RESUMO
Objetivo: Determinar la relación entre el riesgo de caídas y deterioro cognitivo en adultos mayores del Centro Médico Naval "Cirujano Mayor Santiago Távara" 2010-2015. Materiales y métodos: Fue un estudio observacional, analítico, retrospectivo, que consistió en el análisis secundario de una base de datos. Se evaluó el riesgo de caídas mediante los resultados de la prueba de alcance funcional (AF), mientras que para determinar el deterioro cognitivo se utilizó el cuestionario de Pfeiffer. Adicionalmente, se estudiaron factores socio-demográficos como la edad, sexo, nivel educativo; y clínicos como la presencia de comorbilidades, polifarmacia o antecedentes de caídas. Resultados: La muestra estuvo conformada por 1786 adultos mayores. El 45,1% tenían entre 71 y 80 años, de sexo masculino (58,9%), con nivel educativo técnico/superior (70,9%), tenían 2 o más comorbilidades (48,9%). Se encontró asociación estadística (p<0,05) entre AF alterado y la edad, el nivel educativo, la presencia de comorbilidades, y el deterioro cognitivo. Al realizar el modelo multivariado, se encontró que el deterioro cognitivo se asoció al riesgo de caídas con un PR ajustado de 3,05 (IC 95%: 2,45-3,79). Conclusión: Se encontró que el deterioro cognitivo estuvo asociado a un riesgo tres veces mayor de caídas en adultos mayores del Centro Médico Naval "Cirujano Mayor Santiago Távara" durante los años 2010-2015.
Objective: To determine the relationship between the risk of falls and cognitive impairment in elderly subjects at Cirujano Mayor Santiago Tavara Peruvian Navy Medical Center for the 2010-2015 period. Materials and Methods: This is a retrospective observational and analytical study, which consisted in a secondary analysis of a database. The risk of falls was assessed using the results of the functional scope test (FS), while cognitive impairment was assessed with the Pfeiffer score. Additionally, socio-demographic factors, such as age, sex, and educational level were studied; also, clinical factors, such as comorbidities, polypharmacy or previous falls were assessed. Results: Nearly eighteen hundred (1786) elderly subjects were included. Nearly half of all subjects (45.1%) were between 71 and 80 years old; most of them were male (58.9%); and the majority had technical/higher education level (70.9%). Nearly half of all subjects (48.9%) had 2 or more comorbidities. A statistical association (p<0.05) was found between an altered FS and age, educational level, presence of comorbidities, and cognitive impairment. The multivariate analysis showed that cognitive impairment was associated with a high risk of falls (adjusted PR: 3.05; 95% CI: 2.45-3.79). Conclusion: It was found that cognitive impairment was associated with a threefold risk of falls in elderly subjects from Cirujano Mayor Santiago Tavara Peruvian Navy Medical Center during 2010-2015.
RESUMO
PURPOSE: We compared biochemical control and quality of life with intermittent (6 months) versus continuous (36 months) androgen deprivation therapy (ADT) in a non-inferiority randomized phase 3 trial in patients with biochemical failure (BF) after external beam radical radiotherapy (EBRT). MATERIALS AND METHODS: Patients were stratified according to the Gleason score (GS) and were classified as low risk with a GS < 6 and 7 (3 + 4) and high risk with a GS of 7 (4 + 3) and >7. Patients were followed with PSA determinations and quality-of-life assessments (QLQ C-30 and QLQ PR-25) every 6 months for a period of 3 years. BF after radiation was defined as a PSA level of nadir +2 ng/ml. Disease progression (DP) after ADT was defined as PSA ≥4 ng/ml (BF) and/or metastases. RESULTS: Seventy-seven patients were included in this multicenter phase 3 trial from 2005 to 2009. Thirty-eight and 39 patients were included in the intermittent and continuous groups, respectively. The median follow-up for both groups was 48 months (40-68). DP after ADT in the intermittent group was seen in three patients (distant metastases in one patient) versus 0 in the continuous group. The QLQ-C30 and QLQ PR-25 scores did not show any statistically difference between the two ADT groups. CONCLUSIONS: No significant differences were seen in DP and QLQ between intermittent (6 months) and continuous (36 months) ADT in patients with BF after EBRT.