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1.
Artículo en Español | PAHO-IRIS | ID: phr-53288

RESUMEN

[RESUMEN]. Objetivo. Evaluar la validez predictiva de un método de clasificación funcional (CF) sobre el uso de los servicios de urgencias y hospitalización, mortalidad y costos de la atención en salud en adultos mayores. Métodos. Estudio de cohorte retrospectivo que incluyó 2 168 adultos mayores en un programa de atención de las enfermedades crónicas no transmisibles (ECNT) en Medellín (Colombia). Los pacientes fueron estratificados según un método de CF con base en el estado funcional, presencia de factores de riesgo y control de la comorbilidad. Durante un año de seguimiento, se evaluó la validez predictiva de la CF sobre los desenlaces estudiados; se midieron la discriminación y la calibración con el estadístico-C y de Hosmer-Lemeshow (H-L), respectivamente. Resultados. El promedio de edad fue 74,6 ± 7,9 años; el 40,8% (n = 884) fueron hombres y 7,7% (n = 168) murieron. El riesgo de muerte (razón de posibilidades [OR, por su sigla en inglés]: 1,767; 3,411; 8,525), hospitalización (OR: 1,397; 2,172; 3,540) y un costo elevado de la atención en salud (OR: 1,703; 2,369; 5,073) aumentaron en la medida que hubo un deterioro en la CF, clases 2B, 3 y 4, respectivamente. El modelo predictivo para el desenlace muerte mostró una buena capacidad de discriminación (estadístico-C = 0,721) y calibración (estadístico de H-L = 10,200; P = 0,251). Conclusión. Existe una relación de dosis y respuesta entre el deterioro de la CF y un riesgo más elevado de muerte, hospitalización y costo elevado. La CF tiene validez predictiva para la tasa de mortalidad y podría utilizarse para la estratificación de adultos mayores en programas de atención de las ECNT con miras a dirigir las acciones de intervención.


[ABSTRACT]. Objective. Evaluate the predictive validity of a functional classification (FC) method for the use of emergency services and hospitalization, mortality, and health care costs among older adults. Methods. Retrospective cohort study that included 2 168 older adults in a chronic noncommunicable disease (CNCD) care program in Medellin, Colombia. Patients were stratified according to a FC method based on functional status, presence of risk factors, and control of comorbidity. During one year of follow-up, the predictive validity of the FC method was assessed for the studied outcomes. Discrimination and calibration were measured with the C-statistic and Hosmer-Lemeshow (HL) test, respectively. Results. The average age was 74.6 ± 7.9 years; 40.8% (n = 884) were men and 7.7% (n = 168) died. The risk of death (odds ratio [OR]: 1.767; 3.411; 8.525), hospitalization (OR: 1.397; 2.172; 3.540) and high cost of health care (OR: 1.703; 2.369; 5.073) increased in proportion to a deterioration in functional classification (classes 2B, 3, and 4, respectively). The predictive model for the outcome of death showed good capacity for discrimination (C-statistic = 0.721) and calibration (HL statistic 10.200; P = 0.251). Conclusion. There is a dose-response relationship between deterioration in FC and a higher risk of death, hospitalization, and high cost. FC has predictive validity for the mortality rate and could be used to stratify older adults in CNCD care programs with a view to guiding interventions.


[RESUMO]. Objetivo. Avaliar a validade preditiva de um método de classificação funcional (CF) para a utilização de serviços de emergência e internação hospitalar, mortalidade e custos da atenção de saúde em idosos. Métodos. Estudo de coorte retrospectivo com 2 168 idosos atendidos em um programa de atenção de doenças crônicas não transmissíveis (DCNT) em Medellín, Colômbia. Um método de CF foi usado para estratificar os participantes segundo o estado funcional, presença de fatores de risco e controle de comorbidades. No período de acompanhamento de um ano, a validade preditiva da CF foi avaliada para os desfechos de interesse. A capacidade discriminatória (estatística C) e a calibração (teste de Hosmer-Lemeshow [H-L]) do modelo foram avaliadas. Resultados. A média de idade dos participantes do estudo foi 74,6 ± 7,9 anos, 40,8% (n = 884) eram do sexo masculino e 7,7% (n = 168) vieram a óbito. Houve aumento do risco de óbito (odds ratio [OR] 1,767; 3,411–8,525), internação hospitalar (OR 1,397; 2,172-3,540) e custo elevado da atenção de saúde (OR 1,703; 2,369–5,073) com o declínio funcional – classes funcionais 2B, 3 e 4, respectivamente. O modelo preditivo para o desfecho de óbito demonstrou boa capacidade discriminatória (estatística C = 0,721) e calibração (estatística H-L = 10,200; P = 0,251). Conclusão. Há uma relação de dose-resposta entre o declínio da CF e risco maior de óbito, internação hospitalar e custo elevado da atenção. A CF tem validade preditiva para a taxa de mortalidade e poderia ser utilizada na estratificação de idosos em programas de atenção de DCNT para ajudar a direcionar as medidas de intervenção.


Asunto(s)
Fragilidad , Envejecimiento , Enfermedad Crónica , Urgencias Médicas , Hospitalización , Mortalidad , Costos de la Atención en Salud , Fragilidad , Envejecimiento , Enfermedad Crónica , Urgencias Médicas , Hospitalización , Mortalidad , Costos de la Atención en Salud , Fragilidad , Envejecimiento , Enfermedad Crónica , Urgencias Médicas , Hospitalización , Mortalidad , Costos de la Atención en Salud
2.
Artículo en Ruso | MEDLINE | ID: mdl-33580764

RESUMEN

OBJECTIVE: To test the hypothesis that weak electromagnetic fields of low frequencies (0.5-26 Hz) could affect daytime sleep features and structure. MATERIAL AND METHODS: Parameters of daytime sleep continuity were compared in the study with counterbalanced control/exposition (40 min exposure to electromagnetic field at 1 Hz/0.004 µT) scheme in 22 healthy volunteers. Nonlinear regression model was used to assess daytime sleep continuity. RESULTS: Exposure to a weak electromagnetic field of ultra-low frequency significantly improved the quality of sleep, assessed by the indicator of sleep continuity, namely, there were fewer transitions from the second and deeper stages of sleep to the first stage and to the state of wakefulness (p<0.0001). CONCLUSION: The results can be used to develop non-pharmacological methods of sleep correction, as well as to improve the quality of short-term sleep and its positive effect on well-being, cognitive function and working capacity.


Asunto(s)
Campos Electromagnéticos , Fragilidad , Cognición , Humanos , Sueño , Vigilia
8.
Medicine (Baltimore) ; 100(4): e24400, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530237

RESUMEN

ABSTRACT: Frailty is a common geriatric condition due to aging, defined as a decrease in the functional reserve to maintain the homeostasis. As part of the aging process, body composition changes occur. This study investigated the relationship between body composition and frailty in a community-dwelling elderly Korean population.This cross-sectional cohort study analyzed data of 2,385 elderly participants (aged 70-84 years, 1131 males and 1254 females) of the Korean Frailty and Aging Cohort Study from 2016 to 2017. Body composition, including total and trunk fat masses and fat-free mass, were measured with dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index, and fat-free mass index (FFMI) represented total fat mass, trunk fat mass, and fat-free mass according to height. Based on the frailty index developed by Fried, we compared the frail and non-frail groups. Poor physical performance assessed with the short physical performance battery score of < 9 is considered frailty. To evaluate the relationship between the variables, simple and fully adjusted multivariable logistic regression analyses were performed according to sex.Among the participants, 462 (19.3%) were defined as the frail group, with a significantly high mean age of 77.9 ±â€Š4.0 years. In the logistic regression analysis of frailty based on body mass index (BMI) categories, underweight (BMI < 18 kg/m2) participants showed a high incidence of frailty in both sexes. BMI showed an association with frailty only in males. Lower FFMI was associated with a higher incidence of frailty in both sexes, which was statistically significant in the fully adjusted models. In the female, fat-related indexes including body fat percentage, FMI, and trunk fat mass index showed a significant association with poor physical performance. In contrast, males with low FFMI only showed a significant association with poor physical performance.Frailty was closely correlated with lower FFMI in both sexes. The poor physical performance associated with frailty correlated with fat-related body composition in females and fat-free mass in males, owing to the difference in body composition between the sexes. In the assessment of frailty, body composition and sex-related differences should be analyzed.


Asunto(s)
Anciano Frágil/estadística & datos numéricos , Fragilidad/epidemiología , Vida Independiente/estadística & datos numéricos , Rendimiento Físico Funcional , Factores Sexuales , Absorciometría de Fotón , Anciano , Anciano de 80 o más Años , Composición Corporal , Índice de Masa Corporal , Estudios Transversales , Femenino , Fragilidad/fisiopatología , Evaluación Geriátrica , Humanos , Modelos Logísticos , Masculino , Prevalencia , República de Corea/epidemiología , Medición de Riesgo
9.
J Frailty Aging ; 10(2): 176-181, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33575708

RESUMEN

BACKGROUND: Survivors of childhood cancer (CCS) are at risk for early aging and frailty. Frailty in CCS has been assessed with established clinical criteria, a time-intensive approach requiring specialized training. There is an unmet need for cost-effective, rapid methods for assessing frailty in at-risk adolescent and young adult (AYA) CCS, which are scalable to large populations. OBJECTIVES: To validate a sensor-based frailty assessment tool in AYA CCS, compare frailty status between CCS and controls, and assess the correlation between frailty and number of CCS comorbidities. DESIGN, SETTING, AND PARTICIPANTS: Mean frailty index (MFI) was assessed by a frailty wrist sensor in 32 AYA CCS who were ≥1 year off therapy and in remission. Results were compared with 32 AYA controls without cancer or chronic disease. MEASUREMENTS: Frailty assessments with and without a simultaneous cognitive task were performed to obtain MFI. Results were compared between cases and controls using a Student t test, and the number of pre-frail/frail subjects by Chi Square test. The contribution of radiation therapy (RT) exposure to MFI was assessed in a sub-analysis, and the correlation between the number of comorbidities and MFI was measured using the Pearson method. RESULTS: MFI was strongly correlated with gait speed in AYA CCS. CCS were more likely to be pre-frail than controls without cancer history (p=0.032), and CCS treated with RT were more likely to be pre-frail than CCS not treated with RT (p<0.001). The number of comorbidities was strongly correlated with MFI (ρ=0.65), with a 0.028 increase in MFI for each added condition (p<0.001). CONCLUSIONS: Results from this study support higher risk for frailty among CCS, especially those with multiple comorbidities or who were treated with RT. A wrist-worn sensor-based method is feasible for application in AYA CCS, and provides an opportunity for cost-effective, rapid screening of at-risk AYA CCS who may benefit from early interventions.


Asunto(s)
Supervivientes de Cáncer , Fragilidad , Dispositivos Electrónicos Vestibles , Adolescente , Supervivientes de Cáncer/estadística & datos numéricos , Estudios de Casos y Controles , Fragilidad/diagnóstico , Fragilidad/epidemiología , Humanos , Proyectos Piloto , Medición de Riesgo/métodos , Adulto Joven
10.
Bratisl Lek Listy ; 122(2): 116-119, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33502879

RESUMEN

OBJECTIVES: Frailty is a common problem in patients with type 2 diabetes mellitus (T2DM). It is considered to be associated with inflammation. Novel markers derived from hemogram, such as neutrophil/lymphocyte ratio (NLR) and mean platelet volume/lymphocyte ratio (MPVLR), are proposed as inflammatory markers. In present study, we aimed to compare NLR and MPVLR levels of frail patients with T2DM to non­frail diabetic subjects. METHODS: Diabetic subjects were grouped in frail and non-frail groups according to the Edmonton Frail Scale. General characteristics and laboratory data of the frail and non-frail groups were compared. RESULTS: The MPVLR of the frail (3.9 [1.4-13.2] %) group was significantly higher than that of the non-frail (3.4 [1.5-6.9] %) group (p = 0.02). MPVLR was positively and significantly correlated with Edmonton Frail Scale score (r = 0.21, p = 0.03). A MPVLR level greater than 3.41 % has 71 % sensitivity and 51 % specifity in predicting frailty. CONCLUSION: We suggest that elevated MPVLR could be a finding that marks frailty in diabetic subjects. Inexpensive and easy­to­assess nature of the MPVLR may be useful in predicting frailty in type 2 diabetic population (Tab. 2, Fig. 1, Ref. 32).


Asunto(s)
Diabetes Mellitus Tipo 2 , Fragilidad , Diabetes Mellitus Tipo 2/complicaciones , Humanos , Recuento de Linfocitos , Linfocitos , Volúmen Plaquetario Medio
11.
Rev Med Suisse ; 17(720-1): 50-53, 2021 Jan 13.
Artículo en Francés | MEDLINE | ID: mdl-33443831

RESUMEN

2020 has seen the birth of several relevant studies in emergency medicine of which the following is a selection : 1) conservative treatment for primary spontaneous pneumothorax may be offered ; 2) tranexamic acid does not provide benefit in gastrointestinal bleeding ; 3) the Canadian Syncope Risk Score is validated for the risk stratification of syncopal patients ; 4) early administration of tranexamic acid does not have a significant effect on the neurological prognosis of patients with moderate to severe trauma brain injury ; 5) the notion of frailty seems to be predictive of mortality in the event of intra-hospital cardiac arrest in elderly patients ; 6) a pharmacological cardioversion strategy followed by electrical cardioversion is as effective as initial electrical cardioversion for atrial fibrillation in the emergency room.


Asunto(s)
Medicina de Emergencia/métodos , Medicina de Emergencia/tendencias , Anciano , Fibrilación Atrial/terapia , Lesiones Traumáticas del Encéfalo/terapia , Canadá , Cardioversión Eléctrica , Fragilidad , Humanos , Neumotórax/terapia , Medición de Riesgo , Síncope , Ácido Tranexámico
12.
JCO Glob Oncol ; 7: 46-55, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33434066

RESUMEN

PURPOSE: The COVID-19 pandemic remains a public health emergency of global concern. Determinants of mortality in the general population are now clear, but specific data on patients with cancer remain limited, particularly in Latin America. MATERIALS AND METHODS: A longitudinal multicenter cohort study of patients with cancer and confirmed COVID-19 from Oncoclínicas community oncology practice in Brazil was conducted. The primary end point was all-cause mortality after isolation of the SARS-CoV-2 by Real-Time Polymerase Chain Reaction (RT-PCR) in patients initially diagnosed in an outpatient environment. We performed univariate and multivariable logistic regression analysis and recursive partitioning modeling to define the baseline clinical determinants of death in the overall population. RESULTS: From March 29 to July 4, 2020, 198 patients with COVID-19 were prospectively registered in the database, of which 167 (84%) had solid tumors and 31 (16%) had hematologic malignancies. Most patients were on active systemic therapy or radiotherapy (77%), largely for advanced or metastatic disease (64%). The overall mortality rate was 16.7% (95% CI, 11.9 to 22.7). In univariate models, factors associated with death after COVID-19 diagnosis were age ≥ 60 years, current or former smoking, coexisting comorbidities, respiratory tract cancer, and management in a noncurative setting (P < .05). In multivariable logistic regression and recursive partitioning modeling, only age, smoking history, and noncurative disease setting remained significant determinants of mortality, ranging from 1% in cancer survivors under surveillance or (neo)adjuvant therapy to 60% in elderly smokers with advanced or metastatic disease. CONCLUSION: Mortality after COVID-19 in patients with cancer is influenced by prognostic factors that also affect outcomes of the general population. Fragile patients and smokers are entitled to active preventive measures to reduce the risk of SARS-CoV-2 infection and close monitoring in the case of exposure or COVID-19-related symptoms.


Asunto(s)
/mortalidad , Supervivientes de Cáncer/estadística & datos numéricos , Neoplasias/mortalidad , /aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , /virología , Causas de Muerte , Bases de Datos Factuales/estadística & datos numéricos , Femenino , Fragilidad/epidemiología , Humanos , Estudios Longitudinales , Masculino , Oncología Médica/estadística & datos numéricos , Persona de Mediana Edad , Neoplasias/complicaciones , Pronóstico , Estudios Prospectivos , ARN Viral/aislamiento & purificación , Medición de Riesgo/estadística & datos numéricos , Factores de Riesgo , Fumar/epidemiología , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-33408084

RESUMEN

INTRODUCTION: Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes. RESEARCH DESIGN AND METHODS: This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis. RESULTS: 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count. CONCLUSIONS: In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups.


Asunto(s)
/epidemiología , Diabetes Mellitus/epidemiología , Fragilidad/diagnóstico , Unidades de Cuidados Intensivos/estadística & datos numéricos , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Comorbilidad , Diabetes Mellitus/terapia , Femenino , Fragilidad/epidemiología , Hospitales de Enseñanza , Humanos , Modelos Logísticos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Tasa de Supervivencia , Adulto Joven
14.
High Blood Press Cardiovasc Prev ; 28(1): 5-11, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33471297

RESUMEN

The COVID-19 infection has rapidly spread around the world and a second wave is sweeping in many countries. Different clinical and epidemiological aspects characterize the disease and their understanding is necessary to better face the management of the pandemic in progress. The Italian society of arterial hypertension with the SARS-RAS study has contributed significantly to the knowledge of the interaction between inhibition of the renin-angiotensin system and COVID-19 infection. Furthermore, the study results help to understand some of the main aspects related to mortality and morbidity deriving from the infection through a multicentre analysis throughout the national territory.


Asunto(s)
Antihipertensivos/uso terapéutico , Presión Arterial/efectos de los fármacos , Hipertensión/tratamiento farmacológico , Sistema Renina-Angiotensina/efectos de los fármacos , Antihipertensivos/efectos adversos , /mortalidad , Comorbilidad , Estudios Transversales , Fragilidad/mortalidad , Humanos , Hipertensión/diagnóstico , Hipertensión/mortalidad , Hipertensión/fisiopatología , Italia/epidemiología , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Resultado del Tratamiento
17.
J Surg Res ; 257: 252-259, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32862053

RESUMEN

BACKGROUND: Emergency laparotomy (EL) is an increasingly common procedure in the elderly. Factors associated with mortality in the subpopulation of frail patients have not been thoroughly investigated. Sarcopenia has been investigated as a surrogate for frailty and poor prognosis. Our primary aim was to evaluate the association between easily measured sarcopenia parameters and 30-day postoperative mortality in elderly patients undergoing EL. Length of stay (LOS) and admission to an intensive care unit were secondary end points. METHODS: We conducted a retrospective cohort study, over a 5-year period, of patients aged 65 y and older who underwent EL at a tertiary university hospital. Sarcopenia was evaluated on admission computed tomography scan by two methods, first by psoas muscle attenuation and second by the product of perpendicular cross-sectional diameters (PCSDs). The lowest quartile of PCSDs and attenuation were defined as sarcopenic and compared with the rest of the cohort. Attenuation was stratified for the use of contrast enhancement. Multivariant logistic regression was performed to determine independent risk factors. RESULTS: During the study period, 403 patients, older than 65 y, underwent EL. Of these, 283 fit the inclusion criteria and 65 (23%) patients died within 30 d of surgery. On bivariate analysis, psoas muscle attenuation, but not PCSDs, was found to be associated with 30-day mortality (OR = 2.43, 95% CI = 1.34-4.38, P = 0.003) and longer LOS (35.7 d versus 22.2 d, Δd 13.5, 95% CI = 6.4-20.7, P < 0.001). In a multivariate analysis, psoas muscle attenuation, but not PCSDs, was an independent risk factor for 30-day postoperative mortality (OR = 2.35, 95% CI = 1.16-4.76, P = 0.017) and longer LOS (Δd = 14.4, 95% CI = 7.7-21.0, P < 0.001). Neither of the sarcopenia parameters was associated with increased admission to an intensive care unit. DISCUSSION: Psoas muscle attenuation is an independent risk factor for 30-day postoperative mortality and LOS after EL in the elderly population. This measurement can inform clinicians about the operative risk and hospital resource utilization.


Asunto(s)
Tratamiento de Urgencia/efectos adversos , Fragilidad/diagnóstico , Laparotomía/efectos adversos , Complicaciones Posoperatorias/mortalidad , Músculos Psoas/diagnóstico por imagen , Sarcopenia/diagnóstico , Anciano , Anciano de 80 o más Años , Estudios Transversales , Estudios de Factibilidad , Femenino , Fragilidad/complicaciones , Mortalidad Hospitalaria , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Medición de Riesgo/métodos , Factores de Riesgo , Sarcopenia/complicaciones , Tomografía Computarizada por Rayos X
18.
J Surg Res ; 257: 326-332, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32889331

RESUMEN

BACKGROUND: Elderly (65 and older) fall-related injuries are a significant cause of morbidity and mortality. Although frailty predicts poor outcomes in geriatric trauma, literature comparing frailty scoring systems remains limited. Herein, we evaluated which frailty scoring system best predicts falls over time in the elderly. MATERIALS AND METHODS: Acute surgical patients 65 y and older were enrolled and prospectively observed. Demographics and frailty, assessed using the FRAIL Scale, Trauma Specific Frailty Index (TSFI), and Canadian Frailty Scale (CSHA-CFS), were collected at enrollment and 3 mo intervals following discharge for 1 y. Surveys queried the total number and timing of falls. Changes in frailty over time were assessed by logistic regression and area under the curve (AUC). RESULTS: Fifty-eight patients were enrolled. FRAIL Scale and CSHA-CFS scores did not change over time, but TSFI scores did (P ≤ 0.01). Worsening frailty was observed using TSFI at 6 (P ≤ 0.01) and 12 mo (P ≤ 0.01) relative to baseline. Mortality did not differ based on frailty using any frailty score. Increasing frailty scores and time postdischarge was associated with increased odds of a fall. AUC estimates with 95% CI were 0.72 [0.64, 0.80], 0.81 [0.74, 0.88], and 0.76 [0.68, 0.84] for the FRAIL Scale, TSFI, and CSHA-CFS, respectively. CONCLUSIONS: The risk of falls postdischarge were associated with increased age, time postdischarge, and frailty in our population. No scale appeared to significantly outperform the other by AUC estimation. Further study on the longitudinal effects of frailty is warranted.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Fragilidad , Indicadores de Salud , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Mortalidad , Estudios Prospectivos , Medición de Riesgo
19.
J Frailty Aging ; 10(1): 10-16, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33331616

RESUMEN

AIM: As a person ages, the risk of falls increases, which affects quality of life and represents a financial burden to health- and social-systems, and a greater morbidity and mortality risk. Falls lead to decreased social contact, anxiety, long-term physical disability, severe dependency and hospitalizations. Currently, few studies address this phenomenon using a uniform methodology; therefore, this study aims to explore the prevalence of falls and associated-variables in older adults across Europe. METHODS: In this cross-sectional analysis, we used data from Wave 6 of SHARE. The prevalence of falls was assessed through the answer "falling down" to the question "For the past six months at least, have you been bothered by any of the health conditions on this card?". Multilevel logistic regression was used, using falls as a dependent variable. Multilevel univariable logistic regression models were made to identify potential associated factors. RESULTS: From the 41,098 participants, 56.3% were female, and the average age was of 70.0 ± 8.9 years. The prevalence of falls was 8.2% (CI 8.0% to 8.4%), being higher in women (10.1% vs. 5.8%) and increasing with age. Age, female gender, being frail or pre-frail, higher scores on the EURO-D scale, polypharmacy and fear of falling were found to be significantly associated with falls. CONCLUSIONS: We found that falls are prevalent in the European community-dwelling population, with variations between countries. As a public health priority, identification of the variables associated with falls is important in order to identify/monitor the risk in older groups and develop tailored and cost-effective interventions for falls prevention.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Vida Independiente , Anciano , Estudios Transversales , Miedo , Femenino , Fragilidad , Humanos , Masculino , Prevalencia , Calidad de Vida , Factores de Riesgo
20.
J Frailty Aging ; 10(1): 17-21, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33331617

RESUMEN

OBJECTIVES: To study the prevalence and overlap between malnutrition, sarcopenia and frailty in a selected group of nursing home (NH) residents. DESIGN: Cross-sectional descriptive study. SETTING: Nursing homes (NH). PARTICIPANTS: 92 residents taking part in an exercise and oral nutritional supplementation study; >75 years old, able to rise from a seated position, body mass index ≤30 kg/m2 and not receiving protein-rich oral nutritional supplements. MEASUREMENTS: The MNA-SF and Global Leadership Initiative on Malnutrition (GLIM) criteria were used for screening and diagnosis of malnutrition (moderate or severe), respectively. Sarcopenia risk was assessed by the SARC-F Questionnaire (0-10p; ≥4=increased risk), and for diagnosis the European Working Group of Sarcopenia in Older People (EWGSOP2) criteria was used. To screen for frailty the FRAIL Questionnaire (0-5p; 1-2p indicating pre-frailty, and >3p indicating frailty), was employed. RESULTS: Average age was 86 years; 62% were women. MNA-SF showed that 30 (33%) people were at risk or malnourished. The GLIM criteria verified malnutrition in 16 (17%) subjects. One third (n=33) was at risk for sarcopenia by SARC-F. Twenty-seven (29%) subjects displayed confirmed sarcopenic according to EWGSOP2. Around 50% (n=47) was assessed as pre-frail or frail. Six people (7%) suffered from all three conditions. Another five (5%) of the residents were simultaneously malnourished and sarcopenic, but not frail, while frailty coexisted with sarcopenia in 10% (n=9) of non-malnourished residents. Twenty-nine (32%) residents were neither malnourished, sarcopenic nor frail. CONCLUSIONS: In a group of selected NH residents a majority was either (pre)frail (51%), sarcopenic (29%) or malnourished (17%). There were considerable overlaps between the three conditions.


Asunto(s)
Fragilidad , Desnutrición/epidemiología , Sarcopenia/epidemiología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Evaluación Geriátrica , Hogares para Ancianos , Humanos , Masculino , Desnutrición/diagnóstico , Casas de Salud , Sarcopenia/diagnóstico
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