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1.
Exp Gerontol ; 167: 111899, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-35907475

RESUMO

Barker's hypothesis affirms that undernourishment in early-life induces metabolic reprogramming that compromises organism functions later in life, leading to age-related diseases. We are exposed to environmental and social conditions that impact our life trajectories, leading to ageing phenotypes as we grow. Epigenetic mechanisms constitute the link between both external stimuli and genetic programming. Studies have focused on describing the effect of early adverse events such as trauma, famines, or childhood labor on epigenetic markers in adulthood and the elderly. However, we lack information on epigenetic programming in individuals born in rural communities from underdeveloped countries, exposed to negative influences during fetal and postnatal development, particularly chronic malnutrition. Hence, in this exploratory analysis, we characterize the epigenome of individuals and some parents from Tlaltizapan (a rural community in Mexico originally studied almost 50 years ago) and collect anthropometric data on growth and development, as well on the living conditions of the families. Our results help build a biological hypothesis indicating that most of the epigenetic age measures of the subjects are significantly different among them. Interestingly, the most affected methylated regions correspond to pathways involved in neuronal system development, reproductive behaviour, learning and memory regulation.


Assuntos
Metilação de DNA , Desnutrição , Estudos de Coortes , Epigênese Genética , Epigenômica , Humanos , Desnutrição/genética , População Rural
2.
J Prev Alzheimers Dis ; 9(4): 569-579, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36281661

RESUMO

Timely and accurate diagnosis of Alzheimer's disease (AD) in clinical practice remains challenging. PET and CSF biomarkers are the most widely used biomarkers to aid diagnosis in clinical research but present limitations for clinical practice (i.e., cost, accessibility). Emerging blood-based markers have the potential to be accurate, cost-effective, and easily accessible for widespread clinical use, and could facilitate timely diagnosis. The EU/US CTAD Task Force met in May 2022 in a virtual meeting to discuss pathways to implementation of blood-based markers in clinical practice. Specifically, the CTAD Task Force assessed: the state-of-art for blood-based markers, the current use of blood-based markers in clinical trials, the potential use of blood-based markers in clinical practice, the current challenges with blood-based markers, and the next steps needed for broader adoption in clinical practice.


Assuntos
Doença de Alzheimer , Humanos , Doença de Alzheimer/tratamento farmacológico , Biomarcadores , Comitês Consultivos
3.
J Nutr Health Aging ; 25(1): 33-40, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33367460

RESUMO

OBJECTIVES: The aim of this study was to compare a short and a long version of an intrinsic capacity index and test their cross-sectional association with relevant health outcomes in older adults. DESIGN: Cross-sectional analysis of the baseline data of the FraDySMex study. PARTICIPANTS: 543 community-dwelling adults aged 50 years and older living in 2 municipalities in Mexico City, from which 435 had complete data on the variables of interest. METHODS: The intrinsic capacity indices were obtained using principal components analysis. The performance of the indices was tested respective to frailty, IADL and ADL. RESULTS: The short and long versions of the IC index performed well for assessing functional status. Using biometrical variables like the phase angle, grip strength and gait speed measured by the GAIT rite improved the index performance vis a vis IADL disability (Lawton), but not to the other evaluated outcomes. CONCLUSIONS: Both the long and short versions of the intrinsic capacity indices tested were able to classify older adults according to their functional status and were associated with relevant health outcomes.


Assuntos
Fragilidade/epidemiologia , Vida Independente/normas , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , México , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento
4.
J Nutr Health Aging ; 25(7): 824-853, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34409961

RESUMO

The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living - experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.


Assuntos
Envelhecimento/fisiologia , Exercício Físico , Fragilidade , Promoção da Saúde , Qualidade de Vida , Idoso , Exercício Físico/fisiologia , Terapia por Exercício/normas , Fragilidade/prevenção & controle , Humanos , Fenótipo , Comportamento Sedentário
5.
Ageing Res Rev ; 64: 101164, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32977058

RESUMO

The aging process has been linked to the occurrence of chronic diseases and functional impairments, including cancer, sarcopenia, frailty, metabolic, cardiovascular, and neurodegenerative diseases. Nonetheless, aging is highly variable and heterogeneous and represents a challenge for its characterization. In this sense, intrinsic capacity (IC) stands as a novel perspective by the World Health Organization, which integrates the individual wellbeing, environment, and risk factors to understand aging. However, there is a lack of quantitative and qualitative attributes to define it objectively. Therefore, in this review we attempt to summarize the most relevant and promising biomarkers described in clinical studies at date over different molecular levels, including epigenomics, transcriptomics, proteomics, metabolomics, and the microbiome. To aid gerontologists, geriatricians, and biomedical researchers to understand the aging process through the IC. Aging biomarkers reflect the physiological state of individuals and the underlying mechanisms related to homeostatic changes throughout an individual lifespan; they demonstrated that aging could be measured independently of time (that may explain its heterogeneity) and to be helpful to predict age-related syndromes and mortality. In summary, we highlight the areas of opportunity and gaps of knowledge that must be addressed to fully integrate biomedical findings into clinically useful tools and interventions.


Assuntos
Metabolômica , Proteômica , Envelhecimento , Biomarcadores , Epigenômica , Humanos
6.
J Nutr Health Aging ; 24(9): 959-965, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33155621

RESUMO

OBJECTIVES: Intrinsic capacity is a composite of five domains that summarizes the physical and mental capacities of an individual. Intrinsic capacity is increasing in relevance for adapting health systems to population ageing. Therefore, our objective was to analyse how intrinsic capacity has been assessed in older adults and if these measurements have been validated, as an initial step towards the construction of a standard intrinsic capacity index. DESIGN: Narrative review with electronic searches performed in PubMed and Cochrane databases, including the studies which used the term "intrinsic capacity" in the context of human ageing and health. The full text was then accessed to select studies with at least one operationalised domain of intrinsic capacity. We also looked for information on the validity and reliability of the reported measures of intrinsic capacity. RESULTS: We included ten articles reporting a quantitative measurement of intrinsic capacity. There were two intrinsic capacity scores which combined retrospective data on the intrinsic capacity domains sub-scores, with low concordance among tests chosen to measure each domain. Two studies reported on reliability and validity of the IC scores. The main gaps in the construction and validation process were a) analysis undertaken with each domain separately rather than for the construct of intrinsic capacity, b) lack of a clear conceptual and operational definition of the vitality domain, c) summary score that depends upon the distribution of the study sample. CONCLUSION: Further validation of the intrinsic capacity concept is needed, together with more robust approaches to measure it. A standard index of IC has not been validated for translation into clinical or research purposes.


Assuntos
Saúde Pública/métodos , Padrões de Referência , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos
7.
J Nutr Health Aging ; 23(9): 788-795, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31641727

RESUMO

OBJECTIVES: Intrinsic capacity (IC) is one of the latest views of positive aging. In its current status lacks a biological substrate amenable to be intervened. The aim of this study was to determine the association of allostatic load (AL) with IC. DESIGN: We present a cross-sectional analysis of the Costa Rican Longevity and Healthy Aging Study. SETTING: This report is from a representative sample of Costa Rican older adults; one of the countries that integrate the Central America region. PARTICIPANTS: 2,827, 60-year or older community-dwelling individuals. METHODS: An IC index was gathered and validated, including different domains: cognitive, psychological, sensory, vitality and locomotion. AL was integrated with: blood pressure, abdominal obesity, body mass index, HDL-cholesterol, glycosylated hemoglobin, DHEAS, cortisol, epinephrine and norepinephrine. AL was grouped in three categories according to the number of abnormal biomarkers (0-1, 2-3 and ≥4). Chronic diseases, socioeconomic level, sex and age were the adjusting variables. Ordinal logistic regression models were estimated in order to test the strength of the association. RESULTS: From a total sample of 1,888 individuals, 51% (n=962) were women, 36.4% were in the 60-69 age category. The mean score of the IC index was of 6.6 (±2.2). Odds ratio (OR) of the adjusted models were significant for the group of those with 2-3 abnormal biomarkers of AL (OR 0.67, p=0.007) and also for those with ≥4 (OR 0.56, p=0.002), when compared to the reference group of AL (0-1 abnormal biomarkers). CONCLUSIONS AND IMPLICATIONS: AL showed an incremental association with IC, even when adjusted for factors such as socioeconomic status and chronic diseases. Targeting therapeutically AL could potentially improve IC in older adults and therefore decreasing the progression to disability or to overt dependency.


Assuntos
Envelhecimento/fisiologia , Alostase/fisiologia , Envelhecimento Saudável/fisiologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , HDL-Colesterol/sangue , Doença Crônica , Estudos Transversais , Sulfato de Desidroepiandrosterona/sangue , Epinefrina/sangue , Feminino , Hemoglobinas Glicadas/análise , Hispânico ou Latino , Humanos , Hidrocortisona/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal , Razão de Chances
8.
Sci Rep ; 9(1): 10593, 2019 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-31332237

RESUMO

Frailty is an age-associated condition, characterized by an inappropriate response to stress that results in a higher frequency of adverse outcomes (e.g., mortality, institutionalization and disability). Some light has been shed over its genetic background, but this is still a matter of debate. In the present study, we used network biology to analyze the interactome of frailty-related genes at different levels to relate them with pathways, clinical deficits and drugs with potential therapeutic implications. Significant pathways involved in frailty: apoptosis, proteolysis, muscle proliferation, and inflammation; genes as FN1, APP, CREBBP, EGFR playing a role as hubs and bottlenecks in the interactome network and epigenetic factors as HIST1H3 cluster and miR200 family were also involved. When connecting clinical deficits and genes, we identified five clusters that give insights into the biology of frailty: cancer, glucocorticoid receptor, TNF-α, myostatin, angiotensin converter enzyme, ApoE, interleukine-12 and -18. Finally, when performing network pharmacology analysis of the target nodes, some compounds were identified as potentially therapeutic (e.g., epigallocatechin gallate and antirheumatic agents); while some other substances appeared to be toxicants that may be involved in the development of this condition.


Assuntos
Epigênese Genética/efeitos dos fármacos , Fragilidade/genética , Envelhecimento/efeitos dos fármacos , Envelhecimento/genética , Apoptose/efeitos dos fármacos , Apoptose/genética , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Fragilidade/tratamento farmacológico , Genes/efeitos dos fármacos , Genes/genética , Humanos , Músculo Liso/efeitos dos fármacos , Músculo Liso/fisiologia , Farmacologia/métodos , Proteólise/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Biologia de Sistemas/métodos
9.
J Nutr Health Aging ; 23(9): 771-787, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31641726

RESUMO

OBJECTIVE: The task force of the International Conference of Frailty and Sarcopenia Research (ICFSR) developed these clinical practice guidelines to overview the current evidence-base and to provide recommendations for the identification and management of frailty in older adults. METHODS: These recommendations were formed using the GRADE approach, which ranked the strength and certainty (quality) of the supporting evidence behind each recommendation. Where the evidence-base was limited or of low quality, Consensus Based Recommendations (CBRs) were formulated. The recommendations focus on the clinical and practical aspects of care for older people with frailty, and promote person-centred care. Recommendations for Screening and Assessment: The task force recommends that health practitioners case identify/screen all older adults for frailty using a validated instrument suitable for the specific setting or context (strong recommendation). Ideally, the screening instrument should exclude disability as part of the screening process. For individuals screened as positive for frailty, a more comprehensive clinical assessment should be performed to identify signs and underlying mechanisms of frailty (strong recommendation). Recommendations for Management: A comprehensive care plan for frailty should address polypharmacy (whether rational or nonrational), the management of sarcopenia, the treatable causes of weight loss, and the causes of exhaustion (depression, anaemia, hypotension, hypothyroidism, and B12 deficiency) (strong recommendation). All persons with frailty should receive social support as needed to address unmet needs and encourage adherence to a comprehensive care plan (strong recommendation). First-line therapy for the management of frailty should include a multi-component physical activity programme with a resistance-based training component (strong recommendation). Protein/caloric supplementation is recommended when weight loss or undernutrition are present (conditional recommendation). No recommendation was given for systematic additional therapies such as cognitive therapy, problem-solving therapy, vitamin D supplementation, and hormone-based treatment. Pharmacological treatment as presently available is not recommended therapy for the treatment of frailty.


Assuntos
Fragilidade/diagnóstico , Fragilidade/terapia , Sarcopenia/diagnóstico , Sarcopenia/terapia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Exercício Físico/fisiologia , Humanos , Programas de Rastreamento/métodos
12.
J Nutr Health Aging ; 22(10): 1148-1161, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30498820

RESUMO

OBJECTIVES: Sarcopenia, defined as an age-associated loss of skeletal muscle function and muscle mass, occurs in approximately 6 - 22 % of older adults. This paper presents evidence-based clinical practice guidelines for screening, diagnosis and management of sarcopenia from the task force of the International Conference on Sarcopenia and Frailty Research (ICSFR). METHODS: To develop the guidelines, we drew upon the best available evidence from two systematic reviews paired with consensus statements by international working groups on sarcopenia. Eight topics were selected for the recommendations: (i) defining sarcopenia; (ii) screening and diagnosis; (iii) physical activity prescription; (iv) protein supplementation; (v) vitamin D supplementation; (vi) anabolic hormone prescription; (vii) medications under development; and (viii) research. The ICSFR task force evaluated the evidence behind each topic including the quality of evidence, the benefit-harm balance of treatment, patient preferences/values, and cost-effectiveness. Recommendations were graded as either strong or conditional (weak) as per the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Consensus was achieved via one face-to-face workshop and a modified Delphi process. RECOMMENDATIONS: We make a conditional recommendation for the use of an internationally accepted measurement tool for the diagnosis of sarcopenia including the EWGSOP and FNIH definitions, and advocate for rapid screening using gait speed or the SARC-F. To treat sarcopenia, we strongly recommend the prescription of resistance-based physical activity, and conditionally recommend protein supplementation/a protein-rich diet. No recommendation is given for Vitamin D supplementation or for anabolic hormone prescription. There is a lack of robust evidence to assess the strength of other treatment options.


Assuntos
Programas de Rastreamento/métodos , Sarcopenia/diagnóstico , Sarcopenia/terapia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Sarcopenia/patologia
13.
Eur Geriatr Med ; 7(3): 262-266, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27656259

RESUMO

INTRODUCTION: Calf circumference is a surrogate measurement of muscle mass. However, there is scarce evidence on its validity in predicting adverse outcomes such as mobility disability. The aim of this report is to determine if calf circumference could predict incident mobility disability in Mexican 60-year or older adults. METHODS: This is a secondary analysis of the Mexican Health and Aging Study and in particular of its two first waves. Sixty-year or older adults without mobility disability in the first assessment were included and followed-up for two years. Calf circumference quartile groups were compared to test the difference of incident mobility disability. Logistic regression models were fitted to test the independent association when including confounding variables. RESULTS: A total of 745 older adults were assessed, from which 24.4% of the older adults developed mobility disability at follow-up. A calf circumference > 38 cm was associated with a higher risk of developing mobility disability, even after adjustment in the multivariate model, with an odds ratio 0.55 (95% confidence interval 0.31-0.99, P = 0.049). CONCLUSIONS: High calf circumference in Mexican older adults is independently associated with incident mobility disability. This could reflect the impact of adverse health conditions such as obesity (with high fat tissue) or edema. Further research should aim at testing these results in different populations.

14.
J Frailty Aging ; 5(1): 15-9, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26980364

RESUMO

BACKGROUND: The implementation of an aging biomarker into clinical practice is under debate. The Frailty Index is a model of deficit accumulation and has shown to accurately capture frailty in older adults, thus bridging biological with clinical practice. OBJECTIVES: To describe the association of socio-demographic characteristics and the Frailty Index in different age groups (from 20 to over one hundred years) in a representative sample of Mexican subjects. DESIGN: Cross-sectional analysis. SETTING: Nationwide and population-representative survey. PARTICIPANTS: Adults 20-years and older interviewed during the last Mexican National Health and Nutrition Survey (2012). MEASUREMENTS: A 30-item Frailty Index following standard construction was developed. Multi-level regression models were performed to test the associations of the Frailty Index with multiple socio-demographic characteristics across age groups. RESULTS: A total of 29,504 subjects was analyzed. The 30-item Frailty Index showed the highest scores in the older age groups, especially in women. No sociodemographic variable was associated with the Frailty Index in all the studied age groups. However, employment, economic income, and smoking status were more consistently found across age groups. CONCLUSIONS: To our knowledge, this is the first report describing the Frailty Index in a representative large sample of a Latin American country. Increasing age and gender were closely associated with a higher score.


Assuntos
Envelhecimento , Idoso Fragilizado , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Envelhecimento/psicologia , Estudos Transversais , Feminino , Idoso Fragilizado/psicologia , Idoso Fragilizado/estatística & dados numéricos , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Indicadores Básicos de Saúde , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fatores Sexuais , Fatores Socioeconômicos
15.
J Lat Am Geriatr Med ; 2(1): 8-13, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-29057380

RESUMO

OBJECTIVE: To estimate the prevalence of sarcopenia in Mexican older adults using simple measurements and tailored cutoff values for the components of the European Working Group on Sarcopenia in Older People algorithm. MATERIAL AND METHODS: This study used cross-sectional data from the third wave (2012) of the Mexican Health and Aging Study. Gait speed and handgrip strength cutoff values were tailored for Mexican older adults. Muscle mass was estimated by a formula, which uses simple anthropometry and demographic characteristics. RESULTS: From the total of 1,238 older adults included in our study, sarcopenia prevalence was 11% (n = 137). When categorizing sarcopenia, 39.1% (n = 484) had pre-sarcopenia, 8.3% (n = 103) moderate sarcopenia, and 2.75% (n = 34) had severe sarcopenia. CONCLUSIONS: Sarcopenia is a common problem in Mexican older adults, and its frequency along with its severity increases with age. Tailored cutoff values could help in identifying those subjects that could have benefited from intervention.

16.
J Frailty Aging ; 4(3): 139-43, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26889463

RESUMO

BACKGROUND: Physical performance tests play a major role in the geriatric assessment. In particular, gait speed has shown to be useful for predicting adverse outcomes. However, risk factors for slow gait speed (slowness) are not clearly described. OBJECTIVES: To determine risk factors associated with slowness in Mexican older adults. DESIGN: A two-step process was adopted for exploring the antecedent risk factors of slow gait speed. First, the cut-off values for gait speed were determined in a representative sample of Mexican older adults. Then, antecedent risk factors of slow gait speed (defined using the identified cut-points) were explored in a nested, cohort case-control study. SETTING PARTICIPANTS: One representative sample of a cross-sectional survey for the first step and the Mexican Health and Aging Study (a cohort characterized by a 10-year follow-up). MEASUREMENTS: A 4-meter usual gait speed test was conducted. Lowest gender and height-stratified groups were considered as defining slow gait speed. Sociodemographic characteristics, comorbidities, psychological and health-care related variables were explored to find those associated with the subsequent development of slow gait speed. Unadjusted and adjusted logistic regression models were performed. RESULTS: In the final model, age, diabetes, hypertension, and history of fractures were associated with the development of slow gait speed. CONCLUSIONS: Early identification of subjects at risk of developing slow gait speed may halt the path to disability due to the robust association of this physical performance test with functional decline.

17.
J Am Geriatr Soc ; 46(11): 1387-95, 1998 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9809760

RESUMO

OBJECTIVE: To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations. DESIGN: A cross-sectional study. SETTING: Three Mexican communities (urban areas of medium and low income and a rural area). PARTICIPANTS: A total of 121 men and 223 women aged 60 years and older and 93 men and 180 women aged 35 to 59 years were selected randomly for inclusion in the survey, which was derived from the CRONOS study (Cross-Cultural Research on Nutrition in the Older Adult Study Group) promoted by the European Economic Community. MEASUREMENTS: A personal interview assessed demographic information, personal medical history, and functional status, and a 24-hour diet recall was obtained. A physical examination included anthropometric and blood pressure measurements. A fasting blood sample was obtained for measurements of lipids, insulin, and glucose. RESULTS: Diabetes prevalence was higher in men than in women for all age groups: 16.7% versus 9.5% in younger adults and 30.8% versus 22.8% in older adults. For all age groups, diabetes was more highly prevalent in urban communities. Using a multivariate stepwise logistic regression, variables associated independently with diabetes in older individuals were: gender (male sex: OR = 2.1; P < .009); diminished carbohydrate intake in the diet (OR = 0.77; P < .03); central distribution of adiposity (OR = 1.9; P < .03); and functional disability (OR = 2.3; P < .01). This relationship was not observed with living area, income, education, fiber and alcohol intake, body mass index, or age. Individuals 80 years and older had a diminished atherogenic risk profile. Diabetes in older people was associated significantly with hypertriglyceridemia, impaired functional status, and an increased prevalence of ischemic heart disease; in younger adults diabetes was associated with low density lipoprotein (LDL) hypercholesterolemia, hypertriglyceridemia, and a proportionally higher fat intake. CONCLUSION: This survey confirms the high prevalence of diabetes in the older Mexican population - particularly in men and in individuals living in urban areas - associated with an increased prevalence of other coronary risk factors. Diabetes was associated with higher fat, low carbohydrate, low fiber diets and increased prevalence of central distribution of adiposity. In the older subjects, diabetes was associated significantly with hypertriglyceridemia, impaired functional status, and increased prevalence of ischemic heart disease. A bias produced by early mortality and a survivorship effect must be considered in studies of older individuals. The health situation in the older Mexican population presents a complex problem that needs correct diagnosis and better strategies to benefit those segments of the population at increased risk.


Assuntos
Doença das Coronárias/etiologia , Diabetes Mellitus/epidemiologia , Saúde da População Rural/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Distribuição por Idade , Idoso , Estudos Transversais , Complicações do Diabetes , Ingestão de Energia , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Prevalência , Fatores de Risco , Distribuição por Sexo , Inquéritos e Questionários
18.
Metabolism ; 50(3): 311-8, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11230784

RESUMO

The objective of this comparative cross-sectional study was to determine the prevalence of dyslipidemias and examine its association with food intake and metabolic variables in urban and rural elder Mexican populations. Three different communities (urban areas of medium and low income and a rural area) were studied. A total of 344 subjects aged 60 years and older and 273 aged 35 to 59 years were included. The evaluated parameters were personal medical data, 24-hour diet recall, and fasting plasma lipids, insulin, and glucose levels. Older subjects, especially men, living in the rural area had lower cholesterol levels (5.02 +/- 0.97 v 5.6 +/- 1.07 mmol/L; P <.05) and insulin levels (12 +/- 10 v 42 +/- 68 mU/mL) and higher high-density lipoprotein cholesterol concentrations (1.31 +/- 0.36 v 1.07 +/-0.28 mmol/L) than the elders from the urban medium-income group. Possible explanations for these differences are found in the dietary habits of the groups. Rural elders had higher amounts of fiber (20 +/- 11 v 10 +/- 6 g/d) and carbohydrate (70% +/- 0.08% v 52% +/- 0.11% of calories) and lower fat (18% +/- 0.07% v 33% +/- 0.1% of calories) in their diets. In the urban groups, low-density lipoprotein hypercholesterolemia was present in 17.8% of adult and 39.1% of elderly women (P =.00001). In conclusion, environmental factors still play a prominent role in the pathophysiology of the dyslipidemias in the elderly.


Assuntos
Envelhecimento/fisiologia , Apolipoproteínas B/sangue , Hiperlipidemias/epidemiologia , Lipídeos/sangue , Saúde da População Rural , Saúde da População Urbana , Adulto , Distribuição por Idade , Envelhecimento/sangue , Doença das Coronárias/etiologia , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo
19.
J Nutr Health Aging ; 8(5): 333-9, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15359348

RESUMO

INTRODUCTION: Oral health status in older people is frequently poor which can contribute to inadequate dietary patterns and nutrition status. OBJECTIVE: To investigate whether an association between the number of teeth present and dietary fiber intake exists in elderly people living independently, across different geographic and socioeconomic locations. METHODS: A cross-sectional household survey was undertaken in three Mexican communities (urban, marginal urban, and rural), incorporating geographic and socio-demographic information and a 24-hour diet recall. Dental status (teeth present, coronal and root caries, and periodontal status) was determined by clinical examination. Data were analyzed using ANOVA, Pearson's chi2 and Tukey's range tests. RESULTS: 407 persons 60 years old and over participated in the study. Subjects in the rural community had better dental/periodontal status and more teeth present than urban and marginal-urban participants. Intake of fiber was 8.4 g/day for the urban, 7.6 g/day for the marginal-urban, and 13.5 g/day for the rural community. While gender had no detectable effect, the location of residence and the number of teeth present were associated with mean fiber intake; having more than 21 teeth and/or living in a rural location were associated with increased mean fiber intake.


Assuntos
Dentição Permanente , Fibras na Dieta/administração & dosagem , Saúde Bucal , Saúde da População Rural/estatística & dados numéricos , Saúde da População Urbana/estatística & dados numéricos , Distribuição por Idade , Idoso , Análise de Variância , Estudos Transversais , Inquéritos de Saúde Bucal , Inquéritos sobre Dietas , Feminino , Nível de Saúde , Humanos , Masculino , Rememoração Mental , México , Pessoa de Meia-Idade
20.
J Nutr Health Aging ; 8(5): 355-61, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15359352

RESUMO

BACKGROUND: An adequate nutritional status is essential for maintaining the independence in the elderly. The height and weight self-report is considered a useful alternative for the estimation of body mass index (BMI). The validity of the self-report is an issue that has not been dealt with in developing countries. AIM: To assess the validity of the height and weight self-report in adults Mexican citizens. DESIGN: Transversal study. STUDY POPULATION: 1707 persons (836 males, 871 females) were asked for their height and weight and were measured. RESULTS: Mean (+/- standard deviation) age was 59.09 +/- 9.86 SD; mean years of education was 5.51 +/-4.67 years. We found a high correlation between self-reported and measured weight (R2= 0.837); the difference between both values rose along with the age (from 0.4 kg to 1.74 kg). A systematic difference between self-reported and measured height was found. Self-reported height was over-estimated, and the bias increased along with the age of the subjects (from 1.57 cm to 2.57 cm); further, over-estimation was larger in female individuals (+2.22 cm in female vs. +1.21 cm in male subjects). We calculated a linear model that predicts real height from self-reported height with moderate, although statistically significant results (R2= 0.39 y 0.50, for female and male, respectively, p < 0.0001). Knee height was also used to estimate "adulthood height" and thus, BMI. This method showed age-related dissimilarities, and the linear regression model yielded an unacceptably low correlation (R2= <0.10). The best method to estimate real BMI was to consider self-reported parameters. DISCUSSION: Height and weight estimation using self-reported parameters is an acceptable method. Its precision is not so high in subjects > 75 years. Height over-estimation is an expected finding congruent with age-related corporal changes. The estimation of height using knee height is not a useful method. CONCLUSION: Height and weight self-report is a valid method that may be used to accurately estimate height and weight in Mexican people.


Assuntos
Envelhecimento/fisiologia , Estatura/fisiologia , Peso Corporal/fisiologia , Autorrevelação , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Lineares , Masculino , México , Pessoa de Meia-Idade , Obesidade/epidemiologia , Reprodutibilidade dos Testes
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