great challenges, one of them being the feeding process. Older people residing in the rural area have a greater supply of in natura food, a fact that occurs through the cultivation of the same in their residences. OBJECTIVE: To evaluate the food profile of the elderly population residing in the rural area of the Municipality of Caxias do Sul. METHODS: A cross-sectional study was carried out by 16 elderly people of both sexes who participated in the Conviver project. The mental state of the participants was evaluated through the Mini Mental State Examination and food intake through a 24-hour food recall with a three-day report. Data were analyzed statistically through the Student's t-Test and the Mann-Whitney Test using SPSS software version 22. RESULTS: The consumption of processed and ultraprocessed by the elderly represented 30.28% of the total energy value. The elderly presented consumption above the established by DRI for carbohydrates and below for lipids, calcium, fiber, vitamins A, B6 and B12. The intake of protein, sodium, iron and vitamin C were within the recommendations. CONCLUSION: The elderly participants of the study presented a diet rich in carbohydrates, but with deficiencies of micronutrients.

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OBJECTIVE: The aim of this study was to assess nutritional status and associated factors in elderly individuals. METHODS: This cross-sectional study was conducted in residential homes with a probabilistic cluster sample. Two-hundred eighty-seven individuals 65-74 y of age were interviewed and examined in the city of Cruz Alta, state of Rio Grande do Sul, Brazil. A structured questionnaire was used to assess the socioeconomic, behavioral, and general health conditions; the number of present teeth were counted. Nutrition was assessed with a validated instrument-the Mini Nutritional Assessment-which classifies the patient as normal (eutrophic), at nutritional risk, or malnourished. For data analysis, the participants were categorized in eutrophic or at nutritional risk (at risk of malnutrition + malnourished). The associations were assessed by either the χ2 or Mann-Whitney tests. Uni- and multivariate Poisson regression analyses verified the associations. The significance level was set at 5%. RESULTS: The prevalence of nutritional risk was 48.4%. In the multivariate model, edentulous individuals with no complete denture or with only one complete denture (prevalence ratio PR, 1.59; 95% confidence interval [CI], 1.18-2.13) and elderly individuals with no access to the dentist (PR, 1.48; 95% CI, 1.11-1.88) presented higher potential for nutritional risk than their respective controls. CONCLUSIONS: The results showed that approximately half of the participants (48.4%) were at nutritional risk. The lack of complete or partial rehabilitation of edentulous patients and the lack of access to the dentist were associated with higher nutrition risk.

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