Characteristics and Circumstances of Falls in the Community-Dwelling Older Adult Population.

Objective: The study aimed to describe the characteristics and circumstances of falls in the community-dwelling older adult population. Design: This was a cross-sectional observational and descriptive study involving primary health care centers in Lleida and Castellón de la Plana, Spain. Randomized sampling was used to include 966 individuals aged 75 years or older residing in single-family homes and in possession of a health care card. Data were obtained using the Survey on Fragility in Older People in Lleida (FRALLE survey). Study variables included the occurrence of falls in the past year and fall characteristics such as whether it was a first or successive fall, cause, season, and time of the day the fall occurred, whether the respondent fell flat on the ground, and time the participant remained on the floor. Other variables involved the circumstances of the fall, including the general location of the fall and specific location within the home if applicable, lighting/weather conditions, objects which may have precipitated the fall, floor conditions, and type of footwear. Results: The prevalence of falls was 25.9% with regard to the previous year, with 70% of these participants reporting having fallen previously. Falls most often occurred by accident, during the daytime, and in the winter. Variables that showed statistical significance with regard to age group were: falling flat on the ground (P = .031), fall location (P = .000), presence of an object favoring the fall (P = .039), floor conditions (P = .011), and type of footwear (P = .029). By sex, variables that showed statistical significance included the need for assistance to get up (P = .045) and type of footwear (P = .028). Conclusions: The prevalence of falls was found to be similar in the studied cities. The results show the most common characteristics and circumstances of falls in older adults in the community, making it possible to guide future preventive strategies.

Estudio de fragilidad en adultos mayores. Diseño metodológico / Study of the elderly frailty. Methodological design

Objetivo: Conocer y analizar las 9 dimensiones de vida relacionada con la fragilidad de las personas mayores de 75 y más años de edad residentes en la comunidad de la ciudad de Castellón de la Plana. Metodología: Estudio descriptivo, transversal, dirigido a 992 personas de 75 y más años de edad, que disponen de tarjeta sanitaria y residen en viviendas familiares, a través de un muestreo aleatorio estratificado. Se realiza un cuestionario personal a través de la encuesta FRALLE, que recoge los criterios de fragilidad junto a las 9 dimensiones de vida. Resultados: Tres meses después del inicio del estudio se han captado 316 individuos, lo que supone el 31,9% del total de la muestra requerida. Conclusiones: La participación del personal previamente entrenado ha facilitado el acceso a la población y la respuesta obtenida. La encuesta FRALLE ofrece rigurosidad y validez ajustada a la consecución de los objetivos del estudio actual. La colaboración clínico-universitaria es importante para la obtención de resultados y el desarrollo de intervenciones posteriores

Objective: To know and analyse the 9 dimensions of life related to the frailty of elderly people aged 75 and over who live in the local community of Castellón de la Plana. Methodology: Descriptive and transversal study, involving 992 elderly people of 75 years old or over, who have a health card and live in familiar dwellings, by means of a stratified random sample. A personal questionnaire was conducted using the FRALLE survey, which collects the frailty criteria and the 9 dimensions of life. Results: Three months after starting our research, 316 individuals have participated in the study which means 31.9% of the expected total sample. Conclusions: The involvement of the previously trained nursing staff has eased the Access to the elderly and the data collected. The FRALLE survey offers scientific rigour and validity suitable for the achievement of the current study objectives. The collaboration between nursing and academia is important to obtain the results and the development of subsequent interventions

[Prevalence and associated factors of falls in community-dwelling elderly]. / Prevalencia y factores asociados a caídas en adultos mayores que viven en la comunidad.

OBJECTIVE: To estimate the prevalence of falls and to identify their associated factors in community-dwelling elderly. DESIGN: A descriptive, cross-sectional study. SETTING: Primary Health Care, Lleida. PARTICIPANTS: Six hundred and forty people aged 75 and older were included, in possession of a health card and living in single-family houses, through random sampling. Main measurements Data source comes from the survey of frailty in Lleida (FRALLE Survey). The variables used were the occurrence of falls, sociodemographic factors, health status, quality of life related to health and fear of falling. RESULTS: The prevalence of falls was 25.0% (95% CI 24.8-25.1). After multivariate analysis, basic disability (OR=2.17; 95% CI 1.32-3.58), depressive symptoms (OR=1.67; 95% CI 1.07-2.59) and fear of falling (OR=2.53; 95% CI 1.63-3.94) were the only factors independently associated with falls in the last year. CONCLUSIONS: One out of 4 older people reported at least a fall in the last year. This study demonstrates that fear of falling, depressive symptoms and basic disability are independent variables associated with previous falls. These 3 factors can lead to a flattering spiral of falling and may be potential targets for effective functioning in the context of falls.

Sintomatología depresiva en ancianos. La influencia del género / Depressive symptoms in elderly women. The influence of gender

Objetivo. Examinar las posibles diferencias de género en la presencia de sintomatología depresiva en personas mayores de 75 años de la comunidad. Métodos. Se trata de un estudio transversal descriptivo. La fuente de datos fue la encuesta realizada para el estudio de fragilidad en Lleida (encuesta FRALLE). Los síntomas depresivos se midieron con The Center for Epidemiologic Studies Depresion Scale (CES-D). Para analizar la relación del género con los síntomas depresivos se usaron técnicas de regresión logística. Resultados. La prevalencia de síntomas depresivos fue del 33,1% para el conjunto de la muestra, del 22,8% para los varones y del 40,3% para las mujeres. En toda la población, el género obtuvo resultados estadísticamente significativos en los 3 modelos construidos. Así, las mujeres tenían un mayor riesgo de depresión que los varones, incluso después de ajustar por los factores sociodemográficos y por los de estado de salud, presentando casi el doble de probabilidades de padecer depresión. Conclusiones. Los datos obtenidos sugieren que las mujeres tienen más riesgo de presentar síntomas depresivos que los varones. Así mismo, los factores protectores de sintomatología depresiva son el nivel alto de estudios en las mujeres y la presencia de pareja en los varones(AU)

Objective. To examine gender differences in depressive symptoms in people over 75 years of age in the community. Methods. This is a descriptive cross-sectional study. The data was obtained from the study of frailty in Lleida (FRALLE survey). Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Logistic regression were used to analyse the relationship of gender with depressive symptoms. Results. The prevalence of depressive symptoms was 33.1%; 22.8% for men and 40.3% for women. In the total population, gender was statistically significant in all three models constructed. Thus, women have nearly double the prevalence rates for depression compared to men, even after adjusting for social and demographic factors and the health status. Conclusions. The results suggest that women have a higher risk of depressive symptoms than men, and the protective factors of depressive symptoms are higher education in women, and the presence of a partner in men(AU)

[Depressive symptoms in elderly women. The influence of gender]. / Sintomatología depresiva en ancianos. La influencia del género.

OBJECTIVE: To examine gender differences in depressive symptoms in people over 75 years of age in the community. METHODS: This is a descriptive cross-sectional study. The data was obtained from the study of frailty in Lleida (FRALLE survey). Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D). Logistic regression were used to analyse the relationship of gender with depressive symptoms. RESULTS: The prevalence of depressive symptoms was 33.1%; 22.8% for men and 40.3% for women. In the total population, gender was statistically significant in all three models constructed. Thus, women have nearly double the prevalence rates for depression compared to men, even after adjusting for social and demographic factors and the health status. CONCLUSIONS: The results suggest that women have a higher risk of depressive symptoms than men, and the protective factors of depressive symptoms are higher education in women, and the presence of a partner in men.

Abordaje de una persona con úlceras venosas infectadas / Approach of a person with infected venous ulcers

Las personas con heridas venosas infectadas precisan que se solucione el problema agudo (infección), para posteriormente tratar la causa de base (hipertensión venosa). Mediante una correcta valoración de la persona se puede establecer un tratamiento integral. En el caso expuesto se consigue la curación de una úlcera venosa de 12 años de evolución en 11 semanas de tratamiento, con el consiguiente ahorro para el Sistema de Salud, mejora de la calidad de vida de la persona y su entorno, y disminución de las cargas asistenciales(AU)

People infected with venous wounds need to solve the acute problem (infection), later to treat the underlying cause (venous hypertension). By a proper assessment of the person can establish a comprehensive treatment. In the case above is achieved healing a venous ulcer 12 years of evolution in 11 weeks of treatment, with consequent savings for the health system, improving the quality of life of the person and the environment and cut red tape care (AU)

[Approach of a person with infected venous ulcers]. / Abordaje de una persona con ulceras venosas infectadas.

People infected with venous wounds need to solve the acute problem (infection), later to treat the underlying cause (venous hypertension). By a proper assessment of the person can establish a comprehensive treatment. In the case above is achieved healing a venous ulcer 12 years of evolution in 11 weeks of treatment, with consequent savings for the health system, improving the quality of life of the person and the environment and cut red tape care.

Criterios de fragilidad del adulto mayor. Estudio piloto / Frailty criteria in the elderly: a pilot study

Objetivo: Testar la medición de fragilidad mediante los criterios de Fried modificados por Ávila-Funes en personas de 75 años o más que viven en sus domicilios.Diseño: Estudio piloto de diseño transversal.Emplazamiento: Todas las áreas básicas de salud (7) de la ciudad de Lleida.Participantes: Se seleccionó una muestra probabilística de cada estrato, siendo la muestratotal de 323 individuos.Mediciones principales: Características sociodemográficas, medidas de los 5 criterios de fragilidad(pérdida involuntaria de peso, baja energía o «agotamiento», lentitud en la movilidad,debilidad muscular y baja actividad física) y escalas de valoración geriátrica (índice de Charlson,test Pfeiffer, índice de Katz y de Lawton y Brody, test MNA escala CES-D).Resultados: La prevalencia de fragilidad fue del 8,5%. Los factores asociados a fragilidad fueronel sexo femenino y tener pocos ingresos mensuales. A medida que la fragilidad aumenta, elestado cognitivo, las actividades de la vida diaria y el estado nutricional se deterioran y existemayor comorbilidad. Las puntuaciones de los criterios de fragilidad empleados presentaron unacorrelación significativa con las puntuaciones de las escalas de valoración geriátrica estudiadas.Conclusiones: La prevalencia de fragilidad es similar a otros estudios consultados que hanempleado los mismos criterios para definirla. Las medidas de los criterios de fragilidad hanresultado ágiles para la trascripción de los resultados. El estudio de la fragilidad mediantemarcadores específicos permite la prevención y el perfeccionamiento de nuevos programas deintervención(AU)

Objective: To measure the frailty of people 75 years or over and who live in their own homesbased on Fried’s criteria and modified by Ávila-Funes.Design: Pilot study of cross-sectional design.Site: Primary Health Care Centres (7) in the city of Lleida.Participants: A probabilistic sample was selected for every stratum. The total sample was 323individuals.Primary measurements: Socio-demographic characteristics, measurement of the five frailtycriteria (involuntary lose of weight, low energy or exhaustion, slow mobility, muscle weakness,low physical activity), and geriatric assessment scales (Charlson Index, Pfeiffer’s Test,Katz Index, Lawton and Brody Index, MNA Test and CES-D scale).Results: The prevalence of frailty was 8.5%. Factors associated with frailty were, female sexand low monthly income. It was observed that if the frailty increases, there is deterioration ofcognitive status, activities of daily living and nutritional status. There is also higher morbidity.Frailty criteria scores showed a significant correlation with geriatric assessment scales scores.Conclusions: The prevalence of frailty in elderly people is similar to those in other studies thathave used the same criteria. The measurement of frailty criteria in this study demonstratesa better ability for transcription of results. A frailty study using specific markers enhancesprevention and improvement of new intervention programs(AU)

[Frailty criteria in the elderly: a pilot study]. / Criterios de fragilidad del adulto mayor. Estudio piloto.

OBJECTIVE: To measure the frailty of people 75 years or over and who live in their own homes based on Fried's criteria and modified by Ávila-Funes. DESIGN: Pilot study of cross-sectional design. SITE: Primary Health Care Centres (7) in the city of Lleida. PARTICIPANTS: A probabilistic sample was selected for every stratum. The total sample was 323 individuals. PRIMARY MEASUREMENTS: Socio-demographic characteristics, measurement of the five frailty criteria (involuntary lose of weight, low energy or exhaustion, slow mobility, muscle weakness, low physical activity), and geriatric assessment scales (Charlson Index, Pfeiffer's Test, Katz Index, Lawton and Brody Index, MNA Test and CES-D scale). RESULTS: The prevalence of frailty was 8.5%. Factors associated with frailty were, female sex and low monthly income. It was observed that if the frailty increases, there is deterioration of cognitive status, activities of daily living and nutritional status. There is also higher morbidity. Frailty criteria scores showed a significant correlation with geriatric assessment scales scores. CONCLUSIONS: The prevalence of frailty in elderly people is similar to those in other studies that have used the same criteria. The measurement of frailty criteria in this study demonstrates a better ability for transcription of results. A frailty study using specific markers enhances prevention and improvement of new intervention programs.

Influencia de la textura de la dieta sobre el estado nutricional en adultos mayores / Influence of the texture of the diet on the nutritional state in elderly

La enfermera tiene un papel fundamental en el campode la alimentación, sobre todo en la vigilancia de lacomposición de las dietas. Los objetivos de este estudiofueron describir el tipo de paciente que lleva una dietatriturada y analizar la influencia de la dieta triturada sobreel estado nutricional. Se trata de un estudio transversalcon personas de 65 años o más, atendidas en centrosasistenciales de la ciudad de Lleida. El estudiodescriptivo se realizó a través de la prueba de 2. Lacomparación entre la variable dependiente y la media delos valores totales del test Mini Nutritional Assessment(MNA) y otros datos nutricionales se analizó a travésdel test-t de Student. Se pudo concluir que las personasque requerían dieta triturada estaban peor nutridas quelas que requerían una dieta normal (AU)

The nurse has a key role in the field of nutrition, especiallyin monitoring the composition of the diets. The objectivesof this study were to describe the type of patient who carriesa pulverized diet and analyze the influence of diet on nutritionalstatus crushed. This is a cross-sectional study withpeople 65 years or older and who attended medical centresin the city of Lleida. The descriptive study was conductedthrough the test 2. The comparison between the dependentvariable and the average of the total value of the test MiniNutritional Assessment (MNA) and other nutritional datawas analyzed by Student’s t-test. We concluded that peoplewho needed diet were crushed worse than those fed a normaldiet required (AU)

[Nutritional status of Catalonia's elderly people with different health care needs]. / Estado nutricional de la población mayor de Cataluña de diferentes niveles asistenciales.

Nutritional status of Catalonia's elderly people with different health care needs. The aims of this study were to assess the prevalence of malnutrition through the Mini Nutritional Assessment (MNA) in the elder population of Lleida (Catalonia) from different levels of care and to determine if that scale is a good way of monitoring our population. A cross-sectional study was designed. It included men and women of 65 years or more users of primary health care centre, the acute hospital, nursing home and health and assisted social services. The MNA was used in your short form (MNA-SF) and MNA total (MNA). This questionnaire is designed to screen the nutritional status of elderly people, when they arrived to the hospital and during their stay. Three hundred and ninety-eight individuals (184 men) were included aging 77 on average. According to the categories of the MNA, the prevalence of malnutrition of the total sample was 22.6% and risk of malnutrition of 35.4%. The MNA has been validated in our population getting a sensitivity of 77% and specificity of 70%. In conclusion, it can be affirmed that there was a high prevalence of undernourishment, foremost in health and social care services and in the medicine service of acute hospital. The MNA is a useful tool for monitoring nutritional care at different levels in both the short form and in total form.

Estado nutricional de la población mayor de Cataluña de diferentes niveles asistenciales / Nutritional status of Catalonia’s elderly people with different health care needs

Los objetivos de este estudio fueron evaluar la prevalencia de desnutrición a través de la Mini Encuesta Nutricional del Anciano (MNA) en la población mayor de Lleida (Cataluña) de diferentes niveles asistenciales y valorar si dicha escala es un buen método de monitorización en nuestro medio. Para ello se diseñó un estudio transversal en el que se incluyeron personas de ambos sexos, igual o mayores de 65 años, procedentes del centro de salud, del hospital de agudos de la residencia asistida y de centros socio-sanitarios. Se utilizó la MNA en su versión corta (cribado) y versión íntegra (MNA total). Este cuestionario está diseñado para la valoración nutricional de los individuos mayores tanto a la admisión en hospitales e instituciones como para la monitorización durante su estancia. Se incluyeron 398 individuos (184 hombres), con una edad media de 77 años. Según las categorías de la MNA, la prevalencia de desnutrición del total de la muestra fue del 22,6 por ciento y de riesgo de desnutrición del 35,4 por ciento. La MNA ha sido validada en nuestro medio obteniendo una sensibilidad del 77 por ciento y una especificidad del 70 por ciento. Se podría afirmar como conclusión que existe una elevada prevalencia de riesgo de desnutrición y desnutrición establecida en Cataluña sobretodo en los centros socio-sanitarios y en el servicio de medicina interna del hospital de agudos. Los resultados son similares a otros estudios contrastados. La MNA es una herramienta útil para el monitoreo nutricional en los distintos niveles asistenciales tanto en el cribado como en su versión íntegra.

The aims of this study were to assess the prevalence of malnutrition through the Mini Nutritional Assessment (MNA) in the elder population of Lleida (Catalonia) from different levels of care and to determine if that scale is a good way of monitoring our population. A cross-sectional study was designed. It included men and women of 65 years or more users of primary health care centre, the acute hospital, nursing home and health and assisted social services. The MNA was used in your short form (MNA-SF) and MNA total (MNA). This questionnaire is designed to screen the nutritional status of elderly people, when they arrived to the hospital and during their stay. Three hundred and ninety-eight individuals (184 men) were included aging 77 on average. According to the categories of the MNA, the prevalence of malnutrition of the total sample was 22.6 percent and risk of malnutrition of 35.4 percent. The MNA has been validated in our population getting a sensitivity of 77 percent and specificity of 70 percent. In conclusion, it can be affirmed that there was a high prevalence of undernourishment, foremost in health and social care services and in the medicine service of acute hospital. The MNA is a useful tool for monitoring nutritional care at different levels in both the short form and in total form.