COVID infection displaces serious cardiovascular disease from the resuscitation room.

The SARS-COV2 Pandemic has required the emergency departments to focus their attention and care to COVID-19-diagnosed patients over patients with other pathologies. Descriptive study of patients attended in the resuscitation room between 1st of March and 31st May 2019 and compared to the same period in 2020. We include all the patients attended were included in the study and their clinical variables evaluated and their diagnosis at discharge. Six hundred and fifty-nine patients were attended in 2019 and 384 in 2020. There were no differences between age and gender. In 2019, 83.2% of the cases attended had a cardiac pathology, followed by neurological pathology and traffic accidents. This data is also significant since in the same period of 2020 cardiac pathology fell to 8.3%. The COVID pandemic has reduced patients attended at resuscitation room, and especially cardiovascular ones. These are preliminary results and more studies should be done to confirm or to study this trend.

Prevalence and Risk Factors Associated With Low Fluid Intake in Institutionalized Older Residents.

OBJECTIVE: The aim of this study was to determine the prevalence of low fluid intake in institutionalized older residents and the associated factors. DESIGN: This was a cross-sectional study. SETTING AND PARTICIPANTS: The study was carried out at a nursing home with a capacity for 156 residents, all of whom were older than 65 years. MEASURES: Data were collected on the fluids consumed by each resident over a period of 1 week. Information relating to sociodemographic variables and to residents' health, nutrition, and hydration status was also collected. RESULTS: Of 53 residents, 34% ingested less than 1500 mL/d. The factors with the greatest correlation associated with low fluid intake were cognitive and functional impairment, the risk of suffering pressure ulcers, being undernourished, a texture-modified diet, dysphagia, impaired swallowing safety, and BUN:creatinine ratio. CONCLUSIONS/IMPLICATIONS: The results obtained highlight the scale of low fluid intake in nursing homes and also aid to identify and understand the factors associated with this problem. The findings could help us to develop specific strategies to promote the intake of liquids and thereby reduce the incidence of dehydration in nursing homes.

Problemas del equilibrio y de la marcha relacionados con la fragilidad en mujeres adultas mayores físicamente activas / Balance and gait problems related to frailty in physically active older women

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Correction: Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both?

[This corrects the article DOI: 10.1371/journal.pone.0194967.].

Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or both?

BACKGROUND: Despite the number of studies that have tried to demonstrate that there is an association between previous falls and the fear of falling, the relationship between these two variables remains a matter of controversy. OBJECTIVES: Our objective was to investigate whether the fear of falling is a cause of falls, a consequence, or both in community-dwelling adults aged ≥ 75 years old. METHODS: A descriptive, longitudinal, prospective study was performed. A total of 640 individuals were interviewed between 2009 and 2011. Sociodemographic data, health status, history of falls and fear of falling were assessed at baseline and at 24 months. RESULTS: The prevalence of falls at baseline was 25% as opposed to 35.2% at 24 months. The prevalence of the fear of falling was 41.5% at baseline. Logistic regression analysis showed a significant association between a history of falls and the fear of falling. Other factors associated with the fear of falling were female gender, comorbidity, depressive symptoms, and disability. In total, 41.7% of the subjects who had reported a fear of falling at baseline had suffered at least one fall 24 months later. Unadjusted Cox regression analysis revealed that the fear of falling was a risk factor for falls. According to the final model adjusted for other covariates, the only reliable predictor was female gender. The Cox model stratified by gender failed to show a crude association between fear of falling and falls. CONCLUSION: A previous history of falls in the previous year was a good predictor of the fear of falling; but the fear of falling was a predictor of falls during follow-up only in the unadjusted model, pointing to strong gender turns out as an effect modifier of the association of FOF and subsequent falls. Nursing staff working in elderly care should not only routinely assess patients' previous history of falls, but also evaluate their fear of falling and its associated factors.

Differences in fitness level between women aged 60 and over participating in three different supervised exercise programs and a sedentary group.

The aim of this study was to compare fitness levels in women aged 60 and over participating in a supervised exercise program (involving tai chi, recreational gymnastics, and/or aquatic fitness) with those in a sedentary group. An observational, descriptive, cross-sectional study was performed on a total of 171 women aged from 60 to 92 who attended public community clubs for older adults. The instruments used included the Senior Fitness Test, the Tinetti Balance Assessment Tool, the Katz Index, and the Lawton & Brody Activities of Daily Living Scale. Significant differences in fitness levels were observed when we compared the exercise groups with the sedentary group. Women with better fitness levels had a lower risk of suffering falls and greater autonomy in performing activities of daily living and instrumental activities of daily living. Agility and gait control were found to be independently associated with exercise groups.

El ejercicio físico y su efectividad sobre la condición física en personas mayores frágiles. Revisión sistemática de ensayos clínicos aleatorizados / Effectiveness of physical exercise on fitness in frail older adults: a systematic review of randomised trials

El ejercicio físico es una actividad clave en la intervención de la fragilidad, por lo que mantener una buena condición física es parte esencial para la prevención o mejora de la misma. El objetivo de esta revisión fue examinar los beneficios del ejercicio físico sobre la condición física en personas mayores frágiles. Se realizó una extensa búsqueda bibliográfica de las bases de datos electrónicas, incluyendo ensayos clínicos aleatorizados (ECA) de los últimos 15años. La calidad metodológica se obtuvo mediante la escala PEDro. Fueron incluidos 10 artículos, obteniéndose una muestra de 1.130 sujetos. La puntuación en la escala PEDro osciló entre 5 y 8/10. El entrenamiento multicomponente de la condición física, al parecer, es la mejor estrategia para mejorar la condición física. Son necesarios más estudios para clarificar cuáles deben ser las características más adecuadas de estos programas de ejercicios, al mismo tiempo que incrementar la evidencia científica a nivel hospitalario y de institucionalización (AU)

Performing exercise to maintain a good physical condition is crucial to improve and prevent frailty in older adults. The aim of this review was to assess the beneficial effects of physical exercise on fitness in frail older adults. A thorough literature search of randomised clinical trials (RCT) in the last 15 years was performed on different electronic databases. The methodological assessment of studies was obtained using the PEDro scale. Ten RCT were included, providing a final sample of 1,130 individuals. Scores on the PEDro scale ranged from 5 to 8/10. Multicomponent training programs seem to be the best strategy to improve fitness outcomes. Further studies should be performed in order to optimise the design of supervised exercise programs, and further research is needed in hospital and institutionalised settings (AU)

[Effectiveness of physical exercise on fitness in frail older adults: A systematic review of randomised trials]. / El ejercicio físico y su efectividad sobre la condición física en personas mayores frágiles. Revisión sistemática de ensayos clínicos aleatorizados.

Performing exercise to maintain a good physical condition is crucial to improve and prevent frailty in older adults. The aim of this review was to assess the beneficial effects of physical exercise on fitness in frail older adults. A thorough literature search of randomised clinical trials (RCT) in the last 15 years was performed on different electronic databases. The methodological assessment of studies was obtained using the PEDro scale. Ten RCT were included, providing a final sample of 1,130 individuals. Scores on the PEDro scale ranged from 5 to 8/10. Multicomponent training programs seem to be the best strategy to improve fitness outcomes. Further studies should be performed in order to optimise the design of supervised exercise programs, and further research is needed in hospital and institutionalised settings.

Prevalencia y factores asociados a sospecha de malos tratos en la unidad geriátrica del área de urgencias del hospital / Prevalence and factors associated with suspected mistreatment in a geriatric unit in a hospital emergency area

Objetivo. Conocer la prevalencia de sospecha de maltrato e identificar los factores asociados en las personas mayores sin déficit cognitivo, que son atendidas por la unidad geriátrica ubicada en el servicio de urgencias del hospital. Métodos. Estudio descriptivo y transversal de una población de 65 años o más, valorada por la Unidad Funcional Interdisciplinaria Sociosanitaria (UFISS) geriátrica del servicio de urgencias del hospital Arnau de Vilanova de Lleida. El total de participantes fue de 127. La sospecha de maltrato se midió con el cuestionario de la American Medical Association (AMA) y la Canadian Task Force (CTF). Las variables estudiadas fueron las características sociodemográficas y la dependencia funcional. Resultados. La prevalencia de sospecha de maltrato fue del 29,1% (IC del 95%: 0,21-0,37). Los subtipos más frecuentes fueron por abandono y psicológico, y menos frecuente por negligencia. Los factores asociados fueron el sexo femenino, profesión previa no remunerada, ser viudo, y vivir solo. Conclusiones. Tres de cada 10 personas mayores fueron identificadas como posibles víctimas de maltrato. Debido al relativo aislamiento de muchos adultos mayores que son maltratados, una visita inesperada al servicio de urgencias puede ser la única oportunidad para su detección. Las unidades geriátricas ubicadas en esta área deberían incluir en la valoración integral, la sospecha de malos tratos a dicha población. Para ello, es necesario poder contar con un instrumento con un alto índice de sensibilidad y especificidad para la detección de los malos tratos en las personas mayores(AU)

Objective. To know the prevalence of mistreatment and to identify the associated factors among elderly people without cognitive impairment, seen in the geriatric unit, located in the hospital emergency area. Methods. Cross-sectional study of a population of 65 years or older assessed by the geriatric Interdisciplinary Social Welfare Functional Unit (ISSFU) of the emergency area in the Arnau de Vilanova hospital of Lleida. We excluded participants with cognitive impairment. The total number of participants was 127. The suspicion of mistreatment was measured using the Questionnaire of the American Medical Association (AMA) and the Canadian Task Force (CTF). The variables studied were social demographic characteristics and functional dependency. Results. Prevalence of suspicion of mistreatment was 29.1% (95% CI: 0.21-0.37). The most frequent subtypes were neglect and psychological, and less frequent was negligence. Associated factors were being female, being in unpaid work, being a widow and living alone. Conclusions. Three out of ten elderly people were identified as possible victims of abuse. Due to the relative isolation of many of the elderly who were abused, an unexpected visit to the emergency area may be the only opportunity for detection. Geriatric units located in this area should include the suspicion of mistreatment of this population in their comprehensive assessment. For this, it is necessary to have tool with a high degree of sensitivity and specificity for detection of abuse in the elderly(AU)

[Prevalence and factors associated with suspected mistreatment in a geriatric unit in a hospital emergency area]. / Prevalencia y factores asociados a sospecha de malos tratos en la unidad geriátrica del área de urgencias del hospital.

OBJECTIVE: To know the prevalence of mistreatment and to identify the associated factors among elderly people without cognitive impairment, seen in the geriatric unit, located in the hospital emergency area. METHODS: Cross-sectional study of a population of 65 years or older assessed by the geriatric Interdisciplinary Social Welfare Functional Unit (ISSFU) of the emergency area in the Arnau de Vilanova hospital of Lleida. We excluded participants with cognitive impairment. The total number of participants was 127. The suspicion of mistreatment was measured using the Questionnaire of the American Medical Association (AMA) and the Canadian Task Force (CTF). The variables studied were social demographic characteristics and functional dependency. RESULTS: Prevalence of suspicion of mistreatment was 29.1% (95% CI: 0.21-0.37). The most frequent subtypes were neglect and psychological, and less frequent was negligence. Associated factors were being female, being in unpaid work, being a widow and living alone. CONCLUSIONS: Three out of ten elderly people were identified as possible victims of abuse. Due to the relative isolation of many of the elderly who were abused, an unexpected visit to the emergency area may be the only opportunity for detection. Geriatric units located in this area should include the suspicion of mistreatment of this population in their comprehensive assessment. For this, it is necessary to have tool with a high degree of sensitivity and specificity for detection of abuse in the elderly.

Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey.

The aim of this study was to assess the prevalence of frailty and to identify factors associated with frailty in older people living in the community through a cross-sectional study of community-dwelling persons age 75 and older. A total of 640 individuals were interviewed using the FRALLE survey between 2009 and 2010. This survey measures frailty through the five Fried criteria, and through questions on sociodemographics, health habits, health status, social relations and data on health-related quality of life. The mean age of the participants was 81.3 ± 5.0; 39.7% were men. The prevalence of frailty was 9.6% (95% confidence interval (CI): 7.6-11.5) and that of pre-frailty was 47% (95% CI: 42.7-51.2). After the logistic regression, age (over 85 years) (odds ratio (OR): 3.61; 95% CI: 1.65-7.91; p<0.001), depressive symptoms (OR: 3.13; 95% CI: 1.37-7.13; p=0.0006), comorbidity (OR: 5.20; 95% CI: 1.78-15.16; p=0.0002), cognitive impairment (OR: 3.22; 95% CI: 1.48-7.02; p=0.0003), poor social ties (OR: 0.57; 95% CI: 0.43-0.77; p<0.001) and poor physical health (OR: 0.98; 95% CI: 0.97-0.98; p<0.001) were significantly associated with frailty. There is great variability in the prevalence of frailty depending on the study considered. The lack of homogeneity in the measurement of the five criteria, the age of participants and the degree of dependence could explain the differences observed. Here, the factors associated with frailty were age, comorbidity, cognitive impairment and depressive symptoms, while the diversity of social interaction and health-related physical function were protective factors.