Oral health and self-rated health in community-dwelling older adults in Colombia.

BACKGROUND: The relationship between oral health and specific health conditions, such as cardiovascular disease or cognitive impairment, has been extensively studied. However, the effect of oral health status on self-rated health has not been assessed. This could be relevant in older people considering that poor self-rated health status and oral diseases are highly prevalent in this population. The aim of this study was to determine the association between different parameters of oral health and self-rated health status (SRHS) in Colombian community-dwelling older adults. METHODS: This is a secondary analysis of the SABE-Colombia study performed in 2015. The dependent variable was defined as the SRHS status assessed by the question "Compared with other people, your age: Do you consider your health status to be better, equal, or worse?" We considered four independent variables: total edentulism considering the high prevalence in older people, the GOHAI score to assess self-rated oral health, and the use of fixed and removable dental prostheses as potential modifiers of oral health. An adjusted ordinal logistic regression was performed by each independent variable. RESULTS: After the exclusion of missing data, 17,945 persons were included in the final analysis. A total of 10.6% reported worse SRHS, 37.6% reported equal SRHS, and 51.6% reported better SRHS. The worse SRHS group was older and had a higher proportion of dependence, cognitive impairment, and depressive symptoms. The frequency of total edentulism and the lower mean score of GOHAI were significant in the worse SHRS group. An ordinal logistic regression for each independent variable was performed, finding that edentulism increases the probability of worse SHRS, while the GOHAI and use of removable or fixed dental prostheses increase the probability of better SRHS. CONCLUSION: We found an association between total edentulism, GOHAI Index, the use of dental prostheses (both removable and fixed), and self-rated health status, showing the relevance of oral health status to self-rated health status independent of comorbidities and geriatric syndromes. This result supports the inclusion of oral health evaluation in comprehensive geriatric assessment.

Characterization in end-of-life care of older people attended by geriatricians.

BACKGROUND AND OBJECTIVE: Symptom control at the end of life is essential, and palliative sedation is a viable intervention option for the care of terminally ill patients. This study aims to characterize the elderly population receiving end-of-life care plans and their management with palliative sedation in a geriatric unit at a high complexity hospital. MATERIALS AND METHODS: A cross-sectional study was conducted, and a descriptive analysis was performed. Medical records of 163 patients admitted to a high complexity hospital in Bogota, Colombia between January 2016 and December 2019 were reviewed. RESULTS: From 163, 141 patients received an end-of-life care plan, and 22 were managed with palliative sedation. The mean age was 84 years, the most frequent cause of death was respiratory infections and 44% of patients had a history of cancer. Prior to admission, functional decline and the presence of moderate to severe dementia were frequently found. About one in ten persons required palliative sedation, which lasted an average of 2.22±5 days. The most common refractory symptom was dyspnea (45.45%), followed by pain (36.36%). CONCLUSIONS: Palliative sedation is prevalent in the elderly population and characterizing this population can provide increased knowledge to improve end-of-life care.

Factores asociados al desarrollo de delírium en pacientes ancianos en el postoperatorio de cirugía por fractura de cadera / Factors Related to the Development of Delirium in Elderly Patients in the Postoperative Period of Hip Fracture Surgery / Fatores associados ao desenvolvimento de Delirium em pacientes idosos no pós-operatório de cirurgia de fratura de quadril

Introducción: durante el postoperatorio por cirugía de cadera, el delírium es la complicación más frecuente en los pacientes ancianos, con una alta incidencia y prevalencia, la cual lleva a una alta morbimortalidad en ellos. Objetivo: identificar los factores asociados con delírium en pacientes ancianos durante su posto-peratorio de cirugía por fractura de cadera. Materiales y métodos: se realizó un estudio observacional analítico de corte retrospectivo con pacientes hospitalizados por el grupo de Ortogeriatría en el Hospital Universitario San Ignacio en Bogotá (Colombia), entre enero de 2017 y septiembre de 2020. Resultados: se incluyeron 210 personas, en quienes se documentó una incidencia de delírium del 28.57 %. En el análisis bivariado, las variables con asociación estadísticamente significativa fueron edad, dependencia, demencia previa, malnutrición, polifarmacia y tipo de anestesia. Sin embargo, en el análisis multivariado, las dos variables con asociación estadísticamente significativa fueron edad (OR: 1.05; IC95 %: 1.01-1.10; p = 0.014) y demencia (OR: 2.83; IC95 %: 1.28-6.27; p = 0.010). Conclusión: las variables asociadas con delírium reportadas en el estudio concuerdan con la literatura ya publicada. Esto abre las puertas a futuras investigaciones no solo para identificar nuevos o más factores asociados, sino también para adoptar medidas en conjunto con los programas de ortogeriatría, a fin de intervenir estos factores y, de esta manera, poder disminuir la incidencia y prevalencia del delírium y, por ende, su morbimortalidad.

Introduction: Post-operative delirium after hip surgery is the most common complication among the elderly, with a high incidence and prevalence, which leads to high morbidity and mortality rates among them. Objective: To identify the main factors associated with post-operative delirium after hip surgery among older adults. Materials and methods: a retrospective analytical observational study was conducted using data from patients hospitalized by the Orthogeriatric group at the San Ignacio University Hospital in Bogotá, Colombia, between January 2017 and September 2020. Results: 210 people were included in the study, with a documented incidence of delirium of 28.57% was documented. In the bivariate analysis, the variables with a statistically significant association with delirium were age, dependency, previous dementia, malnutrition, polypharmacy, and type of anesthesia used in the procedure. Nonetheless, in a multivariate analysis, the two variables with a statistically significant association were age (OR: 1.05; 95%CI: 1.01-1.10; p = 0.014) and dementia (OR: 2.83; 95% CI: 1.28-6.27; p = 0.010). Conclusion: the variables associated with postoperative delirium reported in our study align with the existing literature. This opens doors to future research not only to identify new or more risk factors, but also to adopt measures, jointly with the Orthogeriatric programs, to intervene such factors so that the incidence and prevalence of delirium can be reduced, and therefore, reduce the morbidity and mortality among the elderly.

Introdução: o delirium no pós-operatório de cirurgia de quadril é a complicação mais frequente em pacientes idosos, com alta incidência e prevalência, o que leva a alta morbimortalidade nos mesmos e, assim, o objetivo deste estudo foi identificar os fatores associados ao delirium em pacientes idosos no pós-operatório de cirurgia de fratura de quadril. Materiais e métodos: foi realizado um estudo observacional analítico retrospectivo com pacientes internados pelo grupo de Ortogeriatria do Hospital Universitário San Ignacio, em Bogotá, Colômbia, entre janeiro de 2017 e setembro de 2020. Resultados: foram incluídas 210 pessoas, nas quais foi documentado incidência de delirium de 28,57%. Na análise bivariada, as variáveis com associação estatisticamente significativa foram idade, dependência, demência prévia, desnutrição, polifarmácia e tipo de anestesia. Porém, na análise multivariada, as duas variáveis com associação estatisticamente significativa foram idade (or: 1,05; Ic 95% 1,01-1,10; p: 0,014) e demência (or: 2,83; Ic 95% 1,28-6,27, p: 0,010). Conclusão: as variáveis associadas ao delirium relatadas em nosso estudo concordam com a literatura publicada anteriormente. Isso abre as portas para pesquisas futuras não só para identificar novos ou mais fatores associados, mas também para adotar medidas em conjunto com programas de ortogeriatria para poder intervir nesses fatores e, assim, reduzir a incidência e prevalência de delirium e, portanto, a morbimortalidade

Clinical value of Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales to predict hospital-associated functional decline in an acute geriatric unit in Colombia.

Background: Older adults admitted to a hospital for acute illness are at higher risk of hospital-associated functional decline during stays and after discharge. Objective: This study aimed to assess the calibration and discriminative abilities of the Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales as predictors of hospital-associated functional decline at discharge in a cohort of patients older than age 65 receiving management in an acute geriatric care unit in Colombia. Methods: This study is an external validation of ISAR and HARP prediction models in a cohort of patients over 65 years managed in an acute geriatric care unit. The study included patients with Barthel index measured at admission and discharge. The evaluation discriminate ability and calibration, two fundamental aspects of the scales. Results: Of 833 patients evaluated, 363 (43.6%) presented hospital-associated functional decline at discharge. The HARP underestimated the risk of hospital-associated functional decline for patients in low- and intermediate-risk categories (relation between observed/expected events (ROE) 1.82 and 1.51, respectively). The HARP overestimated the risk of hospital-associated functional decline for patients in the high-risk category (ROE 0.91). The ISAR underestimated the risk of hospital-associated functional decline for patients in low- and high-risk categories (ROE 1.59 and 1.11). Both scales showed poor discriminative ability, with an area under the curve (AUC) between 0.55 and 0.60. Conclusions: This study found that HARP and ISAR scales have limited discriminative ability to predict HAFD at discharge. The HARP and ISAR scales should be used cautiously in the Colombian population since they underestimate the risk of hospital-associated functional decline and have low discriminative ability.

Antecedentes: los adultos mayores ingresados en un hospital por una enfermedad aguda tienen un mayor riesgo de deterioro functional hospitalario durante su estancia y después del alta. Objetivo: este estudio tuvo como objetivo evaluar las capacidades de calibración y discriminación de las escalas Hospital Admission Risk Profile (HARP) e Identification of Seniors at Risk (ISAR) como predictores de deterioro funcional hospitalario al alta en una cohorte de pacientes mayores de 65 años que recibieron manejo en una unidad geriátrica de agudos en Colombia. Métodos: este estudio es una validación externa de los modelos de predicción ISAR y HARP en una cohorte de pacientes mayores de 65 años atendidos en una unidad geriátrica de agudos. El estudio incluyó pacientes con índice de Barthel medido al ingreso y al alta y la evaluación de la capacidad de discriminación y calibración, dos aspectos fundamentales para esta medición. Resultados: de 833 pacientes evaluados, 363 (43.6%) presentaron deterioro funcional hospitalario al momento del alta. La escala HARP subestimó el riesgo de deterioro funcional hospitalario para los pacientes en las categorías de riesgo bajo e intermedio (relación entre eventos observados /esperados (ROE) 1.82 y 1.51, respectivamente). El HARP sobrestimó el riesgo de deterioro funcional hospitalario para pacientes en la categoría de alto riesgo (ROE 0.91). El ISAR subestimó el riesgo de deterioro hospitalario para pacientes en categorías de bajo y alto riesgo (ROE 1.59 y 1.11). Ambas escalas mostraron una pobre capacidad de discriminación, con un área bajo la curva (AUC) entre 0.55 y 0.60. Conclusiones: este estudio encontró que las escalas HARP e ISAR tienen una capacidad de discriminación limitada para predecir deterioro funcional hospitalario al alta. Las escalas HARP e ISAR deben usarse con cautela en la población colombiana ya que subestiman el riesgo de deterioro funcional hospitalario y tienen baja capacidad de discriminación.

El sentimiento de soledad en la población adulta mayor participante en centros de día en Bogotá, Colombia

Objetivo: Identificar los factores asociados a las categorías de soledad en población adulta mayor en centros de día en Bogotá, Colombia. Materiales y métodos: Se realizó un estudio cuantitativo, transversal y analítico para medir la soledad en personas mayores que participan en un centro de día de la ciudad de Bogotá, mediante la escala ESTE en personas mayores, entre noviembre de 2020 y junio de 2021. Para cumplir con el objetivo, se realizó un análisis estadístico descriptivo univariado, de tal forma que, para las variables cuantitativas, se empleó media con desviación estándar o mediana con rangos intercuartílicos, de acuerdo con los criterios de normalidad utilizando la prueba Shapiro Wilk, y para las variables categóricas, frecuencias absolutas y proporciones. El análisis bivariado se realizó con las pruebas t de Student y chi cuadrado (p < 0,05), lo cual contribuyó a la construcción de un modelo de regresión logística, con las variables con significancia estadística. Resultados: Se incluyeron 215 personas adultas mayores con promedio de edad de 70,5 años; 72 % correspondían al sexo femenino, 56,5 % tenían educación primaria, 38,6 % eran solteros y 67,4 % presentaban antecedente de enfermedad crónica no transmisible. Según la escala ESTE, en soledad familiar registraron nivel bajo (67 %); en soledad conyugal, entre nivel alto y medio (79 %); en soledad social, nivel alto y medio (51 %); en crisis de adaptación, nivel alto y medio (43 %). Se encontraron asociaciones en soledad conyugal con sexo femenino (p = 0,001), en soledad social con clase baja (p = 0,027) y en crisis de adaptación con clase baja (p = 0,024). Conclusiones: Los factores que se asocian al sentimiento de soledad en población adulta mayor participante en centros de día son, en la categoría de soledad conyugal, ser mujer, y, en soledad social y crisis de adaptación, pertenecer a clase baja.

Objective: To identify the factors associated with the categories of loneliness among the elderly population attending day care centers in Bogotá, Colombia. Materials and methods: An analytical, cross-sectional and quantitative study was carried out to measure the loneliness among older people attending a day care center in the city of Bogotá between November 2020 and June 2021 using the ESTE scale. To meet the objective, a univariate descriptive statistical analysis was performed, such that, for the quantitative variables, the mean with standard deviation or median with interquartile ranges were used, in accordance with the Shapiro-Wilk test for normality, and for the categorical variables, absolute frequencies and proportions were used. The bivariate analysis was conducted using Student's t-test and chi-square test (p < 0.05), which contributed to build a logistic regression model with statistically significant variables. Results: A total of 215 elderly people with a mean age of 70.5 years were included in the study: 72 % were females, 56.5 % had primary education, 38.6 % were single and 67.4 % had a history of chronic non-communicable disease. According to the ESTE scale, the study subjects showed a low level of family loneliness (67 %), a high and medium level of marital loneliness (79 %), a high and medium level of social loneliness (51 %) and a high and medium level of adaptation crisis (43 %). It was found that marital loneliness was associated with females (p = 0.001), social loneliness with lower class (p = 0.027) and adaptation crisis with lower class (p = 0.024). Conclusions: The factors associated with the feeling of loneliness among the elderly population attending day care centers are, in the marital loneliness category, being a woman and, in the social loneliness and adaptation crisis categories, belonging to the lower class.

Clinical value of Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales to predict hospital-associated functional decline in an acute geriatric unit in Colombia

Background: Older adults admitted to a hospital for acute illness are at higher risk of hospital-associated functional decline during stays and after discharge. Objective: This study aimed to assess the calibration and discriminative abilities of the Hospital Admission Risk Profile (HARP) and the Identification of Seniors at Risk (ISAR) scales as predictors of hospital-associated functional decline at discharge in a cohort of patients older than age 65 receiving management in an acute geriatric care unit in Colombia. Methods: This study is an external validation of ISAR and HARP prediction models in a cohort of patients over 65 years managed in an acute geriatric care unit. The study included patients with Barthel index measured at admission and discharge. The evaluation discriminate ability and calibration, two fundamental aspects of the scales. Results: Of 833 patients evaluated, 363 (43.6%) presented hospital-associated functional decline at discharge. The HARP underestimated the risk of hospital-associated functional decline for patients in low- and intermediate-risk categories (relation between observed/expected events (ROE) 1.82 and 1.51, respectively). The HARP overestimated the risk of hospital-associated functional decline for patients in the high-risk category (ROE 0.91). The ISAR underestimated the risk of hospital-associated functional decline for patients in low- and high-risk categories (ROE 1.59 and 1.11). Both scales showed poor discriminative ability, with an area under the curve (AUC) between 0.55 and 0.60. Conclusions: This study found that HARP and ISAR scales have limited discriminative ability to predict HAFD at discharge. The HARP and ISAR scales should be used cautiously in the Colombian population since they underestimate the risk of hospital-associated functional decline and have low discriminative ability.

Antecedentes: los adultos mayores ingresados en un hospital por una enfermedad aguda tienen un mayor riesgo de deterioro functional hospitalario durante su estancia y después del alta. Objetivo: este estudio tuvo como objetivo evaluar las capacidades de calibración y discriminación de las escalas Hospital Admission Risk Profile (HARP) e Identification of Seniors at Risk (ISAR) como predictores de deterioro funcional hospitalario al alta en una cohorte de pacientes mayores de 65 años que recibieron manejo en una unidad geriátrica de agudos en Colombia. Métodos: este estudio es una validación externa de los modelos de predicción ISAR y HARP en una cohorte de pacientes mayores de 65 años atendidos en una unidad geriátrica de agudos. El estudio incluyó pacientes con índice de Barthel medido al ingreso y al alta y la evaluación de la capacidad de discriminación y calibración, dos aspectos fundamentales para esta medición. Resultados: de 833 pacientes evaluados, 363 (43.6%) presentaron deterioro funcional hospitalario al momento del alta. La escala HARP subestimó el riesgo de deterioro funcional hospitalario para los pacientes en las categorías de riesgo bajo e intermedio (relación entre eventos observados /esperados (ROE) 1.82 y 1.51, respectivamente). El HARP sobrestimó el riesgo de deterioro funcional hospitalario para pacientes en la categoría de alto riesgo (ROE 0.91). El ISAR subestimó el riesgo de deterioro hospitalario para pacientes en categorías de bajo y alto riesgo (ROE 1.59 y 1.11). Ambas escalas mostraron una pobre capacidad de discriminación, con un área bajo la curva (AUC) entre 0.55 y 0.60. Conclusiones: este estudio encontró que las escalas HARP e ISAR tienen una capacidad de discriminación limitada para predecir deterioro funcional hospitalario al alta. Las escalas HARP e ISAR deben usarse con cautela en la población colombiana ya que subestiman el riesgo de deterioro funcional hospitalario y tienen baja capacidad de discriminación.

Perfil de paciente geriátrico y factores asociados a mortalidad en población mayor de 80 años con infección por COVID-19: experiencia de un hospital universitario en Bogotá

Objetivo: Caracterizar el perfil del paciente e identificar los factores asociados a mortalidad de población mayor de 80 años hospitalizada por infección por COVID-19, a cargo del Servicio de Geriatría en un hospital universitario de la ciudad de Bogotá. Materiales y métodos: Se llevó a cabo un estudio observacional analítico, basado en la revisión de historias clínicas de una cohorte retrospectiva, en el que se incluyeron pacientes de 80 años o más con infección confirmada por COVID-19, en el período del 1 de marzo de 2020 al 28 de febrero de 2021. La variable dependiente fue mortalidad; las variables independientes, edad, factores clínicos, situación basal y paraclínicos. Resultados: Se identificaron 280 pacientes, con mediana de edad de 84 años, y la mayoría de perfil robusto. El síntoma más frecuente fue tos, seguido por disnea. El 60,3 % de los pacientes presentaron linfopenia, además de elevación de dímero D (> 1000 ug/L), y en la mayoría de los casos se describieron patrones radiológicos típicos de COVID-19. La mortalidad fue del 41,4 %, principalmente asociada a mayor edad, proteína C reactiva elevada, dependencia para actividades básicas de la vida diaria, antecedente de trastorno neurocognitivo mayor, comorbilidad y los pacientes con perfiles dependiente y frágil. Conclusiones: La población geriátrica presenta un alto riesgo de mortalidad por infección por COVID-19. El presente estudio permitió evidenciar qué perfiles de paciente dependientes y frágiles, así como presencia de comorbilidades como trastorno neurocognitivo mayor, enfermedad pulmonar obstructiva crónica y polifarmacia previa al ingreso podrían influir en el desenlace.

Objective: To characterize the geriatric patient profile and identify the mortality-associated factors in a population over 80 years hospitalized with COVID-19 infection in the geriatric ward of a university hospital in the city of Bogotá. Materials and methods: An analytical observational retrospective cohort study based on chart reviews was conducted. The study included patients over 80 years with confirmed COVID-19 infection from March 1, 2020 to February 28, 2021. The dependent variable was mortality and the independent variables were age, clinical factors, baseline characteristics and paraclinical status. Results: Two hundred eighty (280) patients with a median age of 84 years, most of whom were overweight, were identified. The most frequent symptom was cough followed by dyspnea. Out of all patients, 60.3 % presented lymphopenia and elevated D-dimer levels (> 1,000 μg/L), and most of them showed typical imaging patterns of COVID-19. Mortality accounted for 41.4 % and was mainly associated with older age, elevated C-reactive protein, activities of daily living impairment, history of major neurocognitive disorder, comorbidity, and dependent and frail patient profiles. Conclusions: The geriatric population has an increased risk of mortality from COVID-19 infection. The present study showed that dependent and frail patient profiles, as well as the presence of comorbidities such as major neurocognitive disorder, chronic obstructive pulmonary disease and polypharmacy prior to admission, could influence the outcome.

Nutrition-Focused Care for Community-Living Adults: Healthcare Utilization and Economic Benefits.

OBJECTIVES: We assessed the impact of a recently reported nutritional quality improvement program (QIP) on healthcare resource utilization and costs for older, community-living adults in Bogotá, Colombia. METHODS: The study included 618 community-dwelling, older adults (> 60 years) who were at risk or malnourished and receiving outpatient clinical care. The intervention was a QIP that emphasized nutritional screening, dietary education, lifestyle counseling, 60-day consumption of oral nutritional supplements, and 90-day follow-up. For economic modeling, we performed 90-day budget impact and cost-effectiveness analyses from a Colombian third-party payer perspective. The base-case analysis quantified mean healthcare resource use in the QIP study population. Analysis was based on mean input values (deterministic) and distributions of input parameters (probabilistic). As the deterministic analysis provided a simple point estimate, the cost-effectiveness analysis focused on the probabilistic results informed by 1000 iterations of a Monte-Carlo simulation. RESULTS: Results showed that the total use of healthcare resources over 90 days was significantly reduced by > 40% (hospitalizations were reduced by approximately 80%, emergency department visits by > 60%, and outpatient clinical visits by nearly 40%; P < .001). Based on economic modeling, total cost savings of $129 740 or per-patient cost savings of $210 over 90 days could be attributed to the use of nutritional QIP strategies. Total cost savings equated to nearly twice the initial investment for QIP intervention; that is, the per-dollar return on investment was $1.82. CONCLUSIONS: For older adults living in the community in Colombia, the use of our nutritional QIP improved health outcomes while lowering costs of healthcare and was thus cost-effective.

Síntomas depresivos y prevalencia de fragilidad en adultos mayores colombianos. Análisis secundario de la encuesta SABE Colombia 2015

Objetivo: Analizar la relación entre los síntomas depresivos y la prevalencia de fragilidad medida como fenotipo de fragilidad. Materiales y métodos: Estudio secundario de la encuesta SABE Colombia 2015. Se utilizaron las puntuaciones de la escala Yesavage como variable independiente, la prevalencia de fragilidad calculada con el fenotipo de fragilidad de Fried. Realizamos un análisis descriptivo y bivariado de la muestra, seguido de un análisis multivariado ajustando por variables de confusión. Resultados: Analizamos información de un total de 19 004 participantes mayores de 60 años, participantes sin deterioro cognitivo de la encuesta, a quienes se les administró la escala Yesavage. La media de edad fue 69.25 años, el 56 % de los participantes eran mujeres, la prevalencia de fragilidad fue del 12 % y se encontró síntomas depresivos en 57,4 % de la muestra. En el análisis multivariado encontramos asociaciones estadísticamente significativas entre las puntuaciones más altas de la escala Yesavage y la presencia de fragilidad (Yesavage 5-10) OR 1.20 (0.98-1.46) p valor 0.066 y (Yesavage >10) 2.05 (1.46-2.89) <0.001 después de ajustar por edad, sexo, comorbilidades, funcionalidad, escolaridad y estado marital Conclusiones: Nuestro estudio muestra asociaciones estadísticamente significativas entre la presencia de síntomas depresivos medidos con la escala Yesavage y la prevalencia de fragilidad según el índice de Fried. Aunque existe escasa evidencia en cuanto a la asociación de estas dos entidades en Latinoamérica, nuestros resultados son consistentes con estudios previos en la región.

Objetive: There is scarce evidence in Latin America that describes depression in the elderly population with fragility. The aim of this paper is to provide a better understanding of the relationship between depressive symptoms in elderly and the prevalence of frailty. Material and methods: We performed secondary analysis of the SABE Colombia 2015 survey. The Yesavage scale scores were used as an independent variable, the prevalence of frailty was estimated with the Fried fragility phenotype. We performed a descriptive and bivariate analysis of the sample, followed by a multivariate analysis adjusting for confounding variables. Results: We analyzed information from a total of 19,004 participants over 60 years of age, participants without cognitive impairment of the survey, who were administered the Yes-avage scale. The mean age was 69.25 years, 56 % of the participants were women, the prevalence of frailty was 12 % and depressive symptoms were found in 57.4 % of the sample. In the multivariate analysis we found statistically significant associations between frailty and the higher Yesavage scores (score 5-10) OR 1.20 (0.98-1.46) p valor 0.066 and (score> 10) 2.05 (1.46-2.89) <0.001 after adjusting for age, sex, comorbidities, functionality, schooling and marital status. Conclusions: Our study shows an independent relationship between depressive symptoms and frailty phenotype in the SABE Colombia 2015s survey There is lack of data and characterization of this population in Latin America regarding the relationship of these conditions, however our results are consistent with previous reports from this region.

Use of a nutrition-focused quality improvement program for community-living older adults at malnutrition risk is associated with better nutritional outcomes.

BACKGROUND & AIMS: Among older adults, malnutrition or its risk is common and is associated with increased morbidity and mortality plus increased need for healthcare utilization. We aimed to identify and treat malnutrition risk among older adults who received care at an outpatient clinic after a recent hospitalization and/or for management of a chronic disease. METHODS: From the outpatient clinic of Hospital Universitario San Ignacio, Bogotá, Colombia, we recruited older adults (>60 years) with malnutrition or its risk according to the Mini Nutritional Assessment-Short Form (MNA-SF). Patients were excluded if they had dementia or were not expected to live 90 days or more. Intervention was a nutrition-focused quality improvement program (QIP) including: i) education of patients and caregivers about the health importance of complete and balanced macro- and micronutrient intake plus physical exercise; and ii) nutritional intervention with dietary counseling and provision of oral nutritional supplements (ONS) for daily intake. To assess the effect of our intervention, we collected nutritional outcome data pre- and post-participation of patients in the nutrition-focused QIP. For pre-post comparisons, we used MNA-SF scores and calf circumference (a proxy for leg muscle mass) measures along with nutrition-related anthropometric determinations of body weight and body mass index (BMI). The ONS treatment phase was 60 days, with follow-up measurements up to 30 days after ONS treatment ended (90 days after intervention start). RESULTS: Of 677 enrolled patients, 618 completed the QIP, while 565 had complete anthropometric data. Patients had a mean age of 74.1 ± 8.7 years, an average of 2.6 comorbidities, included a high proportion of females (69.4%), with medium socioeconomic status (76%). After QIP intervention, 324 (52.4%) patients had improvement in nutritional outcomes; improvement was significant in all four measures (P-values < 0.001). Higher ONS adherence was associated with the highest improvement in nutritional status. CONCLUSIONS: For community-living older adults receiving outpatient care, comprehensive nutritional care offered via a nutrition-focused QIP was associated with significant improvements in indicators of nutritional status (MNA-SF scores and calf circumference) and maintenance or improvements in nutrition-related anthropometric measures (body weight and BMI). GOV IDENTIFIER: NCT04042987.

Revisión narrativa: unidad de ortogeriatría, la propuesta para reducir los desenlaces adversos en adultos mayores con fracturas de cadera por fragilidad / Narrative review: Orthogeriatrics unit, the proposal to reduce adverse outcomes in older adults with fragility fractures

Introducción Las fracturas de cadera son un problema de salud pública debido a su asociación con altas tasas de mortalidad a un año, deterioro funcional y empeoramiento de la calidad de vida. Un enfoque multidisciplinario mejora los resultados de los pacientes adultos mayores con fracturas por fragilidad. Objetivo Realizar una revisión narrativa para evaluar la evidencia de las unidades de ortogeriatría como estrategia para reducir desenlaces adversos en adultos mayores con fracturas de cadera por fragilidad. Materiales y métodos Se realizó una búsqueda de la literatura en las siguientes bases de datos: PubMed,Cochrane y Scielo, con los términos: "hip fracture" or "fragility fracture" AND "multidisciplinary team" or "Geriatric co management" or AND "orthogeriatric" or "ortho-geriatric". Resultados El manejo por ortogeriatría reduce el tiempo de evaluación pre-quirúrgico, complicaciones postoperatorias y la estancia hospitalaria. La valoración interdisciplinaria ha demostrado ser eficaz para disminuir el deterioro funcional, la mortalidad intrahospitalaria, la mortalidad a los 30 días y el riesgo de institucionalización en comparación con otros modelos de atención. Estos factores impactan sobre la optimización de recursos disminuyendo los costos en salud. Conclusión Los servicios de ortogeriatría son el modelo ideal para tratar las fracturas de cadera por fragilidad en adultos mayores. En Colombia se deben implementar más unidades de ortogeriatría para mejorar la atención intrahospitalaria, crear programas de seguimiento y rehabilitación.

Introduction Hip fracture is a public health problem due to its association with high mortality rates at one year, functional decline and worsening of quality of life. A multidisciplinary approach improves outcomes for elderly patients with fragility fracture. Objective To carry out a narrative review to evaluate the evidence of orthogeriatric units as a strategy to reduce adverse outcomes in older adults with fragility hip fractures. Material and Methods A literature search was carried out in the following databases: PubMed, Cochrane and Scielo, with the terms: "hip fracture" or "fragility fracture" AND "multidisciplinary team" or "Geriatric co management" or AND "orthogeriatric" or "ortho-geriatric". Results Care by orthogeriatrics reduces pre-operative surgical time, postoperative complications and hospital stay. Interdisciplinary assessment has been shown to be effective in reducing functional decline, in-hospital mortality, 30-day mortality, and the risk of institutionalization compared to other models of care. These factors impact on the optimization of resources, reducing health costs. Conclusion Orthogeriatric services are the ideal model to treat fragility fractures in older adults. In Colombia, more orthogeriatric units should be implemented to improve in-hospital care, create follow-up and rehabilitation programs.

In-hospital complications in an acute care geriatric unit / [Complicaciones intrahospitalarias en una unidad geriátrica de agudos].

Introduction: In-hospital complications frequently occur in hospitalized people over 65 worsening their clinical outcomes. There are, however, few studies on the factors associated with in-hospital complications in elderly patient care. Objective: To evaluate factors associated with in-hospital complications in a geriatric acute care unit in Bogotá, Colombia. Materials and methods: We conducted an analytical, observational, retrospective study in a cohort of 1,657 patients over 65 years of age who received care in the geriatric unit of a high complexity hospital in Bogotá, Colombia. The dependent variable was in-hospital complications and the independent variables, the degree of functional dependence on admission, dementia, nutritional status, social support, comorbidity, and polypharmacy. We used Poisson's linear regression model to identify associated variables. Results: The bivariate analysis showed that functional dependence (PR=2.092, p≤0.001) and malnutrition (PR=2.850, p≤0.001) were associated with a higher rate of hospital-acquired infection. In the multivariate analysis, functional dependence (PR=1.931, p=0.003) and malnutrition (PR=2.502, p=0.002) remained independent factors for in-hospital complications. Conclusion: In acute care centers, integral assessment at admission to identify functional dependence and malnutrition predicts in-hospital complications.

Introducción. Las complicaciones hospitalarias ocurren con gran frecuencia en personas mayores de 65 años hospitalizadas y conllevan peores resultados clínicos. Son pocos los estudios sobre los factores asociados con las complicaciones hospitalarias en la atención de adultos mayores. Objetivo. Evaluar los factores asociados con las complicaciones hospitalarias en una unidad geriátrica de agudos en Bogotá, Colombia. Materiales y métodos. Se hizo un estudio observacional analítico basado en una cohorte retrospectiva que incluyó 1.657 pacientes mayores de 65 años atendidos en una unidad de hospitalización en Bogotá, Colombia. La variable dependiente fueron las complicaciones hospitalarias y, las independientes, la dependencia funcional, la demencia, el estado nutricional, el soporte social, las comorbilidades y la polifarmacia. Se utilizó el modelo de regresión lineal de Poisson para determinar las variables asociadas. Resultados. En el análisis bivariado se encontró que la dependencia funcional (razón de prevalencia, RP=2,092; p≤0,001) y la malnutrición (RP=2,850; p≤0,001) eran factores asociados con una mayor tasa de complicaciones hospitalarias. En el análisis multivariado aparecían como factores independientes (dependencia funcional: RP=1,931 y p=0,003; malnutrición: RP=2,502 y p=0,002). Conclusión. El hacer una evaluación integral que permita determinar la dependencia funcional y la malnutrición en el momento de ingreso en las unidades de hospitalización, permitiría predecir complicaciones hospitalarias.

Complicaciones hospitalarias en una unidad geriátrica de agudos / In-hospital complications in an acute care geriatric unit

Resumen | Introducción. Las complicaciones hospitalarias ocurren con gran frecuencia en personas mayores de 65 años hospitalizadas y conllevan peores resultados clínicos. Son pocos los estudios sobre los factores asociados con las complicaciones hospitalarias en la atención de adultos mayores. Objetivo. Evaluar los factores asociados con las complicaciones hospitalarias en una unidad geriátrica de agudos en Bogotá, Colombia. Materiales y métodos. Se hizo un estudio observacional analítico basado en una cohorte retrospectiva que incluyó 1.657 pacientes mayores de 65 años atendidos en una unidad de hospitalización en Bogotá, Colombia. La variable dependiente fueron las complicaciones hospitalarias y, las independientes, la dependencia funcional, la demencia, el estado nutricional, el soporte social, las comorbilidades y la polifarmacia. Se utilizó el modelo de regresión lineal de Poisson para determinar las variables asociadas. Resultados. En el análisis bivariado se encontró que la dependencia funcional (razón de prevalencia, RP=2,092; p≤0,001) y la malnutrición (RP=2,850; p≤0,001) eran factores asociados con una mayor tasa de complicaciones hospitalarias. En el análisis multivariado aparecían como factores independientes (dependencia funcional: RP=1,931 y p=0,003; malnutrición: RP=2,502 y p=0,002). Conclusión. El hacer una evaluación integral que permita determinar la dependencia funcional y la malnutrición en el momento de ingreso en las unidades de hospitalización, permitiría predecir complicaciones hospitalarias.

Abstract | Introduction: In-hospital complications frequently occur in hospitalized people over 65 worsening their clinical outcomes. There are, however, few studies on the factors associated with in-hospital complications in elderly patient care. Objective: To evaluate factors associated with in-hospital complications in a geriatric acute care unit in Bogotá, Colombia. Materials and methods: We conducted an analytical, observational, retrospective study in a cohort of 1,657 patients over 65 years of age who received care in the geriatric unit of a high complexity hospital in Bogotá, Colombia. The dependent variable was in-hospital complications and the independent variables, the degree of functional dependence on admission, dementia, nutritional status, social support, comorbidity, and polypharmacy. We used Poisson's linear regression model to identify associated variables. Results: The bivariate analysis showed that functional dependence (PR=2.092, p≤0.001) and malnutrition (PR=2.850, p≤0.001) were associated with a higher rate of hospital-acquired infection. In the multivariate analysis, functional dependence (PR=1.931, p=0.003) and malnutrition (PR=2.502, p=0.002) remained independent factors for in-hospital complications. Conclusion: In acute care centers, integral assessment at admission to identify functional dependence and malnutrition predicts in-hospital complications.

Factores asociados a caídas en el servicio ambulatorio de geriatría de un hospital universitario en Bogotá (Colombia) / Factors Associated with Falls in the Outpatient Geriatric Service of a University Hospital in Bogotá, Colombia / Fatores associados a quedas no serviço ambulatorial de geriatria de um hospital universitário em Bogotá, Colômbia

Resumen Introducción: las caídas en el adulto mayor influyen de manera negativa en su estado funcional y el riesgo de caídas se eleva progresivamente con la edad, por lo que es importante objetivar todos los factores de riesgo de cada paciente. El objetivo fue describir la prevalencia y los factores asociados con caídas en los pacientes del servicio ambulatorio de geriatría del Hospital Universitario San Ignacio en Bogotá (Colombia). Materiales y métodos: se realizó un estudio descriptivo con pacientes valorados en la consulta externa de geriatría del Hospital Universitario San Ignacio desde enero de 2017 hasta diciembre de 2018. Resultados: se incluyeron 233 pacientes, en quienes se documentó una prevalencia de caídas del 44.5 %. En el análisis bivariado, las variables con asociación estadísticamente significativa fueron: la presencia de trastorno neurocognitivo mayor (TNCM) (OR: 2.31; IC 95 %: 1.28-4.18; p: 0.005), el miedo a caer (OR: 2.27; IC 95 %: 1.24-4.18; p: 0.008), un grado de dependencia moderado a total (OR: 1.93; IC 95 %: 1.11-3.35; p: 0.019) y un mal estado nutricional (OR: 1.18; IC 95 %: 1.099-3.18; p: 0.02). No obstante, en el análisis multivariado, las variables que mantuvieron la asociación fueron el TNCM (OR: 2.09; IC 95 %: 1.14-3.86; p: 0.001) y el miedo a caer (OR: 2.27; IC 95 %: 1.19-4.32; p: 0.001). Conclusión: las variables asociadas con caídas en nuestra población se relacionan con lo descrito en la literatura mundial; son necesarias intervenciones para corregir estos factores y evitar caídas, así como diseñar más estudios para detectar otros factores asociados.

Abstract Introduction: Falls in the elderly have a negative impact on functional status and the risk of falls increases progressively with age, so it is important to objectify all the risk factors of each patient. Our objective was to describe the prevalence and factors associated with falls in patients from the geriatric outpatient service of the San Ignacio University Hospital in Bogotá, Colombia. Materials and methods: A descriptive study was carried out with patients assessed in the geriatric outpatient clinic of the San Ignacio University Hospital from January 2017 to December 2018. Results: 233 patients were included, documenting a prevalence of falls of 44.5%. In the bivariate analysis, the variables with a statistically significant association were: the presence of major neurocognitive disorder (MNCD) (OR: 2.31; 95 %> CI: 1.284.18; p: 0.005), fear of falling (OR: 2.27; 95 %> CI: 1.24-4.18; p: 0.008), a moderate to total degree of dependence (OR: 1.93; 95 %> ci 1.11-3.35; p: 0.019) and a poor nutritional status (OR: 1.18; 95 °/o CI: 1.099-3.18; p: 0.02). However, in the multivariate analysis, the variables that maintained the association were MNCD (OR: 2.09; 95 %> CI: 1.14-3.86; p: 0.001) and fear of falling (OR: 2.27; 95 %> CI: 1.19-4.32; p: 0.001). Discussion: The variables associated with falls in our population are related to what is described in the world literature; Interventions are necessary to correct these factors and avoid falls in our population, as well as to design more studies to detect other associated factors.

Resumo Introdução: as quedas em idosos impactam negativamente o estado funcional e o risco de quedas aumentam progressivamente com a idade, por isso é importante objetivar todos os fatores de risco de cada paciente. Nosso objetivo foi descrever a prevalência e os fatores associados às quedas em pacientes do ambulatório de geriatria do Hospital Universitário San Ignacio em Bogotá, Colômbia. Materiais e métodos: foi realizado um estudo descritivo com pacientes avaliados no ambulatório de geriatria do Hospital Universitário San Ignacio no período de janeiro de 2017 a dezembro de 2018. Resultados: foram incluídos 233 pacientes, documentando uma prevalência de quedas de 44,5%. Na análise bivariada, as variáveis com associação estatisticamente significativa foram: presença de trastorno neurocognitivo maior (TNCM) (OR: 2.31; IC 95%: 1,28-4,18; p: 0,005), medo de cair (OR: 2,27; IC 95%: 1,24-4,18; p: 0,008), grau de dependência moderado a total (OR: 1,93; IC 95%: 1,11-3,35; p: 0,019) e estado nutricional ruim (OR: 1,18; IC 95%: 1,099-3,18; p: 0,02); porém, na análise multivariada, as variáveis que mantiveram a associação foram TNCM (OR: 2,09; IC 95%: 1,14-3,86; p: 0,001) e medo de cair (OR: 2,27; IC 95%: 1,19-4,32; p: 0,001). Conclusão: as variáveis associadas às quedas em nossa população estão relacionadas ao que é descrito na literatura mundial; são necessárias intervenções para corrigir esses fatores e evitar quedas em nossa população, bem como desenhar mais estudos para detectar outros fatores associados.

Association of Malnutrition with Functional and Cognitive Trajectories in People Living with Dementia: A Five-Year Follow-Up Study.

BACKGROUND: In dementia, functional status depends on multiple factors in addition to cognition. Nutritional status is a potentially modifiable factor related to homeostasis and proper functioning of body systems and may contribute to cognitive and functional decline. OBJECTIVE: This paper aims to analyze the association of malnutrition with the course of cognitive and functional decline in people living with dementia. METHODS: This is an analysis of a longitudinal cohort study, the Dementia Study of Western Norway. Data of 202 patients diagnosed with mild dementia were analyzed; Alzheimer's disease (AD) (n = 103), Lewy body dementia (LBD) (n = 74), and other dementias (OD) (n = 25). Cognition was assessed with the Mini-Mental State Examination and functional decline through the activities of daily living included in the Rapid Disability Rating Scale. The Global Leadership Initiative on Malnutrition Index was used to determine nutritional status. Associations of nutritional status with cognitive and functional decline were evaluated through adjusted linear mixed models. RESULTS: At baseline, the prevalence of general malnutrition was 28.7%; 17.3% were classified as moderate malnutrition and 11.38% as severe malnutrition (there were no significant differences between AD and LBD). Malnutrition at diagnosis and over follow-up was a significant predictor of functional-decline, but not of cognitive decline. CONCLUSION: According to our results malnutrition was associated with faster functional loss but, not cognitive decline in older adults with dementia. A more comprehensive dementia approach including nutritional assessments could improve prognosis.

Effect of physical activity on cognitive domains in dementia and mild cognitive impairment: overview of systematic reviews and meta-analyses.

OBJECTIVE: To assess the effect of physical activity on cognitive domains in persons with dementia or mild cognitive impairment. DESIGN: An overview of systematic reviews and meta-analyses of randomized controlled trials were performed. METHODS: A literature search was performed in PubMed, Scopus, and Cochrane Database of Systematic Reviews databases up to February 2020. Data about the change in cognitive domains after physical activity intervention was extracted and plotted. RESULTS: We included 11 meta-analyses in this overview. The most frequent type of physical activity for the intervention group was the aerobic exercise with a duration between 6 and 78 weeks. Global cognition was the most common form of assessing the cognitive function, follow of executive function, delayed recall, attention, and verbal fluency. We found a positive effect of physical activity on global cognition, executive function, and delayed recall, but no effect on verbal fluency, attention, and immediate recall. CONCLUSION: Physical activity shows a positive effect on cognition in people with dementia and mild cognitive impairment, especially when it was assessed as global cognition. Positive effects on executive function and memory were also shown. This result confirms the relevance of physical activity in the treatment of persons with cognitive impairment.

Delirium prevalence in a Colombian hospital, association with geriatric syndromes and complications during hospitalization.

BACKGROUND: The aim of this paper is to describe the prevalence of Delirium and the factors associated with its presentation and complications identified in a geriatric unit in Colombia. MATERIAL AND METHODS: This is a retrospective observational study that included all patients admitted consecutively for two years in a geriatric unit of a hospital in Bogotá, Colombia. We assessed delirium prevalence with the Confusion Assessment Method (CAM). The independent variables were age, sex, functional impairment (Barthel<90), malnutrition (MNA<12), pressure ulcers at admission, state of the social support network, number of comorbidities, polypharmacy (5 or more drugs), complications such as ICU requirement, hospital stay, in-hospital functional impairment and mortality were also evaluated. As an exclusion criterion: not having CAM registered in the medical record, all the patients had this information. RESULTS: We studied 1599 subjects with a mean age of 86 years (IQR 9). Delirium prevalence was 51.03%. Delirium was associated with a higher rate of: pressure ulcers on admission [OR 3.76 (CI 2.60-5.43 p<0.001)], functional impairment [OR 2.38 (CI 1.79-3.16 p<0.001)], malnutrition [OR 2.06 (CI 1.56-2.73 p<0.001)], and infection [OR 1.46 (CI 1.17-1.82 p<0.001)]. Moreover delirium has a higher association with mortality [OR 2.80 (1.03-7.54 p=0.042)], in-hospital functional decline [OR 1.82 (1.41-2.36 p<0.001)], and longer hospital stay [OR 1.04 (1.04-1.09 p=0.006)]; independently of age, sex, pressure ulcers on admission, functional impairment, malnutrition, dementia, infection and limited social network. CONCLUSION: Our study suggests that infectious diseases and geriatric syndromes such as, functional dependence, pressure ulcers, malnutrition or major cognitive impairment are independently associated with the presence of delirium on admission. Additionally, the presence of delirium is independently associated during hospitalization with complications, longer hospital stay, functional impairment and mortality.

Life-space assessment and associated clinical factors: SABE Colombia / Avaliação do espaço de vida e fatores clínicos associados: SABE Colômbia

OBJECTIVES: Our aim was to assess whether an association exists between chronic diseases or multimorbidity and limited life space in older adults. METHODS: This is a secondary analysis of the SABE (Salud, Bienestar y Envejecimiento) Colombia Study. We assessed chronic diseases through self-report, and a limited life space was defined as any score ≤ 60 in the Life-Space Assessment scale. Multimorbidity was defined as having two or more coexisting diseases. We performed bivariate analyses and multivariate logistic regressions aiming to obtain odds ratios with 95% confidence intervals. RESULTS: The prevalence of limited life space was 2.95% with a mean score of 76.27 ± 19.34. Statistically significant associations were found between limited life space and mental disease (OR 1.45; 95%CI 1.15 ­ 1.82) and between limited life space and multimorbidity (OR 1.32; 95%CI 1.06 ­ 1.63). CONCLUSIONS: Mental disease and multimorbidity are associated with limited life space in older adults. Therefore, preventing, diagnosing, and treating mental illness should be sought in addition to the existing preventive and therapeutic approaches available for noncommunicable diseases.

OBJETIVO: Nosso objetivo foi avaliar se existe uma associação entre doenças crônicas ou multimorbidade e espaço de vida limitado em idosos. METODOLOGIA: Esta é uma análise secundária do Estudo SABE (Salud, Bienestar y Envejecimiento) Colômbia. Avaliamos as doenças crônicas por meio de autorrelato, e espaço de vida limitado foi definido como uma pontuação ≤ 60 na escala do Life-Space Assessment. Multimorbidade foi definida como a coexistência de duas ou mais doenças. Realizamos análises bivariadas e regressões logísticas multivariadas com o objetivo de obter odds ratios com intervalos de confiança de 95%. RESULTADOS: A prevalência de espaço de vida limitado foi de 2,95% com pontuação média de 76,27 ± 19,34. Associações estatisticamente significativas foram encontradas entre espaço de vida limitado e doença mental (OR 1,45; IC95% 1,15 ­ 1,82) e entre espaço de vida limitado e multimorbidade (OR 1,32; IC95% 1,06 ­ 1,63). CONCLUSÕES: A doença mental e a multimorbidade estão associadas ao espaço de vida limitado em idosos. Portanto, deve-se buscar formas de prevenir, diagnosticar e tratar doenças mentais além das abordagens preventivas e terapêuticas atualmente disponíveis para doenças não transmissíveis

Behavioural Disturbances in Patients with Diagnosis of Neurocognitive Disorder in Bogotá (Colombia). / Alteraciones del comportamiento de pacientes con diagnóstico de trastorno neurocognoscitivo en Bogotá (Colombia).

INTRODUCTION: The main aim of this study is to determine the prevalence of behavioural disturbances (BD) in a group of patients with diagnosis of neurocognitive disorders assessed by a memory clinic in a referral assessment centre in Bogotá, Colombia, in 2015. MATERIAL AND METHODS: This is an observational, retrospective descriptive study of 507 patients with a diagnosis of neurocognitive disorder (according to DSM-5 criteria) evaluated in a referral centre in Bogotá, Colombia, in 2015. RESULTS: Among the group of patients assessed, analyses reveal mean age for minor neurocognitive disorders of 71.04 years, and 75.32 years for major neurocognitive disorder (P <0.001). A total of 62.72% of the sample were female. The most prevalent aetiology of the neurocognitive disorders was Alzheimer's disease, followed by behavioural variant frontotemporal dementia and neurocognitive disorders due to multiple aetiologies. BD occur more frequently in neurocognitive disorder due to behavioural variant frontotemporal dementia (100%), Alzheimer's disease (77.29%) and vascular disease (76.19%). The most prevalent BD in the group assessed were apathy (50.75%), irritability (48.45%), aggression (16.6%), and emotional lability (14.76%). CONCLUSIONS: BD are highly prevalent in patients with diagnosis of major neurocognitive disorder. BD are more prevalent in behavioural variant frontotemporal dementia than any other group. Apathy, irritability, emotional lability and aggression are the BD that occur with greater prevalence in our sample. We discuss the importance of BD in the clinical progression of neurocognitive disorders.

Alteraciones del comportamiento de pacientes con diagnóstico de trastorno neurocognoscitivo en Bogotá (Colombia) / Behavioural Disturbances in Patients with Diagnosis of Neurocognitive Disorder in Bogotá (Colombia)

RESUMEN Introducción: El objetivo de este estudio es determinar la frecuencia de alteraciones conductuales (AC) en un grupo de pacientes con diagnóstico de trastorno neurocognoscitivo (TN) valorado por clínica de memoria en un centro de evaluación en Bogotá, Colombia, durante el ano 2015. Material y métodos: Estudio observacional descriptivo y de corte retrospectivo de 507 pacientes con diagnóstico de trastorno neurocognoscitivo (según criterios del DSM-5), valorados en un centro de referencia en Bogotá en 2015. Resultados: La media de edad de los sujetos con trastorno neurocognoscitivo leve en el momento del diagnóstico era 71,04 arios y la de aquellos con trastorno neurocognoscitivo mayor, 75,32 años (p < 0,001). El 62,72% de la muestra son mujeres. La etiología más frecuente del trastorno neurocognoscitivo fue la enfermedad de Alzheimer probable, seguida por la degeneración lobar frontotemporal, variante conductual, y el trastorno neurocognoscitivo debido a múltiples etiologías. Las AC se presentan con mayor frecuencia en TN debido a degeneración frontotemporal variante conductual (100%), enfermedad de Alzheimer (77,29%) y vascular (76,19%). Las AC más prevalentes en el grupo evaluado fueron la apatía (50,75%), la irritabilidad (48,45%), la agresividad (16,6%) y la labilidad emocional (14,76%). Conclusiones: Las AC son prevalentes en pacientes con diagnóstico de trastorno neurocognoscitivo mayor. Según la etiología del trastorno neurocognoscitivo mayor, las AC son más prevalentes en la degeneración frontotemporal variante conductual. Apatía, irritabilidad, labilidad emocional y agresividad son las AC más comunes en toda la muestra.

ABSTRACT Introduction: The main aim of this study is to determine the prevalence of behavioural disturbances (BD) in a group of patients with diagnosis of neurocognitive disorders assessed by a memory clinic in a referral assessment centre in Bogotá, Colombia, in 2015. Material and methods: This is an observational, retrospective descriptive study of 507 patients with a diagnosis of neurocognitive disorder (according to DSM-5 criteria) evaluated in a referral centre in Bogotá, Colombia, in 2015. Results: Among the group of patients assessed, analyses reveal mean age for minor neurocognitive disorders of 71.04 years, and 75.32 years for major neurocognitive disorder (P < 0.001). A total of 62.72% of the sample were female. The most prevalent aetiology of the neurocognitive disorders was Alzheimer's disease, followed by behavioural variant fronto-temporal dementia and neurocognitive disorders due to multiple aetiologies. BD occur more frequently in neurocognitive disorder due to behavioural variant frontotemporal dementia (100%), Alzheimer's disease (77.29%) and vascular disease (76.19%). The most prevalent BD in the group assessed were apathy (50.75%), irritability (48.45%), aggression (16.6%), and emotional lability (14.76%). Conclusions: BD are highly prevalent in patients with diagnosis of major neurocognitive disorder. BD are more prevalent in behavioural variant frontotemporal dementia than any other group. Apathy, irritability, emotional lability and aggression are the BD that occur with greater prevalence in our sample. We discuss the importance of BD in the clinical progression of neurocognitive disorders.