Factors Associated with Frailty Syndrome in Older Adults.

OBJECTIVE: Frailty is a common geriatric syndrome, characterized by a decrease in energy reserve and stress resistance, resulting in an accumulated decline of multiple physiological systems and greater vulnerability. Frailty syndrome has a multifactorial etiology involving a biological basis associated with sociobehavioral factors. We verify the association of frailty syndrome with family functionality level, nutritional status and medication adherence in older adults. DESIGN: Observational and analytical study. SETTING AND PARTICIPANTS: Conducted at ambulatory the university hospital, with patients aged 60 years or older. MEASUREMENTS: Cognitive function was measured using the Mini-Mental State Examination (MMSE); nutritional status was evaluated using the Mini Nutritional Assessment (MNA) and Body Mass Index, BMI; the 5-item FRAIL scale was used for frailty screening; family functioning was assessed using the Family APGAR Index, which evaluates Adaptability, Partnership, Growth, Affection, and Resolve; Self-reported medication adherence was measured by the eight-item Morisky Medication Adherence Scale (MMAS-8). RESULTS: The study involved 308 older adults, with a mean age of 70.40 years, There was an association between frailty and highly dysfunctional family with an OR of 5.9 (95% CI 1.9-18.5)(p<0.05), nutritional risk assessed by BMI, where low weight presented an OR of 2.5 (95% CI 1.1-5.8) and obesity an OR of 2.8 (95% CI 1.1-7.0)(P <0.05) and a nutritional risk assessed by MNA with an OR 6.3(95% CI 1.9-20.4) and low medication adherence with an OR of 8.9 (95% CI, 3.6-21.6)(P = 0.01). CONCLUSION: Frailty syndrome is associated with high levels of family dysfunction, nutritional risk and poor medication adherence amongst older people.

Endogenous sex hormones are not associated with subclinical atherosclerosis in menopausal women.

AIM: The aim of this paper was to compare the carotid intima-media thickness (IMT) in pre- and postmenopausal women and to evaluate the association between endogenous sex hormones, body fat distribution, and insulin resistance and the IMT. METHODS: This cross-sectional study included 145 women aged 45-65 yr, comprising 56 premenopausal (FSH<20IU/mL and regular menstrual cycles) and 89 postmenopausal (FSH>40IU/ml and amenorrheic). All patients were evaluated for lipid profile, estradiol and testosterone, insulin ratio (G/I), HOMA-IR, and ultrasound measurement of IMT. Each variable was assessed for correlation with IMT using the univariate model. RESULTS: No difference was observed in IMT between pre- and postmenopausal women. A positive and statistically significant correlation was found between IMT and FSH levels (rs=0.21, P<0.009) and HOMA (rs=0.16, P<0.04). A positive and statistically significant correlation was observed between testosterone and waist (rs=0.3, P<0.04). No correlation was found between IMT and time of menopause (r=0.02, P=0.19). CONCLUSION: Estradiol and testosterone are not associated with subclinical atherosclerosis in menopausal women. A positive correlation between IMT and FSH may reflect an association between low estrogen and IMT. Abdominal fat can be an important link between androgenic levels and cardiovascular risk.

Nutritional status, dietary intake and serum levels of vitamin C upon diagnosis of cancer in children and adolescents.

INTRODUCTION: The prevalence of malnutrition upon diagnosis, together with reduced food intake secondary to disease and treatment, make the periodic assessment of nutritional status (including the intake of antioxidant nutrients) of considerable importance to the follow up of patients with cancer. OBJECTIVES: Assess the nutritional status and frequency of inadequate vitamin C levels among children and adolescents with cancer at the beginning of treatment and determine associated factors. METHODS: A cross-sectional study was carried out with 30 patients under 18 years. Nutritional status was assessed using laboratory methods and anthropometric measurements. Vitamin C adequacy was assessed through its serum concentration and dietary intake. RESULTS: In the sample, 10% were short for their age and 13.3% were underweight. The triceps skinfold measurement revealed fat depletion in 68% and the arm muscle circumference measurement revealed muscle depletion in 32.0%. Seventy percent of the patients had vitamin C deficiency and had greater weight loss, lower Z scores for all anthropometric indicators analyzed, lower serum albumin and higher C-reactive protein than those without vitamin C deficiency, but these differences were not statistically significant. CONCLUSIONS: Children with cancer may have nutritional deficits upon diagnosis. Further studies are needed on the association between serum levels of antioxidant and nutritional status in order to offer safe, effective nutritional support.