Support and Social Contact as a Decisive Meta-Variable in Morbidity and Social Welfare of the Older Person.

Bacground: This article tackles social support as a meta-variable that is reinforced by a set of social variables, which correlate and act as predictors of social welfare and life quality of the older person. OBJECTIVE: The objective of the study is to know how social support, networks and social contacts can influence the health of the elderly person, especially if these are interrelated factors. METHOD: The population studied are individuals from both sexes living in Toledo (Spanish people) and who were 65 years of age or over. Several scales were applied to assess the frequency of and the degree of satisfaction with perceived social support received from different sources in relation to social support. The co relational analysis showed significant positive associations between scores and measures of and social support, social relations, contact and social networks. RESULTS: We conclude that the support in general is very good, over 90% of people from the sample have someone who would help if needed. Social and health factors are interrelated with social support. Social contact can also be considered as a life quality estimate. He progressive loss of contact over the years is a social factor that affects the quality of life. CONCLUSION: The meta-analysis we find that social support and the emotional factor, along with social interactions, have powerful effects on preventing morbidity and mortality, which are important social indicators. We conclude that social support based on positive social interactions provides an optimal state of health in the older person.

Serum uric acid concentrations and risk of frailty in older adults.

OBJECTIVES: To evaluate for the first time the longitudinal relationship between serum uric acid concentrations and risk of frailty. METHODS: Prospective cohort study of 2198 non-institutionalized individuals aged ≥60years recruited in 2008-2010. At baseline, information was obtained on socio-demographic factors, health behaviors and morbidity, while serum uric acid was determined in 12-h fasting blood samples. Study participants were followed-up through 2012 to assess incident frailty, defined as ≥2 of the following 4 Fried criteria: exhaustion, muscle weakness, low physical activity, and slow walking speed. RESULTS: During a mean 3.5-year follow-up, 256 cases of incident frailty were identified. After multivariate adjustment, the odds ratios (95% confidence interval) of frailty comparing the second and third tertiles of uric acid to the lowest tertile were, respectively: 1.18 (0.83-1.68) and 1.57 (1.11-2.22); p-linear trend=0.01. The corresponding result for a 1mg/dL increase in serum uric acid concentration was 1.12 (1.00-1.24). Similar associations were observed across subgroups defined by sex, age, body mass index, and physical activity. As regards each frailty component, the odds ratios (95% confidence interval) per 1mg/dL increase in serum uric acid were 1.10 (0.99-1.23) for low physical activity, 1.08 (0.95-1.23) for low walking speed, 1.08 (0.67-1.73) for exhaustion and 0.91 (0.81-1.02) for weakness. CONCLUSIONS: Serum uric acid concentrations are positively associated with the risk of frailty in older adults. Further studies are needed to evaluate whether specific dietary recommendations or pharmacological strategies aimed at lowering serum uric acid would be beneficial to prevent the development of this syndrome.

Assessment the short-term effects of wrack removal on supralittoral arthropods using the M-BACI design on Atlantic sandy beaches of Brazil and Spain.

Wrack removal has been adopted indiscriminately, with no previous assessment of the ecological implications for sandy beach ecosystem. This study evaluated, through an M-BACI design, the effect of wrack removal on supralittoral arthropods on Atlantic sandy beaches receiving different types of wrack: mangrove propagules (Brazil), seagrasses and macroalgae (Spain). Impacted plots were contrasted with controls in 8 successive periods before and after experimental wrack removal. After the disturbance, drastic decreases in the densities of the amphipod Platorchestia monodi, coleopterans Cleridae, Nitidulidae and Phaleria testacea (Brazilian beaches) and amphipod Talitrus saltator (Spanish beaches) were detected in the impacted plots. The recovery patterns of arthropods might be related to wrack features (amount, composition, and degradation) combined with density and species-specific strategies (e.g. mobility, feeding preferences) in each Atlantic region. The temporary suppression of wrack and its associated fauna can have potential effects on the wrack-derived process and food-web structure on sandy beaches.

Frailty assessment based on trunk kinematic parameters during walking.

BACKGROUND: Physical frailty has become the center of attention of basic, clinical and demographic research due to its incidence level and gravity of adverse outcomes with age. Frailty syndrome is estimated to affect 20 % of the population older than 75 years. Thus, one of the greatest current challenges in this field is to identify parameters that can discriminate between vulnerable and robust subjects. Gait analysis has been widely used to predict frailty. The aim of the present study was to investigate whether a collection of parameters extracted from the trunk acceleration signals could provide additional accurate information about frailty syndrome. METHODS: A total of 718 subjects from an elderly population (319 males, 399 females; age: 75.4 ± 6.1 years, mass: 71.8 ± 12.4 kg, height: 158 ± 6 cm) volunteered to participate in this study. The subjects completed a 3-m walk test at their own gait velocity. Kinematic data were acquired from a tri-axial inertial orientation tracker. FINDINGS: The spatio-temporal and frequency parameters measured in this study with an inertial sensor are related to gait disorders and showed significant differences among groups (frail, pre-frail and robust). A selection of those parameters improves frailty classification obtained to gait velocity, compared to classification model based on gait velocity solely. INTERPRETATION: Gait parameters simultaneously used with gait velocity are able to provide useful information for a more accurate frailty classification. Moreover, this technique could improve the early detection of pre-frail status, allowing clinicians to perform measurements outside of a laboratory environment with the potential to prescribe a treatment for reversing their physical decline.

Medical, environmental and personal factors of disability in the elderly in Spain: a screening survey based on the International Classification of Functioning.

OBJECTIVES: The International Classification of Functioning, Disability and Health (ICF) advocates a multifactorial and multifaceted conceptualization of disability. The objective of this study was to ascertain major medical, environmental and personal determinants of severe/extreme disability among the elderly population in Spain. The assessment scheme was consistent with the ICF model of disability. METHODS: Nine populations contributed probabilistic or geographically-defined samples following a two-phase screening design. The Mini-Mental State Examination and the 12-item version of the World Health Organization-Disability Assessment Schedule, 2(nd) ed. (WHO-DAS II), were used as cognitive and disability screening tools, respectively. Positively screened individuals underwent clinical work-up for dementia and were administered the 36-item version of the WHO-DAS II to estimate ICF disability levels. We used logistic regression for the purposes of data combination, adjusted for age and sex in all analyses. RESULTS: The sample was composed of 503 participants aged ≥ 75 years. Alzheimers disease and depression were highly predictive of severe/extreme disability (OR: 17.40, 3.71). Good access to social services was strongly associated with a low level or absence of disability (OR: 0.05 to 0.18). Very difficult access to services and having dementia or another psychiatric disorder were associated with an increase in disability (OR: 66.06). There was also a significant interaction effect between access to services and neurological disorders (OR: 12.74). CONCLUSIONS: Disability is highly prevalent among the Spanish elderly and is influenced by medical, social and personal factors. Disability could potentially be reduced by ensuring access to social services, preventing dementia and stroke, and treating depression.