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Doctoral Thesis
DOI
https://doi.org/10.11606/T.5.2018.tde-28032018-094437
Document
Author
Full name
Luciana Alvarenga da Silva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Siqueira, Silvia Regina Dowgan Tesseroli de (President)
Andrade, Daniel Ciampi Araujo de
Fabri, Gisele Maria Campos
Faria, Maria Estela Justamante de
Jacob Filho, Wilson
Title in Portuguese
Avaliação sensitiva em idosos saudáveis: estudo longitudinal
Keywords in Portuguese
Comorbidade
Doença crônica
Envelhecimento
Funções sensitivas
Idoso
Abstract in Portuguese
O processo de envelhecimento é acompanhado de diminuição gradativa sensitiva de uma forma geral, e sabe-se que alterações como perda olfativa podem anteceder o aparecimento de doenças neurodegenerativas, como a Doença de Alzheimer (DA) e a Doença de Parkinson (DP). Além disso, anormalidades somestésicas são encontradas em doentes com Diabetes mellitus (DMII), e estão associadas ao aparecimento da neuropatia diabética, que pode ser precipitada pela Hipertensão Arterial Sistêmica (HAS). Sendo assim, o objetivo deste estudo foi avaliar longitudinalmente as sensibilidades somestésica, gustativa e olfativa, correlacionando-as com as características clínicas de idosos, bem como com a incidência de novas doenças. Foram recrutados 57 idosos do Serviço de Geriatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP); destes, 36 compareceram à segunda avaliação e 24 à terceira avaliação anual. Foram utilizados os instrumentos: avaliação clínica (dados do prontuário médico incluindo doenças prévias e novas, medicamentos e exames - hemograma, glicemia e colesterol), avaliação de pressão arterial (PA), frequência cardíaca (FC), Mini Exame do Estado Mental (MEEM), avaliação sistematizada da sensibilidade (limiares olfativos, gustativos, percepção térmica - frio e calor, percepção mecânica - tátil e vibratória, percepção dolorosa de superfície e reflexo córneo-palpebral). Os dados foram tabulados e analisados estatisticamente considerando-se um nível de significância de 5%. Foi observado aumento dos limiares olfativos (p < 0,001), salgado (p=0,024), azedo (p=0,020), amargo (p=0,001), frio na face (p=0,019), frio na mão (p=0,004), tato na face (p < 0,001), tato na mão (p=0,012) e vibração na face (p=0,018). Houve associação da sensibilidade com doenças prévias (p < 0,05). Em conclusão, observou-se que alterações sensitivas se associaram com o aumento da idade e doenças prévias se relacionaram a variações de sensibilidade, embora limiares sensitivos não se associaram a incidência de novas doenças
Title in English
Sensitivity evaluation in healthy elderly: longitudinal study
Keywords in English
Aging
Chronic disease
Comorbidity
Elderly
Sensation
Abstract in English
The aging process is associated with a gradual reduction of sensory thresholds in general, and olfactory loss can predict neurodegenerative illnesses, such as Alzheimer´s Disease and Parkinson´s Disease. Besides, somatosensory abnormalities are often in patients with Diabetes mellitus and are a symptom of diabetic neuropathy, which can be precipitated by systemic arterial hypertension. Thus, the objective of this study was to evaluate, in a longitudinal design, somatosensory, gustative and olfactory perceptions and to investigate the association of them with the clinical characteristics and incidence of new diseases. Fifty-seven elderly were recruited; 36 completed the second annual evaluation and 24 completed the third annual evaluation. They were patients from the Geriatric Clinic of Hospital das Clínicas of the Medical School of the University of Sao Paulo. The following instruments and evaluations were performed: clinical evaluation (data from medical records including old and new diseases, medication, exams - hemogram, glycaemia and cholesterol, measurements of arterial pressure and cardiac frequency), the Mini-Mental State Exam (MMSE), and quantitative sensory testing (olfactory, gustative, thermal, tactile, vibratory, pain thresholds and corneal reflex). Data were tabled and statistically analyzed considering a level of significance of 5%. During the follow-up, there was an increase of the olfactory (p < 0.001), salty (p=0.024), sour (p=0.020), bitter (p=0.001), facial cold (p=0.019), hand cold (p=0.004), facial tactile (p < 0.001), hand tactile (p=0.012) and facial vibration (p=0.018) thresholds. There was an association of sensitivity with previous diseases (P < 0.05). In conclusion, sensory alterations were associated with aging and the prevalence of previous diseases was associated with sensory abnormalities. However, sensory thresholds did not correlate to the incidence of new diseases
 
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Publishing Date
2018-03-29
 
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