ABSTRACT
Background: Depression and dependence have a great impact on the quality of life of older people. Aim: To validate the SF-12 (short-form) health related quality of care questionnaire (HRQOL) as an alternative of the SF-36 to estimate health-related quality of life (HRQoL) and its association with depression and dependence in Chilean older people living in the community. Material and Methods: The questionnaire was answered by 4,124 Chilean older people (61% women). HRQoL was evaluated with the SF-36 questionnaire. The SF-12 questionnaire includes 12 items from the SF-36. Results: The internal consistency of the SF-12 questionnaire was high (0.88). The effect size of the differences in the averages of the SF-12 and SF-36 scales was small (0.06-0.41). Good agreement was found between the physical and mental components of the SF-12 and SF-36 (0.94 and 0.89). Logistic regressions determined that people with dependence and depression have a higher risk of poor HRQoL. The figures for the physical component were, mild depression: odds ratio (OR) (95% confidence intervals (CI) = 3.28 (2.74-3.93), severe depression: OR (IC95%CI) = 4.66 (3.55-6.11), mild to moderate dependence: OR (95CI%) = 3.67 (2.97-4.54), severe dependence: OR (95%CI) = 13.06 (7.23-23.61). For the mental component, the figures were: mild depression: OR (95CI%) = 6.11(5.05-7.38), severe depression: OR (95CI%) = 22.01(14.47-33.49), mild to moderate dependence: OR (95CI%) = 1.59 (1.28-1.97), severe dependence: OR (95CI%) = 1.60 (1.04-2.47), adjusting for sociodemographic and health-related variables. Conclusions: The validity of the SF-12 for measuring HRQoL was demonstrated. People with depression and dependence have a worse physical and mental quality of life.
Subject(s)
Humans , Male , Female , Aged , Quality of Life , Depressive Disorder , Surveys and Questionnaires , Health Surveys , Depression/diagnosisABSTRACT
Background: The rapid increase in life expectancy in Chile, with obesity as the main nutritional problem in all age groups, makes it necessary to ask whether the years gained are healthy. Aim: To study the trajectories of disability associated with obesity in Chilean elderly groups from different socio-economic and demographic backgrounds. Material and Methods: Longitudinal study of 3 cohorts of older adults from Santiago: the SABE cohort including 1235 people born before 1940; the Alexandros cohort including 950 people born between 1940 and 1948 from Primary Health Care centers and the ISAPRES cohort of 266 people from private health insurance registries (ISAPRES) born before 1947. An interview yielded socio demographic data and history of diseases. Anthropometric measurements and hand dynamometry were performed. Cognitive status was assessed by the mini mental state examination, depressive symptoms through the geriatric depression socore-5 and functional limitations through self-reporting of basic (ADL), instrumental (IADL) and advanced daily living (AADL) activities. Results: We report here baseline results from ISAPRES and SABE cohorts. Important social and gender differentials were observed. After adjustment by age and gender, a significant lower frequency of limitations in ADL (odds ratio (OR) = 0.17; 95 percent confidence intervals (CI): 0.079-0.343), IADL (OR = 0.27; 95 percentCI: 0.159-0.452), and AADL (OR = 0.42; 95 percentCI: 0.298-0.599) persisted in the ISAPRE cohort, compared to the SABE cohort. Obesity was associated with functional limitations only in AADL (OR = 1.65; 95 percentCI: 1.18-2.31) and hand dynamometry was associated with lower functional limitation in ADL, IADL and AADL. Conclusions: This study demonstrates profound socio-economic and gender inequalities in older people, thus showing that the years of healthy life gained are not the same for the whole society.
Subject(s)
Aged , Female , Humans , Male , Disabled Persons/statistics & numerical data , Life Expectancy , Obesity/epidemiology , Socioeconomic Factors , Activities of Daily Living , Body Mass Index , Chile/epidemiology , Epidemiologic Methods , Life Expectancy/trends , Muscle Strength Dynamometer , Obesity/physiopathology , Sex DistributionABSTRACT
El síndrome de ovario poliquístico(SOP) es una disfunción endocrinometabólica heterogénea de alta prevalencia, con una probable base genética, que compromete la función reproductiva de la mujer joven y que se encuentra en estrecha asociación a la insulinorresistencia (IR), Dentro de su compleja fisiopatología destacan la hipersecreción de LH e insulina, las cuales agravan una alteración preexistente de la biosíntesis esteroidal. La presencia de IR predispone a estas pacientes a desarrollar complicaciones cardiovasculares y metabólicas, las que suelen ser precoces. Por otro lado, la incidencia de patologías metabólicas asociadas a IR es mayor en los familiares de pacientes SOP que en los de mujeres normales, de ahí que el tratamiento de este síndrome no sólo debe ser sintomático, sino fundamentalmente preventivo. Asimismo, el SOP debería ser considerado un marcador de una patología familiar, un camino a la diabetes y un problema de salud pública
Subject(s)
Humans , Female , Hyperinsulinism , Obesity , Polycystic Ovary Syndrome/physiopathology , Anovulation/therapy , Diabetes Mellitus , Hyperandrogenism , Hyperinsulinism , Insulin Resistance , Obesity , Polycystic Ovary Syndrome/complicationsABSTRACT
La insulinorresistencia, es la base fisiopatológica de múltiples enfermedades de alta prevalencia, entre las que se destacan: la obesidad androide, la intolerancia a la glucosa, la diabetes mellitus, la hipertensión arterial y la dislipidemia. Además, se presenta en otras situaciones patológicas frecuentes, entre otras, diabetes gestacional, ovario poliquístico y en sujetos pequeños para la edad gestacional. Finalmente, está presente en una serie de condiciones fisiológicas y patológicas poco frecuentes o muy excepcionales, ya sea de origen genético, congénitas o adquiridas. Quizás más que por su prevalencia, el principal problema reside en, que esta condición puede permanecer desconocida y el daño metabólico puede ocurrir mucho antes que un exámen fortuito o el cuadro florido de una diabetes 2 nos lleve finalmente a su diagnóstico. El propósito de esta revisión es dar una orientación diagnóstica práctica de este síndrome tanto desde el punto de vista clínico como de las metodologías actualmente en uso