The Mental Health Research Protocol of the Multidimensional Study of the Elderly in the Family Health Strategy in Porto Alegre, Brazil (EMI-SUS)

Eduardo Lopes Nogueira, Paula Fernandes Moretti, Francisco Pascoal Ribeiro Junior, Edgar Chagas Diefenthaeler, Alfredo Cataldo Neto, Paula Engroff Engroff, José Celestino Borges Filho, Fernanda Loureiro, Irenio Gomes

Abstract


Introduction: The rapid aging process in low and middle-income countries poses a major challenge and has special repercussions for mental health. This is especially true for diseases that impair cognition and emotion regulation such as depression and dementia. In Brazil, caring for the elderly is a public health priority. Aims: To describe the scientific methodology and practical applicability of a mental health study tailored to seniors; to provide data to improve mental health assessment and care; to describe a primary care methodology that is replicable in other regions. Methods: A cross sectional study using stratified randomized sampling. Study participants were residents of Porto Alegre, over 60 years, and enrolled in the Family Health Strategy program. Study prioritized the examination of psychiatric and cognitive characteristics by using multiprofessional indicators of mental health. Data was collected in two phases: screening and specialized diagnosis. Conclusion: The paper provides a methodological model to assist researchers in similar studies. Striking an adequate balance between assistance and research is a major challenge. Protocols that prospect and examine the leading mental health problems in the elderly could close the gap between identification of older adults with early symptoms and those at risk of developing depression and dementia. A stratified approach to screening and diagnosing cognitive and mood and disorders for all levels in public health that uses low cost instruments in a real setting will benefit communities and can provide local empowerment.


Keywords


Research methodology. Mental health. Elderly. Method. Geriatric psychiatry.

Full Text:

PDF

References


Lee R. The Demographic Transition: Three Centuries of Fundamental Change. Journal of Economic Perspectives. 2003;(17)4:167-90.

Moriguchi Y. Aging, preventive geriatrics and the role of physical exercise to improve health with longevity. Pan Am J Aging Res. 2013 (1)1:3-4.

Von Guten A. Behavioral and psychological symptoms and signs of dementia in low and middle income countries. Pan Am J Aging Res. 2013;1(2):27-31.

Boing AF, Melo GR, Boing AC et al. Associação entre depressão e doenças crônicas: estudo populacional. Rev Saúde Pública. 2012;46(4):617-23.

World Alzheimer Report. Journey of Caring: An analysis of long-term care for dementia. 2013.

Viana MC, Teixeira MG, Beraidi F et al. São Paulo Megacity Mental Health Survey – A population-based epidemiological study of psychiatric morbidity in the São Paulo Metropolitan Area: aims, design and field implementation. Rev Bras Psiquiatr. 2009;31(4):375-86.

Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Envelhecimento e saúde da pessoa idosa. Brasília (DF); 2006. Cadernos de Atenção Básica, 19. Série A. Normas e Manuais Técnicos.

Lima-Costa MF, Uchoa E, Guerra H. The bambuí health and ageing study (BHAS): melhodological approach and preliminary results of a population-based cohort study of elderly in Brazil. Rev Saúde Pública. 2000;34(2):126-35.

Gomes I, Nogueira EL, Engroff P. The multidimensional study of the elderly in the Family health strategy in Porto Alegre, Brazil (EMI-SUS). Pajar. 2013;1(1):20-4.

Almeida OP, Almeida SA. Confiabilidade da versão brasileira da Escala de Depressão Geriátrica (GDS) versão reduzida. Arq Neuropsiquiatr. 1999;57(2B):421-6.

Ministério da Saúde, Secretaria de Atenção à Saúde, Departamento de Atenção Básica. Envelhecimento e saúde da pessoa idosa. Brasília (DF); 2006. Cadernos de Atenção Básica, 19. Série A. Normas e Manuais Técnicos.

Stanley R, Kuruvilla A, Kumar S, Gayathri K, Mathews P, Abraham V, et al. The Vellore screening instruments and strategies for the diagnosis of dementia in the community. International Psychogeriatrics. 2009;21(3):539-47.

Bertolucci PH, Okamoto IH, Brucki SM et al. Applicability of the Cerad Neuropsychological battery to Brazilian elderly. Arq Neuropsiquiatr. 2001;59(3-A):532-6.

Grassi-Oliveira R, Stein LM, Pezzi JC. Tradução e validação de conteúdo da versão em português do Childhood Trauma Questionnaire. Rev Saúde Pública. 2006;40(2):249-55.

Amaral-Carvalho V, Caramelli P. Brazilian adaptation of the Addenbrooke’s cognitive examination-revised (ACE-R). Dement Neuropsychol. 2007;1:212-6.

Carvalho VA, Barbosa MT, Caramelli P. Brazilian version of the Addenbrooke Cognitive Examination-revised in the diagnosis of mild Alzheimer disease. Cogn Behav Neurol. 2010;23:8-13.

Carvalho VA, Caramelli P. Normative Data for Healthy Middle-Aged and Elderly Performance on the Addenbrooke Cognitive Examination Revised. Cogn Behav Neurol. 2012;25:72-6.

McKhann GM, Knopman DS, Chertkow H et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging- Alzheimer’s Association workgroups on diagnostic guidelines

for Alzheimer’s disease. Alzheimers Dement. 2011;7(3):

-9.

American Psychiatric Association. DSM-IV. Washington, DC; 1994.

World Health Organization, WHO. Schedules for clinical assessment in neuropsychiatry (SCAN). Geneva: WHO;1992.

Amorim P. Mini International Neuropsychiatric Interview (MINI): validação de entrevista breve para diagnóstico de transtornos mentais. Rev Bras Psiquiatr. 2000;22: 106-15.

Marques JMA, Zuardi AW. Validity and applicability of the Mini International Neuropsychiatric Interview administered by family medicine residents in primary health care in Brazil. Gen Hosp Psychiatry. 2008;30:303-10.

Kowal P, Kahn K, Ng N, et al. Ageing and adult health status in eight lower-income countries: the INDEPTH WHO-SAGE collaboration. Glob Health Action. 2010;3: 11-22.

World Health Organization, WHO. Global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. Provisional agenda item 6.2. 130th session. EB130/9; 2011.

Mitchell AJ, Bird V, Rizzo M, et al. Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta analysis of GDS30 and GDS15. J Affect Disord. 2010;125(1-3):10-7.




DOI: http://dx.doi.org/10.15448/2357-9641.2014.1.19457

e-ISSN: 2357-9641

 

 This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE) http://www.publicationethics.org

Licença Creative Commons

Except where otherwise noted, content of this journal is licensed under a Creative Commons Attribution 4.0 International license.

 

Editorial Policies of Brazilian Scientific Journals. Deposit availability: Blue .

 

Copyright: © 2006-2020 EDIPUCRS