[Malnutrition and obesity in self-sufficient elderly and health determinants related to both nutritional disorders]. / Desnutrición y obesidad en mayores autónomos y determinantes de salud relacionados con ambos trastornos nutricionales.

OBJECTIVE: Evaluate the nutritional status in older adults in the community, to determine malnutrition, obesity and their risks and to identify determinants related to both clinical situations. DESIGN: Cross-sectional study. SITE: 3 Primary care health centers in La Rioja in urban, semiurban and rural areas. PARTICIPANTS: 409 people ≥ 65 years old who came to receive consultation, with 3 abandonments. INTERVENTIONS: Nutritional assessment by tools screening and anthropometric measurements. MAIN MEASUREMENT: The MNA SF® was used to determine the prevalence of malnutrition and the BMI for obesity. Sociodemographic, socioeconomic, health-disease variables, lifestyle habits, metabolic status, and anthropometric measurements were included. Binary logistic regression was performed to predict dichotomous dependent variables. RESULTS: The prevalence of malnutrition and its risk (DR) were 18.7% and obesity and its risk were 66,5%. The multivariate model for malnutrition and DR includes polypharmacy, dyslipidemia, sedentary lifestyle, and having mental pathology (OR=3.09, 2.01, 2.12, 1.72, respectively). On the other hand, the probability of presenting obesity is associated with cardiovascular risk, age, excessive-moderate alcohol consumption, hypertension and low adherence to the Mediterranean diet (OR=2.73, 4.27, 2.03, 1.97, 1.81 respectively). CONCLUSION: This results stand out that the study population has a poor nutritional status, detecting a risk of malnutrition, obesity and overweight. The identified predictors related to lifestyle habits, presence of diseases, psychosocial problems, metabolic alterations, etc. They can guide the selection of those people who would benefit from screening to detect and approach the risk of malnutrition early.

Mastery and Marital Processes: Mechanisms Linking Midlife Economic Adversity and Later-Life Loneliness for Husbands and Wives in Enduring Marriages.

Research has documented that loneliness is a major public health concern, particularly for older adults in the United States. However, previous studies have not elucidated the mechanisms that connect family economic adversity to husbands' and wives' loneliness in later adulthood. Thus, using prospective dyadic data over 27 years from 254 enduring couples, the present study investigated how spouses' mastery, as an intraindividual process, and marital functioning, as a couple process, link midlife family economic adversity to spouses' later-life loneliness. The results provided support for three linking life course pathways: an adversity-mastery-loneliness pathway, an adversity-marital functioning-loneliness pathway, and a mastery-marital functioning-loneliness pathway. The results also showed spousal contemporaneous dependencies in mastery and loneliness. These findings demonstrate the persistent influence of midlife family economic adversity on husbands' and wives' loneliness nearly three decades later and elucidate linking mechanisms involving mastery and couple marital functioning. Findings are discussed as they relate to life course and family systems theories. Implications address multiple levels including national- and state-policies and couple-level clinical interventions.

Las investigaciones han documentado que la soledad es un gran problema de salud pública, particularmente en el caso de los adultos mayores en los Estados Unidos. Sin embargo, hay estudios previos que no han dilucidado los mecanismos que conectan las dificultades económicas familiares con la soledad de los esposos y las esposas en la tercera edad. Por lo tanto, utilizando datos diádicos prospectivos durante 27 años de 254 parejas duraderas, el presente estudió investigó cómo la dominancia de los cónyuges como proceso intraindividual y el funcionamiento conyugal como proceso de pareja vinculan las dificultades económicas familiares de la mediana edad con la soledad de los cónyuges en la tercera edad. Los resultados respaldaron tres vías asociadas en el transcurso de la vida: una vía de dificultades-dominancia-soledad, una vía de dificultades-funcionamiento conyugal-soledad, y una vía de dominancia-funcionamiento conyugal-soledad. Los resultados también demostraron dependencias contemporáneas conyugales en la dominancia y la soledad. Estos resultados demuestran la influencia constante de las dificultades económicas familiares durante la mediana edad en la soledad de los esposos y las esposas casi tres décadas después, y dilucidan los mecanismos conectivos relacionados con la dominancia y el funcionamiento conyugal de la pareja. Se exponen los resultados en relación con el transcurso de la vida y las teorías de sistemas familiares. Las implicancias abordan varios niveles, incluidas las políticas nacionales y estatales, y las intervenciones clínicas a nivel de la pareja.

[Reference values for SPPB in people over 60 years of age in the Basque Country]. / Valores de referencia del SPPB en personas mayores de 60 años en el País Vasco.

PURPOSE: To provide reference values of Short Physical Performance Battery (SPPB) in adults and older adults in the Basque Country by identifying cut-off points for measuring fragility and comparing the values with other populations in Spain. LOCATION: Bilbao capital, Basque Country (Spain). PARTICIPANTS: 1923 people over 60 years old included in the Health Program for the Elderly of the City of Bilbao participated in the study. The PA program was delivered twice a week for a minimum of 12 weeks, with 50-minute sessions. MAIN MEASUREMENTS: Participants were evaluated with the SPPB, which assesses balance (PE), gait speed test (PM) and chair stand test (PS). Based on the results obtained from all tests, the functionality of the participants was identified as: severe (0-4 points), moderate (4-6 points), mild (7-9 points) and minimal (10-12 points) limitation. RESULTS: Mean age was 77.9 (5.6) years, 87.9% were women and 12.1% were men. The SPPB showed significant differences in age (p = 0.000) and gender (p = 0.005). In addition, a comparison was made with a similar population: 70-75 years = 0.6 (Cohen's d), 76-79 years = 0.98 (Cohen's d), and >80 years = 0.98 (Cohen's d). CONCLUSIONS: The present study indicates normative values for SPPB. People's functionality decreases, as they get older. Despite the current findings available to health professionals for more effective detection of fragility, many of them have not yet been translated into clinical practice.

Health status and gerontological evaluation in Mexican older adults in the face of the COVID-19 pandemic.

INTRODUCTION: Older adults constitute the most vulnerable population group to the COVID-19 pandemic. In Mexico, their biopsychosocial conditions might intensify their vulnerability. METHOD: Affiliation to health systems, health conditions and gerontological evaluation of 3,218 older adults were analyzed following the methodology of the PAHO-Mexico Health, Well-being and Aging Survey. RESULTS: 88.6 % of older adults referred being affiliated to health systems; 30.2 %, 52.4 %, 10.3 %, 4.1 % and 5.6 % referred suffering from diabetes mellitus, high blood pressure, chronic obstructive pulmonary disease, heart disease and cerebrovascular disease, respectively; 15.6 % reported urinary incontinence, and 11.3%, fecal incontinence; 12.1 % of the women referred having suffered from breast cancer at some point, and 6.3 %, cervical cancer. The habit of smoking tobacco was observed in 11.1 %, risk of malnutrition in 32.8 %, established malnutrition in 4.1 %, functional dependence for basic and instrumental activities of daily life in 16.3 % and 17.6 %, respectively. CONCLUSION: Comprehensive gerontological evaluation is essential for efficient care of older adults who suffer from COVID-19, and for adequate care of the effects or health conditions at the conclusion of the confinement imposed by the pandemic.

INTRODUCCIÓN: Los adultos mayores constituyen el grupo más vulnerable ante la pandemia por COVID-19; en México, sus condiciones biopsicosociales podrían potenciar su vulnerabilidad. MÉTODO: Se analizó afiliación a sistemas de salud, condiciones de salud y evaluación gerontológica de 3218 adultos mayores conforme a la metodología de la Encuesta Salud, Bienestar y Envejecimiento OPS-México. RESULTADOS: 88.6 % de los adultos mayores refirió afiliación a un sistema de salud; 30.2, 52.4, 10.3, 4.1 y 5.6 % indicaron padecer diabetes mellitus, hipertensión arterial, enfermedad pulmonar obstructiva crónica, enfermedad cardiaca y evento vascular cerebral, respectivamente; 15.6 % reportó incontinencia urinaria y 11.3 %, fecal; 12.1 % de las mujeres indicó haber padecido en algún momento cáncer de mama y 6.3 %, cáncer cervicouterino. Se observó hábito de fumar tabaco en 11.1 %, riesgo de malnutrición en 32.8 %, malnutrición establecida en 4.1 %, dependencia funcional para las actividades básicas en 16.3 % e instrumentales de la vida diaria en 17.6 %. CONCLUSIÓN: La evaluación gerontológica integral es fundamental para la atención eficiente de los adultos mayores que padecen COVID-19 y para la adecuada atención por los efectos o condiciones de salud al terminar el confinamiento por la pandemia.

The Meta Marriage: Links Between Older Couples' Relationship Narratives and Marital Satisfaction.

Drawing upon a relatively understudied population and a unique observational task, the current study sought to examine how older couples' interactional behaviors during a relationship narrative task were associated with marital satisfaction over time. Using observational data from a sample of 64 older, higher-functioning married couples, we analyzed a series of Actor-Partner Independence Models (APIM) to explore how couples' interactional behaviors during a relationship narrative task were associated with spouses' marital satisfaction both concurrently and one year later. Analyses revealed that spouses' behaviors (e.g., expressions of positive affect, negative affect, communication skills, engagement) were associated with their self-reported marital satisfaction both at the time of the narrative and with changes in marital satisfaction. We found particularly robust evidence for the role of husbands' negative affect during the narrative task in predicting changes in both spouses' marital satisfaction over time. Our results indicate that researchers and clinicians should carefully consider the influence of development on the associations between spouses' behaviors and marital satisfaction. Further, those seeking to improve marriages in later life may need to consider the meaningful role that gender appears to play in shaping the marital experiences of older couples.

Prevalence and patterns of multimorbidity among the elderly in Burkina Faso: cross-sectional study.

OBJECTIVES: To assess the prevalence and distribution patterns of multimorbidity among urban older adults in Burkina Faso. METHODS: Cross-sectional study among community-dwelling elderly people aged ≥60 in Bobo-Dioulasso. We performed interviews, clinical examination and medical record review. Multimorbidity was defined as co-occurrence of at least two chronic diseases in one person whether as a coincidence or not. RESULTS: The overall prevalence of multimorbidity among older adults was 65%. Age ≥70 was associated with multimorbidity in multivariate analysis: adjusted OR = 1.65, 95% CI (1.01-2.68, P = 0.04). The most common chronic diseases were hypertension (82%) 95% CI (78; 86), malnutrition (39%) 95% CI (34; 44), visual impairments (28%) 95% CI (24; 33) and diabetes mellitus (27%) 95% CI (22; 31). Those aged ≥70 had significantly more malnutrition (50% vs. 31%, P = 0.0003) and osteoarthritis (8% vs. 3%, P = 0.01) than those aged 60-69. CONCLUSIONS: The high prevalence of multimorbidity requires a reorganization of healthcare systems in sub-Saharan Africa, especially in Burkina Faso. Interventions and care guidelines usually focused on individual diseases should be improved to better reflect this reality.

Impact of influenza vaccination history in the clinical course of older adults hospitalized with COVID-19.

BACKGROUND AND PURPOSE: Some studies have shown that influenza vaccination is associated with a lower risk of SARS-CoV-2 infection; in patients with COVID-19 infection, admission to intensive care is reduced, with less need for mechanical ventilation, shorter hospital stays, and reduced mortality. This study aimed to determine if a history of annual influenza vaccination impacts the clinical course of SARS-CoV-2 infection during hospitalization. METHODS: This was an observational, prospective, cohort study of patients older than 65 admitted to the COVID-19 unit from January to June 2021. The history of influenza vaccination over the last 5 years was assessed in each patient during hospitalization. We measured the length of hospital stay, the need for admission to the intensive care unit (ICU), the patient's oxygen requirements, complications during hospitalization, and outcome (medical discharge or death). Patients with a history of vaccination against SARS-CoV-2 were not included. RESULTS: We analyzed 125 patients, 50.4% (n=63) with history of influenza vaccination and 49.6% (n=62) without a history of influenza vaccination. In-hospital mortality was 44.8%, higher in the unvaccinated (54.8%) population (p=0.008). ICU admission was 27% higher in vaccinated (35%) patients (p=0.05). Patients without a history of influenza vaccination had a higher prevalence of cardiac (8% vs. 5%, p=0.04) and renal complications (29% vs. 13%, p=0.02). Patients with a history of vaccination had a greater need for invasive mechanical ventilation (25.4%, p=0.02). CONCLUSION: In this study, a history of influenza vaccination in older adults with SARS-CoV-2 infection was related to lower in-hospital mortality.

[Multicenter cross-sectional study on the prevalence of delirium in orthogeriatric units: «DELFRA 24 study¼ protocol]. / Estudio transversal multicéntrico sobre la prevalencia de delirium en unidades de ortogeriatría: protocolo de «Estudio DELFRA 24¼.

INTRODUCTION: Delirium is the most common perioperative complication in older adults with hip fracture (HF), leading to a catastrophic impact on their functional recovery and cognitive status. Currently, the true prevalence of this syndrome is unknown as its detection and management are not standardized in clinical practice. METHODS: A multicenter observational cross-sectional study will be conducted nationwide, involving different orthogeriatric units in Spain. The prevalence of delirium will be assessed using the 4AT scale, along with its characteristics and its relationship with other geriatric syndromes, sociodemographic variables, surgical characteristics, and laboratory parameters. RESULTS: Data collection is scheduled to take place on World Delirium Day (Wednesday, March 13, 2024), and therefore, the results are expected during the second or third quarter of 2024. CONCLUSIONS: Understanding the real prevalence and characteristics of delirium in older adults with HF could contribute to the development of strategies for its detection and management, reducing the impact of its consequences.

Impact of memory bias in the dietary estimation of older adults measured through a food frequency questionnaire and weighed food records: A cross-sectional study in older adults and primary caregivers.

Introduction: Introduction: changes in cognitive performance and memory of older adults (OA) can interfere in their reporting their diet. Objective: to evaluate the impact of memory bias in dietary estimation between OA and their primary caregivers (PC) through the food frequency questionnaire (FFQ) for Mexican OA and weighed food records (WFR). Methods: the present analysis uses the estimated dietary information based on the response provided by 51 older adults (OA) and their primary caregivers (PC) from the validation study of the FFQ for Mexicans OA was conducted during lockdowns for COVID-19. The personnel who applied FFQ and WFR were trained with standardized instruments and procedures. The Wilcoxon test was used to compare the intake per day of the foods and food groups, the Spearman correlation coefficient was used to evaluate the grams of intake per day of the food groups, and kappa coefficient was used to compare the level of food items and food groups between OA and PC. Results: in 11 of 14 food groups, no significant differences were observed between the amounts of intake reported by OA and PC. In the groups of dairy products, fruits, vegetables, and legumes, moderate agreement was observed (κ = 0.63 to 0.79), and in the rest of the groups was strong to perfect (κ ≥ 0.80). Correlation of the amount of intake between OA and PC was high in all food groups (r ≥ 0.87). Conclusion: the high correlation and high agreement between the amounts and frequencies of the food groups consumed as reported by the older adults and primary caregivers indicate that the information from both respondents is reliable.

Introducción: Introducción: los cambios cognitivos y la memoria que presentan los adultos mayores (AM) pueden interferir al momento de reportar los alimentos de su dieta. Objetivo: evaluar el impacto del sesgo de memoria en la estimación de la dieta entre AM y sus cuidadores principales (CP) a través del cuestionario de frecuencia de alimentos (CFA) para AM mexicanos y el registro de peso de alimentos (RPA). Métodos: el presente análisis utiliza la información dietética estimada con base en la respuesta proporcionada por 51 adultos mayores (AM) y sus cuidadores principales (CP) del estudio de validación del CFA para AM mexicanos que se realizó durante el confinamiento por COVID-19. El personal que aplicó CFA y RPA fue capacitado con instrumentos y procedimientos estandarizados. Se utilizó prueba de Wilcoxon para comparar la ingesta por día de los alimentos y grupos de alimentos, el coeficiente de correlación de Spearman para evaluar los gramos de ingesta por día de los grupos de alimentos y el coeficiente kappa para comparar el nivel de alimentos y grupos de alimentos entre AM y CP. Resultados: en 11 de 14 grupos de alimentos no se observaron diferencias significativas entre las cantidades de ingesta reportadas por AM y CP. En los grupos de lácteos, frutas, verduras y legumbres se observó concordancia moderada (κ = 0,63 a 0,79), y en el resto de los grupos fue de fuerte a perfecta (κ ≥ 0,80). La correlación de la cantidad de ingesta entre AM y CP fue alta en todos los grupos de alimentos (r ≥ 0,87). Conclusión: La alta correlación y la alta concordancia entre las cantidades y frecuencias de los grupos de alimentos consumidos según lo informado por los adultos mayores y los cuidadores principales indican que la información de ambos encuestados es confiable.

Cognitive function in Mexican older adults 6-months after recovering from SARS-CoV-2 infection.

BACKGROUND: SARS-CoV-2 infection has been associated with multiple short- and long-term complications including depression, and cognitive impairment (CI). However, older adults with CI after COVID-19 have not been fully documented. OBJECTIVE: To evaluate cognitive function in Mexican adults post-recovery from SARS-CoV-2 infection. METHODS: In this prospective observational cohort study, we assess cognitive function (CF) by the Montreal Cognitive Assessment (MOCA) test with a cut-off less than 26 points, and functional status via telemedicine. Eligible patients with a history of moderate-severe COVID-19 aged ≥60 years, cognitively healthy (evaluated by Everyday Cognition Scale) and required admission to an intensive care unit (ICU) were included. Patients with history of dementia, stroke, and delirium during the cognitive evaluation were excluded. The association between CI and COVID-19 was assessed with a Cox regression model. RESULTS: From the 634 patients admitted to the ICU, 415 survived, afterward 308 were excluded and 107 were analyzed. Mean age was 70 years, 58% were female, and 53% had severe COVID. The mean MoCA score was 21±5 points, CI was present in 61 patients (57%). Infection severity (RR 1.87; 95% CI: 1.11-3.15, p<0.05), lower education (RR 0.92; 95% CI: 0.87-0.97, p<0.01), and activity daily living disability (RR 1.87; 95% CI: 1.07-3.26, p<0.05) were the main factors associated with CI (unadjusted model by age and sex). The delayed recall, orientation, and language (83.2, 77.6 and 72.9% respectively) domains were the most affected in patients with CI. CONCLUSIONS: Fifty-seven percent of patients analyzed developed CI six months post-ICU discharge due to SARS-CoV-2, and COVID severity was the main factor associated to its outcome.

Prevalence of polypharmacy and drug interaction in older adults with rheumatic disease.

INTRODUCTION/AIM: Older people with rheumatic diseases tend to have a greater number of associated comorbidities, which will require the use of more drugs, increasing the risk of hospitalizations, complications, and drug interactions. In Mexico, there has been an estimated prevalence of polypharmacy of up to 55%, however there are scarce reports on the topic in our elderly population with rheumatic diseases. We aimed to determine the prevalence of polypharmacy and the association of drug interactions in patients treated for rheumatic disease. METHODS: A retrospective observational study was conducted on patients undergoing treatment for rheumatic diseases who were treated in geriatrics and rheumatology clinics from January to December 2021. The presence of polypharmacy and drug interactions was evaluated using the BOT Plus Pharmacological Surveillance System. The prevalence of polypharmacy and the association of drug interactions were estimated. RESULTS: We evaluated 320 patients, with a mean age of 67.05±5.8 years, predominantly female (85%). The prevalence of polypharmacy was 68.1% (n=218), of which 214 (98.1%) patients had related drug interactions; 27.1% were severe and 53.2% as moderate interactions. Factors related with increased risk of drug interactions were being exposed to hypertension increased the risk of drug interactions (POR 1.75, 95% CI 1.44-2.14; P<0.001), having osteoarthritis (POR 1.21, 95% CI 1.04-1.42; P=0.032) and thyroid disease (POR 1.45, 95% CI 1.28-1.65; P=0.001). The most prevalent serious interactions were leflunomide-methotrexate in 27 (46.5%) patients and buprenorphine-tramadol in 8 (13.7%). CONCLUSIONS: A high prevalence of polypharmacy and drug interactions was observed in elderly patients with rheumatic diseases. The main associated factors were comorbidities, particularly high blood pressure, osteoarthritis and thyroid diseases.

[Operational domains of healthy aging: a qualitative description in older adults in Peru]. / Dominios operativos del envejecimiento saludable: una descripción cualitativa en personas adultas mayores de Perú.

BACKGROUND AND OBJECTIVE: Understanding the domains of healthy aging (HA) through the perceptions of older adults is important for the multidimensional determination of the construct according to the culture of Peru and for the development of plans that promote the health, well-being, resources and strengths of older adults. The purpose of this study is to qualitatively explore the operational domains of HA in Peruvian older adults. METHOD: The approach adopted was fundamental qualitative descriptive. A purposive sampling was used and 26 participants attending senior centers belonging to the municipal commune of Lima were recruited (Medad=67.9; SD=6.64). Semi-structured interviews were conducted and the content analysis was carried out using an inductive method identifying the units of meaning of the HA. RESULTS: The content analysis showed 11 sub-themes and 4 main themes. The identified themes were as follows: "functional health", "psychological well-being", "active engagement with life" and "religion". Given this, the results demonstrate the multidimensionality of HA in Peruvian older adults. CONCLUSION: The operational domains of HA indicate the importance of individual perceptions considering functional health, psychological well-being, active engagement with life, and religion. This perspective supports the multidimensional concept of HA. This can be implemented as a guide for government entities working with PAMs. In addition, to formulate new public policies focusing on the domains of HA.

Investigation of the adaptation of older adults to online learning and artificial intelligence.

PURPOSE: The purpose of this study was to investigate the adaptation of older adults, to online learning and artificial intelligence. MATERIAL AND METHODS: 210 older adults (109 women; 101 men) aged 65 and over, were included. Hodkinson Mental Test, Online Learning Readiness Scale (OLRS) and Artificial Intelligence Anxiety Scale (AIAS) were used in evaluation. Older adults with 6 score and above in Hodkinson Mental Test, in which their cognitive level was evaluated, were included. Older adults were stratified according to their gender and age (Group I: 65-70 years; Group II: 71-75 years; Group III: 76 years and over). RESULTS: In comparison analysis between age groups, there was a significant difference in the total score and all subdimensions of OLRS in favor of Group I (p<0.05), and in the total score and all subdimensions of AIAS (p<0.05). When analyzed according to gender, "The computer/Internet self-efficacy" subdimension of OLRS was significantly higher in male older adults (p<0.05). "Learning" subdimension of AIAS was significantly higher in female older adults (p<0.05). CONCLUSION: With increasing age in older adults, the readiness for online learning decreases and the level of artificial intelligence anxiety increases. There is no difference between male and female older adults in the readiness for online learning and artificial intelligence anxiety levels, and it is moderate in both genders. In this context, we think that information about online and artificial intelligence applications for older adults would be beneficial.

Impact of a geriatric intervention based on the Comprehensive Geriatrics Assessment on avoidable admissions in older patients at risk evaluated in the Emergency Department.

OBJECTIVE: To know the impact of a geriatric intervention based on the Comprehensive Geriatric Assessment (CGA) on avoidable admissions in older patients at risk evaluated in the Emergency Department. METHOD: Prospective observational unicenter study. We included patients, from October 1, 2018 to January 31, 2020, over 75 years who were attended at the Emergency Department with a Triage Risk Screening Tool (TRST) score≥2. All patients were evaluated by a geriatrician through the CGA. The reasons for going to the Emergency room were collected and also the main intervention carried out by Geriatrics, whether admission or discharge was indicated and whether the admission was avoidable. We did a cost analysis calculating this by (bed/day×average stay×number of admissions avoided). RESULTS: We included 260 patients, 66% were women and the mean age was 86 years. 73.5% patients had polypharmacy, the mean Charlson index was 2.5 (5.6). 63.3% were independent for walking and 20.8% independent for basic activities of daily living. 59% had cognitive impairment. 91.5% lived at home. The most frequent reason for visiting the Emergency room was decline of general state in 22% and the most frequent intervention carried out by Geriatrics was assistance in the decision making process in 35.4% followed by referral to a preferential outpatient geriatric care circuit in 32.7%. Other interventions carried out by Geriatrics was assistance in clarifying diagnosis (4.2%), assistance in pharmacological adjustment (8.5%), referral to a standard geriatric care pathway (13.1%), telephone follow-up (4.2%) and/or coordination with Social Services for care planning (11.2%). Including all patients, 29.2% required hospital admission and 70.8% were discharged. 40% admissions were avoided, which meant more than 540 thousand euros saved. CONCLUSIONS: A standardized CGA coordinated by Geriatrics in older patients at risk of suffering adverse events in the Emergency room reduces admissions and costs, so it should therefore be established as a recommendation of good clinical practice.

Do octogenarian patients undergoing total knee replacement return to physical activity? / ¿Los pacientes octogenarios sometidos a reemplazo total de rodilla regresan a la actividad física?

BACKGROUND AND OBJECTIVES: It has been shown that total knee replacement improves functional capacity and physical activity; however, the influence of age remains unclear. The objective is evaluate the pre and postoperative physical activity measured with the Knee Society Score (KSS) score and the Tegner score. MATERIALS AND METHODS: A retrospective cohort analysis was conducted on patients who underwent total knee replacement (TKR) between January 2016 and December 2019 at our institution. Demographic variables (age, sex, and body mass index), activities of daily living, age-adjusted Charlson Comorbidity Index, American Society of Anesthesiologists score, the Knee Society Score (KSS) in its clinical (KSSc) and functional (KSSf) subscales, the Tegner functional scale, activity variables from the 2011 KSS version, and pain assessment using the visual analog scale were collected. Differences in these variables were analyzed between two age groups: group A (between 65 and 79 years old) and group B (80 years or older). RESULTS: A total of 450 patients were evaluated (group A=245, group B=167). Group A showed a Tegner improvement of 1.19 (95% CI: 1.06-1.31), whereas group B averaged 0.61 (95% CI: 0.43-0.80) (P<.001). Age >80 was an independent risk factor for less Tegner improvement. In KSSc, group A improved by 43 points (95% CI: 40.82-46.14), while group B showed a greater increase of 53 points (95% CI: 49.74-57.80). Adjusted for confounders, those>80 showed significantly higher KSSc improvement (12.8 points). For KSSf, group A improved by 33.91 points (95% CI: 31.07-36.75), and group B by 15.57 points (95% CI: 11.78-19.35). Adjusted for confounders, patients >80 had less improvement than those <80 (19 points). CONCLUSIONS: Patients who underwent TKR experienced improvements in physical and functional activity parameters. While these improvements were seen in the entire population, they were most notable in patients younger than 80 years.

Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland.

Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (ß = 0.16), embitterment (ß = 0.06), cognitive reappraisal (ß = -0.41), and the presence of meaning in life (ß = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.

KEY FINDINGS: Older adults with and without probable CPTSD differ in terms of age, employment status, adverse childhood experiences, psychiatric comorbidities, well-being, and life satisfaction.Temporal (in-)stability: In older adults, probable CPTSD appears to be unstable over a 21-month period with around one-third of the participants showing a stable course.Treatment targets: The identified significant predictors anger, embitterment, cognitive reappraisal, and the presence of meaning in life beliefs are potential treatment targets.

[Effect of resveratrol on cognitive functions in older adults: a systematic review and meta-analysis]. / Efecto del resveratrol sobre las funciones cognitivas en adultos mayores: una revisión sistemática y metaanálisis.

Introduction: Introduction: resveratrol has multiple beneficial effects on different body systems, including the central nervous system, however, the results reported on the effect on cognitive functions in older adults are inconsistent. Therefore, the purpose of this systematic review is to present a synthesis of knowledge about the effect of resveratrol on cognitive functions in older adults. Method: a systematic review was carried out according to the PRISMA-2009 criteria. The search for articles was carried out until September 7, 2021 in PubMed, Scopus, Web of Science, PsycINFO, SciELO, and TESIUNAM. The outcome variables were delayed, immediate, and working memory, and processing speed. The standardized mean difference (SMD) was estimated to assess the effect. Results: one thousand sixty-five studies were found, of which six met the eligibility criteria for the systematic review and meta-analysis. No significant effect was found on delayed memory (SMD = 0.69, 95 % CI: 0.85-2.23, p = 0.38), immediate memory (SMD = 0.56, 95 % CI: -0.20-1.31, p = 0.15), working memory (SMD = -0.21, 95 % CI: -0.74-0.32, p = 0.43) and processing speed (SMD = 0.25, 95 % CI: -0.58-1.07, p = 0.55). Conclusion: our results suggest that resveratrol does not have an effect on cognitive functions in older adults, however, it is necessary to carry out more studies with different doses, type of nutraceutical formulation and treatment time.

Introducción: Introducción: el resveratrol tiene múltiples efectos beneficiosos en diferentes sistemas del organismo, incluido el nervioso central, sin embargo, los resultados reportados sobre el efecto en las funciones cognitivas en adultos mayores son inconsistentes. Por lo anterior, el propósito de esta revisión sistemática es presentar una síntesis del conocimiento sobre los efectos del resveratrol en las funciones cognitivas en adultos mayores. Método: se llevó a cabo una revisión sistemática acorde con los criterios de PRISMA-2009. La búsqueda de artículos se realizó hasta el 7 de septiembre de 2021 en PubMed, Scopus, Web of Science, PsycINFO, SciELO y TESIUNAM. Las variables de desenlace fueron memoria diferida, inmediata y de trabajo y velocidad del procesamiento. Se estimó la diferencia de medias estandarizadas (DME) para evaluar el efecto. Resultados: se encontraron 1.065 estudios, de los cuales seis cumplieron los criterios de elegibilidad para la revisión sistemática y metaanálisis. No se encontró un efecto significativo en la memoria diferida (DME = 0,69, IC 95 %: 0,85-2,23, p = 0,38), memoria inmediata (DME = 0,56, IC 95 %: -0,20-1,31, p = 0,15), memoria de trabajo (DME = -0,21, IC 95 %: -0,74-0,32, p = 0,43) y velocidad de procesamiento (DME = 0,25, IC 95 %: -0,58-1,07, p = 0,55). Conclusión: nuestros resultados sugieren que el resveratrol no tiene un efecto sobre las funciones cognitivas en adultos mayores. No obstante, es necesario realizar más estudios con diferentes dosis, tipos de formulación del nutracéutico y tiempo de tratamiento.

Validity and reliability of SCREEN II (Seniors in the Community: Risk Evaluation for Eating and Nutrition) search in Turkish society.

Introduction: Objective: the aim of this study is to determine the reliability and the validity of the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN II) scale, which has been developed with the aim of evaluating eating and nutrition risks. Methods: a total of 207 elderly were included in the study. The Standardized Mini Mental Test (SMMT) was applied to individuals for mental adequacy assessment and then SCREEN II scale was applied. For the selection of scale items, main components factor analysis and Varimaks conversion has been applied to the data and it has been decided to use the components which have 0.40 and bigger factor loading. Results: in accordance with the validity and reliability analyzes, it was determined that the 3 subscales and 12-item adaptation of the SCREEN scale were suitable for Turkish society. These subscales are "Food intake and eating habits", "Conditions and difficulties affecting food intake" and "Weight change and food restriction". When the Cronbach alpha internal consistency values were evaluated for the reliability of the SCREEN II scale, the obtained values indicated that the items in each subscale were consistent with each other and formed a whole. Conclusion: the findings have shown that SCREEN II is a reliable and valid scale for the elderly people living in Turkey.

Introducción: Objetivo: el objetivo de este estudio es determinar la fiabilidad y la validez de la escala de evaluación de riesgos para la alimentación y la nutrición en adultos mayores en la comunidad (SCREEN II, por sus siglas en inglés), que se ha desarrollado con el objetivo de evaluar los riesgos alimentarios y nutricionales de las personas mayores. Métodos: se incluyeron en el estudio un total de 207 personas mayores. Se aplicó el SMMT (Standardized Mini-Mental Test) para la evaluación de función cognitiva y luego se aplicó la escala SCREEN II. Para la selección de ítems de la escala, se han aplicado a los datos el análisis factorial de componentes principales y la conversión de Varimaks, y se ha decidido utilizar los componentes que tienen una carga factorial de 0,40 y mayor. Resultados: El estudio mostró que las tres subescalas y la adaptación de los 12 ítems de la herramienta fueron de utilidad cuando se aplicaron a la población turca. Las tres subescalsa fueron: " ingesta de alimentos y hábitos dietéticos", "condiciones y dificultades que afectan a la ingestión de alimentos" y "cambios en el peso y restricción alimentaria". Al aplicar los valores de consistencia interna Cronbach alpha se evidenció que los ítems de cada subescala eran consistentes entre sí y constituían un todo. Conclusión: los hallazgos han demostrado que SCREEN II es una escala confiable y válida para las personas mayores que viven en Turquía.

Older person's experience of PT4Ageing-A programme on self-management «support¼ in chronic illness.

OBJECTIVE: This study sought to describe the experience of a group of older adults who participated in a chronic illness self-management program. METHODS: The study employed a qualitative phenomenological approach. Participants were eight elders and data collected using semi-structured interviews Data was analysed using thematic analysis. RESULTS: Five themes emerged from the analysis: (1) Tips to improve our daily lives, (2) I was always motivated, (3) Sharing and mutual help, (4) They made us believe we were capable (5). It would be great if it did not end here. Globally, the participants of the program described their experience as very positive. They identified gains from participating in the program, such as learning strategies to help them cope with their health problems, improving their ability to manage their illnesses more autonomously and building social support, that even persisted after the conclusion of the intervention. CONCLUSION: The findings of this study provide insight into how older adults experience a program for the self-management of chronic illness. For the development of future programs, support building must be considered. Older adults who participate in self-management programmes exhibit improved self-efficacy in relation to the management their chronic illnesses and greater autonomy in self-care.

[Reminiscence program supported by artificial intelligence and based on intangible cultural heritage aimed at the elderly: A pilot study]. / Programa de reminiscencia apoyado en inteligencia artificial y basado en el patrimonio cultural inmaterial dirigido a personas mayores: un estudio piloto.

INTRODUCTION: Technological applications are an innovative way of providing reminiscence therapy and must meet the users' needs. Intangible cultural heritage as a basis for such therapy has not been explored yet. We evaluated the applicability of a new technological application supported by artificial intelligence for reminiscence therapy based on intangible cultural heritage aimed at older people. MATERIAL AND METHODS: A prospective observational study was carried out with people aged 65 or over, without cognitive impairment and with mild and moderate cognitive impairment who attended six centers for older people in Spain and Portugal. Participants tested the first prototype of the individualized LONG-REMI program in four consecutive weekly sessions. The usability and satisfaction of the experience were evaluated using the VAS scale at the end of the intervention. Emotions were evaluated using the PANAS scale before and at the end of the intervention. RESULTS: Data from 56 participants were analysed. For all participants, usability and satisfaction were highly perceived, with scores of 7.75±1.88 and 8.38±1.57, respectively. The positive affect subscale PANAS showed significant changes (28.86±8.88 before the intervention versus 36.70±9.43 post intervention, Z = -4.18, P = 0.000). There were no significant changes in the PANAS negative affect subscale. CONCLUSIONS: The first prototype of the LONG-REMI technological application can be used by older people both with and without cognitive impairment. This has the potential to be an instrument for future cognitive therapies with stimulating activities and benefits for emotions.