[Show abstract][Hide abstract] ABSTRACT: Background: the aim of the study was to evaluate the relationship between type 2 diabetes (T2DM), depression and depressive symptoms and their clinical impact on T2DM. Methods: the authors evaluated 214 outpatients, 105 with diabetes (T2DM group) and 109 non-diabetics (control group), with ages ranging between 50 and 75 years (T2DM group 65.1 ± 5.6 years, control group 63.4 ± 5.8 years). Use of antidepressant treatment or score ≥ 16 on the Beck depression inventory (BDI) was considered depression. Complications of diabetes and total symptom score (TSS) for peripheral neuropathy were reported by patients. Results: diabetes group had a higher frequency of depression (35.2%) compared to controls (21.1%) (p=0,021), with 2.4 times increased risk of depression. The presence of depressive symptoms was also higher in T2DM group (mean BDI 9.5 ± 8.8 versus 6.9 ± 6.2; p=0.039). Symptoms of diabetic neuropathy were higher in depressed subjects. The metabolic control and presence of complications in T2DM group were not associated with depression. Conclusion: T2DM led to an increased risk of depression, but this did not influence the metabolic control or the presence of other complications.
[Show abstract][Hide abstract] ABSTRACT: The menopausal transition can be categorized into several stages, which are accompanied by various changes that may have a significant impact on quality of life. Vasomotor symptoms (VMS) usually appear in the beginning of the menopausal transition and may persist until the end of life. These symptoms are common reasons for seeking medical care and include hot flashes or night sweats which last from 1 to 15 min and may involve sweating, palpitations, nausea, dizziness, chills, pain, or pressure in the head or chest; changes in breathing patterns and heart rate; and sleep disturbances. Although their physiopathology is not well known, it is thought that hot flashes may be caused by increased thermoregulatory responses, which lead to intense sensations of heat and flushing, accompanied by an increase in blood flow. The incidence and intensity of VMS may vary according to clinical factors such as ethnicity, obesity, and mood. Although several hormonal and nonhormonal treatments may be used to treat VMS, their risks and benefits should always be weighed on a case-by-case basis. To further explore this issue, this chapter will review the physiopathology, epidemiology, and treatment of VMS.
[Show abstract][Hide abstract] ABSTRACT: Quality of life (QOL) has been defined in several different ways by different authors and studies. In an attempt to operationalize this concept, a number of instruments have been developed to transform subjective QOL information into objective and measurable data which could be used to develop health-care policies and programs to improve health and health-related QOL in individuals and populations. Currently, several specific and generic QOL instruments are available in the literature, and investigators suggest that both types of evaluation be used in order to provide an accurate assessment. Periods of life such as the climacteric are associated with symptoms that may have a significant impact on QOL. These are often influenced by women’s beliefs and attitudes about menopause itself. A number of tools have been developed to assess the influence of such symptoms on QOL, and the development and use of each of these instruments will be discussed in this chapter.
[Show abstract][Hide abstract] ABSTRACT: Objectives:
The aim of the present study was to evaluate the functional mobility and its relationship to cognitive ability in patients with type 2 diabetes (T2DM), age between 50 and 65 years and under 10 years of diagnosis.
Materials and methods:
An observational, analytical and cross-sectional study, involving no diabetic and type 2 diabetic individuals with inadequate glycemic control, selected by convenience sampling. In both groups, were administered structured questionnaire and cognitive assessment with Mini-Mental State Examination (MMSE) and the clock drawing test (CDT), besides assessment of functional mobility by the Timed Up & Go (TUG).
In TUG, DM2 patients presented a mean time of 11.27 seconds versus 9.52 seconds (p = 0.013). The association between cognitive decline and decrease of mobility was positive in individuals with T2DM (p = 0.037). In the subgroup that showed decrease of mobility and associated cognitive decline, 18% were patients with DM2 and 1.6% were individuals without T2DM (p < 0.01).
Patients with T2DM presented worse functional mobility and cognitive performance, supporting the hypothesis that DM2 influence functional mobility and cognitive ability, regardless of neuropathic or vascular complications. These data suggest that hyperglycemia is an aggravating factor in the performance of activities requiring mental functions such as attention, working memory and orientation.
Full-text · Article · Dec 2014 · Arquivos Brasileiros de Endocrinologia & Metabologia
[Show abstract][Hide abstract] ABSTRACT: To compare frequency and risk of falls based on a functional mobility test in diabetic and non-diabetic individuals.
Cross-sectional study involving patients with and without type 2 diabetes mellitus (DM2) selected by convenience sampling. Men and women between the ages of 50 and 65 were included and divided as group 1 (G1) - with DM2 diagnosis for < 10 years fasting blood glucose at interview/test time, as well as prior > 200 mg/dL; and group 2 (G2) - no diabetes, same age group, and fasting blood glucose < 100 mg/dL. Both groups responded to a structured questionnaire about their health, fall risk, and underwent a physical exam and a mobility assessment test (Timed Up and Go - TUG). The results were analyzed by the software SPSS, with TUG being categorized in ranges of risk for fall. We considered that the risk was positive for all those who fit into medium- and high-risk range.
Fifty patients with DM2 and 68 patients without DM2 were assessed. There were no statistical differences in the number of falls between the groups, however non-diabetic subjects obtained a higher performance in TUG test (p = 0.003) as the risk categories were observed. Reduced visual acuity and difficulty in getting up were more frequently reported in G1 (p < 0.05).
There appears to be an association between hyperglycemic status and poorer mobility, with an increased fall risk even in younger patients and in those with shorter disease duration.
Preview · Article · Apr 2012 · Revista da Associação Médica Brasileira
[Show abstract][Hide abstract] ABSTRACT: To verify the prevalence of women with risk of fractures estimated by ultrasonometry of the calcaneus (UOC) in a population of elderly women and its association with clinical risk factors.
Cross-sectional study of which sample was randomly selected and submitted to a structured questionnaire about risk factors for fractures. All women underwent UOC.
We studied 168 Caucasian postmenopausal women, with a mean age of 69.56 ± 6.27 years; 81% of these women had abnormal test results and 41% of the abnormal results were considered higher risk. Women with abnormal test results had lower weight, height and BMI, and had lower values of SOS, BUA, BQI and T-score. After adjustment, BMI remained significant for abnormal UOC (OR = 3.37, 95% CI: 1.19 9.56, p = 0.02), and history of previous fractures for UOC of the higher risk range (OR = 4.44, 95% CI: 1.16-16.96, p = 0.03).
We observed a high prevalence of risk of fractures determined by the UOC. Our prevalence was higher than those in other Brazilian studies. There was an association between UOC and BMI and previous history of fractures.
Full-text · Article · Dec 2011 · Revista da Associação Médica Brasileira
[Show abstract][Hide abstract] ABSTRACT: To investigate the relationship between quality of life and spinal fracture in women aged over 60 living in Southern Brazil.
A case-control study was conducted with the application of the WHOQOL-bref questionnaire to 100 women living in the city of Chapecó (SC), aged over 60, postmenopausal, white or Caucasian, with no important cognitive impairment or a history of diseases known to affect bone metabolism, or malignant neoplasias. The population was divided into two groups depending on the presence or absence of fractures in the spine radiography. We analyzed variables related to the current and previous medical history, life habits and family history of fractures, and the domains and facets that compose the WHOQOL-bref. All participants were informed about the objectives and methodologies adopted and gave written informed consent to participate in the study.
The mean age of the women in the fracture group was older than that of women with fractures (p<0.05). Also women with fractures tended to belong to a higher social class, to have more years of study, a higher family income, and a greater use of alcoholic drinks (p<0.05). In the evaluation of the WHOQOL-bref domains, the fracture group had the highest average in the psychological field (χ=63.6±3.0) and the lowest in the environment field (χ=9.3±58.8). In the group without fracture, the highest average also occurred in the psychological domain (χ=67.2±9.3) and the lowest in the field of social relations (χ=57.5±7.7). Statistical analysis showed no significant correlation between the averages of the facets that make up the areas between the groups with and without fractures.
This study suggests that there is no impairment of quality of life among older women with vertebral fractures, but the relation between QL and time of occurrence and severity of the fractures should be better evaluated. Both groups had higher scores in the psychological domain, showing that the respondents rely on personal beliefs, spirituality and religion, accept their physical appearance while maintaining self-esteem and the ability to think, to learn and to concentrate despite the presence of this disease. There was no statistically significant difference between groups or between domains in the same group.
No preview · Article · May 2011 · Revista brasileira de ginecologia e obstetrićia: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia
[Show abstract][Hide abstract] ABSTRACT: Fractures are the main problems related to bone fragility in postmenopausal women and account for the increase in the risk of new fractures, mortality, and costs. This study's objective was to verify the occurrence of vertebral fragility fracture and correlate it with demographic, behavioral, and clinical factors in a Brazilian population. The cross-sectional study was based on a random sample of elderly women living in Chapecó, Santa Catarina State, Brazil. The sample consisted of 186 white women over 60 years of age. Of these, 48.9% had asymptomatic vertebral fractures, with higher prevalence in T11-12 and L4-5. Adjusted analysis showed a gradient between age and vertebral fracture, while fracture prevalence was 2.3 times higher in women over 80 years. Fracture prevalence was 1.44 times higher in sedentary as compared to non-sedentary women. Due to the high prevalence of asymptomatic vertebral fractures, the authors suggest the use of spinal x-rays in elderly women for fracture screening and prevention.
Full-text · Article · Sep 2010 · Cadernos de saúde pública / Ministério da Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: A strong aging tendency is currently being observed in the world population, leading to an increase n the prevalence of such diseases as osteoporosis and fractures. This study aimed to determine the prevalence of fracture risk, estimated by quantitative ultrasound of the calcaneus in a population of postmenopausal women residing in the Ilha de Paquetá neighborhood of Rio de Janeiro, Brazil. We conducted anthropometric measurements and quantitative ultrasound of the calcaneus using Sonost 2000 in 385 postmenopausal women. Some 59.22% of the sample showed a T-score < -1, while 16.88% had T-score < -2.5. The test parameters varied with increasing age, with a statistically significant difference (p < 0.05) between fracture risk groups according to age, time since menopause, weight, BMI, and body fat. There was a correlation between sound velocity and BMI (r = 0.155; p = 0.002). We concluded that some 60% of the female study population showed some degree of fracture risk. The women at highest risk (T-score < -2.5) were older, with more time since menopause, and had higher weight and BMI as compared to the other groups.
Preview · Article · Mar 2007 · Cadernos de Saúde Pública
[Show abstract][Hide abstract] ABSTRACT: Observa-se uma forte tendência de envelhecimento da população mundial levando a um aumento da prevalência de doenças como a osteoporose e fraturas. O objetivo deste estudo foi determinar a prevalência de risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres na pós-menopausa, residentes na Ilha de Paquetá, Rio de Janeiro, Brasil. Realizamos medidas antropométricas e ultra-sonometria óssea de calcâneo com aparelho Sonost 2000 em 385 mulheres pós-menopausadas. Observamos que 59,22% da amostra apresentava T-score < -1, sendo que 16,88% tinham T-score < -2,5. Houve variação em todos os parâmetros do exame conforme o aumento da idade, e diferença estatisticamente significativa (p < 0,05) entre os grupos de risco para fratura por idade, tempo de menopausa, peso, IMC e percentual de gordura corpórea. Houve correlação entre velocidade do som e IMC (r = 0,155; p = 0,002). Concluímos que cerca de 60% da população feminina estudada apresenta algum grau de risco para fraturas. As mulheres do grupo de maior risco (T-score < -2,5) eram mais velhas, com maior tempo de menopausa, maior peso e IMC do que as dos outros grupos.
Preview · Article · Feb 2007 · Cadernos de Saúde Pública