The population aged 60 and over is growing rapidly worldwide, reflecting rising life expectancy and health challenges. Tai Chi is a Chinese mind–body practice and has been recommended for older adults. Evidence maps organize and synthesize information about evidence in a specific field or topic, highlighting consensus and knowledge gaps. This evidence map aims to identify the effects of Tai Chi on health outcomes in older adults. This map used The Campbell Collaboration’s methodology. The search was conducted in five databases: PubMed, Embase, CINAHL, Scopus, and Web of Science. The Brazilian Academic Consortium for Integrative Health data of Traditional Chinese Medicine mind–body practices was utilized to manually include studies. The AMSTAR 2 was used to assess quality assessment, and the Tableau was used to graphically present the results. Based on 7.862 systematic reviews, we included 118 of Tai Chi for older adults. The quality assessment was 36 high, 07 moderate, 42 low, and 33 critically low. Each of the 238 effects was classified: 171 as positive, 47 as potentially positive, 13 no effects, and 07 as inconclusive. High-quality evidence that positive effects were related to balance, depression, anxiety, cognitive performance, risk of fall, quality of life, well-being, sleep quality, and Parkinson’s disease. Inconclusive or no effect was related to concentration, agility, muscle mass, HDL cholesterol, stroke, hypertension, and coronary heart disease. The most widely used Tai Chi style was the Yang style, for two to three times per week, with each session lasting 30 to 60 min for 12 to 24 weeks. Most interventions targeted community-dwelling older adults with a mean age of 69.5 years; among these, 42 reviews reported a female majority. Based on 56 associations, Tai Chi has been applied in different areas of older adult health. The effect of tai chi may depend on the style, frequency, time, and duration. Despite all results, the evidence suggests methodological rigor, homogeneous populations with larger samples. The Tai Chi effectiveness evidence map will serve to inform decision-making on healthcare for older adults, considering the Decade of Healthy Ageing 2021–2030 and the Global Strategy for Traditional, Complementary, and Integrative Medicine 2025–2034.

Digital exclusion from essential services is conventionally framed as a user deficiency requiring digital literacy training. We challenge this perspective, arguing that exclusion results from structural interface design failures rather than individual incapacity. This analysis positions interface design as a social determinant of health, examining how design decisions create systematic barriers to healthcare, social services, and civic participation. We synthesize evidence from multiple global contexts examining the persistence of the Windows, Icons, Menus, Pointer (WIMP) paradigm developed in the 1970s, structural bias in contemporary design processes, and health consequences of compulsory digitization. The WIMP paradigm persists despite five decades of demographic change, embedding assumptions about visual acuity, motor control, and technical literacy that systematically exclude older adults and other populations. Homogeneous design workforces reproduce these exclusionary patterns. Compulsory digitization transforms design failures into barriers to fundamental rights: 38% of U.S. adults aged 65+ were unprepared for telehealth during COVID-19; digital-only healthcare scheduling excludes patients lacking smartphone proficiency; interface complexity correlates with functional dependence and accelerated cognitive decline in older populations. Addressing interface design as a social determinant of health requires comprehensive intervention: regulatory frameworks mandating accessibility across essential services, genuine co-design with excluded populations, cultural adaptation, workforce diversification, exploration of post-WIMP paradigms, and policy commitments recognizing accessible design as a fundamental right rather than accommodation.

Introduction: Adequate fiber consumption is essential for the prevention of chronic non-communicable diseases at all stages of life, due to the prebiotic effect and the regulation of blood cholesterol and glucose levels. Objective: To describe consumption and evaluate factors associated with fiber intake among older adults. Methods: Were evaluated 166 participants aged 60 years or more from the EPIDOSO Study in S & atilde;o Paulo, Brazil. Food consumption data were collected using three 24-hour dietary recall. Linear regression analysis was performed using a hierarchical model to assess the association of independent variables and fiber consumption. Results: The prevalence of inadequate fiber consumption was 75.3%. The variables associated with fiber consumption were overweight (beta =-0.11; CI =-0.09,-0.02), alcohol consumption (beta =-0.09; CI =-0.17,- 0.01), fat intake (beta =-0.39; CI =-0.61,-0.16) and folate intake (beta = 0.29; CI = 0.12, 0, 45). Discussion: Results show a high prevalence of inadequate fiber intake, corroborating other population-based studies carried out in Brazil. In this study, inadequate fiber intake was associated with factors such as overweight, alcohol consumption, fat and folate intake. Conclusion: The low fiber intake observed emphasizes the need to promote healthy eating habits among aged people, to increase consumption of fiber-rich foods and preventing health outcomes caused by low fiber intake.

OBJECTIVES:To investigate the effects of the Mindfulness-Based Health Promotion (MBHP) program on quality of life (QOL) and well-being in older adults compared to an active control group. METHOD:A randomized controlled trial nested within a cohort study was conducted. Participants were allocated to either the MBHP intervention or an active control group (ACG) receiving computer-based cognitive stimulation. Outcomes included QOL, psychological health, sleep quality, and religiosity. Both interventions lasted four months. A mixed-methods approach was used, collecting qualitative and quantitative data at baseline and post-intervention. RESULTS:Statistically significant improvements in QOL were observed only in the ACG. However, the MBHP group showed improvements in stress, anxiety, intrinsic religiosity, and sleep quality compared to the ACG. Qualitative findings indicated enhanced perceptions of social support, self-awareness, self-care, and sleep quality in the MBHP group. Notably, a discrepancy emerged between the QOL quantitative results and the subjective improvements described in interviews. CONCLUSION:The MBHP program did not significantly improve QOL compared to the cognitive stimulation control. Nonetheless, well-being indicators were positively impacted in the MBHP group. Future research should explore which profiles of older adults might benefit most from regular mindfulness practice.

Objectives:Functional asymmetry is a hallmark of aging-related motor decline, contributing to impaired gait, balance deficits, and increased fall risk. This study aimed to evaluate the effects of a single session of Neuro Postural Optimization (NPO), a non-invasive neuromodulation protocol based on Radio Electric Asymmetric Conveyer (REAC) technology, on central neurophysiological balance and functional symmetry in older adults. Methods:Eighteen participants (mean age: 72.4 ± 6.1 years) underwent a standardized REAC-NPO session. Assessments were performed immediately before and after treatment using the Timed Up and Go (TUG) test, the Gait Speed test, the Five Times Sit-to-Stand (FTSTS), and Handgrip dynamometry. Results:Statistically significant improvements were found in TUG (p=0.026), Gait Speed (p=0.041), and FTSTS (p=0.003). No significant change was observed in handgrip strength (p=0.530), supporting a central rather than peripheral mechanism of action. Functional dysmetria, a reproducible and quantifiable indicator of maladaptive central motor control, was completely corrected in all participants immediately after the REAC-NPO session. Conclusions:A single REAC-NPO session can restore functional symmetry and improve mobility-related outcomes in older adults. The immediate and complete correction of functional dysmetria supports the potential role of REAC-NPO in fall prevention strategies and functional recovery programs for aging populations.

O domínio das habilidades digitais é essencial em diversas profissões, especialmente na área da saúde, na qual o uso de tecnologias possibilita realizar diagnósticos, telemedicina e a gestão de prontuários. O Teste de Inteligência Digital em Saúde (IDs) foi desenvolvido para apoiar na autoavaliação dessas competências digitais entre profissionais da saúde. Dividido em três fases, a primeira avaliou a literacia digital de estudantes da UNIFESP. A segunda fase expandiu o conceito, abrangendo inteligência digital, cidadania e segurança digital. A fase final resultou em uma versão beta com um portal online gratuito, fornecendo diagnósticos detalhados e sugestões para aprimoramento. O Teste IDs auxilia na educação contínua, fortalecendo habilidades digitais essenciais no Sistema Único de Saúde (SUS).Descritores: Telemedicina, Educação em Saúde, Inquéritos e Questionários. Health digital intelligence test: a self-assessment tool for digital competencies Abstract: Digital proficiency is essential in various professions, particularly in healthcare, where technologies facilitate diagnostics, telemedicine, and record management. The Digital Health Intelligence Test (IDs) was developed to allow healthcare professionals to self-assess their digital skills. It was created in three phases: the first evaluated the digital literacy of students at UNIFESP, the second incorporated the concept of digital intelligence, including citizenship and digital security. The final phase led to a beta version with a free online portal, offering detailed diagnostics and suggestions for improvement. The IDs test supports continuous education, strengthening essential digital skills in the Unified Health System (SUS).Descriptors: Telemedicine, Health Education, Surveys and Questionnaires. Test de inteligencia digital en salud: una herramienta de autoevaluación de competencias digitales Resumen: La competencia digital es esencial en diversas profesiones, especialmente en el ámbito de la salud, donde el uso de tecnologías facilita diagnósticos, telemedicina y la gestión de expedientes médicos. La Prueba de Inteligencia Digital en Salud (IDs) fue creada para permitir la autoevaluación de las competencias digitales de los profesionales de la salud. Se desarrolló en tres fases: la primera evaluó la alfabetización digital de estudiantes de la UNIFESP; la segunda fase incorporó el concepto de inteligencia digital, abarcando ciudadanía y seguridad digital. La fase final resultó en una versión beta con un portal en línea gratuito que ofrece diagnósticos detallados y sugerencias de mejora. La prueba IDs apoya la educación continua, fortaleciendo habilidades digitales esenciales en el Sistema Único de Salud (SUS).Descriptores: Telemedicina, Educación en Salud, Encuestas y Cuestionarios.

OBJECTIVE:To evaluate the impact of cognitive stimulation via digital inclusion and the practice of video games on the cognition of the older population. METHOD:This is a randomized controlled intervention study, nested in a population cohort study. Based on the application of the Clinical Dementia Rating (CDR) test, individuals aged 60 years or older with scores 0 and 0.5 were included and randomly allocated in the Intervention Group (IG) or Control Group (CG). Initially, 160 participants met the selection criteria and underwent neuropsychological evaluation via the Montreal Cognitive Assessment (MoCA), applied before and after intervention. The IG (n = 62) participated in computer-based intervention once a week for one-and-a-half hours, for 4 months. The CG (n = 47) participated in the mindfulness workshops held in the same period. RESULTS:The digital literacy intervention group averaged 2.6 points more in the MoCA after 4 months. The change in the final MoCA decreased in 0.46 points at each unit in the basal MoCA. Individuals with average schooling had an increase of 0.93 points in the change of the MoCA in relation to individuals with low or high schooling. CONCLUSION:Digital inclusion combined with the practice of video games has the potential to improve the cognition of the older population.

The aging of the population demands a closer look at the desires and needs of older adults. Although promoting active and healthy aging is a priority for public health, much of the work in this area is quantitative, using an epidemiological methodology focused on risk and protective factors for the health of this population. This methodological bias does not capture the experience of aging or explain the behavior of each individual in relation to their health. The objective of this essay is to reflect on the importance of qualitative studies in understanding the needs, strengths, and weaknesses of older adults, which will shed light on motivation, behavior, and the meaning of physical activity and health care practices.

Aged have a high consumption of medications with anticholinergic activity (MAA), being more vulnerable to adverse events. Using the anticholinergic risk scales, we investigated the prevalence and burden of MAA in the aged, the agreement between the scales and the implications of using MAA with a burden of 2 and 3 on the scales in relation to polypharmacy, cognition and functionality. Cross-sectional study with aged, of both sexes, aged ≥ 60 years old. The prevalence and burden of MAA were investigated by scales: anticholinergic drug scale (ADS), anticholinergic risk scale (ARS), anticholinergic cognitive burden scale (ACB), Brazilian scale of medications with anticholinergic activity (BSMAA). We analyzed the agreement of the scales with Kappa coefficient and investigated by logistic regression the association of MAA with: gender, age, polypharmacy; cognitive capacity (MMSE) and functional capacity (BOMFAQ questionnaire). Of those interviewed, 1,143 aged used medication and 53.5% used MAA. A good agreement was found between: ADS/ACB (0.642), ADS/SBMAA (0.669), ACB/SBMAA (0.656). In the multivariate analysis: gender and polypharmacy were statistically significant.

O envelhecimento da população demanda um olhar mais atento para os desejos e necessidades dos idosos. Embora a promoção de um envelhecimento ativo e saudável seja assunto prioritário para a saúde pública, boa parte dos trabalhos desta área são quantitativos, de metodologia epidemiológica, focados nos fatores de risco e proteção para a saúde desta população. Esse viés metodológico não capta a experiência vivida do envelhecimento, não explica as ações de cada um em relação à sua saúde. O objetivo deste ensaio é refletir sobre a importância dos estudos qualitativos na compreensão das necessidades, forças e fraquezas dos idosos que irão refletir na motivação e na maneira de atuar e dar significado à prática de atividade física e ao cuidado com a sua saúde.

EDITORIAL article Front. Aging, 15 November 2023Sec. Interventions in Aging Volume 4 - 2023 | https://doi.org/10.3389/fragi.2023.1281737

Life expectancy at birth (hereafter, life expectancy) and longevity are established indicators of population health [...]

Interest in plant-based diets and vegetarianism is increasing worldwide, however, a concern for total vegetarians is vitamin B12 (B12) deficiency. We conducted a systematic review to investigate non-animal food sources of B12. Databases were PubMed, LILACS, Cochrane, Embase and Google Scholar, up to September 9, 2020. Quality of the eligible studies were assessed. We identified 25 studies which assessed B12 content in seaweeds, mushrooms, plants and fermented foods. Initial studies were microbiological bioassay, ELISA and HPLC. In the last decade, more sensitive method for real B12 determination was used, the liquid chromatography-electrospray ionization tandem mass spectrometry chromatograms. Real B12 content varied from mean (SD) mcg/portion size of seaweed hijiki 3 x 10(-3)/7 g to non 1.03-2.68/sheet; mushroom white button cap 2 x 10(-3) (7 x 10(-4)/20 g dry weight (dw) to shiitake 0.79(0.67)-1.12 (0.78)/20g dw; and fermented foods from soy yogurt 20/cup. It is possible that daily recommendations for B12 can be met by a varied diet containing non-animal B12 food sources. Future research should consider different methods of storage, preparation, fermented foods and standardization of the production of certain foods.

ABSTRACT Objectives: to evaluate the relationship between leisure-time physical activity and functional capacity change among aged people. Methods: we analyzed data of an aged cohort looking for determinants of functional capacity at follow-up. Baseline data were collected between 2007 and 2008 - average follow-up of 3,5 years. A full multivariate linear regression model was built to evaluate functional capacity at the end of the follow-up, controlling for functional capacity at baseline, sociodemographic, health and behavioral characteristics and amount of leisure-time physical activity in the period. Results: final model showed functional capacity independently correlated with age (p<0.001), body mass (p=0.013) and the number of activities of daily living compromised at baseline (p<0.001). Functional capacity improved with increased physical activity but loss statistical significance after adjustments (p=0.384). Conclusions: functional capacity decreases with increased age, increased loss of functional capacity at baseline and increased body mass. Albeit a non-significant association, leisure-time physical activity appears as an important modifiable factor.

ABSTRACT OBJECTIVE To evaluate the utilization of benzodiazepines (BZD) in Brazilian older adults, based on the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM - National Survey of Access, Use and Promotion of Rational Use of Medicines). METHODS The PNAUM is a cross-sectional study conducted between 2013 and 2014, representing the Brazilian urban population. In the present study, we included 60 years or older (n = 9,019) individuals. We calculated the prevalence of BZD utilization in the 15 days prior to survey data collection according to independent variables, using a hierarchical Poisson regression model. A semistructured interview performed empirical data collection (household interview). RESULTS The prevalence of BZD utilization in the older adults was 9.3% (95%CI: 8.3–10.4). After adjustments, BZD utilization was associated with female sex (PR = 1.88; 95%CI: 1.52–2.32), depression (PR = 5.31; 95%CI: 4.41–6, 38), multimorbidity (PR = 1.44; 95%CI: 1.20–1.73), emergency room visit or hospitalization in the last 12 months (PR = 1.42; 95%CI: 1.18–1.70 ), polypharmacy (PR = 1.26; 95%CI: 1.01–1.57) and poor or very poor self-rated health (PR = 4.16; 95%CI: 2.10–8.22). Utilization was lower in the North region (PR = 0.18; 95%CI: 0.13–0.27) and in individuals who reported abusive alcohol consumption in the last month (PR = 0.42; 95%CI: 0.19–0.94). CONCLUSION Despite contraindications, results showed a high prevalence of BZD utilization in older adults, particularly in those with depression, and wide regional and sex differences.

Population aging is 1 of the biggest challenges facing public health today, and cognitive dysfunction is an important concern. Cognitive impairment may be associated with high folate concentrations and low vitamin B12 concentrations; the latter is a common problem among elderly people. Therefore, we hypothesized there was a high circulating folate concentration among older people living in a country with a mandatory folic acid fortification program. We conducted a cross-sectional study to investigate nutritional status of folate and vitamin B12 among aged people. Three dietary recalls, serum folate (sfolate), erythrocyte (red blood cell) folate (RBC folate), and serum vitamin B12 and homocysteine were collected. Linear regression models were used to investigate factors associated with circulating vitamins. We interviewed 169 participants. Half reported inadequate consumption of folate. However, RBC folate deficiency was observed in 27%, 13% in the serum, and a 10% excess of sfolate. One-quarter reported inadequate consumption of B12, but only 5% had deficiency. Factors negatively associated with circulating folate were continuous work and smoking, and positively associated with polyunsaturated fatty acid. Factor negatively associated with the circulating B12 were use of a dental prosthesis and intake of saturated fatty acid. Permanent investigation of excess of sfolate and B12 deficiency, especially among older adults living in countries exposed to a mandatory folic acid fortification program, is important because of the possible relation to the cognitive function.

OBJETIVO: Avaliar a utilização de benzodiazepínicos (BZD) em idosos brasileiros, a partir de dados da Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos (PNAUM). MÉTODOS: A PNAUM é um estudo transversal, conduzido entre 2013 e 2014, com representatividade da população urbana brasileira. No presente estudo, foram incluídos indivíduos com 60 anos ou mais (n = 9019). Foi calculada a prevalência de utilização de BZD nos 15 dias anteriores à coleta dos dados da pesquisa, geral e segundo as variáveis independentes, por meio de análise bruta e ajustada, utilizando modelo hierárquico de regressão de Poisson. A coleta de dados foi realizada por meio de entrevista domiciliar. RESULTADOS: A prevalência de utilização de BZD em idosos foi de 9,3% (IC95%: 8,3–10,4). Após análise ajustada, foram associados à maior utilização de BZD: sexo feminino (RP = 1,88; IC95%: 1,52–2,32), depressão (RP = 5,31; IC95%: 4,41–6,38), multimorbidade (RP = 1,44; IC95%: 1,20–1,73), visita à emergência ou internação hospitalar nos últimos 12 meses (RP = 1,42; IC95%: 1,18–1,70), polifarmácia (RP = 1,26; IC95%: 1,01–1,57) e autopercepção de saúde ruim ou muito ruim (RP = 4,16; IC95%: 2,10–8,22). A utilização foi menor na região Norte (RP = 0,18; IC95%: 0,13–0,27) e em indivíduos que relataram consumo abusivo de álcool no último mês (RP = 0,42; IC95%: 0,19–0,94). CONCLUSÃO: Apesar das recomendações contrárias ao uso, os resultados demonstraram elevada prevalência de utilização de BZD em idosos, particularmente naqueles que apresentam depressão, além de amplas diferenças em relação às regiões do país e ao sexo do indivíduo.

A terapia medicamentosa é parte integrante do plano de assistência ao idoso, sendo a prescrição um processo difícil e desafiador. Investigar a prescrição de idosos é uma prática preconizada como ferramenta na avaliação da qualidade do serviço de saúde, pois, o tratamento medicamentoso é um elemento essencial da atenção clínica ao idoso, e a otimização da prescrição se faz necessária, porquanto tem se tornado mundialmente um importante problema de saúde. O presente estudo tem como objetivo apresentar e discutir os indicadores de qualidade da prescrição em idosos e o uso de instrumentos e medidas como estratégias para sua apropriada utilização no sistema de saúde. O método utilizado foi a revisão narrativa da literatura, por meio de obras já publicadas, encontradas em bases de dados nos idiomas português e inglês, para colaborar com a educação continuada de profissionais de saúde e proporcionar o uso racional e seguro da terapêutica medicamentosa. Diante dos dados apresentados, é imprescindível promover uma prescrição de qualidade e adequada a fim de que os idosos possam ter uma melhor qualidade de vida para que vivam o maior tempo possível em seus domicílios com saúde, autonomia e independência.

A presente pesquisa objetiva analisar em uma coorte populacional de idosos a estrutura de suas fontes de renda e sua relação com fatores sociodemográficos. Trata-se de um estudo transversal, quantitativo, realizado com 1155 idosos que foram acompanhados por uma equipe multidisciplinar de um bairro de classe média-alta da cidade de São Paulo, com segunda onda iniciada em 2008. Dos entrevistados 68% eram mulheres, cerca de 97% dos idosos disseram receber algum tipo de receita mensal advinda de diversas fontes de renda (15 combinações): aposentadoria, pensão, aluguéis, atividade remunerada, e outras, apenas 2,8% disseram não ter nenhum tipo de renda. Quase 60% contou com mais que uma fonte de renda, com 75% centralizada em algum tipo de aposentadoria. A maioria (46%) recebia entre 1 e 3 salários mínimos per capita e apenas 5,3% recebia 10 ou mais salários mínimos. Observou-se diferenças claras entre homens e mulheres em relação ao perfil das fontes de rendas.Palavras chave: Idosos. Renda. Envelhecimento. Aposentadoria. Pensão.

Objetivo: Estimar o efeito da participação em grupos de estimulação e reabilitação cognitiva mediados pelo uso de computadores e Internet sobre a função cognitiva de idosos. Métodos: Estudo prospectivo de intervenção controlada e randomizado por sorteio realizado de 2010 a 2011 com pacientes voluntários atendidos em uma Clínica de Memória do Sul de Santa Catarina, Brasil. O grupo de intervenção (n=56) recebeu um programa de estimulação cognitiva de 20 sessões quinzenais de 1,5 horas cada. O grupo controle (n=53) recebeu acompanhamento médico de rotina. Ambos os grupos receberam orientações de saúde, atividade física e não faziam uso prévio de computadores e Internet. O desfecho foi o ganho de 4 pontos ou mais no Mini Exame de Estado Mental, entre as avaliações. Foi realizada análise de regressão logística com resultados expressos em Odds Ratio (OR) e seus respectivos intervalos de confiança de 95% (IC95%), com nível de significância de p≤0,05. Resultados: O grupo de intervenção obteve uma probabilidade 4,63 vezes maior do desfecho (OR= 4,63; IC 95%: 1,43-14,94) em relação ao grupo controle. Conclui-se que a participação em grupos de estimulação cognitiva mediado pelo uso de computadores e Internet está associado a melhora significativa na função cognitiva de idosos com comprometimento cognitivo leve.