[Prevalence of urinary incontinence and linked factors in men and women over 65]. / Prevalencia de la incontinencia urinaria y factores asociados en varones y mujeres de más de 65 años.

OBJECTIVES: To calculate the prevalence of urinary incontinence and to identify linked factors in a population of elderly people living in their homes. DESIGN: Population survey. SETTING: Leganés (Madrid). PARTICIPANTS: Representative sample of people over 65 registered in Leganés (n=1560). Two interviews at home were conducted. The second interview included a medical examination. The reply rate was 75% (n=1150). MAIN MEASUREMENTS: Frequency of involuntary losses of urine and use of medication and absorbents, health status, use of diuretics and oxybutinin, and demographic and social variables. RESULTS: The prevalence of urinary incontinence was 14% (95% CI, 11%-17%) in men and 30% (95% CI, 26%-34%) in women. Advanced age was associated with greater prevalence in men but not in women. In the multivariate analysis, factors associated with urinary incontinence were comorbidity and cognitive deficit. In addition, in women, high Body Mass Index and seriously limited movement were added factors. 20% of women and 5% of men over 65 used absorbents. The use of diuretics and the low number of patients receiving specific treatment for urinary incontinence suggested that there was low detection of this problem. CONCLUSIONS: Urinary incontinence is common and could be better detected and treated in primary care. Prevention of urinary incontinence in women should begin before old age.

[Non-detected dementia and use of the health services: implications for primary care]. / Demencia no detectada y utilización de los servicios sanitarios: implicaciones para la atención primaria.

OBJECTIVES: To calculate the proportion of cases of dementia detected in people over 70 living in their homes and to describe the use made by people with dementia of the health and social services. MATERIAL AND METHODS: Population survey of the survivors of the cohort "Growing old in Leganés", started in 1993. In the third monitoring (1999-2000), the clinical diagnosis of dementia on the basis of a neurological examination and an extensive neuro-psychological battery was included. Their use of health and social services and prior diagnoses were also asked. RESULTS: In the sample of survivors (n=527), there was 12.1% prevalence of dementia. Only 30% of the demented had previously been diagnosed by the health services. The proportion of undetected dementia was significantly associated with its seriousness (light 95%, moderate 69%, severe 36%). Compared with older persons who were not demented, the demented used more often hospital services, medical and nursing consultations at home and consultations through third parties; and less often, preventive and rehabilitation services. This trend was accentuated in patients with grave dementia. The use of community social services was very low (below 8% in the most serious cases). CONCLUSIONS: The detection of dementia in the elderly is very low and efforts to detect it in primary care need to be stepped up. Specific social-health resources for this population also need to be increased and the attendance guide-lines for primary care teams, and for health professionals in general, need to be changed.

[Functional evaluation of persons over 60 years of age living in an urban community. ANCO project]. / Valoración funcional de personas mayores de 60 años que viven en una comunidad urbana. Proyecto ANCO.

OBJECTIVE: To establish the grade of functional deterioration in older people and analyse associated factors. DESIGN: Cross sectional study. SETTING: City of Córdoba. PARTICIPANTS: The population over 60 years old on the Córdoba municipal roll (49,674) and living at home, from which a sample of 1,103 subjects was taken. INTERVENTIONS: The multidimensional OARS-MFAQ questionnaire was filled in. Calculation of the functional deterioration scores enabled five areas to be evaluated: physical health (PH), mental health (MH), economic resources (ER), social resources (SR) and capacity to perform daily activities (DA) autonomously. MEASUREMENTS AND MAIN RESULTS: Reply rate was 86.8%. The prevalence of serious/absolute deterioration in each of the areas was: 9.3% in SR, 8.5% in DA, 8.4% in ER, 6.9% in MH and 5.8% in PH. CONCLUSIONS: Both the prevalence of functional deterioration in the population group under study and the demand for institutional care are similar to other studies performed in our country, but higher than in Anglosaxon countries.

[The principal causes of mortality in young people in the Autonomous Community of Madrid: 1990-1991]. / Principales causas de mortalidad en jóvenes en la Comunidad Autónoma de Madrid: 1990-1991.

Our objective is to quantify the mortality from AIDS, narcotic related deaths, and traffic accidents among those between 15 and 39 years of age, in the Community of Madrid, 1990-1991. Data provided by the Regional Register of AIDS, Forensic Institute of Madrid, local police teams and the Traffic Directorate General have been used. Mortality from traffic accidents ranked first as a cause of death, followed by narcotic-related deaths and AIDS, both for men and women.

[Short-term prediction of cases of AIDS in Catalonia (1991-1994)]. / Predicción a corto plazo de los casos de SIDA en Cataluña (1991-94).

Predicting AIDS incidence is a useful strategy for health service planning and for the design of preventive and control programmes. The different predictive mathematical models of AIDS can be classified in simple and complex, according to the assumptions used. The present study presents the prediction of the minimum AIDS incidence in Catalonia for the period 1991-94 by means of three simple mathematical models. The models that have been compared are the projection method of Chin and Lwanga, the retroprojection method of Brookmeyer and Gail, and the extrapolation method of Cox and Medley. Baseline information about AIDS cases comes from the AIDS Registry of the "Generalitat" of Catalonia. In a comparable manner, the three methods point out an increase of AIDS incidence until 1994, varying from 1160 to 1733 new cases in that year depending on the method used. We conclude that it will be necessary to increase the provision of health, social and preventive resources against AIDS in Catalonia in the coming years.

[Intravenous drug addiction and the risk of HIV infection in Madrid in 1990]. / Drogadicción intravenosa y riesgo de infección por VIH en Madrid 1990.

As part of a multicenter WHO study on HIV infection among drug injectors, 472 intravenous drug users (IDUs) were interviewed, 240 recruited in the streets and 232 at drug treatment centers. The objectives of the study were to assess the prevalence of HIV infection among IDUs of Madrid, to identify factors associated with risk reduction behaviors, such as the use of sterile syringes and condoms. Chi-square and logistic regression were used to test for differences and to estimate odds ratios. Prevalence of HIV infection among IDUs in Madrid was 50% (53% among those recruited in the street and 38% among those recruited at treatment centers). Forty five per cent of those interviewed were still sharing syringes. Out of the 315 sexually active subjects, only 22% reported using condoms always or almost always. These results suggest that a range of interventions should be implemented to promote change towards healthier behaviors, including syringe-exchange programs, methadone maintenance treatments and pre- and post-test counseling in those agencies which care for this population.

[Jails and AIDS. Risk factors for HIV infection in the prisons of Madrid]. / Cárceles y SIDA. Factores de riesgo de infección por el VIH en las cárceles de Madrid.

The spread and risk factors for HIV infection were studied in 288 men and 95 women at the prisons of Carabanchel and Yeserias, Madrid. These men and women requested care at the AIDS prevention program in the jails of Madrid, from April to December 1987. Among the men studied at Carabanchel, 55% were positive to HIV (77% seropositivity among intravenous drug users, IVDU). Tattooing (OR = 2.8), and number of times in prison (OR = 4.5 comparing those who had been 8 or more times in prison with those who had been in prison only once) were independent risk factors for infection, after controlling for IVDU. No association was found between seropositive status to HIV and reported anal intercourse. Among the women studied at Yeserias, the proportion of HIV seropositive women was 26% (70% of the IVDUs were seropositive). Tattooing, number of times in prison, history of prostitution and history of syphilis were associated with HIV infection. When controlling for IVDU, number of times in prison and history of prostitution were not independent risk factors for infection. These data indicate that there is a need for control measures to avoid further spread of the HIV infection among the inmate population, in particular through the use of contaminated needles while in prison.