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Background: Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives. Method: A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software. Results: Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis-"Expanding the personal and social development of older adults through smartphone communication"-around which three main categories emerged: 1) The smartphone as "a window to the world"; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones. Conclusions: The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.

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OBJECTIVE: To determine the best indicator of mobility decline between dynapenia, low skeletal muscle mass index (SMMI), and sarcopenia defined by the EWGSOP2 using different cutoff points for grip strength. METHODS: A longitudinal study was conducted with a follow-up of eight years, involving 2,680 individuals aged 60 and older who participated in the ELSA study with a walking speed greater than 0.8 m/s at baseline. Dynapenia was defined using different cutoff points for grip strength. SMMI was defined by the 20th percentile of the entire ELSA sample distribution and sarcopenia was defined based on the EWGSOP2, using different cutoff points for grip strength. Mobility was analysed using the walking speed test. RESULTS: Over time, the greatest decline in walking speed occurred in dynapenic women with grip strength < 17 kg (-0.005 m/s per year; 95 % CI: -0.01 to -0.001) and < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001). With regards to sarcopenia, the greatest walking speed decline occurred in women with probable sarcopenia when defined by grip strength < 17 kg [(-0.006 m/s per year; 95 % CI: -0.01 to -0.001) or grip strength < 20 kg (-0.007 m/s per year; 95 % CI: -0.01 to -0.001)]. Dynapenia in men as well as low SMMI and sarcopenia in men and women did not enable identifying the risk of mobility decline. CONCLUSION: Dynapenia and probable sarcopenia defined by grip strength < 17 kg and < 20 kg enabled identifying walking speed decline over time only in women.

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The food industry is challenged to develop nutritious and palatable foods that satisfy older people's needs. So, this work aimed to study the incorporation of nanoemulsions enriched with vitamin D3 and omega-3 fatty acids into two desserts (yogurt and fruit puree), characterizing their nutritional profile, viscosity, and color properties and evaluating their in vitro bioaccessibility and sensory response. The results showed that adding nanoemulsion modified the nutrition profile of desserts due to increasing lipids and calories. The desserts' physical properties were also affected, with a decrease in viscosity and a lightening of color. Regarding digestion, the enriched desserts presented a low release of free fatty acids (14.8 and 11.4%, respectively). However, fruit puree showed the highest vitamin D3 and omega-3 fatty acid in vitro bioaccessibility (48.9 and 70.9%, respectively). In addition, older consumers found this dessert more acceptable than yogurt due to the adequate intensity of its sensory attributes (aroma, flavor, sweetness, and consistency). Therefore, the fruit puree can be enriched with nanoemulsions loaded with vitamin D3 and omega-3 fatty acids to improve the bioaccessibility of lipid bioactive compounds and sensory performance, offering a health-enhancing option for older consumers.

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BACKGROUND: National and international guidelines on frailty assessment and management recommend frailty screening in older people. This study aimed to determine how Brazilian healthcare professionals (HCPs) identify and manage frailty in practice. METHODS: An anonymous online survey on the assessment and management of frailty was circulated virtually through HCPs across Brazil. RESULTS: Most of the respondants used non-specific criteria such as gait speed (45%), handgrip strength (37.6%), and comprehensive geriatric assessment (33.2%). The use of frailty-specific criteria was lower than 50%. The most frequently used criteria were the Frailty Index (19.1%), Frailty Phenotype (13.2%), and FRAIL (12.5%). Only 43.5% felt confident, and 40% had a plan to manage frailty. In the multivariate-adjusted models, training was the most crucial factor associated with assessing frailty, confidence, and having a management plan (p < 0.001 for all). Those with fewer years of experience were more likely to evaluate frailty (p = 0.009). Being a doctor increased the chance of using a specific tool; the opposite was true for dietitians (p = 0.03). Those who assisted more older people had a higher likelihood of having a plan (p = 0.011). CONCLUSION: Frailty assessment was heterogeneous among healthcare professions groups, predominantly using non-specific criteria. Training contributed to frailty assessment, use of specific criteria, confidence, and having a management plan. This data informs the need for standardized screening criteria and management plans for frailty, in association with increasing training at the national level for all the HCPs who assist older people.

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Background: Metabolic Syndrome is a set of disorders that characterized by the association of three or more risk factors, like the obesity central, dyslipidemia, borderline blood pressure, hyperglycemia, and the increase of triglycerides. However, these factors also can be associated with pathophysiology of frailty. Objectives: verifying whether the metabolic syndrome is associated to the positive frailty screening in the older people. Design: Cross-sectional study. Participants: 443 older people living in Rio Branco, Brazil. Setting: Data collection was carried out in two stages: a personal interview and blood collection. Measurements: The diagnosis of metabolic syndrome was based on the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. The frailty screening was performed using subjective questions validated in a previous study. Descriptive statistics and multinomial logistic regression were used for data analyses. Results: There was a predominance of female older people (69.07%), aged between 60 and 79 years (87.13%), with an income greater than or equal to one minimum wage (72.09%), no cognitive decline (75.94%) and depressive symptoms (63.31%), independent for BADL (86.46%) and dependent for IADL (51.69%). From the total sample, 56.88% of the older people were identified as frail, 34.09% pre-frail and 9.03% non frail. The prevalence of metabolic syndrome was 51.69%. After adjusting by the independent variables, an association between metabolic syndrome and pre-frailty was observed, and older people with metabolic syndrome were more likely to be prefrail (RRR=2.36; 95%CI=1.08-5.18). Conclusion: The metabolic syndrome was associated to the increase chance of screening for prefrailty in the older people evaluated, which reinforces the needy to establish preventive measures in relation to the metabolic syndrome to avoid frailty in the older people.

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Introduction and objective: The COVID-19 pandemic has caused mental health problems worldwide. Older people have been particularly affected by the lockdown as their health conditions have changed, although they have been kept in isolation to avoid exposure to contagion. We sought to determine the association between lifestyles and anxiety in older adults during the COVID-19 pandemic. Materials and methods: This study was cross-sectional. We enrolled 150 older adults of both sexes and with a history of chronic diseases from the municipality of El Agustino (Lima, Peru). The 20-item Geriatric Anxiety Scale and the 25-item Lifestyle Questionnaire on eating, physical activity, rest, and sleep were administered in Spanish during July-August 2021. Results: The mean age was 70.8 ± 8.1 years, 54.7% were male, and 75.3% practiced exercise. During the COVID-19 pandemic, 99.3% of the elderly had healthy lifestyles and 40% presented anxiety (mild, moderate, and severe anxiety in 26.7%, 8.7%, and 4.7%, respectively). We found no association between anxiety and lifestyle (p = 0.189), physical exercise was a predictor of lifestyle (p < 0.001) and we did not find predictors of anxiety symptoms (p > 0.05). Conclusions: Our results suggest that there was no link between anxiety symptoms and lifestyle in older adults during the lockdown. It is important to conduct in-depth research on factors associated with anxiety symptoms among older residents in other regions, focusing on population groups with the highest rates of infection and death from COVID-19.

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INTRODUCTION: The study of frailty and its effect on the risk of mortality in older people is of utmost importance, but understanding the critical factors is still limited. Our main objective was to analyze the association of frailty with all-cause mortality in a prospective community cohort of older people. METHODS: A five-year longitudinal follow-up study was conducted with 1,174 community-dwelling older adults (men and women≥65 years old) from different Family Health Centers and community groups from Chile. We evaluated the functional risk, socioeconomic status, and anthropometric variables. The frailty status was evaluated by modified Fried criteria. RESULTS: The diagnosis of frailty was reached in 290 older adult participants, who had significantly increased 5-year all-cause mortality independently of age, sex, cognitive impairment, and socioeconomic status (adjusted HR 1.51, 1.06-2.15). CONCLUSION: Frailty is a predictor of increased mortality independently of age, sex, socio-economic and cognitive factors.

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Introduction: Older people are the group with the greatest digital gap, so their digital literacy is important to improve the conditions in which they age. Methods: A study was conducted with pre- and post-evaluation of a digital literacy (DL) intervention in people aged 60 years and over. A total of 56 participants (experimental group N = 32 and control group N = 24) were recruited for convenience in community centers. The intervention was adapted to the needs of the participants, there were five face-to-face sessions and remote reinforcement for three months, carried out by trained university students for five months. Sociodemographic variables such as self-perception of socioeconomic level and education, among others, were evaluated. The impact was assessed using the digital literacy scale (MDPQ16), indicators of frequency and types of internet and mobile phone use, health literacy (SAHLSA and NSV), quality of life (SF-12), hedonic well-being (Diener's SWLS and Cummins' PWI) and perceived social support using the Zimet scale. Results: The intervention had a significant impact with an effect size of r = 0.27 on digital literacy, separate t-test comparisons revealed a markedly significant change for digital literacy in the experimental group, before and after the pre-post t-test(31) = 3.56, p = 0.001, but not in the control group, t(23) = 0.082, p = 0.93. No direct impact on health literacy, health-related quality of life, and hedonic well-being was identified. We examined the indirect impact of change in digital literacy and found that it correlated with improvements in well-being and social support, as well as quality of life. Individuals with significant changes were detected and compared with those who did not change. Discussion: Evaluation that contributes by identifying elements for improvement in future interventions and discusses the importance of culturally adapting continuing education in older people.

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SUMMARY: Frailty affects the functional autonomy (FA) of older adults and could manifest itself in muscle imbalances in the limbs, resulting in a disparity in size and strength between them. In Chile, information on the relationship between muscle strength (MS) levels and FA asymmetries in older women is limited. This study related the levels of MS, anthropometric parameters, and asymmetries of the lower and upper limbs, with the FA of a group of older Chilean women. The study included 39 women who participated, and their FA was evaluated using the GDLAM index (IG). Based on the score obtained in the IG, they were classified by percentiles as Group 1 with favorable FA (P ≤ 50) and Group 2 with low FA (P > 50). Anthropometric parameters were BMI, fat percentage, bone mass, circumferences (arm, thigh, calf), diameters (humerus, femur) and upper/lower limb strength was evaluated to determine asymmetries. The differences between the covariates of both groups were evaluated using the student's t test and the Mann-Whitney test for independent samples. G1 presented less asymmetry (p > 0.05) in the lower limbs and greater calf circumference than G2 (p < 0.05). G1 presented greater bilateral strength (dominant and non-dominant limb) compared to G2 (p < 0.05). The covariates of age, anthropometry, MS, and lower/upper limb asymmetries influence FA in older women.

La fragilidad afecta la autonomía funcional (AF) de las personas mayores y podría manifestarse en desequilibrios musculares en los miembros, dando lugar a una disparidad de tamaño y fuerza entre ellos. En Chile, la información que relaciona los niveles de fuerza muscular (FM) y las asimetrías con la AF en mujeres mayores es limitada. Este estudio relacionó los niveles de FM, parámetros antropométricos y asimetrías de los miembros inferiores y superiores, con la AF de un grupo de mujeres mayores chilenas. Participaron 39 mujeres, cuya AF se evaluó mediante el índice GDLAM (IG). En función de la puntuación obtenida en el IG, se clasificaron por percentiles en Grupo 1 con AF favorable (P ≤ 50) y Grupo 2 con AF baja (P > 50). Los parámetros antropométricos fueron IMC, porcentaje de grasa, masa ósea, circunferencias (brazo, muslo, pantorrilla), diámetros (húmero, fémur) y se evaluó la fuerza de los miembros superiores/ inferiores para determinar asimetrías. Las diferencias entre las covariables de ambos grupos se evaluaron mediante la prueba t de student y la prueba de Mann-Whitney para muestras independientes. G1 presentó menor asimetría (p > 0,05) en los miembros inferiores y mayor perímetro de pantorrilla que G2 (p < 0,05). G1 presentó mayor fuerza bilateral (miembro dominante y no dominante) en comparación con G2 (p < 0,05). Las covariables de antropometría, FM y asimetrías de extremidades inferiores/superiores influyen en la AF en mujeres mayores.

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Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms, length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15 (75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients (45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population. (AU)

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