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- Phase angle in osteoarthritis patients, relations with pain, muscular mass and strengthPublication . Pais, Sandra; Guerreiro, Pedro; Guerreiro, Carla; Botelho, MartaSeveral researches have been carried out to see the relation between the Phase Angle (PhA), disease and several health risks factors. Ageing is associated with the loss of muscle mass and changes in body composition, which result in a decrease of the PhA. Malnutrition and inflammation have been reported to have a strong influence on PhA in diseased individuals. Subjects with Osteoarthritis (OA) have decreased muscular strength and pain. The aim of this study was to understand if the PhA was altered in patients with OA and if it's related with pain, muscular mass and strength.
- A systematic review of reviews on the psychometric properties of measures of older persons’ ability to build and maintain social relationshipsPublication . Julião, Pedro Lobo; Fernandes, Óscar Brito; Alves, Janice P; Amuthavalli Thiyagarajan, Jotheeswaran; Mikton, Christopher; Diaz, Theresa; Pais, SandraBackground Within the scope of the World Health Organisation's (WHO) world report on ageing and health and how healthy ageing was conceptualised, the WHO has been working with academia towards producing reviews of the psychometric properties of instruments that measure different domains of functional ability. This study aimed to conduct a review of reviews to examine existing and validated instruments measuring the ability of older persons to build and maintain social relationships and to evaluate the psychometric properties of these instruments.Methods We searched for studies published in the English, Spanish and Portuguese languages. No restrictions were placed on the year of publication. The following databases were searched: PubMed, Embase, Psyinfo and Cumulated Index to Nursing and Allied Health Literature. Titles and abstracts were screened and selected articles were screened and reviewed independently by two reviewers.Results A total of 3,879 records were retrieved, of which 39 records were retrieved for full-text analysis. None of the reviews met the inclusion criteria, thus resulting in an empty review.Conclusions Considering the current definition of older persons' functional ability to build and maintain social relationships, this review did not identify instruments that can measure both constructs simultaneously. We suggest the development of an instrument that simultaneously assesses the ability of older persons to build and maintain relationships.
- The frailty of the invinciblePublication . Illario, M.; Zavagli, V.; Noronha Ferreira, L.; Sambati, M.; Teixeira, A.; Lanata, F.; Pais, Sandra; Farrell, J.; Tramontano, D.The COVID-19 pandemic has unveiled the frailty of our societies from too many points of view to look away. We need to understand why we were all caught unprepared. On the one hand, we have all short memories. As we forget too quickly, we were unable to recognize key factors influencing response and preparedness to public health threats. For many years, economic evaluation pushed governments all over the world to cut resources for public health systems, with COVID-19 pandemic the question arises: do we spend too much or too little on health care? What is the right amount to spend on health? Moreover, in many countries, the privatisation, or semi-privatisation, of healthcare may give rise to inequitable access to health care for everyone. Although COVID-19 is very “democratic”, its consequences aren’t. According to OECD, income inequality in OECD countries is at its highest level for the past half century. Three main causes have been recognized, technological revolution, globalization, and “financialisation”. In this scenario, lockdown measures adopted to save lives are showing dramatic economic consequences. To address post COVID-19 reconstruction we need to go beyond GDP. As an economic measure this has many shortcomings in describing the real well-being of a country, and since what we measure affects what we do, new paradigms will have to guide the post COVID-19 reconstruction strategies, as the fate of countries and their citizens is at stake.
- Building bridges for innovation in ageing: synergies between action groups of the EIP on AHAPublication . Bousquet, J.; Bewick, M.; Cano, A.; Eklund, P.; Fico, G.; Goswami, N.; Guldemond, N. A.; Henderson, D.; Hinkema, M. J.; Liotta, G.; Mair, A.; Van Ganse, E.; Nadif, R.; Vera-Munoz, C.; Nalin, M.; Navarro-Pardo, E.; Malva, J.; Nekam, K.; Ninot, G.; Bousquet, P. J.; Kuna, P.; Magnan, A.; Paccard, D.; Pais, Sandra; Palummeri, E.; Panzner, P.; Van Hage, M.; Avignon, A.; Papadopoulos, N. K.; Schmid-Grendelmeier, P.; Papanikolaou, C.; Visser, F.; D'Angelantonio, M.; Pavlickova, A.; Passalacqua, G.; Pastorino, M.; Pastor, E.; Perrot, M.; Plavec, D.; Popov, T. A.; Postma, D. S.; Van den Berge, M.; Schulz, H.; De Carlo, G.; Price, D.; Farrell, J.; Bachert, C.; Raffort, N.; Reuzeau, J. C.; Robalo-Cordeiro, C.; Robine, J. M.; Ventura, M. T.; Schunemann, H. J.; Serrano, E.; Cholley, D.; Fiocchi, A.; Macnee, W.; Correia-Da-Sousa, J.; Sheikh, A.; Bel, E.; Shields, M.; Siafakas, N.; Scichilone, N.; Siciliano, P.; Skrindo, I.; Chorin, F.; Ranberg, K. Andersen; Vergara, I.; Wagner, A.; Dedeu, T.; Smit, H. A.; Sruk, V.; Sourdet, S.; Sousa-Costa, E.; Spranger, O.; Benson, M.; Gouder, C.; Sooronbaev, T.; Carriazo, A. M.; Vezzani, G.; Vidal, D.; Ferrando, M.; Fletcher, M.; Koppelman, G. H.; Blasi, F.; Siciliano, P.; Viegi, G.; Combe, B.; Wagemann, M.; Whalley, B.; Wickman, M.; Wilson, N.; Yiallouros, P. K.; Ferri, M.; Zagar, M.; Fonseca, J.; Zaidi, A.; Crooks, G.; Compas, B.; Kotska, T.; Teixeira, A. M.; Zidarn, M.; Molloy, W.; Hoogerwerf, E. J.; Usero, J.; Bernard, P. L.; Zuffada, R.; Senn, A.; Marcucci, M.; Camuzat, T.; De Oliveira-Alves, B.; Gutter, Z.; Iaccarino, G.; Manuel De Keenoy, E.; Tsartara, S. I.; Kovac, M.; Moda, G.; Fokkens, W. J.; Rodriguez-Manas, L.; Barbara, C.; Baroni, I.; Vontetsianos, T.; Fougere, B.; Abreu, C.; Alonso, J.; Alonso-Bouzon, C.; Ankri, J.; Arredondo, M. T.; Valiulis, A.; Garcia-Lizana, F.; Avolio, F.; Bergmann, K. C.; Kull, I.; Bedbrook, A.; Bialoszewski, A. Z.; Gamkrelidze, A.; Blain, H.; Vasankari, T.; Guerin, O.; Hellings, P. W.; Rodenas, F.; Valero, A. L.; Costa, D. J.; Haahtela, T.; Kvedariene, V.; Illario, M.; Inzerilli, M. C.; Carlsen, K. C. Lodrup; Kardas, P.; Keil, T.; Bonini, S.; Vellas, B.; Robusto, F.; Costa, E.; Maggio, M.; Murray, R.; Mendez-Zorrilla, A.; Menditto, E.; Mercier, J.; Lepore, V.; Michel, J. P.; Branchini, B.; Vollenbroek-Hutten, M.; Wickman, M.; Coste, O.; Roche, N.; Sterk, P. J.; Roller-Wirnsberger, R. E.; Garces, G.; Yorgancioglu, A.; Zuberbier, T.; Barbagallo, M.; Canonica, G. W.; Klimek, L.; Maggi, S.; Coupet, A. -L.; Aberer, W.; Romano, A.; Akdis, C.; Brightling, C. E.; Todo-Bom, A.; Garcia-Aymeric, J.; Adcock, I. M.; Apostolo, J.; Agache, I.; Albera, C.; Majer, I.; Alonso-Trujillo, F.; Angel Guarcia, M.; Vandenplas, O.; Annesi-Maesano, I.; Bruguiere, V.; Bunu, C.; Bush, A.; Garcia-Zapirain, B.; Touchon, J.; Monaco, A.; Nizinska, A.; Caimmi, D. P.; Maggio, M.; Calderon, M. A.; Romano, V.; Canovas, G.; Cardona, V.; Carlsen, K. H.; Cesario, A.; Chkhartishvili, E.; Gemicioglu, B.; Crepaldi, G.; Chiron, R.; Tramontano, D.; Chivato, T.; Chung, K. F.; Rosado-Pinto, J.; Monsonis-Paya, I.; Hellquist-Dahl, B.; Custovic, A.; Dahl, R.; Bourret, R.; Samolinski, B.; Dahlen, S. E.; Triggiani, M.; Demoly, P.; Devillier, P.; Didier, A.; Dinh-Xuan, A. T.; Djukanovic, R.; Manning, P.; Hermosilla-Gimeno, I.; Cabrera-Umpierrez, M. F.; Dokic, D.; Emuzyte, R.; Papadopoulos, H.; Du Toit, G.; Dubakiene, R.; Tsartara, S. I.; Dupeyron, A.; Marti, T.; Heve, D.; Holland, C.; Catala, A.; Nogues, M.; Bescos, C.; Roubille, F.; Humbert, M.; Pecorelli, S.; Hyland, M.; Johnston, S. L.; Just, J.; Jutel, M.; Kaidashev, I. P.; O'Caoimh, R.; Khaitov, M.; Masoli, M.; O'Byrne-Maguire, I.; Ruiz, F.; Kalayci, O.; Kowalski, M.; Kalyoncu, A. F.; Keijser, W.; Kerstjens, H.; Prados-Torres, A.; Vandenplas, O.; Knezovic, J.; Melen, E.; Miculinic, N.; Mihaltan, F.; Ryan, D.; Pappa, D.; Arshad, S. H.; Somekh, D.; Valovirta, E.; Milenkovic, B.; Cesari, M.; Millot-Keurinck, J.; Mlinaric, H.; Momas, I.; Montefort, S.; Morais-Almeida, M.; Salcedo, T.; Moreno-Casbas, T.; Parent, A. S.; Moesges, R.; Mullol, J.; Chavannes, N. H.; Attalin, V.The Strategic Implementation Plan of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) proposed six Action Groups. After almost three years of activity, many achievements have been obtained through commitments or collaborative work of the Action Groups. However, they have often worked in silos and, consequently, synergies between Action Groups have been proposed to strengthen the triple win of the EIP on AHA. The paper presents the methodology and current status of the Task Force on EIP on AHA synergies. Synergies are in line with the Action Groups' new Renovated Action Plan (2016-2018) to ensure that their future objectives are coherent and fully connected. The outcomes and impact of synergies are using the Monitoring and Assessment Framework for the EIP on AHA (MAFEIP). Eight proposals for synergies have been approved by the Task Force: Five cross-cutting synergies which can be used for all current and future synergies as they consider overarching domains (appropriate polypharmacy, citizen empowerment, teaching and coaching on AHA, deployment of synergies to EU regions, Responsible Research and Innovation), and three cross-cutting synergies focussing on current Action Group activities (falls, frailty, integrated care and chronic respiratory diseases).
- Can osteoarthritis, sarcopenia and body composition predict loss of function?Publication . Pais, Sandra; Botelho, Marta; Moreira, Rita; Guerreiro, CarlaBackground: Elderly populations e growing in the majority of Countries in the World. Portugal in currently among the 5 most aged counties with 23,4% of it´s population over 65 and an ageing index of 182[1]. Osteoarthritis is the 3rd cause of responsible for severe disability in adults over 60 years in developed and developing countries[2]. Lack of data at a national or regional level in Portugal compromises the ability to prepare for both health and care need of aged population. Simultaneously the region of Algarve has particular geographic characteristics with 49% of the population living within 2 km from the cost (in 9% of the Algarve’s Territory). Objectives: Are aim was to study our regional population, namely the incidence of Osteoarthritis (OA) and the relation of function ability with OA, Sarcopenia and Body composition.
- Prediction of short-term prognosis in elderly patients with spontaneous intracerebral hemorrhagePublication . Batista, António; Osório, Rui; Varela, Ana; Guilherme, Patrícia; Marreiros, Ana; Pais, Sandra; Nzwalo, HipólitoAim The incidence of spontaneous intracerebral hemorrhage (SICH) increases with age. Data on SICH mortality in the very old are sparse. We aimed to describe the predictors of 30-day SICH mortality in the very elderly in southern Portugal. Methods A total of 256 community representative SICH patients aged >= 75 years (2009-2016) were included. Multiple logistic regression was used to identify predictors of 30-day mortality. Results Mean age was 82.1 years; 57.4% males. The 30-day case fatality was 38.7%. The frequency of patients taking anticoagulants (29.3% vs. 11.5%); comatose (46.9% vs. 2.5%); with hematoma volume >= 30 mL (64.6% vs. 13.4%); intraventricular dissection (78.8% vs. 27.4%) was higher in deceased patients (p < 0.05). Survivors were more often admitted to stroke unit (SU) (68.2 vs. 31.3%) and had lower mean admission glycaemia values (p < 0.05). The likelihood of death was increased in patients with higher admission hematoma volume (>= 30 mL) (OR: 8.817, CI 1.753-44.340, p = 0.008) and with prior to SICH history of >= 2 hospitalizations OR = 1.022, CI 1.009-1.069, p = 0.031). Having higher Glasgow coma scale score, OR: 0.522, CI 0.394-0.692, p < 0.001, per unit was associated with reduced risk of death. Age was not an independent risk factor of short-term death. Conclusions The short-term mortality is high in very elderly SICH. Prior to SICH history of hospitalization, an indirect and gross marker of coexistent functional reserve, not age per se, increases the risk of short-term death. Other predictors of short-term death are potentially manageable reinforcing the message against any defeatist attitude toward elderly patients with SICH. Key summary pointsAim Identification of predictors of short-term death after spontaneous intracerebral hemorrhage (SICH) in the elderly. Findings The short-term case fatality (38.7%) after SICH is high in the elderly. Hematoma volume, decreased level of consciousness and functional reserve, but not age per se, increase the risk of short-term death. Message Age per se should not justify any decision of withholding best treatment in elderly SICH patients. Offering the best acute treatment can potentially improve the clinical outcome.
- 2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or olderPublication . Adams, Jo; Wilson, Nicky; Hurkmans, Emalie; Bakkers, Margot; Balážová, Petra; Baxter, Mark; Blavnsfeldt, Anne-Birgitte; Briot, Karine; Chiari, Catharina; Cooper, Cyrus; Dragoi, Razvan Gabriel; Gäbler, Gabriele; Lems, Willem; Mosor, Erika; Pais, Sandra; Simon, Cornelia; Studenic, Paul; Tilley, Simon; de la Torre-Aboki, Jenny; Stamm, Tanja AObjective To establish European League Against Rheumatism (EULAR) points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older. Methods Points to consider were developed in accordance with EULAR standard operating procedures for EULAR-endorsed recommendations, led by an international multidisciplinary task force, including patient research partners and different health professionals from 10 European countries. Level of evidence and strength of recommendation were determined for each point to consider, and the mean level of agreement among the task force members was calculated. Results Two overarching principles and seven points to consider were formulated based on scientific evidence and the expert opinion of the task force. The two overarching principles focus on shared decisions between patients and non-physician health professionals and involvement of different non-physician health professionals in prevention and management of fragility fractures. Four points to consider relate to prevention: identification of patients at risk of fracture, fall risk evaluation, multicomponent interventions to prevent primary fracture and discouragement of smoking and overuse of alcohol. The remaining three focus on management of fragility fractures: exercise and nutritional interventions, the organisation and coordination of multidisciplinary services for post-fracture models of care and adherence to anti-osteoporosis medicines. The mean level of agreement among the task force for the overarching principles and the points to consider ranged between 8.4 and 9.6. Conclusion These first EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older serve to guide healthcare practice and education.
- Global geriatric evaluation of the Algarve populationPublication . Braz, Nídia; Pais, Sandra; Cordeiro, Clara; Oliveira, Giovanna; Conde, MonserratThe ageing of population challenges communities to adapt and evolve to accommodate the needs of people that live longer (mostly out of work, either healthy, fragile or with chronic disease). Population ageing in the Algarve is higher than in overall Portugal. Studies on health conditions, frailty risk factors and elderly specific needs are undeveloped in Portugal and unknown in the Algarve. Objective To prepare a tool for Global Geriatric Evaluation, to be used in the “Survey of Health and Ageing in the Region of Algarve - SHARA”, a commitment to “European Innovation Partnership on Active and Healthy Ageing”. Methods A preliminary version of the screening tool, which includes well-known instruments to measure health condition (EASY-care), risk of fall (Tinetty), physical activity (Baecke’s modified questionnaire), nutritional condition (MNA), cognitive and depressive status (MMSE, Yesavage geriatric depression scale), together with socio-demographic characteristics, was applied to an independent sample of subjects from an elderly community centre - ARPI (“Associação de Reformados, Pensionistas e Idosos do Concelho de Faro”), with ages between 55 and 89. Results ARPI is mostly frequented by women, who either have risk of malnutrition or malnutrition incidence, a relevant risk of fall or are physically active. Those who live alone, show a higher risk of fall. Conclusions ARPI members are active, but with risk of malnutrition and fall, suggesting the relevance and importance of future interventions in these areas. The proposed screening tool showed to be adequate for the SHARA study, suitable to provide wider information on frailty.
- A study on the influence of prosthetic interface material in transtibial amputees’ gaitPublication . Cavaco, Adriana; Durães, Luísa; Ramalho, Amílcar; Pais, SandraInterfaces of transtibial prosthesis have an important role in the transmission of ground reaction forces, damping gait loads and tissue protection.
- Ageing, Health-Related Quality of Life and Physical Activity – Evidence Based on the EQ-5D-5LPublication . Ferreira, Lara; Pais, Sandra; Ilchuk, Kateryna; Custódio Santos, MargaridaAs a result of increasingly senior populations worldwide, healthy ageing is becoming an important factor that can help reduce the burden of disease and disability and related healthcare costs. Previous research has shown that physical activity (PA) is crucial for healthier ageing and a better quality of life. This study sought to measure the PA and health-related quality of life (HRQoL) of people 55 years old or more. A sample of 202 senior adults completed a survey that comprised the EQ-5D-5L and other items assessing PA and activities of daily living (ADL) performance. Descriptive statistical analyses were carried out to characterise the sample and define its HRQoL. Non-parametric tests were used to compare the respondents' HRQoL according to sociodemographic variables and PA and ADL performance. The level of agreement between HRQoL and ADL scores was assessed using Spearman's rho. Sample subgroups were compared according to their age (i.e. nearly senior and senior) and sport and leisure time activities. Results show that HRQoL is lower for respondents with at least one diagnosed disease. Senior adults who take part in sport and leisure activities overall have a higher HRQoL, which is also impacted by the presence of at least one diagnosed disease and individuals' natural age-related issues. The results show the importance of preventing disease by helping senior adults engage in some level of PA given its impact on HRQoL. This research also confirmed that the EQ-5D-5L is a valid tool for measuring senior people's HRQoL.